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High rates of cannabis use among people with posttraumatic stress disorder (PTSD) have raised questions about the efficacy of evidence-based PTSD treatments for individuals reporting cannabis use, particularly those with co-occurring alcohol or other substance use disorders (SUDs). Using a subset of four randomized clinical trials (RCTs) included in Project Harmony, an individual patient meta-analysis of 36 RCTs (total N = 4046) of treatments for co-occurring PTSD+SUD, we examined differences in trauma-focused (TF) and non-trauma-focused (non-TF) treatment outcomes for individuals who did and did not endorse baseline cannabis use (N = 410; 70% male; 33.2% endorsed cannabis use). Propensity score-weighted mixed effects modeling evaluated main and interactive effects of treatment assignment (TF versus non-TF) and baseline cannabis use (yes/no) on attendance rates and within-treatment changes in PTSD, alcohol, and non-cannabis drug use severity. Results revealed significant improvements across outcomes among participants in all conditions, with larger PTSD symptom reductions but lower attendance among individuals receiving TF versus non-TF treatment in both cannabis groups. Participants achieved similar reductions in alcohol and drug use across all conditions. TF outperformed non-TF treatments regardless of recent cannabis use, underscoring the importance of reducing barriers to accessing TF treatments for individuals reporting cannabis use.

Competing Interests: Declaration of Competing Interest Drs. Back and Therese Killeen are authors on the COPE therapy manuals published by Oxford University Press. Dr. Back has received compensation from UpToDate. Dr. Norman has received compensation from UpToDate and royalties from Elsevier Press. Dr. Hill has been a paid consultant for Canopy Growth Corporation in the past two years. The other authors report no financial relationships with commercial interests.

