Post Traumatic Stress Disorder (PTSD) and medical marijuana


Anecdotal evidence from veterans suggests marijuana may help in the treatment of PTSD (Post Traumatic Stress Disorder). This while unfortunately there is no official set medication to help treat PTSD or its symptoms. Could PTSD be the latest addition to the list of medical conditions to benefit from treatment with cannabis?

PTSD is a serious psychiatric condition that affects an estimated 8% of people in the US and many more around the world. The condition is known to affect 8 million people every year.

UNDERSTANDING PTSD

Post Traumatic Stress Disorder is a psychiatric disorder that, as the name suggests, is usually caused by experiencing a particularly traumatic event (be it scary or dangerous), such as military combat, natural disasters, serious accidents, or sexual or physical abuse.

PTSD is basically characterised by an inability to suppress or process the trauma from these events. Patients with PTSD will usually relive a traumatic event through flashbacks or nightmares, and may suffer from a wide variety of symptoms.

It’s important to note that feeling scared, altered, or experiencing some of the symptoms listed below after a traumatic event is normal. When we experience situations that are dangerous or scary, our body’s “fight or flight” response kicks in, which is caused by split-second changes in our body and is designed to help protect us from harm.

Most people are able to recover from the trauma of an event with time. However, those that don’t may develop PTSD, where the memories and trauma of an event start to impede on their daily lives, causing them to be stressed, anxious, or frightened even when they are not in danger.

It’s also important to realize that not every traumatized person develops PTSD, and not everyone with PTSD has to have been through a dangerous or traumatizing event. Also other circumstances, like the sudden lose of a loved one for instance, can cause PTSD in some people.

SYMPTOMS OF PTSD

The symptoms of PTSD are complex and unique to each patient. Some people may experience all of the symptoms listed below, while others only experience a few.

PTSD symptoms usually have a fast onset of roughly 3 months after a traumatic event. However some patients may take years to develop symptoms. In order to be diagnosed with PTSD, symptoms must last more than 1 month and need to be severe enough so as to affect a person’s daily life, relationships, or work.

PTSD symptoms can usually be categorized as re-experiencing symptoms, avoidance symptoms, arousal or reactivity symptoms, and cognitive/mood symptoms. In order for a physician to diagnose a patient with PTSD, the patient must display:

  • At least one re-experiencing symptom
  • At least one avoidance symptom
  • At least two arousal and reactivity symptoms
  • At least two cognition and mood symptoms

Re-experiencing symptoms can have an effect on a person’s daily life and generally include:

  • Flashbacks. This is where a patient relives a traumatic event multiple times. This can be accompanied by physical symptoms like sweating, a racing heartbeat, agitation, etc.
  • Nightmares.
  • Frightening thoughts.

Avoidance symptoms often lead a person to change his/her behaviour. Someone who was violently attacked or threatened when coming home late at night, for example, may avoid going out after dark. Avoidance symptoms generally include:

  • Avoiding place, objects, or people that remind one of the traumatic event.
  • Avoiding thoughts or feelings related to the traumatic event.

Reactive symptoms are usually constant and can interfere with one's daily life and activities. Reaction/arousal symptoms include:

  • Being startled easily.
  • Feeling and acting tense.
  • Angry outbursts.
  • Difficulty sleeping.

Cognition and mood symptoms usually begin or worsen after a traumatic event and can include:

  • Difficulty to remembering key events of the traumatic event.
  • Negative thoughts, both about oneself and the world in general.
  • Feelings of guilt or blame.
  • Loss of interest in activities one previously enjoyed.

MARIJUANA AND PTSD: WHAT DOES SCIENCE SAY?

Smoking marijuana has the reputation of being good against any kind of stress and has been popular amongst veterans since the infamous Vietnam War.

But even though unofficially it has been known amongst many veterans that cannabis helps, there has been very little research into marijuana as a treatment for PTSD.

We know that when administered, the cannabinoids in cannabis interact with a bunch of receptors that form part of our body’s natural endocannabinoid system and produce a variety of central nervous system effects, including increased feelings of pleasure and altered memory processes.

