June is PTSD Awareness Month, and a recent report from the UK found that cannabis improves health-related quality of life and provides other significant benefits in individuals suffering from PTSD.
What is PTSD?
PTSD is a condition that can occur in people who witness or experience an extremely stressful traumatic event, series of events, or difficult set of circumstances. These events cause an experience that is emotionally and/or physically harmful or life-threatening and can result in ongoing mental, emotional, and physical difficulties. In the past, terms like “shell shock” and “combat fatigue” were used to describe PTSD that occurred in veterans returning from World War I and II, but more recently, we understand that other traumatizing events, such as natural disasters, serious accidents, physical or sexual assaults, domestic violence, and bullying may result in PTSD as well.
PTSD can occur in anyone of any age. Approximately 3.6% of all adults in the US have been diagnosed with PTSD, with a higher prevalence, about 8%, in teenagers. It has been estimated that one in 11 people will be diagnosed with PTSD sometime in their lifetime, with women twice as likely than men to experience it. Although many people experience traumatic events, only 8 - 12% will go on to develop PTSD. Evidence of multiple genetic components for PTSD has been found with reports of genetic overlap with the diagnosis of major depressive disorder.
What are the symptoms of PTSD?
There are four categories of symptoms in PTSD:
- Intrusive thoughts: repeated, involuntary memories, nightmares, and flashbacks
- Avoidance: avoiding reminders such as people, places, and situations that trigger distressing memories, as well as resistance to talking about the event and feelings experienced
- Alterations in cognition and mood: distorted thoughts about the cause or consequences of the event, ongoing fear, horror, anger, guilt, or shame; feeling detached or estranged from others; inability to feel happiness or satisfaction
- Alterations in arousal and reactivity: irritability, angry outbursts; behaving in a self-destructive way; easily startled; difficulty sleeping or concentrating
How is PTSD treated?
The mainstay of treatment for PTSD is therapy and pharmaceutical medications, such as antidepressants, anti-anxiety medications, and antipsychotics. However, these medications may cause significant side effects — especially when taken in combination — and have been shown to have limited efficacy.
PTSD and the endocannabinoid system
Photo by: Gina Coleman/WeedmapsImage lightbox
Abnormalities in the endocannabinoid system have been described in individuals with PTSD, namely an increase in type 1 cannabinoid receptors, reduced endocannabinoid levels, and lower cortisol levels. The presence of all three abnormalities correctly classified nearly 85% of PTSD cases. Since cannabis interacts deeply with the endocannabinoid system, it can target some of the root chemical imbalances involved in PTSD, offering relief and homeostasis within the body.
What does the research show about cannabis and PTSD?
Published in 2022, a report from the UK assessed clinical outcomes in individuals with PTSD from the UK Medical Cannabis Registry using validated patient reports. Across all follow-up periods, statistically significant improvements were observed in the common PTSD symptoms of intrusion, avoidance, and hyperarousal. Additionally, health-related quality of life, sleep, and anxiety were also significantly improved. Although some adverse effects were reported, all were considered minimal in severity.
Throughout the years, several other studies have documented the benefits of cannabis therapy for PTSD:
● 2009: Nabilone, a synthetic cannabinoid that mimics THC, was found to either eliminate nightmares or significantly reduce nightmares in 72% of PTSD patients who did not respond to conventional treatment. Participants reported improved quality of sleep and a reduction of daytime flashbacks. When nabilone was discontinued, nightmares returned, resolving again when the drug was restarted.
● 2014: In a Canadian study, nabilone given to prison inmates with PTSD showed efficacy with significant improvement in insomnia, nightmares, other PTSD symptoms, and Global Assessment of Functioning test. A number of participants were able to discontinue antipsychotic and/or sedative/hypnotic medications, reducing unwanted side effects.
● 2014: PTSD patients who were approved to use medical cannabis as part of the New Mexico Medical Cannabis Program reported over 75% reduction in symptoms with cannabis use.
● 2014: In a study from Israel, 10 patients with chronic PTSD who were given THC 5 mg dose twice a day in an oral form showed a statistically significant improvement in global symptom severity, sleep quality, frequency of nightmares, and PTSD hyperarousal symptoms.
● 2019: In a retrospective study of 11 patients with PTSD who received CBD for 8 weeks, 91% reported a decrease in symptom severity, with less anxiety, better sleep, and improved focus. CBD also relieved nightmares in a subset of these patients experiencing this symptom. CBD was well tolerated and no patients discontinued treatment. Four patients continued on CBD for 36 weeks and all experienced long-term, sustained decreases in the severity of their PTSD symptoms.
FAQ
How does cannabis help PTSD?
Cannabis works with the body's endocannabinoid system. By addressing some of the root-cause imbalances that create PTSD symptoms, cannabinoid compounds can alleviate some of the most difficult challenges of this condition.
What are the best cannabis strains for PTSD?
Many find relief with strains that contain the terpenes myrcene and linalool, as they tend to promote less anxiety and better sleep. Examples include Grand Daddy Purple and OG Kush.
Strains that contain both THC and CBD, like Cannatonic, Harlequin, and AC/DC, are also excellent choices for combating symptoms of PTSD, as the addition of CBD can level out the more potent effects of THC.
Some also report that the terpene pinene is helpful, which is found in Blue Dream. However, others have said that it can be overstimulating, so pay attention to which terpenes are best for your body.
Strains with THCV have also been reported to be helpful, with Doug's Varin, Durban Poison, Pineapple Purps, and Malawi Gold leading the way.
If you're in the beginning stages of finding the right strain to suit your specific needs, consider tracking your consumption in a guided journal or cannabis log book.
How effective is medical cannabis in treating PTSD?
Based on research and anecdotal reports, as well as its proven safety profile, cannabis can be quite effective in reducing the challenging symptoms of PTSD. Some report relief from nightmares, anxiety, pain, among others.
