Cannabis Use May Prolong PTSD SymptomsJanuary 12, 2012 • A GoodTherapy.org News Summary
Cannabis use issues (CUD) are on the rise among military veterans with posttraumatic stress (PTSD). “Indeed, rates of PTSD diagnoses among veterans increased 60% between 2002 and 2007, and rates of CUD diagnoses within the Veterans Affairs (VA) hospital system increased more than 50% between 2002 and 2009,” said Marcel O. Bonn-Miller of the National Center for PTSD and Center for Health Care Evaluation at the VA Palo Alto Health Care System in California. However, when these vets enter treatment and discontinue their cannabis use, their symptoms linger.
Anxiety increases when individuals stop using cannabis to cope with their symptoms, but until now, the cessation of cannabis in relation to PTSD symptoms had not been explored fully. To address this gap, Bonn-Miller and his colleagues conducted a study on veterans who entered treatment for PTSD with a CUD and theorized that they would have smaller treatment gains after abstaining from cannabis use than veterans without a CUD.
The researchers evaluated 260 male veterans that were receiving inpatient treatment for PTSD. They assessed the veterans at two different times over eight years, using the PTSD Checklist-Military Version. They found that the veterans who had CUD realized less change in symptom severity than those without. “Specifically, individuals with a CUD diagnosis who discontinued use, compared with those without a CUD diagnosis, had lower levels of change in total PTSD symptoms, PTSD avoidance/numbing symptoms, and PTSD hyperarousal symptoms,” said Bonn-Miller.
“In addition to these results being statistically significant, they are clinically meaningful.” In particular, those with CUD saw treatment gains similar to veterans who received no treatment at all. Additionally, with more states legalizing cannabis for medicinal purposes, veterans with PTSD who use cannabis may be unknowingly negatively impacting their recovery. This study also demonstrates the relationship between PTSD and cannabis use, underscoring the importance of further research in this area. Bonn-Miller added that clinicians should provide their clients with adaptive coping techniques before they recommend cannabis cessation for the purpose of treating PTSD.
Bonn-Miller, M. O., Boden, M. T., Vujanovic, A. A., & Drescher, K. D. (2011, December 19). Prospective Investigation of the Impact of Cannabis Use Disorders on Posttraumatic Stress Disorder Symptoms Among Veterans in Residential Treatment. Psychological Trauma: Theory, Research, Practice, and Policy. Advance online publication. doi: 10.1037/a0026621
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The preceding article summarizes research or news from periodicals or related source material in the fields of mental health and psychology. GoodTherapy.org did not participate in or condone any studies, or conclucions thereof, that may have been cited. Any views or opinions expressed are not necessarily shared by GoodTherapy.org.
derek dJanuary 12th, 2012 at 5:13 PM
ok so vets are smoking pot- what’s the big deal? heck if i had seen half the stuff that you know they’ve seen and done i would smoke pot as an escape from reality too
JeffJanuary 13th, 2012 at 5:35 AM
So the argument here would take the enxt logical step that if they know that they are doing something that is actually going to prolong the things that they are in reality trying to run away from, then why continue? Well, I see two reasons for that. One it becoes a habit, an addiction so to speak. Many of the men in this type of situation have been using this for so long to cope that they have kind of forgotten what life can be like without it. And two, it does help them forget about the bad and gets them feeling good and silly for a while. We all want that from time to time. So it really is a catch 22. They have to have it to survive, but then again it makes the process of forgetting take even longer. I would love to meet the group who can work all of this out.
Uh HuhJanuary 13th, 2012 at 6:56 PM
I just want to say to derek d and jeff; you two are complete idiots, “and gets them feeling silly for awhile. What the hell do you know about war? What the hell do you know about having to kill somone just because they are told to kill you on site? Is it that you think talking to someone or taking a man made pill to “fix” the problem is better than using a plant that has proven medical benifits? Do some real good, take off your blinders, get off your ass and learn the truth.
Retired ArmyJanuary 14th, 2012 at 6:26 AM
This is premium B.S.
Sara BJanuary 15th, 2012 at 6:07 AM
UhHuh- you have some issues there. I don’t think anyone here is wearing blinders, we are kind of all here to state our version of the truth and to learn. It may not match your own version, but we are here to learn from one another. So I don’t exactly think it is the right method to be so demeaning to other readers and contributors here.
sallyJanuary 15th, 2012 at 11:52 PM
why do they turn to marijuana? that should be the question. why is there such a strong dependence on drugs for our vets? and why are PTSD rates always going up?
