Impact of Medical Cannabis Treatment on Healthcare Utilization in PTSD Patients: A Retrospective Cohort Study

IntroductionMedical cannabis is increasingly used as a therapy for managing post-traumatic stress disorder (PTSD). Patients with PTSD often have high healthcare utilization rates, particularly for acute services. This study examines the association between medical cannabis treatment and healthcare utilization among patients with PTSD. MethodsWe conducted a retrospective cohort study using cross-sectional data with tem-poral elements, derived from administrative records provided by Leafwell, among patients with PTSD. The cohort was defined based on medical cannabis use: the treated group included patients who had used medical cannabis for at least one year (returning for medical card renewal), while the untreated group consisted of cannabis-naive patients reporting no prior cannabis use. The primary outcomes were healthcare utilization within the past six months, including at least one urgent care visit, emergency department (ED) visit, or hospitalization related to their primary medical condition. We used inverse probability weighting with regression adjustment (IPWRA) to estimate the average treatment effect (ATE) of medical cannabis use on healthcare utilization, controlling for key demographics and health factors, including PTSD severity. Sensitivity analyses were conducted to assess the robustness of our findings. ResultsAmong the 1,946 participants, the treated group (n = 1,261) had significantly lower healthcare utilization rates compared to the untreated group (n = 685). Using the doubly robust IPWRA model, medical cannabis treatment was associated with a significant 35.6% reduction in urgent care visits (coefficient = -0.024, Standard Error (SE) = 0.0117) and a 35.1% reduction in ED visits (coefficient = -0.027, SE = 0.0124). Hospitalization rates were 26.3% lower among the treated group but did not reach statistical significance. Sensitivity analyses utilizing alternative ATE estimation strategies displayed consistent reductions in urgent care and ED visits among cannabis users, though hospitalizations remained non-significant. Adjusting the IPWRA models tolerance levels strengthened the found associations while maintaining strong covariate balance. Fewer than 2% of the treated group reported an adverse event. DiscussionThese findings suggest that medical cannabis treatment among patients with PTSD may be associated with reduced utilization of urgent care and ED services. This relationship remains robust across multiple statistical models and sensitivity analyses, underscoring the potential role of medical cannabis in reducing acute healthcare needs in this population. Further longitudinal research is warranted to explore causality and assess its impact on hospitalization rates.