Cannabis and Post-Traumatic Stress Syndrome

Cannabis and PTSD

Modern Medicine and PTSD

Modern medicine has very little to offer patients in terms of pharmaceutic help for PTSD sufferers.  In 2008, the IOM reported that SSRIs (antidepressants that are one of the FDA approved drugs for PTSD treatment) are ineffective. Many of the medications currently prescribed can also cause serious adverse reactions.  There is also treatment resistant PTSD.  These patients can’t take standard medications and are often left with therapy only, which is ineffective in many cases.  Recent studies indicate that this disease has its origins within the endocannabinoid system (ECS).  Pet scan studies have shown that these patients have increased receptors (CB1 receptors) located within the brain.  Other systemic abnormalities include decreased levels of cortisol and anandamide (AEA).  Three specific biomarkers (CB1 receptor numbers, cortisol levels, and anandamide levels) correctly classified 85% of PTSD cases in one particular study.  This finding suggests that there may be a problem with regulation of anandamide levels mediated by the CB1 receptor.  Anandamide is essential to help suppress negative, traumatic memories.

What Is PTSD?

PTSD, or post traumatic stress disorder, is defined by the Mayo clinic as “a mental health condition that’s triggered by a terrifying event — either experiencing it or witnessing it. Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event.”  Most people are able to adjust with time and self-help after a trauma.  Some people do the opposite with escalating symptoms that interfere with every day life and last months or years.  Symptoms of PTSD may appear as soon as a month after a trauma, but sometimes they may not appear until years later.  The symptoms of PTSD make it very difficult to go about daily life or manage work and social relationships.  These symptoms are divided into four different categories: intrusive memories, avoidance, negative changes in thinking and mood, and changes in physical and emotional reactions.  Movies often depict the typical sufferer as having a military service background and involving sudden and intense flashbacks to war-related horrors and bombings.  In truth many sufferers are assault or abuse victims, disaster survivors, or witnesses to horrific crimes or events.  It is estimated that about 7-8% of the population will develop PTSD sometime in their life.  Symptoms are often not as explosive, up-front, and intense as depicted in these films but are just as life-altering and debilitating.  

Cannabis and PTSD

Cannabis medication offers PTSD sufferers new hope as more studies indicate a positive effect on the symptoms of this debilitating disease.  One medical clinic in New Mexico reported that their PTSD patients had a 75% decrease in overall symptoms with cannabis use measured by CAPS scores (a gold standard psychologic test used for PTSD).  Cannabis contains hundred on ingredients commonly called cannabinoids and terpenes.  These substances have been shown to interact with our endocannabinoid system and represent a potential replacement or therapy to help correct low anandamide levels.  This is possible by acting as a substitute, such as using the cannabinoid THC, to activate the CB1 receptors and/or stop the natural “demolition” of already circulating levels.  THC is also thought to shorten the “dreaming” phase of sleep to help reduce the night terrors suffered by many.  Another particular cannabinoid called THCV has been shown to stimulate another receptor called the 5-HT1A receptor.  This activation can produce antipsychotic effects which is helpful in PTSD and schizophrenia as well. 

CBD and PTSD

CBD is a popular, non-psychoactive cannabinoid that has been shown in many medical clinics to be effective in helping to reduce the everyday “stress” part of PTSD.  It has been shown to help form the backbone of effective PTSD therapies when used with THC as reported by leading cannabis physicians.  THC and CBD both have been shown in research studies to decrease the conditioned fear response in humans.  PTSD is a long-term, chronic condition that requires a long acting form of administration to fully control symptoms.  As such, inhalation forms which only work for a short time make it difficult to fully manage this condition.  Longer acting formulas such as sublingual or edibles should be considered  with inhalation methods (smoking or vaping) used for break through symptom control.  This prevents patients from “chasing” their symptoms.  Studies have shown that PTSD patients using edibles are better able to make the connection of “I shouldn’t be anxious in this situation” and have an increased self-awareness.  Cannabis users also report that thought intrusions and irritability improve over time.  These exciting medical findings have been noted by one particular pharmaceutical company, GW Pharmaceuticals, who is exploring the potential of their cannabis-derived Nabiximols to reduce the sleep disturbance symptoms associated with PTSD, as well as anxiety and irritability.  A phase 2/3 study in PTSD will have approximately 325 subjects and is expected to be started in early 2021.  Nabiximols is known as Sativex outside of the US and contains THC, CBD, minor cannabinoids and non-cannabinoid plant components, like terpenes, sterols, and triglycerides. 

Some cannabis strains suggestions for PTSD: Master Kush, Cannatonic, Blue Dream, Pineapple Express, OG Kush, Sunset, Texada, Granddaddy Purple, Blueberry Kush, Northern Lights.  Terpene examples to look for: linalool, limonene.  Users may want to use caution with pinene since it may REDUCE short-term memory loss (memory reduction in PTSD is a good thing for many).  It is also know to induce anxiety in some people.  High CBD strains can be effective as well, especially if suffering from mood swings and bursts of anger.

Written By: Melissa Cornwell
Writer For Ark420 & CannaCook

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