Molecules within the cannabis plant show promising long-term therapeutic impact in the treatment of post-traumatic stress disorder (PTSD). By interfacing with an ancient system tasked with maintaining equilibrium within the body, these cannabinoids may create shifts in the brain that change the way we view traumatic events.
Following birth, all humans are destined for some degree of pain and suffering. While physical wounds heal in time, particularly traumatic events can leave permanent etchings on the psyche. Approximately 1 in 2 people experience a traumatic event in their life. For some, this moment may involve sexual assault or living through a natural disaster. In others, the brutality of war casts a shadow years after engaging in conflict.
However, only a small number of people that experience trauma develop PTSD. Between 7-8% of the US population will experience the chronic psychiatric condition at some point in their life, and the onset varies between individuals. Symptoms may arise immediately, or months or years following a traumatic event.
Characterized by anxiety, sleeping issues, and hyperarousal, the condition has a large impact on quality of life, often leading to isolation and frequent feelings of irritability and guilt. Far from fleeting emotions, these symptoms arise from fundamental changes in brain function. Activity in the amygdala — a region associated with conditioned fear — ramps up. Conversely, the ability of the medial prefrontal cortex to consolidate new memories decreases.
Changes also occur within the endocannabinoid system (ECS) of the brain. The ECS plays a fundamental role in homeostasis — keeping other bodily systems from straying above or below baseline. Composed of receptors, endocannabinoid signalling molecules, and specialized enzymes, the ECS plays a major role in memory processing.
The fear response remains a crucial part of cognitive processing in humans and serves to keep us safe. In PTSD, this reaction becomes damaged. After experiencing a highly emotional event, the brain consolidates the memory ready for retrieval at any time. This function helps us to swiftly identify potential danger, a mechanism that kept our ancestors alive in the tooth and claw throes of pre-agricultural life.
In the PTSD brain, a maladaptive retrieval of memories leads to persistent re-experiencing of a traumatic event, increased arousal, and avoidance of stimuli associated with the moment of trauma. These factors lead to excessive retrieval of vivid memories that consistently evoke stress.
Researchers state that an ideal treatment for the condition would involve blocking the pathological over-consolidation and continuous retrieval of memories while helping to diminish the memory and ease anxiety.
Conventional approaches such as the prescription of antidepressants often fail to meet these goals. In contrast, molecules that interface with the ECS might achieve these criteria, making cannabis a natural and largely safe candidate.
ECS receptors are found throughout the limbic system, the home of the amygdala. Here, they play a key role in regulating emotional behaviour, cognitive processing, and thus help to maintain emotional homeostasis.
Early animal research also demonstrates that targeting the ECS influences memory consolidation and retrieval while helping to drive memory extinction — a process that diminishes the conditioned response to a particular memory over time.
The body’s own internal endocannabinoids, including anandamide and 2-AG, work as signalling molecules within the ECS. External phytocannabinoids share a similar molecular structure with these chemicals, allowing them to bind to the same receptor sites and produce similar effects.
As though fuelled by an intuitive drive to modulate the ECS, many PTSD sufferers appear to self-medicate with cannabis. This behaviour often manifests as an unhealthy overuse in the form of cannabis use disorder. However, the herb also appears to reduce the symptoms of PTSD through receptor-binding actions in the brain.
Scientists have attempted to paint a picture of how dispensary-obtained cannabis helps to reduce the symptoms of PTSD, yet this research remains at the preclinical stage. Prohibition at the federal level in the United States makes conducting clinical trials notoriously difficult.
Some small-scale clinical studies have explored the effects of THC and CBD in isolation. The results showed a reduction in PTSD symptoms such as nightmares and hyperarousal. However, hundreds of molecules within cannabis flowers work in synergy to produce the true effects of each cultivar.
For now, researchers are restricted to observational studies that assess the progress of patients overtime outside of a controlled setting. A 2020 paper published in the journal Cannabis & Cannabinoid Research documents a prospective study that collected data on PTSD patients using dispensary-obtained cannabis over one year.
The researchers recruited 150 participants diagnosed with PTSD. One group consisted of patients that use cannabis to manage their symptoms, whereas non-cannabis users made up the second group and served as controls.
Throughout the study, the research team utilized psychological measuring tools to track outcomes including insomnia and psychosocial functioning. They also harnessed the Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria to monitor the rate of change of PTSD symptoms including avoidance, hyperarousal, and intrusions.
At the end of the study period, the results showed that cannabis greatly benefited the patients in the experimental group, particularly those who opted to use high-THC varieties as opposed to strains higher in CBD. Amazingly, those in the cannabis group reported greater reductions in symptom severity and were 2.5 times more likely to no longer meet the DSM criteria for a PTSD diagnosis.
The authors of the paper state that future research should dedicate time towards identifying any associated risks between PTSD and cannabis use, but state, “This study provides evidence that the types of cannabis available in recreational and medical cannabis dispensaries might hold promise as an alternative treatment for PTSD.”
Fine metalwork undergoes a beating at the anvil. Muscle requires damage to grow. Adaptations only take place following an imposed demand. PTSD remains a lifelong battle for many, but natural tools such as cannabis may provide the catalyst for some to overcome the largest obstacle of their life, only to emerge stronger.
Luke Sumpter is a freelance journalist that specializes in health, wellness, and alternative therapies. Currently, he’s working on a dissertation exploring the emerging role of the endocannabinoid system in orthopaedic medicine.