PTSD / PTS Information: PTSD and Medical Marijuana Treatments
Post Traumatic Stress Disorder, is a psychiatric disorder that can occur following the experience or witnessing of a life-threatening events such as military combat, natural disasters, terrorist incidents, serious accidents, or physical or sexual assault in adult or childhood.
Recent years have brought a wealth of new scientific understanding regarding how medical marijuana or cannabis can be beneficial for treating PTSD / PTS.
Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event.
For many people, symptoms begin almost right away after the trauma happens. For others, the symptoms may not begin or may not become a problem until years later. Symptoms of PTSD may include:
- Repeatedly thinking about the trauma. You may find that thoughts about the trauma come to mind even when you don’t want them to. You might also have nightmares or flashbacks about the trauma or may become upset when something reminds you of the event.
- Being constantly alert or on guard. You may be easily startled or angered, irritable or anxious and preoccupied with staying safe. You may also find it hard to concentrate or sleep or have physical problems, like constipation, diarrhea, rapid breathing, muscle tension or rapid heart rate.
- Avoiding reminders of the trauma. You may not want to talk about the event or be around people or places that remind you of the event. You also may feel emotionally numb, detached from friends and family, and lose interest in activities.
General use of cannabis for PTSD Symptoms
Raphael Mechoulam, Ph.D.
Dr. Mechoulam is the Israeli scientist who identified THC as the psychoactive compound in marijuana, and decades later he discovered the brain’s endocannabinoid system and the endogenous neurotransmitter anandamide. He is one of the most respected Israeli neuroscientists and has been a senior advisor to the Israeli government on marijuana policy and the ethics of research with human subjects. He discussed his experiments demonstrating the neuroprotective effects of the endocannabinoid system in mice that have had traumatic injuries to the brain. He believes the neuroprotective effects of marijuana may eventually have applications for other neurological and psychiatric conditions, including Alzheimer’s and Parkinson’s disease.
Another fascinating discovery, one with implications for PTSD, is that the cannabinoid system is integrally related to memory, specifically to memory extinction. Memory extinction is the normal, healthy process of removing associations from stimuli. Dr. Mechoulam explained that an animal which has been administered an electric shock after a certain noise will eventually forget about the shock after the noise appears alone for a few days. Mice without cannabinoid systems simply never forget – they continue to cringe at the noise indefinitely.
This has implications for patients with PTSD, who respond to stimuli that remind them of their initial trauma even when it is no longer appropriate. By aiding in memory extinction, marijuana could help patients reduce their association between stimuli (perhaps loud noises or stress) and the traumatic situations in their past. Working with Army psychiatrists, Dr. Mechoulam has obtained the necessary approvals for a study on PTSD in Israeli veterans, and hopes to begin the study soon.
The Alternative Medical Journal: General use of cannabis for PTSD Symptoms.
Despite the anecdotal evidence to the contrary, most of the experimental studies that have been conducted so far indicate that by and large the administration of exogenous cannabinoids such as vaporizing therapeutic cannabis may not be the most reliable nor effective means of utilizing the eCB system to treat anxiety and aversive memories such as those formed in PTSD. For reliable and truly effective treatment of these conditions it appears that restricting eCB breakdown by way of FAAH inhibition is the best target discovered so far within the eCB system. (The other eCB targets include the two primary receptors CB1/CB2, vanilloid receptors, eCB reuptake, as well as eCB production.) To this end, Kadmus Pharmaceuticals, Inc. has started to express serious interest in marketing a new FAAH inhibitor they have developed, currently code-named KDS-4103. KDS-4103 appears to have a lot of potential from a pharmacological perspective. Even though it produces analgesic, anxiolitic, and anti-depressant effects it otherwise does not produce a classic cannabis-like effect profile and animals easily discriminate between THC and KDS-4103. All this indicates that KDS-4103 does not produce a â€œhighâ€ like THC and other direct CB1 agonists. KDS-4103 is orally active in mammals and fails to elicit a systemic toxicity even at repeated dosages of 1,500mg/kg body mass. All other available evidence to date also suggests a very high therapeutic margin for KDS-4103. All in all, considering that the kinds of events which usually precipitate PTSD in most individuals often also involve pain, KDS-4103 seems like it may be just about the perfect medication.