This provides reason to believe that cannabinoids may help in the treatment or management of the 3 core symptoms of PTSD: re-experiencing, hyperarousal, and avoidance.

4 small studies (identified in a 2015 article in the American Journal of Health-System Pharmacy) also showed that the use of cannabinoids was associated with global improvements in PTSD symptoms.

A 2012 review of clinical and neurobiological evidence for using cannabis resin to reduce PTSD symptoms also claims that cannabis may help “dampen” the strength or impact of memories and flashbacks, help patients rest or sleep, or feel less anxious. The review also stated that the evidence suggests the endocannabinoid system plays a crucial role in managing stress.

However, the biggest support for cannabis in treating PTSD comes from anecdotal evidence from veterans. Studies have shown that an increasing number of PTSD patients rely on cannabis to help manage their symptoms, and anecdotal evidence from interviews, studies, and other sources confirms this trend.

According to the US Department of Veterans Affairs, “cannabis use disorder” has been the most diagnosed substance abuse disorder among US veterans since 2009. The number of veterans with PTSD and “cannabis use disorder” increased almost 10% from 2002 to 2014.

Unfortunately anecdotal evidence isn’t enough to solidify the case for medicinal cannabis. Due to a lack of research, there are no set facts and figures that show whether marijuana is an effective or safe treatment for PTSD. The fact that cannabis affects individual users differently is also of concern. Some people get a soothing and calming effect from marijuana, while others can feel anxiety and even get panic attacks.

The fact that no clinical studies explicitly looked at cannabis and PTSD combined with the mixed evidence out there is one of the main reasons why the question of whether cannabis can help in the treatment of PTSD doesn’t have a concrete answer. However, that might soon change.

NEW RESEARCH UNDERWAY

In February 2017, the first ever study to look at how cannabis use affects PTSD in veterans went underway in Phoenix, Arizona, USA thanks to approval by the FDA.

The study will be conducted by the California-based Multidisciplinary Association for Psychedelic Studies (MAPS), which has already done some pioneering research on the use of psychedelic substances in medicine.

The study will be held over 4 years and will explicitly evaluate the safety and efficacy of using marijuana to manage PTSD symptoms in 76 US veterans.

The study will test 4 different potencies of cannabis. The first is a placebo cannabis strain with no THC. Two strains will contain 6% and 12% THC respectively, while the fourth will contain 6% CBD.

The participants will smoke up to two joints' worth of marijuana every day from small pipes and also self-administer at home and capture it on video. Neither the participants nor the researchers will know who’s getting what strain.

Participants will have to undergo 17 clinic visits over 12 weeks, a six month follow-up visit, as well as drug screening tests to determine how much THC is in their bloodstream. This study will mark the first real look at cannabis and whether it can help treat the symptoms of PTSD.

HOW CAN PTSD PATIENTS USE CANNABIS?

Medicinal cannabis laws vary. In 2017 in the US, cannabis is legal for medicinal use in 29 states and Washington DC. PTSD is an approved condition under medical marijuana laws in the following US states:

  • Arizona
  • Arkansas
  • Delaware
  • Florida
  • Hawaii
  • Illinois
  • Maine
  • Maryland
  • Michigan
  • Minnesota
  • Montana
  • Nevada
  • New Jersey
  • New Mexico
  • North Dakota
  • Ohio
  • Oregon
  • Pennsylvania
  • Washington
  • West Virginia

Outside of the US, medicinal cannabis is legal in Canada (where it can be prescribed for PTSD), Australia, Argentina, Chile, Croatia, and more. If you live in a region where medical cannabis is legal, consult your local laws for more information of whether PTSD is an eligible condition under the program.

THE FUTURE OF WEED AND PTSD

Unfortunately, there is still a lot of mystery surrounding cannabis and how it may affect people with PTSD. For now, all we have anecdotal reports and very limited evidence. However, thanks to new research like that conducted by MAPS, hopefully it won’t be long before we understand the full medical potential of cannabis.

Note: We have taken the utmost care and precaution whilst writing this article. That being said, please take note of the fact that we are not medical professionals of any kind. Cannabis.info is strictly a news and information website. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment.