Treating PTSD with Cannabis

The psychological effects of war often cause more injury than the physical.

When our military members return from battle, their employer, the Federal government, restricts the medications that will aid their recovery and re-integration into society.

Many soldiers are young people, fresh graduates from adolescence. Their personalities are still in a formative stage. This trait makes them malleable and their superiors use this trait to form an integrative fighting force. It also leaves them vulnerable to the horrors experienced in warfare. The friends and brothers they bond with become victims of violent acts they witness or are a party to. Many bear physical scars that cause pain and restrict their future lives and contributions to society; as soldiers, they inflict violence on unseen victims. These memories return to haunt them after their discharge, a phenomenon known as post-traumatic stress disorder (PTSD).

PTSD has been studied by scientists within the context of our current knowledge of the endocannabinoid system. The scientific community recognizes that the brain is formed with internal cannabinoid receptors (CB₁) for the endocannabinoid anandamide. These receptors can be located and mapped using positron emission tomography (PET) and a radioactively-tagged CB₁ molecule. A group of researchers using PET scans compared the brains of PTSD patients to patients who were lifelong trauma victims (TC) but also to healthy volunteers (HC). They found the patients with PTSD had significant increases brain-wide for the CB₁ receptors compared to the TC group and the HC group. This increase in CB₁ receptors was more pronounced in the women than the men. Only the PTSD group was simultaneously found to have lower levels of circulating anandamide.

Both the PTSD and the TC groups were also found to have lower levels of cortisol, a stress hormone. These findings were correct for eighty-five percent of the PTSD patients examined and allowed the researchers to correlate the physical evidence with the psychological state of mind. The conclusion needs to be verified with a larger sample size of patients but preliminarily it suggests that PTSD patients can be identified through measurement of CB₁ receptor brain proliferation and low levels of anandamide in circulation. The hypothesis is that the brain has a neurological or physiological benefit from CB₁ stimulation and because the blood levels are low the brain up-regulates by creating more receptor sites.

This study was published in Molecular Psychiatry in September 2013. At that time, lead researcher Dr. Alexander Neumeister discouraged the use of botanical cannabinoids as a treatment because research and clinical trials has not yet been done. One result of using botanical cannabinoids is the down regulation of CB₁ receptor sites and the reason for their proliferation and presence was unknown. Their disappearance might lead to depression or anxiety in susceptible individuals. The scientific question remains if supplementing cannabinoids to interact with the CB₁ receptors will exacerbate or ameliorate the symptoms of PTSD but the practical experience of most veterans who have tried Cannabis has been a decrease in their PTSD symptoms.

Former Air Force senior airman Amy Rising worked for four years at the global command center at Scott Air Force base in Illinois. From that location in America, she would coordinate bombing and other missions in Afghanistan and Iraq. Now, after the war, she suffers from severe anxiety.

"What was really hard about working in command was never being able to see the damage you did on the ground," she says. "You start to think about all the orphans and widows you created and that you do hit civilians."

Amy discovered that smoking Cannabis relieved her feelings of anxiety and allowed her to fulfill her role as a mother and to function in society.

In 2011, the Veterans Administration issued an order that patients using Cannabis could not lose their Veterans benefits. The guidelines allowed patients to determine their own 'treatment plans'. The official policy for VA doctors and pain specialists prohibits them from recommending Cannabis for treatment or participating in the acquisition of Cannabis by patients. This policy is in line with federal law placing Cannabis in Schedule I of the Controlled Substances Act. This placement in the same category as LSD and psilocybin is reserved for those drugs that have no known medical use and a high probability of abuse.

Another concern is that without knowledge of other drugs a patient was taking, there could be harmful interactions. In fact, patients are discovering a beneficial interaction between Cannabis and their pain medications, often finding better pain relief through the combination of opiate pain medicine and Cannabis than with their opiate-based medicines alone.

Scott Murphy, an Iraq war veteran, suffers pain from physical injuries accrued while lugging heavy equipment during his service. These injuries contribute to bone pain in his leg, hip and wrist. Murphy was using morphine, OxyContin and muscle relaxers but still had severe pain. Once he tried sublingual cannabinoid drops, he was able to go for eight hours without taking another dose of opiates. Scott Murphy is now the head of Veterans for Safe Access and Compassionate Care and also lobbies on Capitol Hill for the declassification of Cannabis as a Schedule I drug.

Mark di Pasquale also served two years in Iraq as a staff sergeant; Cannabis was his 'exit drug'. Mark tried twenty-two medications without relief and the side effects of these drugs interfered with his ability to function in society. These side effects were worse than the pain from his back and bone injuries - and worse than his PTSD. He quit using drugs and alcohol, adopted a healthy diet and lifestyle and began vaporizing Cannabis for relief. Mark lives in New York, where Cannabis was recently legalized by voters for medicinal use.

These soldiers fought battles and were injured in the line of duty while protecting the United States from foreign harm. They have now returned home to fight the battle for access to the one medicine that will help to relieve the aftereffects of war. PTSD can be a debilitating disorder without the aid of Cannabis, which can bring peace to a war-ravaged mind.