This is an informal, non-clinical, non-medical, non-legal guide on helping someone who has Post Traumatic Stress Disorder and Cannabis Dependencies. It's focused on considering the whole person, life situation, and perspectives on change. The goal is to provide support without enabling or alienating anyone. Something important to start with is identifying potential risk factors, and protective factors. You may be helping yourself, or somebody you care about. Look beyond the substance use itself, at the person's entire life and support system. This journey is one only the person can take for themselves, if they want change in their life. They may not want that for themselves, and forcing that onto somebody is not only unethical, but also doesn't ever work. If you want to guide somebody in that direction, you can do things to encourage self reflection on habits. Bring up the idea of taking breaks from daily or frequent use, and journaling about their experiences. Developing a safety plan and understanding strengths, alongside struggles, is very helpful. There are great free tests out there such as the Cannabis Abuse Screening Test (CAST) and VIO-SCAN (Violence Screening & Assessment of Needs). If there are concerns about an individual's ability to care for themselves or their living conditions, coordinating a home visit with protective services may be necessary. It is better if you can coordinate home visits and support with their pre-existing support network, but if they do not have them, you do not need to carry that on your shoulders. But in the US, Adult Protective Services does exist if a person's situation becomes unbearable, untenable, or if there is abuse, neglect, or exploitation involved. Encouraging small steps, like taking a day off from smoking and journaling, can lead to larger changes. Over time, identifying specific barriers and making appropriate referrals for housing, financial skills, employment support, therapy, or other resources can be beneficial. Success may look like not hearing back, indicating the individual has successfully transitioned and found support. Screening Questions to Consider:

  • Do you consume alcohol? If so, how often and how much? Has anyone expressed concern about your alcohol use? (Alcohol Misuse)
  • Do you experience regular anger? Do you feel in control during these times? Have you been irritable or had outbursts recently? Do you feel in control of your life? (Anger and Inhibition)
  • Have you ever been violent or arrested? Have you had thoughts of harming yourself or others?
  • Do you have sufficient funds for your basic needs and activities? Do you feel capable of handling life's challenges? (Financial Stability)
  • Do you have a strong support network of trusted individuals? (Social Support)
  • Have you witnessed traumatic events? (combat experience, witness to violence, etc.)
  • What are your goals for the near and distant future? What obstacles are you currently facing? (Planning for the Future)
Protective Factors and Developing a Safety Plan:
  • Supported Employment: Stable employment can significantly reduce risk.
  • Financial Self-Management: Meeting basic financial needs lowers risk.
  • Improved Self-Care: Taking care of oneself reduces risk.
  • Stable Living Arrangements: Addressing housing instability is crucial.
  • Chaplain Connection & Social Support: Resilience, self-determination, faith, and social support all decrease risks.

Can Cannabis use be helpful for trauma symptoms?

Current Research: Regarding cannabis and PTSD, research is still ongoing. Some individuals may experience worsened symptoms, and long-term effects are unclear. Clinicians should monitor use and discuss potential risks and benefits. In other words, can be great for shorter term relief for many people, but in long run benefits diminish and addictive habits happen. Clinicians should not push or encourage substance use but rather provide information and support decision-making. Avoiding stigmatization and discriminatory treatment is paramount. Maintaining confidentiality and protecting privileged information is crucial. Providing information about various treatment options and collaborating on harm reduction strategies are essential. The focus should be on the individual's overall well-being and addressing underlying issues that may contribute to substance use. Disclosure and Privacy: Clear guidelines on privacy and disclosure are necessary. Generally, information shared is confidential, but there are exceptions. These may include agency policies, risk of harm to self or others, and suspected abuse or neglect. Understanding these exceptions and ensuring clients are informed is vital.

Sources Cited

Post-Traumatic Stress Disorder (PTSD) 101: Assessing and Reducing Violence Risk in Veterans with PTSD (By Veterans Health Administration - Employee Education System). (2019, September 19). [Video]. VHA TRAIN: U.S. Department of Veterans Affairs. https://www.train.org/vha/course/1088734/details Legalized Cannabis and PTSD Treatment. Melanie Hill. Phd. VA.gov | Veterans Affairs. (n.d.). https://www.ptsd.va.gov/professional/continuing_ed/legalized_cannabis_and_tx.asp This study, which was referenced in PTSD101 by the VHA, helped give more information about demographic specific vulnerabilities to screen for: Elbogen EB, Johnson SC, Wagner HR, Sullivan C, Taft CT, Beckham JC. Violent behaviour and post-traumatic stress disorder in US Iraq and Afghanistan veterans. Br J Psychiatry. 2014;204(5):368-75. doi: 10.1192/bjp.bp.113.134627. Epub 2014 Feb 27. PMID: 24578444; PMCID: PMC4006087. https://pubmed.ncbi.nlm.nih.gov/24578444/