CBD Oil Help Ptsd

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CBD for PTSD: Does Cannabidiol Oil Help With Post-Traumatic Stress Disorder?

Post-Traumatic Stress Disorder (PTSD) is a severe mental condition that is still widely misunderstood. Despite increasing numbers of PTSD patients, it is still most commonly associated with war veterans affected by traumatic events.

Of course, PTSD affects this group of people to a very large extent; but one doesn’t need to be a veteran to suffer from PTSD. In fact, this disorder can be triggered by several other conditions, such as childhood neglect, sexual harassment, or a tragic accident.

Today, we’re going to elaborate on the problem of PTSD and how to use CBD oil to effectively manage its symptoms without dangerous side effects associated with pharmacological treatment.

How Does CBD Help with PTSD?

PTSD is a chronic mental condition that can happen to anyone who has gone through a major trauma. According to PTSD statistics, there is a higher risk of PTSD among specialists working in public services, such as soldiers, policemen, or firefighters, the condition can affect just anybody.

The symptoms of PTSD include anxiety, higher sensory sensitivity, dizziness, forgetfulness, fatigue, depression, headaches, and troubles with focus. PTSD is also characterized by returning traumatic memories, which may lead to a panic attack.

Coincidence or not, CBD can help relieve, or at least manage, the above symptoms on top of reaching the core problem of the condition.

In order to understand that mechanism, we need to elaborate on the interactions between CBD and CB1 receptors in the endocannabinoid system (ECS).

CB1 receptors occur throughout the entire body, with the highest concentrations in the brain and the central nervous system. The indirect activation of CB1 and serotonin receptors through the use of CBD can result in reduced anxiety, better sleep, stable mood, and increased alertness.

Moreover, CBD targets the cannabinoid receptors in the immune system, regulating the release of stress hormones, blocking mood receptors that are compromised by traumatizing stimuli, and stopping reconsolidation memory referred to as flashbacks.

Last but not least, CBD may help a person reprogram their brain to respond to specific stimuli in trauma-releasing circumstances. On the whole, CBD seems to help with PTSD from multiple angles, relieving the mental symptoms and improving one’s physical health as a result.

CBD and PTSD: Research Studies

There are a lot of anecdotal reports from people who successfully use CBD for PTSD.

But is there any scientific evidence to back them up?

According to a study published in Frontiers in Pharmacology, CBD may effectively treat PTSD and an array of specific phobias (1). The effects of CBD were tested on rats that had been regularly exposed to intense fear. Similar to other prey animals, rats tend to adopt a ‘freeze response’ when their life is in danger, but when they were exposed to the same stimuli after being treated with CBD, the level of fear dropped considerably.

In a 2009-2011 study by Greer, Grob, and Halberstadt, the research team evaluated the PTSD response after giving cannabis to 80 patients. The scientists reported a 75% reduction in PTSD-related symptoms on the Clinical Administered Post-traumatic Scale (CAPTS) (2).

Preclinical evidence from 2015 also confirmed that CBD had a strong potential for treating multiple anxiety disorders, including PTSD. The study underlined the effectiveness of acutely administered CBD, adding that the long-term health benefits of the cannabinoid make it a desired supplement for stress management throughout the day (3).

A 2016 study found a link between drugs acting on the endocannabinoid system and the reduction of the symptoms experienced by individuals with PTSD after a memory extinction procedure. The authors of the study attributed these results to the CB1 receptors, which regulate anxiety and memory (4).

Another 2016 study provided clinical evidence that supports the efficacy of CBD as an alternative to pharmaceutical PTSD treatments. The case study involved a girl with PTSD-triggered insomnia; according to the researchers, the girl showed a significant improvement in her PTSD symptoms as well as in her sleep patterns (5).

Finally, a 2019 literature review on medical cannabis, synthetic cannabinoids, and PTSD found that CBD may be an effective treatment for the condition. However, the study concludes that scientists still need more in-depth research on CBD’s therapeutic applications, efficacy, and safety (6).

Can You Use CBD for Depression from PTSD?