So what should all this mean to the individual? Anecdotal evidence says by and large the use of therapeutic cannabis provides a significant improvement in quality of life both for those suffering from this malady and for their family and friends. Whether or not this is taking the fullest advantage possible of the eCB system in the treatment of PTSD is yet to be seen. Mostly the use of cannabis and THC to treat PTSD in humans appears to provide symptomological relief at best. In and of itself, there is nothing wrong with symptomological relief. That’s what taking aspirin for a headache, a diuretic for high blood pressure, opiates to control severe pain, or olanzapine for rapid-cycling mania is all about. We do have the potential, however, to do better than just treating symptoms of PTSD via activation of the cannabinoid receptors. With the right combination of extinction/habituation therapy and the judicious administration of a FAAH inhibitor like KDS-4103 we have the potential to actually cure many cases of PTSD. For the time being though, symptomological treatments are all we have for more generalized anxiety and depression disorders.
If an individual were to want to get the most out of using therapeutic cannabis to improve a PTSD condition they should try to use low to moderate doses with as stable a blood level as possible for general anxiety and depression symptoms. Oral cannabis produces more stable blood levels. Since peak levels will produce the most soporific effect, administration of oral cannabis right before bed should produce the most benefits for improving sleep patterns. If the goal is to use cannabis to facilitate extinction of the response to PTSD triggers than small to moderate doses of cannabis vapors should be administered shortly before planned exposure to the trigger. A series of regular extinction sessions will produce better results than a single session. If cannabis appears to make aversion, fear, or aversive memories worse then the dosage should be lowered. If feelings of fear do not improve with lower dose then discontinue use of cannabis as fear-extinction aide.
In light of all evidence currently available, it is striking that the FDA refuses to investigate cannabinoids for the treatment of anxiety disorders like PTSD yet they have approved studies of MDMA, the club drug Ecstasy, for the treatment of PTSD (Doblin, 2002). Even if you do not accept cannabis as the answer itself, it should be hard to accept that by and large we still have not found effective and reliable ways to utilize the eCB system in modern western medicine. After all, the most potent (meaning it takes the least amount to produce a threshold effect) substance know to humans is not LSD as many still assume but is instead a derivative of fentanyl, know as Carfentanil. The threshold dosages for LSD and Carfentanil are 20-30Âµg (micrograms) and 1Âµg, respectively (Wikipedia, 2 & 3). This makes Carfentanil 10,000 times more potent than morphine, 100 times more potent than fentanyl, and 20-30 times more potent than LSD. At least up until 2005 and unlike LSD, Carfentanil was(is?) regulated as a Schedule II substance in the US (Erowid). For those that do not know, this means that despite perceived extreme dangers from use or abuse of this drug it is still assumed to have medical value. With the lives and well being of so many veterans AND private citizens at stake, those in the scientific community and police makers alike cannot afford to miss the wake up call. Even a child should be able to see the hypocrisy evident in the relative policies concerning cannabinoids and opiates. It is time to fix this appalling imbalance in our policies concerning the pharmacopia or else be the laughing stock of future generations.
- Medical Marijuana
- The term used to describe organically grown marijuana in countries and/or states that have legalized the medicinal use of marijuana, abbreviated as MMJ. Marijuana can be very effective in treating a number of illnesses and diseases. Some of the more common conditions and symptoms treated with medical marijuana include chronic pain, nausea, glaucoma, seizure disorders, cancer, diabetes, muscle spasms, and many more. Currently, 13 U.S. states allow doctors to prescribe medical marijuana to patients suffering from ailments ranging from AIDS to glaucoma. Tens of thousands of seriously ill Americans are now physician-certified users of medical marijuana.
Quote: “Veterans, if provided with the opportunity to use marijuana to alleviate PTSD, would most likely choose to pursue the opportunity.”
