Despite sharing some key features, anxiety disorders differ in a number of underlying ways. Hypervigilance, hyperarousal, dissociation, emotional numbing, and reexperiencing phenomena through nightmares and flashbacks are particular characteristics of PTSD (5). Post-Traumatic Stress Disorder is defined as a debilitating condition affecting the body, mind, and spirit, related to the failure of what scientists call the brain’s “extinction process” which diminishes the impact of traumatic memories. It can stem from direct or witnessed exposure to an event considered to be extremely traumatic and is characterized by symptoms such as anxiety, nightmares, insomnia, flashbacks, and depressions to name a few. The compound effect of these symptoms are believed to be why sometimes individuals suffering from PTSD cope by alcohol or substance abuse (6).
One pioneer investigator into the relationship between cannabis and PTSD is the Multidisciplinary Association for Psychedelic Studies (MAPS). Martin Lee who is a MAPS affiliate and director of Project CBD, has studied PTSD and cannabinoids extensively.
Researchers found that people with PTSD had lower levels of anandamide, a neurochemical that our body produces which acts a messenger molecule playing a role in fertility, appetite, memory, pain, and depression. In other words, one pillar of PTSD is an endocannabinoid deficiency in which the body stops producing enough endocannabinoids to fill receptor sites. This is where the cannabinoids found in marijuana have been shown to play a therapeutic role by replenishing these missing endocannabinoids with those found in cannabis (3).
Concentrated in the brain and central nervous system, the cannabinoid receptor known as CB-1 mediates a broad range of physiological functions, including emotional learning, stress adaptation, and fear extinction (4). Scientists have determined that normal CB-1 receptor signaling deactivates traumatic memories and elevation of anandamide/CB1 receptor signaling reduces anxiety and increases the extinction of fear. However, Lee says “Skewed CB-1 signaling, due to endocannabinoid deficits (low serum levels of anandamide), results in impaired fear extinction, aversive memory consolidation, and chronic anxiety, the hallmarks of PTSD.” Recent research confirms that CBD has the potential to treat symptoms of PTSD safely and effectively without psychotropic impairment by working to bridge the gap between the endocannabinoid system and the processing of traumatic memories in the brain (6). Cannabidiol (CBD) is a non-psychotropic compound in cannabis that stimulates endocannabinoid receptors by inhibiting the FAAH enzyme, the enzyme that metabolizes and destroys anandamide. This is just one of the ways that CBD shows promise as a treatment for PTSD (4).
Dr. Rabinak of Wayne State University and the National Institute of Health summarized what we know about the therapeutic potential of cannabis in PTSD and anxiety disorder treatment:
- Acute THC and CBD reduce amygdala reactivity to threat.
- PTSD is associated with reduced peripheral endocannabinoids and increased CB1 receptor availability in the brain.
- An acute dose of THC pre-extinction facilitates extinction learning and increases activation of the ventromedial prefrontal cortex and hippocampus during extinction recall (2).
Ultimately, the U.S. Department of Veteran Affairs acknowledges that the endocannabinoid system has been clearly demonstrated and that cannabis may help with symptoms in the short term, but warns about the long-term risks of addiction to high-THC cannabis (6). In the past, government funded studies which examined the link between cannabis and PTSD frequently used the term “marijuana abuse disorder” to describe the relationship. The degrading term was coined a co-occurring problem in need of rehabilitation even though there is overwhelming evidence that PTSD and cannabis go hand-in-hand. While most studies point out the prevalence of marijuana abuse among PTSD patients, emerging research is looking at the question in reverse: Rather than PTSD causing abuse of cannabis, could cannabis be effectively treating PTSD? (3)
Currently it is legal for adults over the age of 21 to smoke marijuana recreationally without a doctor’s letter in nine states. Medical marijuana is legal in 29 states and Vermont became the first state to legalize marijuana through the legislature, rather than a ballot initiative when Republican Governor Phil Scott signed the bill into law in January (1). PTSD patients are still advised to first consult a medical professional before treating symptoms with cannabis.
This Map Shows Every State That Has Legalized Marijuana
Melia Berke – http://www.businessinsider.com/legal-marijuana-states-2018-1
Cannabis and Post-traumatic Stress Disorder (ptsd)
Bailey Rahn – https://www.leafly.com/news/health/cannabis-and-post-traumatic-stress-disorder-ptsd
Functional Neuroimaging Of Anxiety: A Meta-analysis Of Emotional Processing in Ptsd, Social Anxiety Disorder, and Specific Phobia
CBD: a Patient’s Guide To Health with Medicinal Cannabis
Leonard Leinow-Juliana Birnbaum