Quitting Weed With PTSD: What Makes It Harder

Quitting weed with PTSD is usually harder than quitting without it, and the research explains why. People with PTSD tend to report stronger cravings and worse withdrawal, and they are more likely to have been using cannabis to sleep and to cope, so stopping takes away a tool they were leaning on. It is still very doable. It goes better with a plan for the nights, and with PTSD treatment lined up alongside the quit rather than after it.

If you are reading this in a bad moment: in the US, call or text 988. Veterans can dial 988 and press 1.

Why PTSD makes quitting harder

The VA National Center for PTSD summarises the research plainly: people with PTSD have particular difficulty stopping cannabis, with greater craving and withdrawal than those without PTSD, and a greater likelihood of using again in the six months after a quit attempt. Among veterans, rates of current cannabis use disorder are considerably higher in those with co-occurring PTSD.

A study of 94 veterans with cannabis dependence found that those with PTSD used cannabis to cope more often and reported more craving, and more severe PTSD symptoms went with more severe withdrawal. The authors describe it as a feedback loop: symptoms drive use, and stopping use sharpens the symptoms.

One nuance is worth knowing. When researchers followed 104 veterans for six months after a quit attempt, PTSD was not linked to lapsing sooner. What differed was that people with PTSD started from heavier use and their use came down more slowly in the first days. So the picture is a slower, rougher start — not a foregone relapse.

Sleep is where it gets decided

If you have PTSD and use cannabis, there is a good chance sleep is a big part of why. In a study of 170 medical cannabis users, those with higher PTSD scores were more likely to use cannabis to improve sleep, and the authors concluded that sleep improvement appeared to be a primary motivator for coping-related use.

That matters because sleep is also one of the slowest withdrawal symptoms to settle. Among the most common sleep symptoms of cannabis withdrawal are reduced sleep and strange or vivid dreams, linked to REM rebound after long-term suppression. In one outpatient study, sleep difficulty and strange dreams were observed for up to seven weeks of continuous abstinence.

Those studies were not specific to PTSD, so nobody can tell you exactly how withdrawal dreams interact with trauma nightmares. But if you already have nightmares, expect the first few weeks of nights to be the hardest stretch, and plan for them rather than hoping they will not come. Nightmares after quitting weed covers why the dreams get so intense and when they settle.

Poor sleep also predicts slips. In one small study of veterans, those with poor sleep quality before quitting had a greater risk of lapsing within the first two days. Sleep is not a side issue here. It is the front line.

What the research says about PTSD after stopping

The fear many people have is that without cannabis, PTSD will be worse. The best long-term data point the other way, though with an important caveat.

A study of 2,276 veterans who went through specialised VA PTSD programmes compared people by what they did with cannabis afterwards. At follow-up, those who stopped and those who never used had the lowest levels of PTSD symptoms, while those who kept using or started had higher symptom severity. Starting cannabis was also linked with more violent behaviour.

That was an observational study, so it cannot prove that stopping caused the improvement. What it does undercut is the idea that cannabis is holding PTSD at bay. The VA's own summary goes further: research to date does not support cannabis as an effective PTSD treatment, and the 2023 VA/DoD clinical guideline recommends against its use for PTSD. The one placebo-controlled trial of whole-plant cannabis in 80 veterans found no significant difference in PTSD symptom reduction between placebo and any of the active preparations.

So the honest expectation is this: the first weeks will likely feel worse, especially at night, and that is withdrawal on top of PTSD. It is not evidence that you need cannabis to function.

Treat PTSD at the same time, not after

A common belief is that you have to be sober for a while before anyone will treat your trauma. The VA says otherwise. People with both PTSD and a substance use problem do not need to wait for a period of abstinence before addressing their PTSD, and trauma-focused treatment does not worsen substance use outcomes.

VA/DoD guidelines say both conditions should be offered evidence-based treatment, and having one should not be a barrier to treating the other. The PTSD talk therapies with the strongest evidence, according to the VA, are Cognitive Processing Therapy, Prolonged Exposure and EMDR, usually over about 8 to 16 sessions.

There are also approaches built for both at once. COPE combines Prolonged Exposure with relapse-prevention work, and the VA notes that in the only trial comparing it directly with Seeking Safety, COPE produced greater PTSD symptom reduction. For the cannabis side on its own, therapy for cannabis use disorder compares the approaches that have been tested.

A practical plan for the first month

None of this replaces treatment, but these are the things that tend to make the difference in the early weeks.