GraysonJanuary 16th, 2012 at 5:21 PM
Smoking marijuana can be a form of escape, but there are SO many other healthier ways to cope with things, ways that actually make you happy and not give you even more problems to deal with. I know that they don’t see anything beyond the hope of getting high and forgetting reality for a little bit, but gosh I just wish that there were some better ways to communicate to these users that there are other options out there and available. And that actually have some great benefits!
Darren FellowesJanuary 25th, 2012 at 9:29 PM
Sorry but I don’t believe this much. A study done by the Israeli physician Irit Akirav published in the Journal of Neuroscience showed that weed could have a positive effect on PTSD symptoms. Not only that but in 2006, another named Tod Mikuriya showed his research involving smokers and said that it worked better to control stressors without major side-effects.
Karl BensonJanuary 31st, 2012 at 9:42 PM
@Darren Fellowes–I actually read that paper when I was in high-school and I had to write a paper on the medical effects of marijuana. He even had the confidence to say that marijuana should be considered first place in the treatment of PTSD symptoms.
Frank McCainJanuary 31st, 2012 at 10:33 PM
Even if marijuana can help PTSD, you can’t rely purely on drugs of any kind to treat trauma. You need counseling, to be talking about it, and resolving the stress that comes with the illness. There is no way marijuana can do that and it only works as well as any effective PTSD suppressant.
JeremyFebruary 1st, 2012 at 8:45 AM
I’m pretty sure that everyone who is saying that smoking marijuana only provides an ephemeral “escape,” or that it only makes you “feel silly for a little while” is not a regular smoker, veteran or PTSD sufferer. The beneficial effects of medical marijuana are not as fleeting as a you think. I’m also curious about what these “other options available” are. Could they possibly be Rx drugs? Why is there such a preference in our society for synthetic chemicals created in a lab when every benefit provided by these chemicals can be found in nature? By the way, that’s how these drugs are developed. They find a natural medicine, then take it to a lab and treat it with chemicals to isolate the compound that is already available.
In truth, it seems the only reason so many people are against marijuana is because of a steady misinformation campaign about Marijuana that started long ago and now is only meant to perpetuate the DEA’s budget and the entire failed “War on Drugs” policy and all of its benefactors (Pharmaceutical companies, private prisons, DEA, NIDA, etc.). It’s time to shed these kind of pre-conceived notions and listen to veterans and PTSD sufferers (like me) about what is actually helping them cope. Thank you.
Michael HollandFebruary 1st, 2012 at 11:07 AM
Pseudoscience. PTSD + CUD = DUMB
David J. Pollin, PhDFebruary 2nd, 2012 at 8:36 AM
As both a mentalh health provider and a veteran there are a number of issues that deserve mentioning. First of all, the choice to seek treatment starts with the veteran’s own view of his situation. It is ultimately the veteran’s decision about how much treatment and what it should be for that matters, not the doctors. There is no one way for people to cope with or recover from PTSD – there are many. But the study is about veterans who are seeking treatment – by definition they are people who are not satisfied with the way things are working for them and feel they need help.
The VA has programs to help veterans who are recovering from both PTSD and dysfunctional substance use/abuse. These programs were largely developed focusing on veterans who have problems with PTSD and abuse of alcohol and other substances and there may be differences in how we may best treat cannabis use/abuse.
It is very common for people with PTSD to use substances to ‘cope’ with anxiety symptoms associated with it but all of them bring the risk of significant problems as well as any benefits. The biggest one is that using any substance makes treatment aimed at resolving symptoms of PTSD or mastering them impossible and there are now several very good treatments that often/usually can help people actually recover from PTSD. Recovery is better than simply managing symptoms.
These treatmants are not interminable, they have an specific protocol and expected course of treatment. If they don’t work, it’s not like gastric stapling, a veteran can always try something else (or go back to what she/he was doing before).
