# Endocannabinoid System Research: Cannabis for PTSD & SUDs > **Author:** Benjamin Caplan, MD (ABFM Board Certified, MA Lic. #240562, NPI: 1962722637) > **Publisher:** CED Clinic (https://cedclinic.com) > **Canonical URL:** https://cedclinic.com/endocannabinoid-system-research-cannabis-ptsd-meta-analysis/ > **Published:** 2026-03-24T15:17:36-04:00 | **Last Modified / Clinically Audited:** 2026-09-28T11:04:07-04:00 > **Clinical Summary:** Explore endocannabinoid system research cannabis PTSD meta-analysis showing trauma-focused treatment efficacy for PTSD and substance use disorders with cannabis use. --- #### Clinical Takeaway People with PTSD and co-occurring [substance use disorders](https://cedclinic.com/cannabinoid-clinical-trials-mental-disorders-evidence-2/) who use cannabis show comparable outcomes to non-cannabis users when receiving trauma-focused treatment, suggesting [cannabis use](https://cedclinic.com/cannabis-cardiovascular-health-insights-2024/) alone should not be a barrier to evidence-based PTSD care. Trauma-focused therapies remain effective for this population, supporting their use even in the presence of active cannabis use. ### #7 Cannabis use and trauma-focused treatment for co-occurring posttraumatic stress disorder and substance use disorders: A meta-analysis of individual patient data. **Citation:** Hill Melanie L et al. *Cannabis use and trauma-focused treatment for co-occurring posttraumatic stress disorder and substance use disorders: A meta-analysis of individual patient data.* Journal of [anxiety disorders](https://cedclinic.com/adolescent-cannabis-use-and-anxiety-research/). 2024. PMID: 38266511. **Study type:** Meta-Analysis, Journal Article, Research Support, N.I.H., Extramural  |  **Topic area:** Anxiety & PTSD  |  **CED Score:** 12 Design: 6 Journal: 0 N: 4 Recency: 1 Pop: 2 Human: 1 Risk: -2 **Quality Gate Alerts:** - Preclinical only **Abstract:** 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](https://cedclinic.com/endocannabinoid-system-emotional-memory-ptsd-treatment/) (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.  |   |  [View on PubMed ↗](https://pubmed.ncbi.nlm.nih.gov/38266511/)[Full Text ↗](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11138203/)[DOI ↗](https://doi.org/10.1016/j.janxdis.2024.102827) [https://cedclinic.com/contact/](https://cedclinic.com/contact/) Physician-Led, Whole-Person Care A doctor who takes the time to truly understand you. Personal care that starts with listening and is guided by experience and ingenuity. 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[Explore Article](https://cedclinic.com/trauma-focused-treatment-ptsd-cannabis-use/) [Endocannabinoid System in PTSD and Substance Use Disorder](https://cedclinic.com/cannabis-use-trauma-focused-treatment-outcomes-ptsd/) Research on the role of the [endocannabinoid system](https://cedclinic.com/endocannabinoid-system-fear-extinction/) in co-occurring PTSD and substance use disorders. [Learn More](https://cedclinic.com/cannabis-use-trauma-focused-treatment-outcomes-ptsd/) Have thoughts on this? 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