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  • Alicia Wallace

Colorado adds PTSD as medical marijuana condition


By Alicia Wallace, The Cannabist Staff

Post-traumatic stress disorder is now a qualifying condition for doctor-recommended medical marijuana in Colorado.

Gov. John Hickenlooper on Monday signed Senate Bill 17 into law. The act opens the doors for Colorado residents to receive a doctor’s OK to use medical marijuana in the treatment of PTSD symptoms.

Colorado doctors could begin to make those PTSD-specific recommendations in as early as a week — or enough time to provide for the state’s information technology office to update the forms, said Dr. Larry Wolk, executive director and chief medical officer for the Colorado Department of Public Health and Environment.

Wolk previously spoke in favor of PTSD’s addition, namely so the state could have more accurate data on patients who were recommended medical marijuana, why they were accessing it and how they were using it.

“A lot of people were using medical marijuana for PTSD but obtaining it under other diagnoses,” Wolk said Tuesday. “We wanted more transparency to what those numbers looked like, what that population looked like.

It’s the first new qualifying condition added under the state’s medical marijuana law since it was implemented in 2001. The state’s eight other qualifying conditions are: cancer, glaucoma, HIV or AIDS, cachexia, persistent muscle spasms, seizures, severe nausea and severe pain.

“Marijuana is not a panacea. But to take it off the table or to say, ‘Try it recreationally to see if it helps your major mental illness’ isn’t the way to go,” said Rep. Jonathan Singer, D-Longmont, who co-sponsored the bill with Sen. Irene Aguilar, D-Denver. “Before you go to a dispensary, talk to a doctor.”

The inclusion of PTSD among Colorado’s medical marijuana qualifying conditions has been a hotly contested issue of recent years.

Coordinated bids led by veterans groups and supported by residents with PTSD fell short as the Colorado Board of Health quashed requests for PTSD’s inclusion. Legislative measures languished in the General Assembly.

The Colorado Board of Health has not added any new qualifying conditions since the medical marijuana law’s inception, citing lack of “peer-reviewed published studies of randomized controlled trials or well-designed observational studies showing efficacy in humans,” officials have previously told The Cannabist.

Colorado Board of Health officials could not be reached for comment. Board members typically refer requests for comment to past meeting minutes and other records.

After the Board of Health’s most recent denial of the proposed addition of PTSD, proponents filed suit against the state. That case is pending in Colorado Appeals Court and likely will be dismissed, said the Hoban Law Firm’s Adam Foster, the attorney representing the PTSD patients.

“I think that veterans and voters stood up and they told their elected officials what was important to them,” Foster said. “I found it very encouraging to see that the democratic process can work. If voters stand up and articulate what is important to them, they can make a difference.”

Proponents have argued that it’s not cost-effective for adults with PTSD to purchase recreational marijuana as a potential treatment for their ailments. They’ve said there is limited availability on the recreational market of suitable marijuana products — heavy in the non-psychoactive compound cannabidiol (CBD) and low in tetrahydrocannabinol (THC) — that have been claimed effective for symptoms such as anxiety, nightmares and pain. Separately, advocates for military veterans say those individuals are at risk of losing their benefits if they use recreational marijuana.

Members of Colorado’s medical and mental health communities have expressed concern about the inclusion of PTSD as a qualifying condition, calling for more qualified research on the potential benefits and harms of using the product to treat symptoms of a complex psychiatric disorder.

Some of that research is ongoing, but initial results may not be known for a couple of years.

“We hope that (medical) professionals and policymakers will continue to say they want to see more of that research and it’s important to fund that research,” Foster said.

As SB 17 moved through the legislature, those concerns homed in on the allowance of medical marijuana for children and teens diagnosed with PTSD.

The bill was amended to include a stipulation that one of the two recommending physicians required for patients under the age of 18 be either a pediatrician, board-certified family physician or board-certified child and adolescent psychiatrist who is part of the family’s medical care plan.

“We probably have the strongest guidelines for safeguarding any sort of abuse in the system,” Singer said, adding that the legislation could serve as a template to address medical marijuana recommendations for other mental health disorders.

Officials for the Colorado Psychiatric Society, the American Academy of Pediatrics Colorado Chapter and Children’s Hospital Colorado were not immediately available Tuesday for comment, but on Wednesday morning provided the following statement:

The Colorado Chapter of the American Academy of Pediatrics, Children’s Hospital Colorado, the Colorado Child and Adolescent Psychiatric Society, and the Colorado Psychiatric Society appreciate that the bill sponsors worked with stakeholders to ensure that important safeguards were included in Senate Bill 17 for children and youth diagnosed with post-traumatic stress disorder. We intend to monitor medical marijuana usage trends among children and youth with this diagnosis. Given the current lack of scientific research regarding medical marijuana as a treatment for individuals with mental health conditions, we believe that scientific research must be pursued to determine if certain components, dosages and delivery mechanisms of marijuana can lead to more effective post-traumatic stress disorder treatment.



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