Cannabis & PTSD

What is PTSD?

Post-traumatic stress disorder or PTSD is an anxiety disorder that is characterised by persistent psychological stress following a traumatic, stressful or frightening event. This stress often manifests itself through flashbacks and nightmares. Sufferers may also experience a sense of isolation and guilt and experience concomitant issues like insomnia, difficulty concentrating, further anxiety disorders and depression.

Physical symptoms of PTSD are thought to manifest due to the body’s release of cortisol and adrenaline when emotionally stressed. This release of stress hormones, colloquially known as the ‘fight-or-flight’ response, means that the person experiencing PTSD will likely experience symptoms even when no real danger is presenting itself anymore.

Collectively, these symptoms can markedly impact an individual’s everyday life by making everyday tasks harder to carry out as normal.

Despite the disorder being originally acknowledged in war veterans, anyone can develop PTSD. In fact, according to the NHS, ‘PTSD is estimated to affect about 1 in every 3 people who have a traumatic experience, but it’s not clear exactly why some people develop the condition and others do not’.

It’s also important to note that while some people may develop PTSD immediately after a traumatic experience, others may develop the disorder anywhere from weeks to years later.

The NHS advises that while a confusion and disturbance of usual feelings is common shortly after a traumatic event occurs, most people should experience an improvement in their symptoms after a few weeks. If the symptoms persist after 4 weeks have passed, a GP should be contacted. The GP can then refer the individual experiencing symptoms onto a relevant medical professional or mental health specialist for continued assessment and treatment of the disorder.

How is PTSD treated?

Despite the symptoms of PTSD often being severe, PTSD can be treated effectively by professionals even when it occurs years after the event. However, the specific symptoms experienced and the length of time following the event will affect the type of treatment offered.

Treatment options:

  • Watchful waiting’ – If the patient’s symptoms are deemed quite mild or have been experienced for less than four weeks, GPs might suggest the patient watches their own symptoms to judge whether any improvement occurs naturally without need for further treatment. Regardless of whether improvement is observed or not, a follow up appointment should be provided within a month
  • Trauma-focused cognitive behavioural therapy – This is a PTSD specific form of cognitive behavioural therapy that typically lasts between 8 to 25 sessions with the same therapist typically once per week.
  • Eye movement desensitisation and reprocessing (EMDR) – This relatively new form of treatment involves the patient making rhythmic eye movements whilst picturing the traumatic event that triggered their symptoms. This treatment works by allowing the patient to work through their disturbing memories properly through the rapid eye movements supposedly mimicking the way the brain processes memories during sleep. As described by EDMR UK & Ireland, the side-to-side movements are thought to ‘effectively stimulate the “stuck” processing system in the brain’ so that the traumatic recollections can be reprocessed like regular memories, thereby reducing the detrimental intensity of the memory causing harm.
  • Medication – Although medications aren’t typically prescribed for those suffering from PTSD, if concomitant issues like insomnia and depression are experienced and the person affected is unwilling to try talking therapies, antidepressants may be prescribed.

How does cannabis help?

One area in which cannabis proves particularly useful for the treatment of PTSD is in reducing nightmares experienced by sufferers. As discussed by Neumister et. al. (2013), for many affected by the disorder, dreaming was diminished whilst under the influence of cannabinoids. This is likely due to the role of the endocannabinoid system in PTSD and the expression of cannabinoid receptors throughout the nervous system.

These findings are echoed by Elms et. al. (2019) who found that CBD seemed to reduce PTSD associated symptoms in a subset of patients who experienced nightmares.

Another study carried out by Jetly et. al. (2015) found that in 10 patients experiencing PTSD from the Canadian military, the use of nabilone, a synthetic form of THC, decreased PTSD related nightmares. However, this study involved only a small number of patients, so further studies are necessary to verify these results in a more substantial patient population.

More generally, in a collation of interview and focus group data involving … carried out by Luther Elliott et. al. (2015), patients stated that cannabis exerted relaxing effect that helped to prevent intrusion events and triggers and helped with diminishing depression and anxiety. Additionally, the majority of the participants preferred self-medication with cannabis to the use of alcohol or psychopharmaceuticals, both of which were reported to have negative side effects.

According to Rafael M. Bitencourt and Reinaldo N. Takahashi, CBD shows an action profile with fewer side effects than the typically used pharmacological therapy for PTSD. The researchers also concluded that even when CBD is consumed in considerably large doses, the compound doesn’t exhibit the anxiogenic profile of other compounds that directly activate endocannabinoid transmission.

While these studies are certainly promising for the treatment of PTSD in both veterans and others using cannabis-based products, more research needs to be carried out on larger scales for concrete findings to be extrapolated and put into medical practice. Hopefully with increased interest in cannabis amid a wave of legalisation across the world, more research will shortly come to the fore.

For more information on these studies and the treatment of PTSD using medical cannabis, take a look at our evidence base, a ground-breaking systematic review of the history of research in this area and a global first-of-its-kind searchable database for clinical referencing.

Follow this link for more information on our online course on PTSD.

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