PTSD is often accompanied by depression that results from chronic episodes and recurring flashbacks. While the effects of CBD are not yet fully understood, the cannabinoid targets the same receptors as some commonly used antidepressants.

For example, CBD uses the same mechanism of action as selective serotonin reuptake inhibitors (SSRIs) (7). Current evidence suggests that CBD has a positive effect on the brain’s serotonin concentrations. Serotonin is a natural neurotransmitter that helps to regulate mood on top of many other things. Low levels of serotonin are associated with depression and low mood. While CBD doesn’t directly stimulate the production of serotonin, studies suggest that it may alter the activity of serotonin receptors — helping to process the brain’s existing levels of serotonin more efficiently.

As mentioned, CBD also helps in the management of stress and anxiety, which are two essential components of depression from PTSD. Those suffering from PTSD are particularly sensitive to normal stressors. If a person suffers from stress-related depression, CBD may come in handy.

Another important benefit of CBD for depression is its ability to stimulate the plasticity of the hippocampus. The hippocampus is the brain’s region responsible for memory, emotional processing, cognitive performance, and mood stability. People with a shrunken hippocampus may experience more frequent flashbacks, learning difficulty, low mood, and suicidal thoughts. Studies have shown that a prolonged CBD treatment may improve the plasticity of the hippocampus, translating into the reduction of the said symptoms (8).

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CBD or THC: Which Is More Effective for PTSD?

As you might have noticed, we’ve mentioned that some studies have tested both THC and CBD as the potential treatment for PTSD. Among those who have experienced the medical benefits of marijuana, there’s a debate over THC and anxiety-related disorders.

THC is directly responsible for the psychotropic effects of marijuana. In low and moderate doses, it can relieve stress and anxiety by providing deep relaxation and a euphoric mood. However, when a person consumes too much THC at a time, it may backfire at you, exacerbating anxious feelings.

However, these results were observed in healthy people with balanced levels of anandamide — the so-called bliss molecule that controls our feelings of happiness, well-being, and calm. People with PTSD have low concentrations of anandamide in the blood, and thus may have a harder time dealing with traumatic memories and feelings of anxiety.

The cannabinoids in cannabis, specifically CBD and THC, act much like anandamide by changing the way cannabinoid receptors work. However, they do it in a different manner. While THC tricks your brain that there is more anandamide in the bloodstream, CBD signals the endocannabinoid system to produce the necessary amount of the endocannabinoid — leveling out imbalances.

Since CBD doesn’t directly bind to the CB1 receptor in the brain, it doesn’t cause a high. For this reason, many PTSD patients choose CBD oil with only trace amounts of THC in order to reap the health benefits without the psychoactive buzz and the risk of causing the aforementioned backfire effect.

If you live in a place that has a medical marijuana program, you can try CBD oil with higher levels of THC, but for many people out there, such products are out of reach due to the legal status of marijuana in their country or state. The only type of CBD oil legal in all 50 states is the one that comes from hemp plants.

How to Use CBD for PTSD

Multiple studies have analyzed different forms of CBD when testing its efficacy for PTSD. Some studies have used oral or sublingual CBD, and others have used topical CBD.

A 2019 study found that PTSD patients who took CBD capsules in conjunction with behavioral therapy saw improvements in their symptoms (9).

The aforementioned case study from 2016 found that the topical application of CBD oil was effective for insomnia in a child with PTSD (10).

Finally, there’s a 2018 review of literature suggesting that a combination of CBD and THC may be the most effective cannabis treatment for PTSD (11).

Finding the best CBD products for PTSD may take some time, so we encourage you to experiment with different forms. Make sure to consult a doctor experienced in cannabis use for professional advice, dosage guidance, and to avoid potential interactions with antidepressants and other medications for PTSD.

CBD Oil Dosage for PTSD

If you’re considering trying CBD oil for PTSD, it’s important to start with a low dose and gradually work your way up to the point where you experience relief from your symptoms.

Dosage recommendations vary and depend on the product you choose, on top of many other factors, such as your weight, age, metabolism, gender, the severity of symptoms, expected effects, and your unique body chemistry.