The second issue is that using cannabis can have limiting effects on veterans’ lives that are not trivial. For one, you cannot take a job that requires a pre-hiring drug screen while using marijuana. Prescription medicines do not have this drawback. It can also have signficant fairly persistent effects on users memory, concentration, emotional control and so on. THC is stored in fat cells and released when the fat is metabolized. Just because a person is not feeling high doesn’t mean they are not being adversely affected. The study referenced suggests they may be
The cannabis sold currently is often much stronger than it was 30 years ago. It may, essentially be a different drug at different times. I don’t believe that people buying usually have reliable information about how much THC is actually IN the a particular ‘dose’.
I know from over 25 years of experience that treatment is better now than it used to be and that it CAN work. If what you are doing now is not working well enough, try to get help. If you tried treatment and it didn’t work well enough, there may be treatment that will work better for you if you try again.
PTSD is the only mental problem that people can get as a direct consequence of courage and devotion to their mission and comrades. Veterans certainly deserve better than just getting by and coping.
Jeremy T.February 11th, 2012 at 2:33 AM
@Frank McCain-Incorrect! According to Veterans for Medical Marijuana Access, cannaboids can encourage memory extinction. Memory extinction is the process of the brain where it no longer associates one stimuli with an event. Just because one Arab guy in Iraq suicide-bombed a place doesn’t mean they all will. A study they cited showed that marijuana would aid in removing the associations of such things.
andyMarch 23rd, 2012 at 3:52 AM
Bear in mind that this site is ‘Supporting Thousands of Therapists & Advocating for Healthy Therapy & Marriage Counseling.’ They are hardly going to print an article saying that cannabis is a miracle cure for PTSD! I have suffered PTSD for nearly thirty years and can only sleep through the night without screaming nightmares when I smoke a bit of weed. I tried something called EMDR (Eye Movement Desensitisation & Reprocessing) on the advice of my psychiatrist. I came within a whisker of killing myself, my partner and two relatives. The ‘therapy’ triggered constant flashbacks and caused me to become suicidal – three times, when driving, I visualised swerving into oncoming trucks and if my partner had not been next to me I would have done it, just to make the pain stop. The six different antidepressants I have tried all give horrendous side-effects and I still don’t sleep. Legalise it, research it, use it. Much love to all PTSD sufferers. Don’t give ‘experts’ & pharmaceutical companies too much power – they are all just looking for ways to sell their products and they are suppressing an ancient and natural treatment which they can’t patent.
TREVELYANMay 12th, 2012 at 4:49 PM
Hi Andy, I agree, it is irresponsible to simply point to Big Pharm drugs and say there ya go. Anyone suffering from PTSD…please look into projectcbd.com – Cannabidiol(CBD)is anti-anxiety & anti-cancer. We need to remove cannabis from being a schedule 1 drug so that more research can be done on this plant.
shrimplateMay 31st, 2012 at 9:31 AM
Dr. Pollin wrote: “I don’t believe that people buying usually have reliable information about how much THC is actually IN the a particular ‘dose’.”
That would be incorrect. The percentages of THC and CBD in any given strain are readily available and “bud-tenders” are well-familiar with these varying percentages.
A “particular dose” is generally referred to as 10mg of THC but personally I think that is low. Users titrate to effect; a manner not unlike Digoxin or Coumadin use but *no* expensive routine labwork is needed.
I am a Registered Nurse with PTSD and I deeply thank all of the veterans who have led research on PTSD. If it weren’t for Vets, people like me who have other causes for our condition would have no treatment options except pills for stress and depression.
MargaretJune 4th, 2012 at 2:47 AM
For over 600 pages of medical cannabis research check out Granny Storm Crow’s list:
“Cannabis Eases Post Traumatic Stress” (news – 2006) ccrmg.org/journal/06spr/ptsd.html
MargaretJune 4th, 2012 at 2:54 AM
This group has a great deal of accurate information on cannabis and PTSD:
Opps, wrong link in my previous attempt at a post
Here is one that works. ncbi.nlm.nih.gov/pmc/articles/PMC2789283/?tool=pmcentrez
“This review focuses on the neural circuitry and pharmacology of the cannabinoid system as it relates to the acquisition, expression, and extinction of conditioned fear as a model of human anxiety. Preclinical studies suggest that these may provide important emerging targets for new treatments of anxiety disorders”
AmyJune 26th, 2012 at 7:09 PM
Post-Traumatic Stress Disorder (PTSD) could be curable with cannabis, suggest re-searchers at Haifa University in Israel. If used within 24 hours of a stress event, PTSD symptoms can be minimized or eliminated, as reported by the research published in the journal Neuro-psychopharmacology.
