From 2020 to 2022, 5.7 percent of Australians experienced post-traumatic stress disorder (PTSD). This is an alarming statistic, and calls for more awareness and treatment options.
PTSD can cause significant distress for the person living with it and for their loved ones, can lead to substance abuse and, sadly, suicide if left untreated.
Alternative treatments such as medical cannabis for PTSD have gained traction in recent years. While the research for how medical cannabis might help manage PTSD is still in the early stages, some studies have had some encouraging results. But first it’s important to understand what PTSD is, what symptoms it can have and how PTSD is related to the endocannabinoid system.
What Is PTSD?
Many different experiences can lead to PTSD, but the condition is usually associated with witnessing or nearly experiencing death, serious injury and/or sexual violence. People might also develop PTSD if they learn that any of these events happened to a close friend or family member.
In the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) PTSD is listed under the ‘Trauma and Stressor-related Disorders’ category. People with PTSD experience several symptoms relating to a traumatic event that happened to them or that they witnessed. Some of the symptoms of PTSD can include:
- recurring, intrusive memories of the traumatic event
- recurring nightmares about the traumatic event
- flashbacks that can feel as if the person is reliving the traumatic event
- distress after encountering something that reminds the person of the traumatic event
- avoiding things, situations or people who remind the person of the traumatic event
- persistent feelings of guilt, shame, fear or anger
- self-destructive or reckless behaviour
- trouble with falling or staying asleep
- hypervigilance
- inability to experience positive emotions
People with PTSD may also experience derealisation or depersonalisation. Derealisation is when the world appears unreal or dreamlike, while depersonalisation is when someone feels disconnected from themselves or like they are watching themselves as an outside observer. PTSD may also lead to reckless behaviour such as dangerous driving, excessive alcohol consumption or illicit drug use.
What Is The Endocannabinoid System And Does PTSD Affect It?
The endocannabinoid system (ECS) is a complex network of cellular receptors that help regulate several bodily functions including mood, appetite and sleep. There are two types of cannabinoid receptors in the ECS: CB1 receptors (found in the brain and central nervous system) and CB2 receptors (found in peripheral tissues and immune cells).
When you consume medical cannabis, you introduce phytocannabinoids into your system that interact with your CB1 and CB2 receptors. Tetrahydrocannabinol (THC) and cannabidiol (CBD) are both phytocannabinoids, but have different effects. THC is primarily responsible for the psychotropic effects of medical cannabis, which is commonly referred to as a ‘high.’
Researchers are exploring phytocannabinoids for how they may be able to help people with PTSD. Some research suggests that heightened signalling within the ECS may improve certain symptoms that are common in people with PTSD such as an exaggerated stress response.
Can Medical Cannabis Reduce PTSD Symptoms?
Although the evidence isn’t yet conclusive, there is some positive clinical evidence to suggest that medical cannabis may help manage some aspects of PTSD. A recent review of human studies suggests that low doses of THC, sometimes with CBD, may be useful in reducing fear associated with traumatic memories.
More specifically, a 2020 study explored the effect that THC has on the amygdala – the brain region responsible for the sensation and regulation of fear. THC has a strong affinity for the CB1 receptors, which are found in large numbers in the amygdala.
The study split participants into three groups: adults with PTSD who were previously exposed to trauma, adults exposed to trauma but without PTSD and healthy adults without trauma. Researchers randomly assigned participants a 7.5 milligram dose of synthetic THC or a placebo, and found that the group who received the THC had reduced activity in their amygdala compared to those who received the placebo.
Another recent review indicates that THC may have some use in reducing nightmares associated with PTSD through its ability to modify REM sleep (the sleep stage when dreams occur). The review notes, however, that more randomised controlled trials are needed to better understand the potential benefits. Another older study supports these findings, however, with participants experiencing reduced hyperarousal symptoms and reduced nightmares associated with PTSD.
These results suggest that THC may have some use in managing PTSD symptoms. More research is needed, however, especially on how medical cannabis might affect PTSD in the long term.
What Are The Risks Of Using Medical Cannabis For PTSD?
It’s important to follow your doctor's guidance when using medical cannabis for any condition. Larger doses of THC may worsen anxiety in people with PTSD rather than reducing it, so it’s important to stick to your prescribed dose.
Cannabis may also have some links to psychosis in vulnerable people, particularly when used illicitly or excessively. When used with the guidance of a medical professional, however, medical cannabis is usually safe.
Seeking Help For PTSD
If you’re showing concerning symptoms, book an appointment with your healthcare provider. A doctor will assess your symptoms and recommend an appropriate course of action. If appropriate, a doctor may prescribe medical cannabis for PTSD, but only once conventional treatments have failed to help or if they caused unmanageable side effects.
If you prefer, you can book an appointment with a medical cannabis clinic to discuss prescription options. PTSD is a serious condition that needs to be managed with appropriate treatments and care – it’s vital to reach out as soon as possible if you’re at all worried about your or someone else’s mental health.