The number of veterans seeking disability compensation for post-traumatic stress disorder (PTSD) has increased by nearly 80% in recent years and the U.S. Department of Veterans Affairs (VA) is currently providing more than $4 billion in compensation to veterans for the condition.
The surge in claims by Vietnam War veterans and other former military personnel has revealed inconsistencies in how veterans are rated for PTSD, as well as in compensation levels. The VA’s Veterans Benefits Administration (VBA) asked the Institute of Medicine and National Research Council to convene a committee of experts to address a number of issues surrounding its administration of veterans’ compensation for PTSD.
The report issued as a result, ‘PTSD Compensation and Military Service,’ recommends ways to fix shortcomings in the VA’s program for evaluating and compensating veterans for service-connected PTSD and to restore confidence that the agency is compensating every veteran fairly. The report also addresses questions concerning how long after a traumatic event PTSD may arise and how to better manage PTSD claims related to sexual harassment or assault during military service. Some interesting facts concerning veterans and PTSD include:
- Around 20% of veterans returning home from the Middle East are being diagnosed with PTSD.
- Doctors at the VA recognize the benefits of medical marijuana as a type of PTSD treatment, yet refuse to recommend it as a treatment option.
- Medical research has shown that marijuana has been highly successful in treating PTSD and its symptoms. Veterans should ask their VA doctor to discuss its use with them and advise them on the medicinal use of marijuana.
- Dr. Phillip Leveque is not only a combat veteran, but a Doctor, a Pharmacologist, and a Forensic Toxicologist. He is an authority on treatment of PTSD and its symptoms with marijuana. Dr. Leveque strongly recommends the use of marijuana to veterans who experience PTSD.
Every veteran deserves any and all types of medical and psychological assistance. Veterans should ask their VA doctor or health care provider to discuss the symptoms they are experiencing and advise them in regards to treatment. If you do not ask you might get passed over and miss treatment opportunities. Do not fear discussing the medicinal use of marijuana, many veterans are using it at this time. One of the difficulties with PTSD is that the readiness or need for treatment might emerge years after the trauma. Due to this fact, veterans and their family members need long-term treatment options and long-term access to treatment – even if they do not experience symptoms at the time they are discharged.
Twenty states as of the year 2013, as well as the District of Columbia, have medical marijuana laws on the books, but America is still a long way from generally accepting marijuana as a medicine. If we are serious about seeking an effective remedy for PTSD and serving the hundreds of thousands of veterans with the disorder, this level of acceptance must change. It is not a guaranteed solution, yet sufficient evidence exists showing that marijuana is a treatment that needs to be pursued further.
In the State of New Mexico, where PTSD was added as a qualifying condition to the state’s medical marijuana program after an evaluation of the research available, more people use marijuana for PTSD than for any other condition. Veterans, if provided with the opportunity to use marijuana to alleviate PTSD, would most likely choose to pursue the opportunity. If it were any other drug, researchers would probably be both organizing and conducting trials as this article is being written. Marijuana; however, is not a new chemical compound created by a pharmaceutical company. It is marijuana and the anti-marijuana forces within the federal government are powerful.
While marijuana was listed as a medicine in the U.S. Pharmacopoeia prior to its prohibition and was widely used for dozens of conditions, Congress chose to temporarily place it in Schedule I in the year 1970 pending the outcome of a government study. The study, produced by a national commission on drug abuse, ultimately concluded that marijuana’s harmful effects were so limited for light to moderate users that it should not even be a criminal offense to use it. Unfortunately, its status as a Schedule I drug remains unchanged today.
Officials argue that marijuana needs to be kept illegal because it is a, ‘dangerous,’ Schedule I drug. These officials refuse to move it out of Schedule I and claim there is no evidence that marijuana has medical value. Officials refuse to allow private entities to cultivate marijuana for research to demonstrate that it does indeed have medical value, and have set up seemingly endless obstacles for any researchers who desire to conduct potentially favorable studies. Without research there is no evidence and no rescheduling, maintaining the perspective that marijuana is dangerous.
