PTSD and Medical Cannabis




     PTSD, or Post-Traumatic Stress Disorder, is a condition that affects many Americans who have undergone a stressful event or experience, and this event has changed their life. It is estimated that 10 million Americans will suffer from this condition each year. PTSD has caused them to be susceptible to the detrimental effects of stress, uncertainty, anxiety, and difficulty existing in everyday life.  Some other characteristics of this illness are depression, anxiety, mental anguish, pain, intense rage, and a feeling of helplessness or terror. Many of these individuals also have difficulty sleeping and regulating their own bodies homeostasis and trouble leading a satisfying and productive life.


     During the Vietnam war, many US Soldiers would smoke cannabis in order to deal with the stress and horrors of combat while on their tour of duty in SE Asia. They experienced life and death routinely, and the trauma of warfare may leave them wounded mentally if not physically. Other individuals may have PTSD due to factors such as witnessing the death of a spouse or loved one from a traumatic or unexpected event. An event such as a hurricane, shooting, or extreme disease. Other experiences that can lead to PTSD include natural disasters, sexual abuse, traffic accidents, and violent crime. This issue is certainly a key concern for our veterans, but not solely confined to that group.


     Post-traumatic stress disorder is often triggered by a direct experience with death or serious harm, either actual or threatened. Some of the symptoms of PTSD can include flashbacks or nightmares which recount the traumatic event and can be hard to erase from your consciousness. Let’s say you are a soldier in combat, and your platoon leader got his head blown off, or killed in combat from an IED and you were right next to him and witnessed the horrible event. This event can haunt you for the rest of your life, and elicit the symptoms of PTSD for days, months, or years later.


     A study in 2012 at Harvard Medical school showed a case history of an individual with severe PTSD symptoms who were self-medicating with hashish. As a result of this study, a comprehensive review was published on using cannabis as a breakthrough treatment for PTSD. This review stated that “Findings from this research study suggest that by altering fear conditioning, memory systems, general CNS arousal, mood, and sleep, exogenous cannabinoids may hold potential for the treatment of people with PTSD.”  


     The body’s own endocannabinoid system deals with the extinction of aversive memories, and the ability of phytocannabinoids to interfere with memory processing has been widely known and accepted for many years. Some studies indicate that abnormal endocannabinoid signaling in the brain is strongly implicated in PTSD patients, so cannabis is a logical area to investigate in this syndrome in order to achieve relief and reduce unpleasant and aversive memories.


     One mechanism of action using cannabis to treat PTSD involves the sleep cycle and the production of bad dreams and nightmares, which may recount the original event and prevent the patient from obtaining adequate rest and rejuvenation which is often beneficial during sleep. It seems that the use of medical cannabis can directly influence your sleep cycle to ensure a restful and uneventful sleep pattern. Specifically, the use of cannabis has been shown to inhibit stage 4 sleep (REM) which is where dreams and nightmares typically occur.


      Another use of cannabis for PTSD is the reduction of stress and increase in dopamine and serotonin levels to help reduce destructive and harmful repetitive thoughts. “Forgetting” is a benefit when negative thoughts and emotions originate from remembering negative or traumatic events that can cause PTSD. Some of the terpenes in cannabis, such as linalool, terpinolene, myrcene are also sedative and can potentiate the cannabinoids present. The terpene pinene should be avoided for PTSD patients as it actually prevents memory loss and may not allow the diminishing of traumatic events.


     Many veterans have used cannabis in combat or near combat situations in foreign countries as the cannabis is plentiful, cheap, and potent… i.e. Southeast Asia, Afghanistan, the Middle East. These soldiers used it to stay calm and counteract the negative side effects of war, and it allows them to operate more effectively and deal with adverse situations with less mental stress and strain. For this reason, their instinct or experience also allows them to want to continue to use cannabis when they return home. A mixed hybrid or Indica strain of approximately 1:1 ratio of THC: CBD is a good starting point, but many vets will tolerate more THC if previous users. Therefore, it is advisable to ramp up the THC, as tolerated, to maybe 5:1, 10:1, or 20:1 ratio.


     As is the case in the general use of cannabis, experimentation with strains, dosage, and administration techniques is necessary for each individual patient to achieve the desired result to reduce the effects of PTSD. Our veterans have put their life on the line for our country in many cases, and deserve adequate access to medical cannabis, even if not endorsed by the Veterans Administration. It is only a matter of time before cannabinoid drugs can safely be prescribed to substitute for the myriad of often detrimental and harmful prescription drugs currently now used to treat our veterans. Many have multiple prescriptions and often the combinations of drugs can cause ill health or even death, while not being effective against the conditions they were originally prescribed for.



                                                      Dr. Stanley R Manstof


                                                      Americans for Safe Access Member

                                                      International Cannabinoid Research Society