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Marijuana and PTSD

Marijuana and PTSD

PTSD symptoms

Some studies suggest that marijuana can help ease symptoms of PTSD, but other studies show the opposite.

Post-traumatic stress disorder (PTSD) is a mental health disorder that can develop after seeing or experiencing a disturbing event.

The symptoms of PTSD can be severe, and unfortunately, treatment does not help everyone. Many people who suffer from PTSD use cannabis to help with their symptoms, but evidence is conflicting.

Clinical studies are underway, and these results should help clarify the relationship between marijuana and PTSD.

What is PTSD?

What is PTSD
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Post-traumatic stress disorder (PTSD) is a mental health condition that can develop in people that have experienced or witnessed a traumatic event. This can include a life-threatening accident, sexual assault, violence, war or a natural disaster, among others.

PTSD was once known as “shell-shock” because it affected soldiers returning from war. But we now know that PTSD does not only affect war veterans. A person from any background can experience PTSD.

Symptoms of PTSD

The symptoms of PTSD can be different for each person. The most common symptoms fall into one of four categories:

Intrusive thoughts – Intrusive thoughts are unwanted thoughts that are difficult to control. They can be repeating memories, nightmares or flashbacks of the traumatic event. Intrusive thoughts are very vivid, and can make sufferers feel like they are re-living events.

Avoiding reminders – People with PTSD may avoid people, places, objects or situations that remind them of the traumatic event. They may also try not to talk about or remember the event.

Negative thoughts – Negative thoughts related to PTSD may include fear, anger, shame or horror. People that survived an event that killed others may also suffer from survivor guilt.

Hypervigilance – Those with PTSD may be more irritable and on edge. People may have trouble sleeping or concentrating, and may be startled more easily than usual. Outbursts of anger and self-destructive behaviour are also common.

Can Marijuana Help Treat PTSD?

Can Marijuana Help Treat PTSD
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Although marijuana is not currently an approved treatment for PTSD, some doctors and patients believe that it can help with PTSD.

Marijuana use is more common in those with PTSD, and those with more severe symptoms are more likely to use marijuana. This suggests that marijuana could be helping them to cope.

Scientists don’t yet know exactly how marijuana works to treat the symptoms of PTSD. But given that so many people with PTSD report symptom relief from cannabis use, it seems likely that there is potential for using cannabis to help with PTSD symptoms.

However, some scientists aren’t as convinced that cannabis has any benefit for people with PTSD. A 2017 review found that there simply isn’t enough evidence to say that cannabis helps people with PTSD.

Another 2017 study of patients that used cannabis while they were receiving therapy for PTSD found that cannabis use actually had no effect on PTSD symptoms, either for better or for worse.

The Multidisciplinary Association for Psychedelic Studies (MAPS) has begun a clinical trial of cannabis for veterans with treatment-resistant PTSD. The study will test the safety and efficacy of four different strengths of marijuana as a PTSD treatment for US military veterans.

The results of the MAPS clinical trials will help settle this ongoing debate.

Benefits of Marijuana For PTSD

Benefits of Marijuana For PTSD
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There are a number of ways that marijuana could help patients with PTSD. Marijuana may be able to relieve certain symptoms of PTSD, such as anxiety and sleep problems.

There is also some evidence that the naturally-occurring endocannabinoid system may be dysfunctional in people with PTSD.

Sleep quality

People with PTSD are more likely to use cannabis than people without PTSD, and many of these patients are using it for sleep disturbances. A 2014 study found that sufferers with worse sleep problems were more likely to self-medicate with marijuana.

Medical marijuana has also been prescribed to some people with PTSD. Nabilone is a drug that was created to mimic the effects of THC.

A 2009 study found that 72% of PTSD patients taking nabilone had significantly fewer nightmares during treatment. Patients also reported better overall quality of sleep, reduced night sweats and even fewer flashbacks during the day.

A 2017 study found that THC may actually impair sleep quality with long-term use, but that CBD may increase sleep quality and reduce daytime sleepiness.

Anxiety relief

Some people with PTSD report that they use cannabis for general relaxation, even though there are no scientific studies confirming that cannabis can actually ease PTSD-related tension.

Those who self-medicate their PTSD with marijuana believe that it can help reduce feelings of hyperarousal and the anxiety that is caused by triggers and reminders of their trauma.

