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Post-traumatic stress disorder is a condition we usually associate with combat veterans, but it can happen to all kinds of people. Anyone who experiences or sees a life-threatening or disastrous event might develop PTSD. Rape and torture victims, as well as people who have been in situations with mass death or suffering, may suffer from it. It’s not the same as simply feeling upset after such an event, even for a period of weeks. A condition is clinically recognized as PTSD only if it lasts for more than four weeks and causes persistent distress or interferes with normal living.

Four symptoms are characteristic of PTSD. There’s a gray area between natural distress and PTSD, so it’s necessary to consider their extent and persistence.

  • Avoidance. While it’s natural not to want reminders of the event, a strong need to avoid anything reminiscent of it can be a symptom.
  • Flashbacks. Vivid and repeated memories of the event are characteristic of PTSD. If they are so strong they feel like re-experiencing the event, either in waking hours or in nightmares, that’s a matter for special concern.
  • Fear, depression, or guilt. Persistent and intense negative feelings related to the event can indicate PTSD, especially if they result in a change in attitude toward oneself and others.
  • Hyperarousal. Feeling a constant sense of danger or irritability may be a symptom. It’s a matter of concern if it results in unhealthy behavior or difficulty in concentration or sleeping.

Does cannabis help PTSD sufferers? The question is a topic of hot debate. Advocates of legalization tend to say yes, and opponents tend to say no, but the only way to answer it is scientific research. The Multidisciplinary Association for Psychedelic Studies has received funding from the State of Colorado to conduct a study of its use with veterans suffering from the condition. The tests are still under way and no conclusions have been reached yet. When completed, it will be the most extensive study of the question so far.

The US Department of Veterans Affairs says that there has been no systematic study of the treatment’s effectiveness, though there have been anecdotal reports that cannabis treatment has helped individuals with PTSD symptoms. It notes that “the human endocannabinoid system plays a significant role in PTSD,” with a higher level of CB1 (cannabinoid type 1) receptor availability in people with the condition.

Improper function of the endocannabinoid system may be a contributing factor to PTSD. Studies associate fatty acid amide hydrolase (FAAH) activity with hyperarousal and aversive memories (flashbacks). FAAH is an enzyme associated with endocannabinoid metabolism. A 2007 paper in Dialogues in Clinical Neuroscience says that there is evidence that cannabinoids help to reduce the effects of PTSD, but THC (the primary active chemical in cannabis) doesn’t appear to contribute much. CBD, a non-psychoactive FAAH inhibitor found in marijuana, may play a more positive role.

A pilot study on oral administration of THC to ten PTSD patients found “statistically significant improvement” in symptoms. Three of them experienced mild adverse effects but didn’t need to discontinue the treatment.

Several states list PTSD as a qualifying condition for medical marijuana. Each one listed here links to a page on the state’s site with information on how to apply.

Anyone seriously considering cannabis as a treatment for PTSD, whether by prescription or self-treatment, should first consult with a doctor. Not all doctors will feel safe recommending it, but they can advise of any negative factors that apply to the patient. Anyone planning self-treatment may also want to seek legal advice. This is an area that will require more research before any strong conclusions are possible.

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