Dr. Mitchell Doucette, Ph.D., MS

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

Dr. Mitchell Doucette, Ph.D., MS, Senior Research Director, Leafwell

Introduction: Medical 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 such as urgent care, emergency department (ED) visits, and hospitalizations. This study examines the association between medical cannabis treatment and healthcare utilization among PTSD patients    Methods: We conducted a retrospective cohort study with cross-sectional data from a survey of PTSD patients. The primary exposure was medical cannabis use, stratified into cannabis-naive patients (untreated) and those who had used cannabis for at least one year (treated). Outcomes included at least one urgent care visit, emergency department (ED) visit, and hospitalization within the past six months related to the medical condition of which they used medical cannabis. We used inverse probability weighting with regression adjustment (IPWRA) as our primary analysis to estimate the average treatment effect (ATE) of medical cannabis use on healthcare utilization controlling for key demographics and health status, including PTSD severity. Several sensitivity analyses were conducted.  Results:  Among 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 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 model’s tolerance levels strengthened found associations while maintaining strong covariate balance.  Conclusions:  These findings suggest that medical cannabis treatment among PTSD patients 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 the impact on hospitalization rates.  

Dr. Doucette is the Senior Research Director at Leafwell and a trained public health scholar. He earned his PhD from Johns Hopkins Bloomberg School of Public Health in 2018. His research interests include estimating the impact of policies, programs, and therapeutics on population-level health. Dr. Doucette has published over 35 peer-reviewed manuscripts, winning the Best Paper of the Year award from the American Journal of Public Health (2018) and the Journal of Urban Health (2022). His work has been featured in numerous media outlets, including the Associated Press, NPR, and the Los Angeles Times, and has been cited by the US Supreme Court. Prior to joining Leafwell, he was the Director of Research Methods at the Center for Gun Violence Solutions at the Johns Hopkins Bloomberg School of Public Health. Dr. Doucette lives outside Hartford, Connecticut with his wife and two young daughters.