SmokySeptember 4th, 2012 at 11:39 AM
Being a PTSD sufferer myself, I have found that certain cannabis strains seem to facilitate exposure therapy by providing a smooth undercurrent of relaxation (this is probably the CBD), and an enhancement of the imagination and associative capacity (probably the THC). This appears to significantly accelerate the treatment. Sometimes it releases a very powerful flood of unwanted memories, that seem to rapidly fade away – as though they are being erased – once the effects of the drug wear off. Some studies confirm that cannabis might improve the extinction of adverse memories, although this is under dispute.
The effects of cannabis on the ability to relax are well known. Personally, I find the artificial relaxation provided by benzodiazepines, antidepressants or any pharamaceutical drug I’ve tried to be downright disgusting when compared to the natural, soothing calm of cannabis. Cannabis makes you feel human. It doesn’t remove the anxiety, it just allows you to accept it. Cannabis also doesn’t have any rebound anxiety once the effects are gone.
For me, pharmaceuticals also have the annoying property of slowing down exposure therapy, by blocking access to the target memories. Cannabis has the opposite effect.
Did this study take into account that cannabis might have different effects on PTSD, depending on what the sufferer does while under the influence of the drug?
One has to take into account, of course, that this concerns a specific kind of cannabis strain, other strains do not have the same effects. Did the researchers include the differences between various cannabis strains as an important factor in their study?
I’ve also found that it’s very important to reduce cannabis use to three days a week. During the four sober days, concentration, short-term memory and motivation get the time to return. Exposure therapy during these days prevents the sufferer from depending on the cannabis for his treatment, preventing the development of addiction.
I must add that I have a relatively high I.Q., which might imply that people with a lower I.Q. will need more sober days to make up for concentration and short-term memory loss during the days of cannabis use.
Did the study take into account that daily cannabis use makes it almost impossible to engage in treatment because of poor concentration and lack of motivation, and that these negative effects can be avoided by fine-tuning the frequency of use?
There’s a lot more I could say and I don’t feel as though I’ve really made my point, but I’m running out of time so I’ll wrap it up quickly.
If it ever turns out that my cannabis use has a bad effect on the treatment of my PTSD, I’ll accept that and stop using it. But right now, it seems as though cannabis is little short of a miracle drug, and pharmaceuticals are only good for an occasional quick fix, when symptoms become unbearable or when the time isn’t right to properly address them. I’m not saying this study is like that, but I strongly suspect that pharmaceutical companies, who have every interest in maintaining the current status quo in PTSD treatment, are using their economic power to distort scientific research to prevent this truth from coming to the surface for as long as possible.
Kevin John BraidFebruary 2nd, 2013 at 11:28 AM
LIES !!!! cannabis is highly benificial to those suffering from PTSD, LOOK more troops kill themselves on their return home than in combat, so support this as it is supporting the troops
DiddybongFebruary 2nd, 2013 at 11:33 AM
I use cannabis for PTSD. Not from being at war but from being abused. It does not prolong episodes or make me worse. If it did why would I use it? It enables me to survive in what at times can be a scary and confusing world. I just wish that I would not be made a criminal for using it. Please leave those of us who see some benefit from it alone. It is better than using toxic pharmaceuticals that do not work and only serve to line pharmaceutical companies profits.
RiizzoeJuly 22nd, 2014 at 6:50 PM
Just want to add my thoughts. Back in 07 when I got out of the Army I was in terrible shape. It was so bad that my wife almost left me. The meds I was on was too addictive and I was virtually a zombie all day/night. Popping pills though out the day to avoid withdraw. I always tell her the person she met before being deployed in 03 is not the same as I am now. I came back literally shoving pills down my throat for relief. I started smoking weed as an alternative and it worked for me for over 7 years. It took several months to ween myself of my meds, but I did it. All the sudden I felt normal while only smoking in the evening. I have now quit smoking to look for a better job and everything is back again. I feel as though I need to rip my skin off and am easily angered along with the feeling that something is out to get me. For 7 years I have been having a great life, but do to a mandatory drug test from every employer I must return to being a zombie once again to find a better job. I liked weed because I could function in society sober by day without any issues and stoned at night to medicate. For me this worked and I am dreading that I will have to take meds again due to my rage and internal feelings. 3 days sober and my old feelings that began in 03 are returning. I would never hurt anyone or anything as this is not in my nature. Overall for 7 years weed has helped tremendously. I am well respected at my place of work and complete all required task plus more (the Army in me). I just can’t wait for the day that weed is legal and I can resolve my PTSD while still having a great job. Life isn’t fair, but I didn’t ask for a war. All people are different, but smoking worked for me. Oh, also still married 10 years now and two great kids! I love my life more than anything, but hate my body when it feels this way.Side note I have done plenty of therapy and work out. Granted I don’t eat as healthy as I would like to, but you only live once and I need some type of crutch. I also do not drink at all. PTSD and drinking do not work for me.
