Cannabis: A Viable Treatment for PTSD?

Cannabis for PTSD?

Self-medication is a common practice, whether it’s eating, smoking, sleeping, etc. There’s always a “fix” for an infirmity not professionally prescribed. In an era where previously illegal substances are becoming medically available, namely marijuana, the relevance of antidote to condition is on the mind of healthcare providers and patrons alike. One such condition under the scrutiny of all is PTSD (Post-Traumatic Stress Disorder). The question is cannabis an appropriate treatment for PTSD? This article will look at the factors surrounding the issue of making marijuana available to patients suffering from PTSD.

What is PTSD

PTSD (Post-Traumatic Stress Disorder), as defined by the NIH (National Institute of Mental Health), is a disorder that develops in some people who have experienced a shocking, scary, or dangerous event. Furthermore, symptoms must last more than a month and be severe enough to interfere with relationships or work to be considered PTSD.

Quick Stats Breakdown:

All statistics provided here by The U.S. Department of Veterans Affairs from their article, How Common is PTSD?

  • About 7 or 8 out of every 100 people (or 7-8% of the [U.S.] population) will have PTSD at some point in their lives.
  • About 8 million [U.S.] adults have PTSD during a given year. This is only a small portion of those who have gone through a trauma.
  • Operations Iraqi Freedom (OIF) and Enduring Freedom (OEF): About 11-20 out of every 100 Veterans (or between 11-20%) who served in OIF or OEF have PTSD in a given year.
  • Vietnam War: About 15 out of every 100 Vietnam Veterans (or 15%) were currently diagnosed with PTSD at the time of the most recent study in the late 1980s, the National Vietnam Veterans Readjustment Study (NVVRS). It is estimated that about 30 out of every 100 (or 30%) of Vietnam Veterans have had PTSD in their lifetime.

It’s not hard to see that these numbers provide clear indication of a recurring mental health issue, on a presumably global scale. This population is a significant market for healthcare providers to cater to. Obviously every pharmaceutical company wants a piece, but could be cannabis as a treatment be formidable competition let alone the doctor’s recommendation?

Government Case Studies

Doctor Bonn-Miller and Doctor Rousseau with the USDVA (U.S. Department of Veterans Affairs) address the government’s position on marijuana treatment for PTSD on the official’s website, ptsd.va.gov.  As of May 10th 2017,

Controlled studies have not been conducted to evaluate the safety or effectiveness of medical marijuana for PTSD. Thus, there is no evidence at this time that marijuana is an effective treatment for PTSD. In fact, research suggests that marijuana can be harmful to individuals with PTSD.

The USDVA, although having no formal study, do have indirect data to show a growing trend in the use of marijuana in veterans with PTSD. The percentage of Veterans in VA with PTSD and SUD (substance use disorders) who were diagnosed with cannabis use disorder increased from 13.0% in fiscal year (FY) 2002 to 22.7% in FY 2014. As of FY 2014, there are more than 40,000 Veterans with PTSD and SUD seen in VA diagnosed with cannabis use disorder.

The trend shows a rising correlation between PTSD and substance abuse, the substance specifically being marijuana. But the attitude of the USDVA toward this trend isn’t an amiable one. Apprehensions about the method of treatment begin with the adverse effects of marijuana consumption. “Medical problems include chronic bronchitis, abnormal brain development among early adolescent initiators, and impairment in short-term memory, motor coordination and the ability to perform complex psychomotor tasks such as driving. Psychiatric problems include psychosis and impairment in cognitive ability.” Included with these problems are addiction and withdrawals, which are only exacerbated in patients suffering from PTSD.

Public Case Studies

Regardless, the information gathered is inconclusive and of little consequence until a formal case study is completed. Fortunately, the State of Colorado has awarded $2,156,000 grant to MAPS (Multidisciplinary Association for Psychedelic Studies) to “explore whether smoked marijuana can help reduce PTSD symptoms.” Taking place at the Scottsdale Research Institute (SRI) in Phoenix, Arizona, this clinical trial will evaluate the safety and efficacy of four different potencies of marijuana for symptoms of PTSD in 76 U.S. veterans. This is the first ever study of its kind. According to the Study Protocol, because it is a pilot study in a small sample, results will be used to assess variability of the outcome measures as inputs for calculation of sample sizes for adequately powered subsequent studies. Basically, they are leaving the table open for drawing conclusions and developing further studies.