Easing fear memory

Early animal studies have found that cannabis has a protective effect when it comes to developing PTSD.

In a 2017 study, researchers found that CBD can block the learning of fear memories, and even speed up the process of forgetting fearful events. Similar studies have not yet been done in humans.

Can Marijuana Make PTSD Worse?

Can Marijuana Make PTSD Worse
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In addition to evidence that cannabis may improve outcomes for people with PTSD, there are also a number of studies showing that marijuana can actually make PTSD worse.

Marijuana may worsen PTSD symptoms

One criticism of using cannabis to help PTSD symptoms is that the anti-anxiety effects are unreliable. Cannabis can increase anxiety even in healthy people, and has been reported to occasionally increase the severity of PTSD symptoms.

A 2015 study on war veterans concluded that using cannabis is not advisable for PTSD patients. They found that marijuana made PTSD symptoms worse, and that marijuana use was correlated with more violent behaviour.

Of course, these results might not necessarily mean that cannabis use leads to worse PTSD symptoms. It is possible that people suffering from worse PTSD symptoms are more likely to use marijuana to help them cope.

Marijuana as an emotional crutch

In some cases, it is possible that people turn to marijuana to help their PTSD because they do not have other coping skills. In other words, they are using marijuana as an emotional crutch.

A 2010 study found that PTSD patients who have trouble controlling their emotions are more likely to use marijuana to help manage their PTSD symptoms.

For these patients, using marijuana may actually prevent them from developing non-drug ways to cope with their disorder. This can lead people to develop less healthy coping skills (such as increased drug use), and cause them greater harm in the long-term.

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THC vs. CBD

THC vs. CBD
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When using marijuana in a medical context, it is always important to consider its cannabinoid content.

THC is marijuana’s main psychoactive compound, responsible for its euphoric, relaxing high. It can also help induce sleep, which can be beneficial for PTSD-related insomnia sufferers.

However, THC has some side effects, including paranoia and increased anxiety. These effects may be intolerable for someone with PTSD.

CBD, on the other hand, is non-psychoactive and is considered to have many medical benefits.  CBD has anti-anxiety and antipsychotic properties, which are thought to balance out the oftentimes intense effects of THC.

When it comes to medical marijuana, it makes sense to include CBD in any treatment for PTSD. Some patients who are sensitive to anxiety and paranoia may prefer to forego THC entirely in favour of CBD-only therapy.

In the future, studies could test the specific roles of THC and CBD in the treatment of PTSD.

What Are Experts Saying?

What Are Experts Saying
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Cannabis researcher and expert Dr. Raphael Mechoulam weighed in on the marijuana for PTSD debate in an article for Veterans For Medical Cannabis Access.

Dr. Mechoulam, a pioneer of cannabis research and the discoverer of THC, believes that cannabis can help treat symptoms of PTSD. But he also thinks that’s not where treatment ends.

“Mostly the use of cannabis and THC to treat PTSD in humans appears to provide symptomological relief at best. In and of itself, there is nothing wrong with symptomological relief … We do have the potential, however, to do better than just treating symptoms of PTSD via activation of the cannabinoid receptors.”

He believes that a combination of psychotherapy and cannabinoid medicine has the potential to cure PTSD. In addition, Dr. Mechoulam believes that marijuana may not be the best way to use the endocannabinoid system for PTSD.

Instead, he points to research on the inhibition of FAAH, an enzyme that breaks down one of the body’s natural cannabinoids, known as anandamide. Interestingly, inhibition of FAAH is one of CBD’s many effects.

Dr. Mechoulam also adds a few tips for those using marijuana for PTSD. He says that when treating PTSD, it’s important to use low doses and keep the blood concentration of cannabinoids stable. He suggests that one of the best ways to do this is by using edible marijuana products.

Summary

There is not much research on the link between marijuana and PTSD, but many people believe it can help.

Some studies suggest that marijuana can help relieve symptoms of PTSD including intrusive thoughts, nightmares and anxiety.

However, other research warns that marijuana can have negative effects on PTSD, including increasing anxiety and limiting the ability to develop healthy coping strategies.

Marijuana’s effects on PTSD may depend on the cannabinoid content. THC is relaxing and euphoric, but may cause anxiety and paranoia. CBD is non-psychoactive and has anti-anxiety effects.

Overall, more research is needed to determine whether marijuana can help with PTSD. The results of ongoing clinical trials will help to settle the debate.

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