Can Cannabis Treat PTSD?
Medical Marijuana for PTSD
After last month’s election, medical marijuana is now legal in 28 states. Medical marijuana can be used to treat a wide range of medical issues, and it is up to each state’s legislature to determine when a medical recommendation may be appropriate.
Some states have an expansive list of conditions that qualify someone for a recommendation, whereas others are quite limited. For example, Illinois allows recommendations for over 35 conditions, whereas Iowa allows recommendations for one condition - epilepsy. Additionally, Georgia has limited the type of medicine available — only low THC oil (less than 5% by weight) for 8 qualifying conditions.
Of the 28 medical marijuana states, 9 currently allow medical marijuana recommendations for patients suffering from Post-Traumatic Stress Disorder: Arizona, Arkansas, Connecticut, Delaware, Florida, Maine, New Mexico, North Dakota & Pennsylvania.
What is PTSD?
PTSD is a chronic disabling condition that plagues trauma victims — typically combat veterans and victims of violent crime or sexual abuse. To put it simply, it’s an illness where people cannot stop remembering a trauma they’ve experienced.
The Diagnostic & Statistical Manual of Mental Disorders (DSM-IV-TR) defines PTSD as the development of characteristic symptoms following exposure to an extreme traumatic stressor. This trauma can involve a direct personal experience of an actual or threatened death or serious injury to oneself or another person. It can also occur upon learning about an unexpected or violent death, serious harm or threat of death or injury experienced by a family member or other loved one. For the condition to qualify as PTSD, the person’s response must involve intense fear, helplessness or horror.
Characteristic symptoms of PTSD include persistent, intrusive recollections or re-experiences of the original event in the form of flashbacks or nightmares. PTSD sufferers may also experience numbing and avoidance, or increased arousal (hyper-vigilance) that can cause sleeping disturbances, difficulty concentrating, angry outbursts or irritability. The experience of these symptoms leads to functional impairment in at least one area of the person’s life and may even be disabling.
How does cannabis help PTSD?
While guidelines for the management of PTSD exist, there is no single pharmacological treatment that has been developed specifically for PTSD. Unfortunately, many PTSD sufferers continue to experience debilitating symptoms for years or even decades. Studies suggest that cannabis can do more than merely ease the symptoms of PTSD — that it can actually treat it. To understand how, we need to briefly discuss the cannabinoid system in the human brain.
The endocannabinoid system is a diffuse network of chemicals and pathways in the body that plays a role in memory formation, appetite, pain tolerance and mood. The human brain has two sets of cannabinoid receptors - CB1 and CB2.
CB1 receptors are distributed primarily in the brain and central nervous system — including the amygdala (the “emotion center” of the brain) and the hippocampus (the “memory center” of the brain). CB2 receptors are distributed throughout the body. CB1 receptors are responsible for marijuana’s psychoactive effects, whereas CB2 receptors are responsible for marijuana’s anti-inflammatory effects.
CB2 receptors can be found in immune cells and work to reduce inflammation. Animal studies have shown that cannabis can impair memory and reduce anxiety when they activate CB1 receptors in the brain.
A study by the NYU Langone Medical Center looking at the biochemical impact of trauma has discovered a connection between the quantity of CB1 receptors and PTSD. Brain imaging shows that people with PTSD have markedly lower concentrations of anandamide than people without PTSD.
Anandamide is an endocannabinoid that binds to CB1. If anandamide levels are too low, the brain compensates by increasing the number of CB1 receptors to help it utilize the remaining endocannabinoids. This finding suggests that PTSD could be treated by targeting the endocannabinoid system in the brain.
Cannabis may be able to treat PTSD
An important question for researchers studying PTSD has been:
"How an external event can impact the biology of an organism to produce such durable memory traces?"
Research on PTSD-inducing fear memories suggests the possibility of reducing fear memory as a way to treat PTSD. Cannabinoids have been known to facilitate memory extinction and impair memory retrieval. Because cannabis affects the emotion and memory storage abilities of the brain, it could be the ideal treatment for PTSD.
Anecdotal evidence suggests that PTSD patients find some relief from symptoms through the ongoing use of cannabis. For example, synthetic cannabinoid Nabilone has been shown to significantly improve treatment-resistant nightmares.
But the medical implications for cannabis could be much bigger — it could have preventative effects. Amazingly enough, one study showed that administering cannabis to rats shortly after exposure to a series of intense stress events prevented PTSD-like symptoms altogether. Cannabis blocked the continuous retrieval of the traumatic event and enhanced the extinction of fear memory, thereby reducing anxiety symptoms.
If this holds true for humans, it suggests that early intervention with cannabis could effectively prevent the onset of PTSD and its symptoms. Perhaps in the not-so-distant future, trauma victims will receive cannabis as part of their immediate medical treatment.