Medical cannabis and post-traumatic stress disorder (PTSD)

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Post-traumatic stress disorder (PTSD) is a serious mental condition that occurs after direct or indirect exposure to an emotionally traumatic event. This can include war, a fatal car crash, sexual abuse, or an unexpected death. Most people who experience these events find that they’re struggling to cope in the immediate aftermath and may experience flashbacks, nightmares, or panic attacks. Among those afflicted, many do get better with time. If a person’s condition doesn’t improve, or their symptoms persist for months—or even years—they may have PTSD. For this diagnosis, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) requires symptoms to be present in a person for at least a month and interfere with everyday life.

Common symptoms include:

  • Intrusive reoccurring and distressing thoughts
  • Avoidance of distressing feelings and environments, or ‘triggers’
  • Persistent change in thought or activity
  • Changes in arousal or mood (i.e. irritability, impulsivity, aggression, insomnia, etc.)
  • Physical symptoms, such as headaches, stomach pain, backache, etc.
Upset man suffering from depression, his counselor supporting him at the office.

To date, medical professionals don’t quite understand why some people develop PTSD following a traumatic event and others do not. Rachel Yehuda of the Icahn School of Medicine at Mount Sinai indicates that there are a few underlying causes, such as previous trauma, childhood abuse, alcoholism that may attribute to this.

 

First responders and PTSD

According to the Federal Framework on Posttraumatic Stress Disorder, approximately three-quarters of Canadians exposed to a traumatic event may potentially develop PTSD.

Data is limited, however, as many individuals with PTSD avoid treatment due to cultural/professional stigma or lack of knowledge. Thus, most research involves veterans and first responders (police officers, firefighters, nurses), as they often encounter occupational stressors (such as conflict, trauma or death) at their work. Indeed, a study by Cerel et al. (2018) found that, out of the 800 participating police officers, 95% had responded to a suicide call which averages for 31 calls of this nature over their entire careers. Of the participants, one in five reported that they had suffered signs of PTSD disorder as a result, including poor sleep and anxiety. Proportionate symptoms such as these can lead to other challenges, including interpersonal problems, substance abuse, and absenteeism.

PTSD Mental health concept. Post Traumatic Stress Disorder. The depressed woman sitting alone on the floor in the dark room background.

Treatment Options

According to Canadian epidemiologist, M.J. Milloy, the prevalence of PTSD amongst Canadians is a “pretty substantial health problem.” More disconcerting, Milloy states: “We haven’t been able to develop any good treatments. There’s talk-therapy and the use of anti-depressants. But by and large, people with PTSD are really suffering alone.” A preventative measure for developing PTSD according to medical professionals is to avoid trauma. This notion however proves impossible for first responders. Further, despite mental health education and wellness training, there is little indication that these programs actually work.

What we do know, however, is that programs such as these can alert professionals to the early indicators of PTSD, and quite possibly, timely treatment. In turn, this may decrease the risk for chronic outcomes, ease suffering, and even prevent suicide. Given the nature of their job, and their frequent encounters with traumatic events, this is particularly important for those who work in emergency response occupations.

There is currently no drug designed to specifically treat PTSD. Most present-day doctors depend on a treatment plan that includes a combination of prescription medication and cognitive-behavioural therapy. Drugs can be costly and dangerous, with patients often complaining that the side effects are too much to bear. * Alternatively, Health Canada designates medical cannabis as an authorized tool for combating the symptoms of post-traumatic stress, and licensed practitioners, such as those at Cannalogue, can grant access as a result.

Middle-aged military man holding his head in pain and depression sitting on the couch. Soldier suffering from psychological trauma.

Cannabis and PTSD: Canadian Case Studies

Canadian research indicating the benefits of medical cannabis for the treatment of PTSD is promising. A study conducted by Dr. George Fraser, for instance, shows that the “majority of patients” suffering from nightmares brought on by treatment-resistant PTSD “experienced either cessation of nightmares or a significant reduction in nightmare intensity” when treated with a cannabinoids. “Subjective improvement in sleep time, the quality of sleep, and reduction of day-time flashbacks and night sweats were also noted,” Fraser says.

Likewise, groundbreaking research conducted by the British Columbia Centre for Substance Use indicates that Canadians with PTSD who use medical cannabis are 60 – 65% less likely to suffer from depression or suicidal thoughts than those who do not. According to The Globe and Mail, this study “is the first national-scale indication of the effectiveness of cannabis at mitigating the hallmark symptoms of PTSD.”

Finally, Zach Walsh, a Professor at the University of British Columbia and Principal investigator for the first controlled trial evaluating the impact of medicinal cannabis on PTSD states that “new research supports the belief that cannabis can help bridge people with PTSD “to a place where they’re ready to take the next step” in recovery (2018). Walsh told The Globe and Mail, that talk-therapy and CBT (cognitive behavioural therapy) are the most common prescriptions for managing PTSD. To even get to that point, however, he says, they have to “get past the critical point of suicidality and a really chaotic, agonizing life.” This is where medical cannabis becomes useful.

 

Final Thoughts

PTSD is a condition that affects thousands of Canadians, yet effective treatments to manage PTSD symptoms are limited. Unlike other treatments, medical cannabis is a promising treatment for improving the often emotionally debilitating symptoms of the disorder. Patients diagnosed with PTSD can use medical cannabis to manage their symptoms without the adverse side effects of antipsychotic or antidepressant drugs.

* The New York Times indicates that opioids and anti-depressants can actually increase thoughts of suicide among those affected by PTSD.

 

Sources

Cerel, J., Jones, B., Brown, M., Weisenhorn, D. A., & Patel, K. (2018). “Suicide exposure in law enforcement officers,” Suicide and Life-Threatening Behavior.doi.org/10.1111/sltb.12516

Fraser, George. “The Use of a Synthetic Cannabinoid in the Management of Treatment-Resistant Nightmares in Posttraumatic Stress Disorder (PTSD),” CNS Neuroscience & Therapeutics 15, no 1. (2009): 84-88.

 

Leeder, Jessica (2019). “Medical cannabis use can help mitigate symptoms of PTSD, study says,” The Globe and Mail, https://www.theglobeandmail.com/canada/article-medicinal-cannabis-use-can-help-mitigate-symptoms-of-ptsd-study-says/

 

Ugwu, Reggie (2017) /“Veterans Groups Push for Medical Marijuana to Treat PTSD,” The New York Times. https://www.nytimes.com/2017/11/03/us/medical-marijuana-veterans.html