CBD oil drops are the most common method of taking CBD among beginners. Squeeze the dropper to measure out your dose and place it under the tongue. From there, it will be absorbed through hundreds of tiny blood vessels in your mouth. Once 60 seconds have passed, swallow the remaining oil and let it pass through your digestive system.

Studies have shown that the dosage ranging from 12 mg to 25 mg of CBD can significantly curb anxiety symptoms, reaching peak effects within 1-2 hours after administration.

Again, it’s essential to start low and go slow. Keep a daily log of your dosage and track the results. Doing so will help you reach the ideal dose when your symptoms start to get better.

Best CBD Oil for PTSD

As mentioned earlier in the article, finding the right product for your needs may take some time. There are hundreds of brands on the market, each of them claiming to sell the best CBD oil for a wide range of conditions, including PTSD. Of course, the market is full of great companies that make high-quality products at affordable prices, but there’s an equal number of manufacturers who don’t bother churning out poor quality products that are mislabeled and sometimes downright dangerous.

Below we’d like to show you our top pick when it comes to organic, full-spectrum CBD oils. The products from this company come from non-GMO hemp and are rigorously tested for their potency and purity.

You may have already read about Royal CBD by now, but in case you didn’t, here’s our short review of this premium CBD oil.

Royal CBD Oil

Product Details

  • Made from locally grown organic hemp
  • Extracted with supercritical CO2
  • Infused with full-spectrum CBD
  • Available in 4 strengths and flavors
  • Up to 2500 mg of CBD per bottle
  • 3rd-party tested for potency and purity
  • Great natural flavor
  • Not available in local CBD stores (this may soon change)
  • No CBD vapes
Why We Recommend Royal CBD Oil for PTSD

Royal CBD specializes in making premium CBD oils that are priced slightly below average — despite the quality of these products being way above the generally agreed standards.

The company uses hemp from multiple farms in different regions of the country, which makes them able to get a consistent product by using various suppliers. The Royal CBD oil is made from organically-grown, non-GMO hemp that is bred specifically to produce high CBD flowers.

The formula of the oil is simple, featuring a CO2-extracted full-spectrum hemp extract and MCT carrier oil. The product comes in four potency options; you can choose from 250 mg, 500 mg, 1000 mg, and 2500 mg bottles. There are also flavored options available, including Berry, Mint, and Vanilla. Only the strongest version doesn’t have a flavored variant, as it would compromise the original cannabinoid profile of the product.

As we said, these are full-spectrum extracts, so you’re getting all the naturally occurring phytonutrients in hemp, including minor cannabinoids, terpenes, essential oils, and flavonoids. These compounds allow your body to process CBD more efficiently, meaning you need less CBD to experience the same results as with isolates. Scientists have a special name for this phenomenon: the entourage effect.

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The entourage effect is leveraged in this product thanks to the suspension in coconut-derived MCT oil. The carrier oil improves CBD’s bioavailability, so it doesn’t lose potency upon ingestion, unlike capsules or edibles.

On top of its best-selling oil, Royal CBD offers capsules, gummies, and topicals. The entire Royal CBD collection is tested for potency and purity in a third-party laboratory. The company also has a 30-day money-back guarantee for those who want to try out its products in a risk-free way.

Final Thoughts on CBD and PTSD

PTSD is a chronic mental health condition that people may develop after experiencing a tragic event, or anything that can cause trauma.

While there are various traditional treatments available, such as counseling and pharmacological medication, evidence suggests that CBD may also help alleviate this condition.

CBD may be able to reduce anxiety, stress, and depression. The interaction between CBD and the endocannabinoid system also produces other beneficial effects, such as better focus, improved sleep patterns, emotional stability, resistance to traumatic memories, and more.

Researchers are still trying to determine the most effective form of CBD — whether it works better as an isolate, full-spectrum extract, or in equal ratios with THC — and the dosage range for anxiety-related conditions. If you’re considering taking CBD oil for the first time, we encourage you to consult a holistic medical practitioner who will be able to point you in the right direction when it comes to the said factors. A consultation with a qualified physician will also help you avoid potential interaction with medications.

Do you take CBD for PTSD? Do you use it on its own or with THC? Let us know in the comment section!

