You know, when it comes to strands and dosages, we're still quite a way off. The ultimate answer is going to be a lot of variability. As much as we'd like it to conform to sort of a single molecule medicine, where we can say we're going to give you this pill and that's the dose, I'm not sure that's where we're going to get with cannabis.
Cannabis may in some ways require us to reconsider how we approach medicine. The challenge in research is not only going to be determining if cannabis is effective, because there are so many people with PTSD—veterans and other—who are reporting that it's effective that, if we were to come out with a study and say it's not effective, they would continue to trust their own experience over the study.
Unlike many medications that start in research and then move into the clinic and then to patients, this is something that's starting with patients and moving backwards to the research, which makes it almost unique. When we try to squeeze it into that pharmaceutical model, we come up with some of these problems.
You've asked where the research is. I am hopeful that, as we complete our study and as we learn more about what the study that Dr. Bonn-Miller was talking about finds out, we'll start to get some signal. But we also need to look at cannabis in a more naturalistic environment and find stories like those we're hearing from veterans and follow them up. How are veterans who are using cannabis therapeutically doing, compared to those who are not, and what works for whom? If cannabis is not effective for some veterans, which ones is it going to be effective for?
Rather than a blanket statement that it's good or it's bad, I don't know if we're going to get to that point. I think what we're going to find is that it's going to be effective for some people in some conditions; certain types of cannabis perhaps combined with other types of interventions are going to be maximally effective, and we'll start to look at fine-tuning it and looking at it more naturalistically. I don't think we shouldn't be doing the RCTs. Those are going to tell us something, but if we rely exclusively on those, we're missing the boat and we may miss some important information and we won't have the impact we'd like to see on the lives of veterans.
I'd like to see research focused on how we can combine cannabis with some of the behavioural interventions. What Dr. Bonn-Miller was talking about with CBD and behavioural exposure for PTSD is very interesting. Those kinds of studies are where I'd like to see it go rather than sort of a yes or no, thumbs up or thumbs down approach.