When former and current service women and men are seriously suffering, to the point where some have even taken their own lives, we at least owe it to them to explore any treatment options – to include marijuana. It is well past time for government officials to take America’s veterans off of the medical marijuana battlefield.
Fighting PTSD with Marijuana
The holiday season is supposed to be full of glad tidings and good cheer, but for many people dealing with post-traumatic stress disorder (PTSD), it can trigger anxiety, depression, anger, and panic attacks. Veterans who spent a Christmas at war will often have flashbacks to that time. Children who were abused have to deal with their parents. People who had a major car accident because of winter ice have to travel. Having a jolly holiday is not something people with PTSD can do.
Following up on our post last week about depression and the holidays, we wanted to explore another holiday-averse psychiatric ailment that may be treatable with cannabis.
What Is PTSD?
PTSD is a condition caused by witnessing extremely traumatic events. It is most common in veterans returning from war, but anyone can develop PTSD. Trauma or a life-threatening event can trigger reactions such as upsetting memories of the event, increased jumpiness, or trouble sleeping. For people who suffer from PTSD, the reactions don’t stop, or they get worse.
Problems with Conventional PTSD Treatments
The main treatment for people with PTSD is cognitive-behavioral therapy, which helps people face their triggers and learn to identify when they’re having an outsized reaction. While fairly effective, this can be a long process, and many PTSD sufferers don’t have the means to go through years of therapy.
Many people with PTSD turn to drugs to try to relieve their fears and shut off their flashbacks. They may start abusing prescription meds for depression and anxiety, and they are often heavy drinkers. The VA estimates that more than two in ten vets with PTSD also have Substance Abuse Disorder, and six in ten vets with PTSD smoke cigarettes, compared to three in ten in the non-PTSD veteran community.
Cannabis may be an alternative treatment for PTSD that won’t come with the risks of addiction that come with other medications. It has been shown to help with depression, anxiety, and insomnia, all hallmarks of PTSD.
Treating PTSD with Cannabis
Veterans for Medical Cannabis Access recommends that PTSD patients start cannabis treatment using low to moderate doses administered orally in the morning to produce stable blood levels, and right before bed to improve sleep patterns.
In more aggressive memory extinction sessions, if patients know they will be walking into a situation that could trigger their PTSD, cannabis vapors should be administered shortly beforehand. The more regularly this is done over time, the better it will work. If it seems to make the patients’ aversion, fear, or aversive memories worse, the dosage is lowered or stopped.
If you or someone you love is suffering PTSD and struggling with the holidays, please don’t hesitate to reach out to us; we are here for you.
Finding Answers to Fight PTSD With Cannabis
Memorial Day is a time to remember those Americans who died in active military service. It is a time to be grateful for those who sacrificed their lives for the ideals of freedom throughout the years.
It can also be a time to remember and appreciate living veterans, many of which still suffer the traumas of war every day. Of the roughly 9 million veterans who served in the Vietnam, Iraq and Afghanistan conflicts, a recent study estimated that approximately 20% have been officially diagnosed with some form of Post Traumatic Stress Disorder (PTSD). Another more sobering statistic is that on any given day, 22 veterans will take their lives. Many experts claim that this number may be much higher, since only 26 states participated in the Department of Veterans Affairs study where this number comes from. California and Texas, which together represent 20% of the entire veteran population, did not participate in the study.
When a person experiences an extremely negative event, such as those that may occur in war, it is normal for the sympathetic nervous system to react in what is called the “fight or flight response.” When the symptoms of trauma linger long after the fact, however, this could be a sign that signaling in the amygdala area of the brain (where flight or fight originates) is off and PTSD has occurred. According to the American Psychological Association, PTSD can be characterized by the following symptoms:
- Spontaneous and distressing memories of the event that may cause nightmares and flashbacks;
- Distress when faced with people, places and situations that remind the person of the event;
- An inability to remember the important aspects of the event that is unrelated to head injury or to the use of substances;
- Withdrawal from others and social situations in general, even those activities that the person use to participate in and enjoy;
- Inability to experience positive emotions;
- Self-destructive behavior;
- Anxiety, hyper-vigilance, paranoia and exaggerated “startle” response;
- Extreme lack of concentration;
- Mood swings, emotional numbness and overall irritability; and
- Avoidance of people, places and situations that remind the person of the event.