References:

  1. Song, Chenchen et al. “Bidirectional Effects of Cannabidiol on Contextual Fear Memory Extinction.” Frontiers in pharmacology vol. 7 493. 16 Dec. 2016, doi:10.3389/fphar.2016.00493
  2. Bitencourt, Rafael M, and Reinaldo N Takahashi. “Cannabidiol as a Therapeutic Alternative for Post-traumatic Stress Disorder: From Bench Research to Confirmation in Human Trials.” Frontiers in neuroscience vol. 12 502. 24 Jul. 2018, doi:10.3389/fnins.2018.00502
  3. Blessing, Esther M et al. “Cannabidiol as a Potential Treatment for Anxiety Disorders.” Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics vol. 12,4 (2015): 825-36. doi:10.1007/s13311-015-0387-1
  4. Song, Chenchen et al. op. Cit.
  5. Shannon, Scott, and Janet Opila-Lehman. “Effectiveness of Cannabidiol Oil for Pediatric Anxiety and Insomnia as Part of Posttraumatic Stress Disorder: A Case Report.” The Permanente journal vol. 20,4 (2016): 16-005. doi:10.7812/TPP/16-005
  6. Orsolini, Laura et al. “Use of Medicinal Cannabis and Synthetic Cannabinoids in Post-Traumatic Stress Disorder (PTSD): A Systematic Review.” Medicina (Kaunas, Lithuania) vol. 55,9 525. 23 Aug. 2019, doi:10.3390/medicina55090525
  7. Sales, Amanda J et al. “Antidepressant-like effect induced by Cannabidiol is dependent on brain serotonin levels.” Progress in neuro-psychopharmacology & biological psychiatry vol. 86 (2018): 255-261. doi:10.1016/j.pnpbp.2018.06.002
  8. Beale, Camilla et al. “Prolonged Cannabidiol Treatment Effects on Hippocampal Subfield Volumes in Current Cannabis Users.” Cannabis and cannabinoid research vol. 3,1 94-107. 1 Apr. 2018, doi:10.1089/can.2017.0047
  9. Elms, Lucas et al. “Cannabidiol in the Treatment of Post-Traumatic Stress Disorder: A Case Series.” Journal of alternative and complementary medicine (New York, N.Y.) vol. 25,4 (2019): 392-397. doi:10.1089/acm.2018.0437
  10. Shannon, Scott, and Janet Opila-Lehman. op. cit.
  11. Bitencourt, Rafael M, and Reinaldo N Takahashi. op. cit.
Nina Julia

Nina created CFAH.org following the birth of her second child. She was a science and math teacher for 6 years prior to becoming a parent — teaching in schools in White Plains, New York and later in Paterson, New Jersey.

Use of CBD Oil in the Treatment of Posttraumatic Stress Disorder

The overarching objective of the proposed project is to test the clinical efficacy of CBD in the treatment of post-traumatic stress disorder using a rigorous double-blind randomized clinical trial methodology. Participants (n=150) meeting full DSM-5 criteria for post-traumatic stress disorder (PTSD) will be randomized to one of 3 treatment arms: (a) CBD -Isolate; (b) CBD-Broad Spectrum; (c) Placebo oil.

We predict that patients receiving CBD isolate or CBD Broad Spectrum will show significantly greater improvements in PTSD symptoms and functional impairment at the posttreatment, one month, and three month follow-up assessments relative to patients receiving placebo oil. Additionally, we expect that patients receiving CBD Broad Spectrum will show significantly greater improvements relative to patients receiving CBD Isolate.

Condition or disease Intervention/treatment Phase
Post Traumatic Stress Disorder Drug: CBD Isolate Other: CBD Broad Spectrum Other: Placebo oil Phase 2

Background and Significance of the Proposed Project

Over 80% of Americans are exposed to a significant trauma sometime during their lifetime and approximately 7% will meet for a threshold diagnosis of posttraumatic stress disorder. PTSD is the most costly anxiety-related disorder and confers significant interference in work, social functioning, increased risk for other physical and mental health problems, and a four-fold increase in suicide rates compared to the general population.