1. Tell whoever treats your PTSD before you quit. A clinician who knows can adjust what you are working on and help with sleep. If you do not have one yet, this is the moment to find one.
2. Plan your nights first. Fixed wake time, a wind-down routine you actually do, and a plan for waking from a nightmare — lights on, feet on the floor, name five things you can see. Ask a doctor about sleep options rather than improvising with alcohol or over-the-counter pills.
3. Expect the spike, and name it. Irritability, anxiety and vivid dreams in the first two weeks are withdrawal. Calling them that helps you ride them out rather than read them as proof you cannot cope. Anxiety after quitting weed explains why it spikes and when it eases.
4. Know your triggers before they arrive. If cannabis was how you got through anniversaries, crowded places or certain conversations, write down what you will do instead in those specific moments.
5. Track days, not perfection. A slip on a bad night does not erase the days before it. People with PTSD often have a slower start, and the research above suggests that is the pattern, not the end of the attempt.

When low mood is part of it

PTSD often travels with depression, and quitting can briefly deepen low mood and flatten pleasure. If nothing feels rewarding in the first weeks, that may be withdrawal-related, and anhedonia after quitting weed covers how long it usually lasts. If low mood is the bigger problem, see quitting weed with depression.

Some people also consider CBD products as a bridge. The evidence there is thin, and some products contain THC; whether CBD helps with weed withdrawal walks through what the trials actually show.

When to get help now

Get professional help rather than going it alone if you have thoughts of harming yourself, flashbacks or dissociation that are getting worse, if you are also drinking heavily or using other substances, if you experience paranoia or hallucinations, or if you are pregnant.

• 988 Suicide and Crisis Lifeline: call or text 988, free and available 24/7.
• Veterans Crisis Line: dial 988 then press 1, or text 838255. You do not need to be enrolled in VA benefits or health care.
• SAMHSA National Helpline: 1-800-662-4357, free, confidential and open 24/7, for finding treatment.

If you are in immediate danger, call your local emergency number. Our articles are written to a clinical standard reviewed by our clinical reviewer, but they cannot assess you. A clinician can.

The short version

• PTSD is linked with stronger cravings, worse withdrawal and a slower start when quitting cannabis.
• Sleep is the pressure point: many people with PTSD use cannabis to sleep, and sleep is one of the slowest withdrawal symptoms to recover.
• Cannabis is not a recommended PTSD treatment, and veterans who stopped had among the lowest PTSD symptoms at follow-up.
• You do not have to be abstinent before starting PTSD treatment. Doing both at once is the recommended approach.
• In a crisis, call or text 988. Veterans press 1.

Sources

• Cannabis Use and PTSD Among Veterans — VA National Center for PTSD — difficulty quitting, guideline position, treatment timing.
• Posttraumatic stress disorder and cannabis use characteristics among military veterans with cannabis dependence — American Journal on Addictions, PubMed — coping, craving and withdrawal.
• The impact of posttraumatic stress disorder on cannabis quit success — American Journal of Drug and Alcohol Abuse, PubMed — lapse timing after a quit attempt.
• Using cannabis to help you sleep: heightened frequency of medical cannabis use among those with PTSD — Drug and Alcohol Dependence, via PMC — PTSD and sleep motives.
• Poor sleep quality as a risk factor for lapse following a cannabis quit attempt — Journal of Substance Abuse Treatment, PubMed — poor sleep and early lapse.
• Self-reported sleep disturbances during cannabis withdrawal in cannabis-dependent outpatients — Sleep Medicine, via PMC — reduced sleep and vivid dreams.
• Sleep disturbance and the effects of extended-release zolpidem during cannabis withdrawal — Drug and Alcohol Dependence, via PMC — how long sleep effects last.
• Marijuana Use Is Associated With Worse Outcomes in Symptom Severity and Violent Behavior in Patients With PTSD — Journal of Clinical Psychiatry, via PMC — PTSD symptoms after stopping.
• Treatment of Co-Occurring PTSD and Substance Use Disorder in VA — VA National Center for PTSD — concurrent treatment and COPE.
• PTSD Treatment Basics — VA National Center for PTSD — CPT, PE and EMDR.
• 988 Suicide and Crisis Lifeline — SAMHSA — crisis support.
• Veterans Crisis Line — 24/7 support for veterans.
• SAMHSA National Helpline — free, confidential support at 1-800-662-4357.