Titel:	Cannabis use and trauma-focused treatment for co-occurring posttraumatic stress disorder and substance use disorders: A meta-analysis of individual patient data.
Autor/in / Beteiligte Person:	Hill, ML ; Kline, AC ; Saraiya, TC ; Gette, J ; Ruglass, LM ; Norman, SB ; Back, SE ; Saavedra, LM ; Hien, DA ; Morgan-López, AA
Zeitschrift:	Journal of anxiety disorders, Jg. 102 (2024-03-01), S. 102827
Veröffentlichung:	<2004->: Amsterdam : Elsevier ; <i>Original Publication</i>: New York : Pergamon Press, c1987-, 2024
Medientyp:	academicJournal
ISSN:	1873-7897 (electronic)
DOI:	10.1016/j.janxdis.2024.102827
Schlagwort:	Male Humans Female Treatment Outcome Ethanol Stress Disorders, Post-Traumatic complications Stress Disorders, Post-Traumatic therapy Stress Disorders, Post-Traumatic diagnosis Cannabis Substance-Related Disorders therapy
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Meta-Analysis; Journal Article Language: English [J Anxiety Disord] 2024 Mar; Vol. 102, pp. 102827. <i>Date of Electronic Publication: </i>2024 Jan 10. MeSH Terms: Stress Disorders, Post-Traumatic* / complications ; Stress Disorders, Post-Traumatic* / therapy ; Stress Disorders, Post-Traumatic* / diagnosis ; Cannabis* ; Substance-Related Disorders* / therapy ; Male ; Humans ; Female ; Treatment Outcome ; Ethanol References: Addict Behav. 2021 Oct;121:106991. (PMID: 34087766) ; Eur J Psychotraumatol. 2021 Dec 22;13(1):2001191. (PMID: 34992759) ; Psychopharmacology (Berl). 2013 Apr;226(4):781-92. (PMID: 23307069) ; Arch Gen Psychiatry. 2005 Jun;62(6):593-602. (PMID: 15939837) ; J Clin Med. 2017 Feb 07;6(2):. (PMID: 28178207) ; Psychol Addict Behav. 2018 May;32(3):277-288. (PMID: 29595297) ; Psychol Addict Behav. 2016 Nov;30(7):743-754. (PMID: 27786514) ; JAMA Psychiatry. 2019 Aug 1;76(8):791-799. (PMID: 31017639) ; Struct Equ Modeling. 2018;25(1):121-136. (PMID: 29910595) ; Ment Health Clin. 2021 Jul 16;11(4):238-242. (PMID: 34316419) ; JAMA. 2012 Aug 15;308(7):690-9. (PMID: 22893166) ; Nat Rev Dis Primers. 2021 Feb 25;7(1):16. (PMID: 33627670) ; Psychother Psychosom. 2017;86(3):150-161. (PMID: 28490022) ; Drug Alcohol Rev. 2015 May;34(3):234-41. (PMID: 25737377) ; Eur J Psychotraumatol. 2014 Feb 05;5:. (PMID: 24511368) ; J Psychiatr Res. 2022 Dec;156:690-697. (PMID: 36401953) ; Neuropharmacology. 2013 Jan;64:396-402. (PMID: 22796109) ; Fam Pract. 2021 Jul 28;38(4):479-483. (PMID: 33558870) ; Psychol Methods. 2017 Sep;22(3):507-526. (PMID: 27266798) ; Am J Drug Alcohol Abuse. 2020 Nov 1;46(6):812-822. (PMID: 33035104) ; Curr Opin Psychol. 2021 Apr;38:80-85. (PMID: 33873044) ; J Nerv Ment Dis. 1980 Jan;168(1):26-33. (PMID: 7351540) ; Psychother Res. 2003 Mar;13(1):125-6. (PMID: 22475169) ; J Trauma Stress. 2022 Jun;35(3):926-940. (PMID: 35124864) ; Contemp Clin Trials. 2022 Apr;115:106705. (PMID: 35176503) ; J Trauma Stress. 2022 Aug;35(4):1154-1166. (PMID: 35275431) ; Addiction. 2019 Jun;114(6):983-993. (PMID: 30694592) ; Psychol Serv. 2021 Nov;18(4):497-503. (PMID: 32134304) ; Contemp Clin Trials. 2021 Aug;107:106479. (PMID: 34157418) ; Behav Res Ther. 2017 Feb;89:33-40. (PMID: 27846419) ; Psychotherapy (Chic). 2019 Sep;56(3):359-373. (PMID: 31282712) ; Clin Psychol Rev. 2015 Jun;38:25-38. (PMID: 25792193) ; Addict Behav. 2019 Mar;90:369-377. (PMID: 30529244) ; J Clin Psychiatry. 2015 Sep;76(9):1174-80. (PMID: 26455669) ; J Dual Diagn. 2011 Oct 1;7(4):194-206. (PMID: 23662094) ; Neuropsychopharmacology. 2019 Sep;44(10):1769-1777. (PMID: 31096264) ; PLoS One. 2021 Mar 17;16(3):e0246990. (PMID: 33730032) ; J Consult Clin Psychol. 2017 Mar;85(3):262-266. (PMID: 28068118) ; Hum Psychopharmacol. 2022 Nov;37(6):e2853. (PMID: 35983959) ; Eur J Psychotraumatol. 2022 May 03;13(1):2041831. (PMID: 35558682) ; Am J Psychiatry. 2023 Feb 1;180(2):155-166. (PMID: 36475373) ; J Psychopharmacol. 2012 Apr;26(4):471-8. (PMID: 22351380) Grant Information: K23 DA055209 United States DA NIDA NIH HHS; R01 AA025853 United States AA NIAAA NIH HHS; R01 DA030143 United States DA NIDA NIH HHS; R25 DA035161 United States DA NIDA NIH HHS Contributed Indexing: Keywords: Attendance; Cannabis; Marijuana; Posttraumatic stress disorder; Substance use Substance Nomenclature: 3K9958V90M (Ethanol) Entry Date(s): Date Created: 20240124 Date Completed: 20240304 Latest Revision: 20240603 Update Code: 20240603 PubMed Central ID: PMC11138203

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Cannabis use and trauma-focused treatment for co-occurring posttraumatic stress disorder and substance use disorders: A meta-analysis of individual patient data.