PTSD and Medical Marijuana

By Gooey Rabinski | June 30, 2015

Post Traumatic Stress Disorder, or PTSD, is an anxiety disorder that afflicts some people who have lived through a highly stressful event, such as warfare, child abuse, sexual assault, terrorism, kidnapping, or other threats to a person’s life.

It is estimated that 11-30 percent of soldiers returning from military combat in Iraq or Afghanistan have PTSD. Around 7.7 million Americans are estimated to have the disorder, commonly associated with war veterans. The main symptoms of this psychologically crippling condition are depression, flashbacks, and anxiety — although pain, insomnia, and nightmares are also common.

Patients with PTSD respond to key stimuli and events that remind them of their initial trauma, even when this response is no longer appropriate. Cannabis, by aiding in something called memory extinction, may help sufferers reduce their association between stimuli (often loud noises or stressful situations) and the traumatic events from their past.

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“There is mounting evidence demonstrating the benefits of medical marijuana for individuals suffering from PTSD,” said Chris Lindsey, legislative analyst for Marijuana Policy Project. The greatest role of cannabis for PTSD patients is a reduction in stress. This reduction, in turn, also decreases all PTSD symptoms, including panic attacks, excessive anger, insomnia, and depression.

In New Mexico, the first state to allow PTSD sufferers to treat their condition with cannabis in 2009, 27 percent of those holding a medical license qualified based on PTSD. The condition is the most common ailment among medical cannabis patients in the state.

Conventional Treatments Inadequate

Many who advocate for more research into the efficacy of cannabis for stress disorders cite the poor results obtained from conventional pharmaceutical drugs, such as Zoloft for the depression associated with PTSD. Cannabis researcher Dr. Sue Sisley explained:

“This illness needs to be treated in a multidisciplinary way. Drugs like Zoloft and Paxil have proven entirely inadequate.”

Dr. Phil Leveque, an Oregon physician and medical cannabis advocate, was known for the large number of medical marijuana permits he issued for PTSD. Prior to his death in 2015, Leveque estimated he authorized 1,000 medical cannabis permits for PTSD alone. Said Leveque:

“Whether they were World War II, Korea, Vietnam, or vets from the current conflicts, 100 percent of my patients said [cannabis] was better than any drug they were prescribed for PTSD.”

Memory Extinction

Dr. Raphael Mechoulamis, the Israeli neuroscientist who discovered THC in 1964 and, later, the endocannabinoid system, has discovered that the cannabinoid system is integrally related to memory — and specifically to something called memory extinction. Memory extinction is the normal process of removing conditional associations from events or stimuli. Thus, a soldier may experience a panic attack after hearing an explosion in a movie or an ambulance siren in traffic because he or she hasn’t experienced memory extinction for a past traumatic event.

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Unfortunately, Dr. Mechoulamis stressed that cannabis isn’t a cure for PTSD. Unlike a condition like Crohn’s or cancer, which can go into remission after proper treatment with marijuana, there is no known cure for PTSD.

The Studies

A June 2014 study at Israel’s University of Haifa published in the journal Neuropsychopharmacology involved the administration of a synthetic cannabinoid that is very similar to THC to rats. The study revealed that all rats exposed to trauma who received cannabinoids within 24 hours of the event did not exhibit symptoms of PTSD, while those that received no marijuana did experience symptoms of stress and anxiety.

Rats given Zoloft, an SSRI antidepressant sometimes prescribed to those suffering PTSD, did little better than rats given the placebo containing no cannabinoids.

This study lead to an understanding of the neurological characteristics of these behavioral effects. In subjects exposed to trauma and trauma reminders, there was an increase in the brain receptors, CB1 and GR, associated with emotional processing. Cannabis prevented an increase in the number of these receptors in the areas of the brain responsible for saving traumatic memories.

“The findings of our study suggest that the connectivity within the brain’s fear circuit changes following trauma, and the administration of cannabinoids prevents this change from happening.”

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A study conducted in New Mexico and published in May 2014 reported that participants reported an average 75 percent reduction in all three major PTSD symptoms while using cannabis. Wrote Dr. George Greer, one of the study’s researchers:

“Many PTSD patients report symptom reduction with cannabis, and a clinical trial needs to be done to see what proportion and what kind of PTSD patients benefit, with either cannabis or the main active ingredients of cannabis.”

Patient Testimonials

Despite a lack of clinical research and human trials, anecdotal information is abundant. Desperate patients, most of whom have tried but gained no benefit from conventional treatments, have begun to experiment with medical cannabis. This has been even easier for those living in states that have legalized medical or recreational use of marijuana for PTSD, depression, anxiety, or insomnia.

Reported a PTSD patient who is a health care professional and had severe reservations about the physical and legal consequences of “smoking pot”:

“I wanted to feel better, to be myself again, and to be the person I was before the PTSD. I smoked the pot. Immediately I felt relaxed and calm. I smiled and laughed. I finally felt at peace for the first time in two years. I slept my first night in three years without the sleep medication.”

Another patient, one who served in combat and was shot in the head, suffers from epilepsy, PTSD, severe anxiety, chronic pain, and clinical depression.

“I am still alive because I smoke [marijuana] every day. Empirical evidence has proven to me that failure to [consume cannabis] generally causes a seizure and, at a minimum, I get really aggressive. I will not live on narcotics. Ibuprofen or aspirin have side effects worse than any temporary pain.”

More Research Needed

Although animal trials have shown a clear link between the prevention of PTSD or its symptoms and cannabis, human trials are necessary to convince the medical establishment — and other research organizations — that medical marijuana is one of the most effective treatments available for PTSD and its millions of sufferers. However, if cannabis continues to be a Schedule I drug under the Controlled Substances Act, its availability for research will remain limited and human trials — at least in the United States — will fail to occur.

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“We’re asking for marijuana from an agency [National Institute on Drug Abuse] designed to prevent people from using marijuana. There’s something fundamental that just doesn’t work here.”

said Dr. Rick Doblin, executive director of the Multidisciplinary Association for Psychedelic Studies, an organization involved in clinical research for the treatment of PTSD by cannabis, MDMA, and other non-conventional therapies.

“People are suffering because the government they served at risk to life and limb is now obstructing the research that would legitimize their treatment,” wrote Phillip Smith from StopTheDrugWar.Org.

Until additional research and human trials are conducted, the widespread adoption of cannabis to treat PTSD will not occur. Like investigation into other conditions, all that is necessary to begin such research is the reclassification of cannabis to Schedule II or lower.

Strains for PTSD

The following indica and hybrid strains are recommended for PTSD because they help reduce anxiety and stress, potential triggers of panic attacks and depression. Patients who suffer from clinical depression as their primary PTSD symptom should experiment with sativa strains, which are known to be most effective for the condition.

  • Blueberry Kush: An indica known for pain and stress relief, in addition to total relaxation.
  • Blue Cheese: An indica-dom known for total body relaxation.
  • Grand Daddy Purple: An indica-dom that is good for depression because it leaves users uplifted, happy, and relaxed.
  • Northern Lights: An indica-dom, this strain is known for relieving stress, anxiety, and nausea.
  • Orange Kush: A true indica that can easily result in couchlock and extreme relaxation.
  • G13: An indica strain known for its potency and relaxation and its ability to “melt away” pain, stress, anxiety, depression, and insomnia.

Photo credit: Army.mil, ob1left

Gooey Rabinski

Gooey Rabinski is the author of Understanding Medical Marijuana.

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