DillardNovember 7th, 2014 at 11:50 AM
I have PTSD from my childhood. I was injured while parachuting. I was then given an exit ticket from active duty. 4 discs (gone), 2 reconstructed ankles, 2 messed up shoulders, amongst other things at the ripe age of 20. I spent the next decade or so strung out on drugs legal and illegal.
Last year I received my first DUI and possession of marijuana. Paid a ton in fines and hours of therapy. The city prolonged the marijuana charges and the county recently picked them up. I spent 24 hours in Maricopa jail. Did I mention that I hate being controlled?
My anxiety has kicked back in full force and I am now failing my classes. I quit smoking weed during this time to avoid any and all jail costs. Now I am ready to get my medical card here in Arizona. My anxiety is through the roof and I cannot focus in my studies. I am now failing and cannot force my brain to work again. I feel like a complete failure and like a piece of sh*t.
No I did not see action over seas. I did see a violent childhood that involved foster homes, homelessness, getting food out of garbage cans, a meth-head mother, and a drunken, violent father. I don’t recall 90% of my childhood.
I feel frustrated. Every time I turn around I get set back with my PTSD. I am so close to getting my AA degree but cannot make it through a damn semester without having episodes.
So to finalize I am going to get my medical Mary Jane card to chill out. It or pain pills seems to be the only things that work and I don’t want synthetic!
The GoodTherapy.org TeamNovember 7th, 2014 at 1:01 PM
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UrbanNamFebruary 23rd, 2015 at 4:30 PM
My dad was a Viet POW. We lived in abuse. I tried various meds which made me suicidal starting at 15: Prozac, Thorazine, Lithium, and some others I can’t remember and each one of those got me stuck in nightmare versions of my trauma and I could not get out or away from that terror. I went cold turkey for a decade for the sake of being a parent and tried Cannabis for the first time and was nothing like those pills because they could not balance me out because I had anxiety, paranoia and depression, that can be 3 different pills. One plant took care of that for me and I do not want to die. I think for complex emotional issues, it should be sainted and put as the first thing to try before introducing harmful chemicals and risking a suicide.
Also, please do not encourage a new comer to eat it without proper guidance and a babysitter.
randompersonApril 9th, 2015 at 6:42 PM
Hi, I have C-PTSD.. Yes, I know it’s not the same as ‘PTSD’, it does typically have a wider array of symptomatology (which is also also probably why it’s often so difficult to diagnose).
As someone who initially had no understanding of PTSD the description of my symptoms to professionals got me diagnosed with about eleven different disorders/dysfunctions/syndromes (aspergers, schizotypal, ADHD, schizophrenia, borderline, dissociative identity disorder – to name only a few), that is until I was fortunate enough to be referred to a therapist who specialized in trauma. After she asked me about my childhood and early adulthood, that was it. After nearly 5 years of medication and psychotherapy that didn’t work… it took her less than 50 min to set me on a path to understanding my dysfunctional life and how to go about overcoming my difficulties.
I’ve self-medicated with cannabis since I was 15 (I’m 33 now), and while it may be true in some cases that usage can prolong symptomatology after cessation, cannabis has prolonged my LIFE. Without cannabis I would likely have turned (and nearly did) to hard drugs/alcohol, criminality, and almost suicide. Thankfully before I even had my first drink I found cannabis.
Essentially self-medicating gave me the time I needed to sort out my problems. My dissonant mind was calm for the first time in nearly 10 years (so much so that being in that altered state allowed me to see myself without the predominantly self-defeating narrative I ascribed to myself and had believed for years).