Over the past two decades, trauma-focused psychotherapies for PTSD have been shown to outperform more traditional supportive psychotherapy or pharmacotherapy and have become the first line treatment for PTSD. Despite these advances, trauma focused treatments such as prolonged exposure therapy (PE) are associated with high rates of treatment refusal, and among those who do enter treatment, approximately 25% drop-out. These data highlight the need to develop PTSD treatment strategies that are both effective and more palatable to patients.

More recently, there’s been considerable excitement in the press over the potential therapeutic use of cannabidiol (CBD) products in the treatment of a variety of physical and mental health problems.( Delta-9-tetrahydrocannabinol (delta-9 THC) is still illegal in most states because of its psychoactive abuse potential. In contrast, cannabidiol (CBD) does not convert to THC in the body and has negligible side effects relative to main stream psychiatric drugs (benzodiazepines and antidepressants) commonly prescribed for the treatment of PTSD. Mounting evidence from studies with rodents suggests that CBD may confer significant promising health-related benefits including anti-inflammatory, pain-relieving, anti-cancer, memory enhancement, and facilitation of fear extinction (see White for a recent review).

The biggest success story for CBD use in humans to date comes from controlled randomized clinical trials demonstrating a 50% or more reduction in previously intractable seizures in children suffering from Dravet syndrome and Lennox-Gastaut syndrome. Moreover, several controlled clinical trials have shown promising findings in reducing psychotic symptoms among patients with schizophrenia and among young adults displaying THC-induced psychosis.

Preliminary Evidence that CBD may offer promise in the treatment of anxiety-related disorders has started to emerge. A small pilot trial with 24 patients presenting with social anxiety disorder found that relative to placebo, a single dose of 100 mg of CBD oil led to lower levels of anxiety, cognitive impairment, and discomfort in their actual speech performance as well as their anxiety before the speech. Unfortunately, human treatment studies for anxiety-related problems is limited almost exclusively to single dose effects on an anxiety challenge task. Studies are clearly needed to assess the effects of multi-dose CBD treatments across the full spectrum of trauma and anxiety-related disorders such as posttraumatic stress disorder.

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The overarching objective of the proposed project is to test the clinical efficacy of CBD in the treatment of posttraumatic stress disorder using a rigorous double-blind randomized clinical trial methodology.

Specific aims of the project include:

Compare the efficacy of an 8-week multi-dose regimen of two CBD oil formulations (CBD Isolate (300 mg/day) and CBD Broad Spectrum) relative to placebo oil in reducing clinician and patient-rated PTSD symptoms at the posttreatment and one month follow-up assessments.

We predict that patients receiving CBD oil (CBD isolate or CBD Broad Spectrum) will show significantly greater improvement in PTSD symptoms and functional impairment at post-treatment and one month follow-up relative to patients receiving placebo oil.

We also predict that patients receiving the CBD Broad Spectrum formulation will show significantly greater improvement in PTSD symptoms and functional impairment relative to patients receiving CBD Isolate.

Examine predictors of patients’ clinical response to the various treatment combinations.

We expect that the superiority of CBD relative to placebo will be more pronounced for patients showing more severe PTSD symptoms at baseline and for those showing significant sleeping difficulties.

We expect that CBD-treated patients will show equivalent levels of side effects as those receiving placebo oil.

STUDY METHODS AND PROCEDURES

Participant Recruitment: 150 participants between the ages of 18 and older will be recruited through several outlets including notices posted on campus, announcements on our research laboratory website and national organizations related to PTSD and its treatment.

Participant Screening: Participants will undergo a two-stage screening procedure. Stage 1 will be a brief structured web-based screening interview. Stage 2 will be a telephone-administered structured clinical interview (CAPS-5). Participants meeting the following inclusion and exclusion enrollment criteria will be invited to take part in the study (see below).

NOTE: ALL STUDY PROCEDURES ARE COMPLETED AT PARTICIPANTS’ HOMES. NO VISITS TO OUR RESEARCH LABORATORY ARE REQUIRED.

