Cannabis should be a first-line treatment for PTSD

By |2019-11-04T00:10:42+00:00November 4th, 2019|Uncategorized|0 Comments

Studies say that 6-12% of the world population is diagnosed with PTSD at some point in life, with women experiencing PTSD twice as often as men. 

With this huge global diagnosis, the American Psychiatric Association recommends only fluoxetine, paroxetine, sertraline, and venlafaxine for those with PTSD. 

However, the professional standard of care for PTSD incorporates prescriptions from every psychotherapeutic class: antidepressants, antihypertensives, antipsychotics, anxiolytics, benzodiazepines, mood stabilizers, narcotics, sedatives, and stimulants.

Despite the myriad of polypharmaceutical choices, 1.1% of the US population (2.1M) chooses cannabis as medicine by way of legal medical cannabis cards. Of US adults diagnosed with PTSD, 65% report regularly using cannabis to reduce their symptoms (despite having legal access or not)! 

This says that patients want alternatives. Medical cannabis can be a safer option to modern medical treatment and prescriptions. Weakened trust for the medical field, unwanted and unexpected side effects, and increased prescription costs especially for those without insurance have driven many patients to consider cannabis.

The efficacy (and science) of medical cannabis for people with PTSD is overwhelming. 

Irregular cannabinoid signalling induced by stress and trauma can cause symptoms of PTSD, including detaching from others, avoidance, flashbacks and nightmares, sleep disturbances, increased pulse rate and blood pressure, negativity and lack of motivation, aggression, anger, and hypervigilance, and memory loss. 

The science says that those with PTSD have lower levels of anandamide (AEA), a naturally occurring endocannabinoid that plays a major role in pain, depression, appetite, memory, and fertility. AEA specifically binds to CB1 and CB2 cannabinoid receptors like a lock and key. THC mimics the binding effects of AEA, and when THC is consumed, PTSD symptoms are greatly reduced (and bodily homeostasis is achieved). 

The safety and side effect profile of cannabis, too, is nowhere as dangerous as most prescription drugs. A patient’s prior experience with cannabis can help determine possible reactions, but the most common adverse psychiatric reactions (which resolve within hours without consequence) include feeling “too high”, dysphoria, disconnected thoughts, panicked reactions, increased heart rate, dizziness, changes in perceptions, and impaired cognitive and motor skills.

Moderate and heavy cannabis users tend to experience fewer of these side effects less often. With increased experience and tolerance, naive and mild cannabis users can consume cannabis daily with comfortably profound psychoactive effects. Patients can even grow THC/CBD-specific cannabis strains to best treat their symptoms for practically free. 

That said, until more providers are willing to trust and prescribe cannabis, individuals will no doubt be forced to self-medicate and find relief on their own. 

Only 9% of medical schools include cannabinoid science in their curriculum, and nearly 90% of residents and fellows report they do not feel prepared to prescribe medical cannabis to patients. This lack of training and knowledge is inadequate for patients who want to find wellness through cannabis.

Providers must work with patients who want to use cannabis. 

We must research the science and end our medical ignorance about this plant. 

We must network with other doctors who confidently recommend cannabis to their patients. 

We must help patients who feel hindered by insurance companies, big pharma, and judgmental physicians find relief in an alternative. 

We must be brave despite any legal reprimands or repercussions for recommending the best possible medicine to our patients.