Cannabis and PTSD

Post Traumatic Stress Disorder is sadly a common disorder and one that did not have a name for a long time.  They didn’t know how to explain why daddy dives under the coffee table every time the screen door slams shut or why he won’t follow a certain route when taking us to school.

The brains response to exposure of traumatic events can leave a litany of debilitating symptoms in its wake.  Intrusive memories such as flashbacks, dreams, avoidance, negative changes in thinking and mood, changes in emotional reactions such as hyperarousal, trouble concentrating and sleep patterns are bound to impact the lives of the affected individual.

It is estimated that 5 million people have PTSD (I believe this is a US figure) but world wide this number would reach millions more.  I’m not sure that many governments around the world care that their citizens suffer from PTSD, let alone take a tally; so determining the extent of the problem is a 'guessing game.'

What we do know is that the effects can last for generations.

The bright side.

Recently, medical marijuana has been given more and more consideration as positive results treating with cannabis becomes evident.  Dr. Sanjay Gupta’s last documentary Weed 3 revealed some encouraging statistics and shed a national spotlight on the topic.

Raphael Mechoulam
Dr. Raphael Mechoulam

Dr. Raphael Mechoulam of Israel, he’s the scientist we can thank for discovering THC, explains it this way.  Mice which have been administered an electric shock after a certain noise will eventually forget about the shock after the noise appears alone for a few days.  Mice without cannabinoid systems simply never forget, they continue to cringe at the noise indefinitely.

This has implications for the PTSD patient trying to get control of their reaction to stimuli.  Dr. Mechoulam has gone on to explain that PTSD patients have decreased levels of anandamide, one of the endocannabinoids, and have an endocannabinoid deficiency.  

A second opinion.

In addition, Dr. Irit Akirav explains in his article published June 5, 2014 in Neuropsychopharmacology, when stimuli presents itself, the brain receptors CB1 and GR, associated with emotional processing, increase.  In rats, synthetic CBD prevented the increase of these two receptors involved in the forming and saving of traumatic memories in the hippocampus and prefrontal cortex.  It appears the synthetic marijuana compound was effective in decreasing PTSD symptoms if administered within 24 hours of a traumatic event experience.  It seems the connectivity with the brain’s fear circuit after trauma may be prevented by CBD’s.  

Many discoveries are happening all the time about the neuroprotective qualities of medical marijuana.  So we’ve heard from the mice and rats, what about the human.

Research was conducted and patients evaluated under the New Mexico Medical Cannabis Program.  From 2009 - 2011, statistics on eighty patients were gathered to analyze the psychometric data on PTSD symptoms.  Using the CAPS system, meaning Clinician Administered Posttraumatic Scale, a 22 item scale scoring 0-4 on validity, severity, improvement as well as rating social and occupational functioning, greater than 75% of the patients had reductions in their scores when they were using cannabis.  Greater than 75%, that’s huge!  (1)

Dr. Mechoulam recommends treating PTSD with cannabis starting with low to moderate dose.  The goals, according to Dr. Mechoulam, is to produce stable blood levels.  He goes on to say, “since peak levels will produce the most soporific (inducing drowsiness) effect, administration of oral cannabis right before bed should produce the most benefits for improving sleep patterns.  If the goal is to use cannabis to facilitate extinction of the response to PTSD triggers then small to moderate doses of cannabis vapors should be administered shortly before planned exposure to the trigger.  A series of regular extinction sessions will produce better results than a single session. If cannabis appears to make a version, fear, or aversive memories worse then the dosage should be lowered.  If feelings of fear do not improve with lower dose then discontinue use of cannabis as fear-extinction aide.”  (2)

Thankfully, research is continuing everyday on the benefits of medical cannabis for PTSD and as a side note: Dr. Sue Sisley, a world renowned PTSD researcher, has found new digs in Colorado and will continue her ground breaking work on the topic.  Can’t wait!

(1) http://www.ncbi.nlm.nih.gov/pubmed/24830188
(2) http://veteransformedicalmarijuana.org/content/general-use-cannabis-ptsd-symptoms