  1. Meets for a current DSM-5 diagnosis of PTSD as their “primary” mental disorder
  2. Age between 18 to 70
  3. Fluent in English
  4. Willingness to provide signed informed consent online
  5. No history of a suicide attempt in the past 6 months
  6. No history of psychosis with the past 6 months

9. No history of current alcohol or substance use disorder within the past 6 months.

10. No current medical problems that would preclude safe ingestion of CBD oil 11. Willingness to refrain from other forms of Cannabis use during the 8-week treatment phase of the study.

12. Has home access to the internet.

Participant Informed Consent:

All study participants will be consented by the study coordinator or a doctoral student research assistant during the screening visit conducted over the phone. The online informed consent document will provide participants with information regarding the aims of the project, what they will be asked to do, any anticipated risks or benefits associated with participating in the study, as well as a clear statement that their participation is voluntary and that they may discontinue participation at any time.

Study Design Overview: The research plan is to conduct a Phase II double-blind placebo controlled randomized clinical trial comparing the efficacy of two CBD oil (300 mg./day) versus Placebo Oil.

Nightly dosing of a hemp-derived formulation of purified CBD isolate (300 mg), CBD Broad Spectrum (300 mg.) or matching placebo oil daily for 8 weeks. Individual doses of both CBD formulations and placebo oil will be provided in identical individual plastic syringes. All patients, PI, and staff who interact with study participants will be blind to participants’ assigned treatment condition.

Clinical Assessment Schedule:

Week 0 – Pre-Treatment Screening Visit: All enrolled study participants will complete from their home a clinical assessment battery consisting of (a) self-report rating scales over the Internet (see measures); and (b) a structured clinical interview (CAPS-5).

Treatment Visits (Weeks 1 – 8) : During this phase, all study participants will (a) receive via Fed-Ex their weekly allotment of CBD/Placebo oil; (b) complete weekly clinical status assessments via the Internet (see measures).

Posttreatment Assessment Visit (Week 9): All participants will complete an online battery of clinical outcome measures identical to those administered during their pre-treatment visit (see outcome measures).

1-Month Follow-up Assessment Visit (Week 13) – All participants will be re-administered the complete battery of primary and secondary outcome measures (see outcome measures).

Primary Clinical Outcomes: The primary clinical outcomes will be (a) scores on the Clinician Administered PTSD Scale (CAPS-5) and (b) independent evaluator ratings of clinical status using the Clinical Global Improvement Scale administered at each of the three posttreatment assessment periods (Week 9, Week 13).

Secondary Clinical Outcomes: Several additional psychiatric outcomes will be assessed at each of the three follow-up assessment visits. These clinical outcomes and their respective measures appear below. Additional information on these measures is available in the accompanying cited publication for each measure.

  • Patient-rated PTSD symptoms using the PCL-5
  • Depression – Patient Health Questionnaire (PHQ-9)
  • Life Impairment – Sheehan Disability Scale (SDS)
  • Quality of Life – World Health Organization (WHOQOL-BREF)
  • Substance Use Disorders – NIDA-Modified Alcohol, Smoking, and Substance Involvement Screening Test (NIDA M-ASSIST)
  • Pittsburgh Sleep Quality Index (PSQI)

Data Management Data Management involves development of methods for ensuring that data collection instruments are programmed; data are properly collected; participants are tracked and monitored over the course of the study; data sets are documented and maintained; variables are created and documented; and main analyses are conducted. To enhance quality control, all data for the current study including demographic information, diagnoses, and participant and clinician rated measures will be directly entered into a HIPPA compliant electronic case report form (eCRF) using Qualtrics – a secure cloud-based platform designed exclusively for supporting HIPPA compliant data capture and storage. Qualtrics provides: (a) An intuitive interface for data entry with data validation; (b) Audit trails for tracking data manipulation and export procedures; (c) Procedures for importing data from external sources; (d) Automated export procedures for seamless data downloads to common statistical packages (SPSS, SAS, Stata, R) to facilitate data analysis; (e) automated and secure data back-up and storage to servers housed at the University of Texas Population Research Center (PRC). Dr. Telch in his role as Principal Investigator will serve as the Senior data manager and will meet bi-weekly with the biostatistician and research staff on issues related to data management.

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