Functional Outcomes of Cannabis Use (FOCUS) in Veterans with Posttraumatic Stress Disorder

创伤后应激障碍（PTSD）是一种致残性精神疾病，影响20%-30%的美国人。 老兵PTSD与包括大麻在内的药物滥用合并症的风险增加密切相关 使用障碍;然而，多个国家现在包括创伤后应激障碍作为一种条件，患者可以合法地 处方医用大麻，尽管事实上还没有一个大规模的随机临床试验， 试验证明大麻治疗PTSD的疗效。本提案的总体目标 是前瞻性研究减少大麻使用对退伍军人心理社会功能的影响， 创伤后应激障碍为此，我们将首先使用生态瞬时评估（EMA）方法来评估 大麻使用与PTSD退伍军人日常功能之间的关系接下来，我们将使用移动的 应急管理（CM）和EMA评估减少大麻使用对日常功能的影响 患有创伤后应激障碍的退伍军人，他们是重度大麻使用者。我们的中心假设是， 大麻的使用将导致退伍军人的功能结果发生积极变化。这样做的理由 它将提供有关减少大麻使用影响的第一个也是唯一的实时数据 对患有创伤后应激障碍的退伍军人的日常功能的影响。因此，这一创新和及时的项目有可能 显著推进VHA医疗保健，并将直接告知正在进行的全国辩论， 大麻使用对创伤后应激障碍退伍军人长期功能恢复的影响。

Posttraumatic stress disorder (PTSD) is a disabling psychiatric disorder that affects 20%-30% of U.S. Veterans. PTSD is strongly associated with increased risk for substance abuse comorbidity, including cannabis use disorder; however, multiple states now include PTSD as a condition for which patients can be legally prescribed medical marijuana, despite the fact that there has not been a single large-scale randomized clinical trial demonstrating the efficacy of cannabis to treat PTSD to date. The overall objective of the current proposal is to prospectively study the impact of reduced cannabis use on psychosocial functioning among Veterans with PTSD. To do so, we will first use ecological momentary assessment (EMA) methods to evaluate the relationship between cannabis use and daily functioning among Veterans with PTSD. Next, we will use mobile contingency management (CM) and EMA to assess the impact of reduced cannabis use on daily functioning among Veterans with PTSD who are heavy cannabis users. Our central hypothesis is that reductions in cannabis use will lead to positive changes in the functional outcomes of Veterans. The rationale for this research is that it will provide the first and only real-time data concerning the impact of reduced cannabis use on daily functioning among Veterans with PTSD. As a result, this innovative and timely project has the potential to significantly advance VHA healthcare and will directly inform the ongoing national debate concerning the impact of cannabis use on the long-term functional recovery of Veterans with PTSD.