During the first stage, subjects of the study are required to record the act of self-administering the marijuana. They are allowed up to 1.8 grams per day, but do not have to consume it all if the PTSD symptoms do not warrant its use.  Subjects will have their THC and CBD levels monitored to ensure the prescribed daily dosage is being taken. Also required, is a daily diary entry, and an on-site weekly evaluation of the subjects well-being. After 3 weeks of consumption, there will be a 2 week cessation period. No marijuana will be consumed for those two weeks, but subjects will continue to provide daily self-assessments.

The next two stages of the study are essentially the same as the first, with the exception of changing the marijuana’s potency. The last stage will continue until all marijuana for the study has been consumed (estimated 2 continuous months).

As of June 1 2017, only 18 participants are enrolled in the study. The total duration of the study is unclear at this time. No conclusive data is available yet, but according to the Study’s Protocol, results will provide information regarding marijuana dosing, composition, side effects, and specific areas of benefit to clinicians and legislators considering marijuana as an acceptable treatment for PTSD.

Another MAPS program, Project CBD, directed by Martin Lee, is able to provide insight on the effects of marijuana on PTSD. In a company newsletter, Lee describes a study done on 46 individuals involved in the 9/11 terrorist attacks:

The researchers found that people with PTSD had lower serum levels of anandamide, an endogenous cannabinoid compound, compared to those who did not show signs of PTSD after 9/11. Innate to all mammals, anandamide (our inner cannabis, so to speak) triggers the same brain receptors that are activated by THC (tetrahydrocannabinol: The High Causer) and other components of the marijuana plant. Concentrated in the brain and central nervous system, the cannabinoid receptor known as CB-1 mediates a broad range of physiological functions, including emotional learning, stress adaption, and fear extinction. Scientists have determined that normal CB-1 receptor signaling deactivates traumatic memories and endows us with the gift of forgetting.

This information is pertinent to Lee and his team because of their research on CBD and its effects on the CB-1 receptor. CBD (Cannabidiol) is an active cannabinoid in marijuana with properties shown to enhance endocannabinoid tone and activate the CB-1 receptor.

So if CBD is an identifiable treatment for the underlying cause of mental illness such as PTSD and depression, then why is the FDA still blocking approved research? There may not even be an answer to the question. NYU’s Neumeister contends that despite “their potential therapeutic value, direct-acting cannabinoid receptor compounds [such as THC] have very limited medical applications, mainly because of their undesirable psychotropic side effects and ability to cause addiction.”

In an attempt to circumnavigate the negative side effects of marijuana, researchers like Neumeister are intent on developing a synthetic activator for the CB-1 receptor. This compound will provide a greater control over side effects and better predication of biological responses to treatment.

Alternative Treatment Options

There are two other prevalent forms of treatment for PTSD. The first being psychotherapy or talk therapy. In their article on PTSD Treatment, Mayo Clinic provides several methods of talk therapy.

  • Cognitive therapy. This type of talk therapy helps you recognize the ways of thinking (cognitive patterns) that are keeping you stuck — for example, negative beliefs about yourself and the risk of traumatic things happening again.
  • Exposure therapy. This behavioral therapy helps you safely face both situations and memories that you find frightening so that you can learn to cope with them effectively. Exposure therapy can be particularly helpful for flashbacks and nightmares. One approach uses virtual reality programs that allow you to re-enter the setting in which you experienced trauma.
  • Eye movement desensitization and reprocessing (EMDR). EMDR combines exposure therapy with a series of guided eye movements that help you process traumatic memories and change how you react to them.

The other primary form of treatment is through pharmaceuticals (Mayo Clinic).

  • Antidepressants. These medications can help symptoms of depression and anxiety. They can also help improve sleep problems and concentration.
  • Anti-anxiety medications. These drugs can relieve severe anxiety and related problems. Some anti-anxiety medications have the potential for abuse, so they are generally used only for a short time.
  • Prazosin. If symptoms include insomnia with recurrent nightmares, a drug called prazosin (Minipress) may help. Although not specifically FDA approved for PTSD treatment, prazosin may reduce or suppress nightmares in many people with PTSD.

Is cannabis an appropriate treatment for PTSD?

Despite the need to develop more effective cannabis based medication without any adverse side effects, marijuana offers some promising medical revelations. It’s unfortunate that the health benefits of cannabis are not being recognized by federally backed research, however general awareness and demand for the data is growing rapidly. We’re not trained medical staff, we can’t recommend how PTSD “should” be treated. Please consult with your personal doctor before deciding on which treatment is right for you or someone you know suffering with PTSD.

If this article has been a helpful source of information please like, share, comment, pass the blunt, etc…

Do you or someone you know struggle with PTSD? Let us know in the comments how cannabis has (or hasn’t) helped with the coping and recovery process!

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Cover Photo: Jayel Aheram

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Editorial Staff

Editorial Staff

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