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PTSD: Is Cannabis a Viable Treatment?

Post-traumatic stress disorder (PTSD) can be incredibly debilitating that can adversely affect numerous aspects of one’s life — including relationships, physical and emotional health, one one’s overall quality of life. With more than half of states in the U.S. (and the District of Columbia) having legalized clinical cannabis, increasingly many patients with PTSD are turning to cannabis as a treatment.

While cannabis may be safer than many of the prescription drugs patients use to treat PTSD, we don’t have a lot of large, high-quality studies investigating cannabis as a treatment for PTSD. The reason there have been so few studies is that the federal government continues to classify cannabis as a Schedule I drug — the most severe Schedule of drugs such as heroin that the government considers to be dangerous and highly addictive. Being a Schedule I drug creates numerous bureaucratic and financial hurdles to conducting the type of high-quality studies we need to validate the efficacy and safety of cannabis to treat PTSD.

The Endocannabinoid System

Our bodies have our very own natural “cannabis system,” called the endocannabinoid system (ECS). The primary role of the ECS is to promote homeostasis. It helps maintain balance. In fact, the ECS is involved in virtually every aspect of our physical and emotional health. Cannabinoids, whether produced naturally in the body (endocannabinoids) or in the cannabis plant (phytocannabinoids), influence our endocannabinoid system by interacting with receptors (CB1 and CB2).

Endocannabinoid deficiencies are associated with poorer physical and emotional health, with the CB1 receptor appearing to play a highly influential role in PTSD.

  • CB1 receptor signaling plays an important role in ensuring appropriate responses to perceived environmental threats and processing of aversive memories (that underlie PTSD)
  • A decrease in anxiety : Increased levels of “anandamide” — a natural cannabinoid produced in the body that acts similarly to THC (also called the “bliss molecule”) —  and enhanced CB1 receptor signaling is associated with a decrease in anxiety and healthy fear memory extinction. Cannabidiol (CBD) appears inhibit activity of an enzyme ( FAAH ) that is known to degrade 2-AG and anandamide, which could elevate anandamide and 2-AG levels.

A multi-institutional team of researchers from NYU, Yale, Harvard, and the University of California at Irvine medical schools, found that, on average, the PTSD group had anandamide levels 53.1% lower than individuals who prior trauma exposure, but were otherwise healthy and not suffering from PTSD. In comparison to health individuals with no history of trauma, the PTSD group had 58.2% lower anandamide levels.

Anandamide is our body’s natural version of THC, the primary psychoactive ingredient in cannabis. So it’s scientifically plausible that if a person has a deficiency in anandamide, compensating with MMJ could alleviate symptoms. Notably, activities like exercise can also boost anandamide levels (which has associated with the “runner’s high” people sometimes feel after intensive exercise).

What Does the Research Say?

Michael Krawitz, the head of Veterans for Medical Cannabis Access, notes, “Cannabis is a [traumatic] memory eraser,” and that research suggests medical marijuana may help reduce nightmares. Flashbacks and nightmares are a common symptom among PTSD patients. Krawitz adds that commonly prescribed drugs (including opioids, benzodiazepines, and powerful anti-psychotic meds) can leave patients “feeling like zombies.” Krawitz explains that many patients find that while many prescription drugs fall short, cannabis helps them function more normally.

Studies seem to support the anecdotes:In an animal study, Brazilian researchers found that boosting cannabinoid levels can reduce anxiety, possibly by helping extinguish traumatic fear memories. The researchers believe CBD may be able to help improve

In an animal study, Brazilian researchers found that boosting cannabinoid levels can reduce anxiety, possibly by helping extinguish traumatic fear memories. The researchers believe CBD may be able to help improve efficacy of exposure-based psychotherapies.

In 2009, researchers published a case series of PTSD patients in the Neuroscience and Therapeutics journal. Researchers assessed 47 patients who didn’t respond favorably to other treatments to block recurring nightmares. The group were given THC.

  • 6 patients experienced a significant reduction in nightmares
  • 28 patients no longer experienced nightmares at all
  • 72% reported statistically significant improvements in symptom management

An Israeli study from 2010, followed 80 PTSD patients over a period of three years. They found most patients experienced an improvement in quality of life. Another Israeli study in 2012, followed 29 male combat veterans. The study participants received smokable cannabis. Patients experienced, on average, a 40% reduction symptoms as based on the CAPS assessment (the most commonly used assessment to assess PTSD symptoms).

And, finally, researchers in New Mexico also conducted a study using the CAPS assessment to track patient outcomes. The study found that patients showed a significant reduction in the three PTSD symptom clusters:

  • reexperiencing the traumatic event
  • avoidance of cues that reminded them of the event
  • hyperarousal such as sleep disturbances and exaggerated responses to stimuli)

Patients reported, on average, a more than 75% reduction in all three of these symptom clusters. The scientists claim their findings are consistent with early research demonstrating the role of the ECS in emotional regulation and memory processing.There are no “magic pills” — or “magic plants” — that can “cure” PTSD. But, research increasingly supports the claims of medical marijuana patients with PTSD who report positive outcomes with cannabis. Many patients claim cannabis is the “only thing” that helps them manage symptoms. Given that our limited research along with the scientific plausibility of cannabis as a medicine, we certainly owe it the patient populations — many of whom are veterans — to accelerate research on cannabis as a treatment for PTSD. We owe it to them!

There are no “magic pills” — or “magic plants” — that can “cure” PTSD. But, research increasingly supports the claims of clinical cannabis patients with PTSD who report positive outcomes with cannabis. Many patients claim cannabis is the “only thing” that helps them manage symptoms. Given that our limited research along with the scientific plausibility of cannabis as a medicine, we certainly owe it the patient populations — many of whom are veterans — to accelerate research on cannabis as a treatment for PTSD. We owe it to them!

1 Comment

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    Marian
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