Sometimes people ask me what it feels like to use cannabis medicinally (opposed to recreational); My answer is that the effect I get is similar to what an artist may experience when stepping back from his art, looking at it in a mirror, or flipping it upside-down. In doing any of these things the work is seen in a new perspective. In the same way the artist uses these techniques to see through his biases, the altered state induced by the consumption of cannabis (which in most cases is a catalyst for divergent thinking) does the same, but instead for strongly held biases about myself. This altered state in particular has an effect of forcing me to see things for what they are, and in that instance lies the opportunity for self acceptance, compassion, forgiveness, empathy, love, and so much more.
Altered states in and of themselves (regardless of the means: chanting, meditation, ssri’s, sensory deprivation) have been, and still are being pioneered by researchers as well as psychonauts (for example, look at the work being done by the members of The Multidisciplinary Association for Psychedelic Studies). Undoubtedly there’s still a lot to be elucidated when it comes to this matter, and while I don’t expect some sort of panacea for the mind to come from these studies it would be a disservice to nature to avert our curiosity with so much still to be learned.
Anyway, It’s a cold confusing world sometimes, if nobody is there for you, be there for yourself. If you feel attacked by the world (being triggered), don’t join in and attack yourself, you’re worth so much more. Be compassionate with yourself.
NEVER GIVE UP! Where there is no way, you will find one, and if the way cannot be found you’ll make one, believe in yourself!
ShuaApril 23rd, 2015 at 6:50 PM
Well I have to adamantly disagree with most of you. Right now my family is dealing with a disabled vet almost 30 with severe ptsd. He got treatment and was improving. That’s when he got deep into reading websites that told him to smoke smoke smoke. He stopped taking his meds and just “self medicated” with weed. Every Single time he smoked his condition worsened. His schizophrenic like symptoms flared and became dangerous…only EVERY time we started smoking. He has a lot of issues but marijuauna Absolutely made it exponentially worse. He is in very bad shape threw himself from a vehicle going 55 on the to a hospital during a bad episode brought on by getting high. He broke his ankles and bad road rash. He will have to have some serious treatment. But he was getting better until he started smoking weed again. So it is not a cure all one size fits all miracle drug. I am living right smack in the middle of the hell that is this truth. It may work for some but absolutely not ALL. The very first thing to help him will Gave to be to get him clear and stop smoking snd never smoke again.
AnnApril 24th, 2015 at 7:00 AM
Shua, I am so sorry that your family is going thru this with a Disable Vet. I have a family member very similar to your relative. More than likely he’s suffering from several Mental Health dxs along with PTSD, as my relative is, who was also self medicating with various drugs. It’s very hard to be in the spot that you are in. I am not making any excuses for either of them. Mental health patients and substance abuse is around 80 percent of the patients have both. Mental Heath for Vets is almost nothing in our area. I agree the weed needs to go, you are exactly right about how it bring out the other symptoms. Depending on your relationship to this person, a) find out who is supplying it…let them know, that it’s basically felony abuse of a disable vet to supply him and if you think you might, tell them you will turn them in. Vets clinic should be drug testing him, also. My Vet was drug test and was weed positive. Dr. will not give him any more pain pills. He has a lot of conditions besides PTSD, Bipolar…other medical stuff that he really does need the pain pills for. Mental illness kills everyday. His hip is bone on bone, VA waited too long to dx that, not a candidate for surgery, as he would probably not make it. Find the enablers and let them know that what they are doing is abuse, and that they can be turned in to the VA for that. Depending on his age, Elder Abuse, also. It would be a full time thing, more than likely, he has more than one source. I am not a fan of weed, the public will see how it affects some people after all these states legalize it. Hope that the taxes will go to build free rehabs for the public. I hope you can tell that I have been almost where you are. For today, my Vet is some better but he was/is a poly substance abuser. He has quit some things this last year due to health, and now has rational ideas…amazing to see him have some of the same thoughts that I do. I hope you find some answers soon and peace for yourself. Remember, take it one day at a time. Hugs to you for trying to help him, so many people have no one who still cares at this point.
Henry PreistSeptember 30th, 2015 at 7:05 AM
Here is a statement from the one presidential candidate who actively supports the legalization of medical marijuana nationwide! “While it is not possible with existing data to determine conclusively that state medical marijuana laws caused the documented declines in adolescent marijuana use, the overwhelming downward trend strongly suggests that the effect of state medical marijuana laws on teen marijuana use has been either neutral or positive, discouraging youthful experimentation with the drug.”
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