How Can Cannabis Help Veterans with PTSD?
Close to 50% of U.S. veterans do not seek treatment of any kind for their PTSD. When they do, conventional medicine’s answer, in addition to talk-therapy, is to prescribe for a smorgasbord of pharmaceutical drugs that come with them a wide array of dangerous side effects and contraindication warnings. Some toxic medications that are often prescribed for PTSD include:
- Tricyclic Antidepressants
- Monoamine Oxidase Inhibitors (MAOIs)
Even with all these drugs at the ready for PTSD-suffering veterans, a report issued by the U.S. Institute of Medicine found that the Pentagon and the VA system still lack adequate treatment methods for veterans with PTSD.
Matthew Kahl, the founder of the organization Veterans for Natural Rights, knows what it is like to suffer from PTSD. Ten months after
returning home from two tours in Afghanistan, he attempted suicide. For five years, he tried everything modern medicine had to offer in order to manage his PTSD, often being prescribed several different medications at once in addition to talk therapy. At one point he was prescribed 15 different medications. When Kahl’s liver and kidneys began to fail as a result, he knew it was time to try something different.
That was when he moved his family to Colorado and began using cannabis. The first thing he noticed was the effect cannabis had on the quality and duration of his sleep.
“When I first moved to Colorado, I started initially seeing results in my sleep patterns and what ended up happening was that everything else kind of followed from that in a cascade,” he explained in a recent interview. “The sleep allowed me to actually give up some of the pharmaceutical drugs I was prescribed… I started shedding those pharmaceutical medications as soon as I started using cannabis.”
Kahl said that at first he used cannabis with “high psychoactive effect” in order to change his mood, lift him out of depression and begin to shed the drug dependency. After a while, however, he began to put his background in neuroscience to use in experimenting with non-anxiety producing strains of cannabis sativa.
“I figured out that sativa with very high THC levels and certain terpenes will often give you anxiety, but if you add a little bit of THC-V in the mix, it actually cuts down on the anxiety so you have a much more clear experience…”
THC-V is similar to the psychoactive component of cannabis, THC, and also works in conjunction with CBD for healing, but because the molecule is shaped slightly differently than straight THC, it attaches in a different way to receptor sites that are part of the endo-cannabinoid system. Kahl is currently assisting Sue Sisley, MD and her team in what will soon be the first-ever cannabis clinical trial to focus on veterans with PTSD. Past studies concerning traumatic brain injury (TBI) and cannabis, especially those conducted by Israeli neuroscientist Dr. Raphael Mechoulam, have demonstrated the neuroprotective effects of cannabis in mice models but Dr. Sisley’s study will be the first to study the effects of cannabis on humans with TBI and PTSD.
Kahl says that ingesting at least some THC in some form is needed in order to change one’s thoughts and mood and help with conditions like PTSD, depression and anxiety.
“…the traditional psychiatric way of pursuing this is to try medications that aren’t psychoactive,” says Kahl. “They developed Prozac in order to be a non-psychoactive version of serotonin…and they have created a monster. They have created a substance that actually kills people and actually causes people to kill themselves.”
As Kahl explains it, part of the mission of Veterans for Natural Rights is not only to advocate for the individual freedom of veterans and others to use and grow cannabis for healing, it is also to create community between veterans, which Kahl says was the BEST version of talk therapy there is, and to promote an overall healthy lifestyle in which cannabis use is a part.
“We are trying to make a healthier lifestyle from the bottom up,” says Kahl. “It’s not about all these pharmaceutical drugs that you can sprinkle on top after you have a bunch of problems. Live a healthy lifestyle from the beginning, consume cannabis and engage in self-healing behaviors like meditation, mindfulness, yoga, and exercise. These are all part of the actual cannabis regimen that will help heal veterans from the scars of war.”