THOUGHTS FROM DOC ►
Medical Cannabis as an Alternative Treatment for PTSD
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Part 3:
by Michael J. Poppa DO, MBA
ast month, I addressed the use of medical cannabis as an effective pain management treatment. This month we are going to discuss medical cannabis as an adjunct treatment for Post-Traumatic Stress Disorder symptoms.
I recently reviewed five studies (2013 Bonn-Miller1, 2014 Roitman2, 2014 Greer3, 2015 Wilkinson4, 2016 Tull5) with various conclusions. In addition, a study was just completed by Dr. Sue Sisley and the Scottsdale Research Institute; however, the study results will not be released until the end of this year or early next summer. Dr. Sisley’s research study consisted of a triple-blind study using flower with various consistencies of THC and CBD. Patients used up to 1.8 grams per day and were evaluated by a third party. Dr. Sisley did state, “Unlike big pharma, where they selectively suppress data that doesn’t make their study drug more favorable, we put in all the good and the bad — for the public to scrutinize.” Needless to say, cannabis use for various medical conditions deserves unbiased studies similar to the one performed by Dr. Sisley and the Scottsdale Research Institute. Most evidence suggests that the therapeutic use of cannabis can significantly improve the quality of life for both those individuals who have PTSD and their families. Medical marijuana is not a cure but does provide adjunct treatment for many of the debilitating symptoms associated with PTSD, including: ● Anxiety – One of the most common afflictions associated with PTSD, is chronic anxiety. Cannabis with higher levels of CBD has shown to reduce stress, fight anxious feelings, and provides mood-enhancing abilities. 20
November 2019
● Nightmares – Typically, individuals with PTSD experience nightmares, which can be an intense side effect of PTSD. Marijuana has the ability to reduce REM (rapid eye movement) sleep, which is the stage where the most vivid dreams occur. ● Insomnia – Often, PTSD individuals experience flashbacks, nightmares, and anxiety, which significantly contributes to insomnia and makes it very difficult to fall asleep. Even those individuals who can attain some level of sleep are sometimes awakened by varying degrees of intense nightmares caused by PTSD. Cannabis has shown to both reduce the amount of time it takes to fall asleep and improve the overall quality of sleep, thus contributing to individuals coping with insomnia. Traditional medical treatment for individuals with PTSD include selective serotonin reuptake inhibitors; however, these drugs may increase symptoms of depression and anxiety. Additionally, pharmacological agents that are used for the treatment of PTSD symptoms often cause disorientation, lethargy, and can produce suicidal thoughts and behaviors. This is not to imply that cannabis used for the treatment of PTSD symptoms is devoid of side effects. A growing concern among veterans and other individuals who have been diagnosed with PTSD is Cannabis Use Disorder (CUD). The awareness and concern for developing CUD, especially in a patient population in which substance abuse and addiction is common requires awareness and open discussion with your treating physician. We are often asked, “What is the best strain of cannabis for PTSD?” There is no easy answer; however, anecdotally, there are numerous strain options available that help an individual to lessen their PTSD symptoms. Before choosing one strain over another, it is important to understand the difference between strains high in THC and those which are CBD dominant. In general, high CBD strains provide mood-stabilizing effects, which is advantageous for treating anxiety, stress, or PTSD symptoms. Strains with large amounts of THC are generally more effective in the evening or at night and can help to provide a restful nights’ sleep. Another factor that should be considered are terpenes. Without getting bogged down into too much information, terpenes are a large class of organic compounds produced by a variety of plants, which are instrumental to the physiological and psychoactive effects of cannabis. In fact, this topic (terpenes) has been well discussed by contributing authors in The EVOLUTION Magazine in previous issues. I strongly suggest you review these articles (see August 2019 issue, page 34) for additional information.
