Many Americans celebrate the Fourth of July with cookouts, ice cream, red, white, and blue everything, cold beer, swimming, and of course, fireworks. It’s the time of year when people can set aside their differences and celebrate what unites them: the love for their country.
But there’s a sad irony to the holiday as well. For many who fought for the freedoms that are celebrated on Independence Day, the Fourth of July can be a serious source of stress and anxiety. This is because millions of veterans suffer from post-traumatic stress disorder, or PTSD.
PTSD is a condition where a traumatic, stressful, distressing, or frightening experience is relived. A particular situation, or “trigger,” can remind the PTSD sufferer of their past experience. Nightmares, flashbacks, feelings of isolation, guilt, irritability, anxiety, and depression are common symptoms. PTSD is often – but not always – grouped with anxiety disorders. Therefore, the flashes and bangs of fireworks can understandably be triggering for many veterans.
This Fourth of July, in honor of the veterans who help guarantee US independence, we here at Leafwell are taking a look at post-traumatic stress disorder (PTSD) and how medical cannabis and CBD can help those who suffer from it.
How Prevalent is PTSD?
Approximately 8 million adults suffer from PTSD in the United States. It is estimated that approximately 8% of adults, or 1 in 13 people, in the US will develop PTSD during their lifetime. This number sharply increases for those in the military and armed forces. Depending on the war they served in, between 11%-30% of veterans experience PTSD.
PTSD also has a strong genetic factor – from 5%-20%. One analysis “uncovered DNA variants at six loci that were strongly associated with PTSD risk. Three of the six loci were specific to certain ancestral backgrounds — two European and one African — and three were only detected in men. The six loci hint that inflammatory and immune mechanisms may be involved in the disorder, which is consistent with findings from previous studies.”
PTSD is closely linked with anxiety and depression, which can make a vet suffering from it feel isolated. This loneliness could explain why 5%-10% of veterans who develop PTSD experience problems creating lasting relationships. Depression and anxiety also have genetic components, and inflammation also features in both of these mental health issues as well.
With anxiety, depression, and loneliness all being associated with PTSD, it’s understandable then why people who suffer from it are also at an increased risk of suicide and drug abuse. Therefore, finding a solution to help treat PTSD is paramount for saving lives, especially the lives of veterans.
How is PTSD Currently Treated?
How Therapy Can Help Veterans with PTSD
There are several treatments that are effective, including trauma-focused cognitive behavioral therapy (CBT) and eye movement desensitization and reprocessing. Therapy methods include cognitive processing therapy (CPT), prolonged exposure (PE), stress inoculation training (SIT), and present centered therapy (PCT). Other non-medication-based treatments include what might be deemed “the basics”: proper sleep, exercise, and nutrition.
Medications for PTSD
Some PTSD sufferers take medication to help their disorder, including antidepressants like sertraline (Zoloft). Sertraline is also used to treat anxiety-related disorders, such as obsessive-compulsive disorder (OCD), panic disorder, and social anxiety disorder.
In some instances, sedatives like benzodiazepines may be prescribed on a short-term basis. Examples of popular benzos are Xanax, Klonopin, and Valium. However, benzodiazepines are highly addictive, and in fact, one study found that abuse or misuse accounted for 17% of overall use of benzodiazepines.
Why Does Cannabis & CBD Work for PTSD?
There is a multitude of reasons why cannabis may work for PTSD. These include:
- Stress and anxiety beating terpenes such as linalool, beta-caryophyllene, and limonene.
- CBD may be used to improve regional cerebral blood flow (rCBF) in the brain. This helps by reducing anxiety and increasing the amount of important hormones and nutrients moved through the brain.
- May help keep the mind off of reliving traumatic experiences via the endocannabinoid system’s involvement in the retrieval of memories and memory consolidation.
- Terpenes like pinene can help prevent hyperventilation, which can occur during an acute anxiety attack associated with PTSD.
- Those who have PTSD have been shown to have lower amounts of anandamide available in their bodies. Increasing the amount of anandamide available in the body may help improve mood and reduce fear and anxiety.
- May help promote sleep and a night’s rest, with fewer sleep disturbances and nightmares.
- Cannabinoids can be used as an alternative to benzodiazepines.
- One study suggests that cannabis can reduce the symptoms of PTSD, at least in the short-term. The same study shows that inhaled cannabis acutely reduced PTSD symptoms by more than 50%.
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Is Medical Marijuana of Particular Use for Veterans?
Based on the findings listed above, medical marijuana for PTSD may be a viable treatment for many veterans. There is no standardized solution for treating PTSD, but CBD and medical cannabis could be a good fit for a vet experiencing anxiety, depression, and/or insomnia as a result of their PTSD. Vaping cannabis and using tinctures may be particularly useful for veterans who need cannabinoid-based medications for PTSD.
A common concern among veterans exploring how medical marijuana helps PTSD is the risk of losing their benefits from the U.S. Department of Veterans Affairs (VA). However, the VA states on their website “veteran participation in state marijuana programs does not affect eligibility for VA care and services.”
What Are the Best Medical Marijuana Products or “Strains” for PTSD?
In general, you should be wary of promises that a specific strain is useful for specific conditions. Instead, focus on the testing of cannabinoids and terpenes for PTSD, anxiety, and depression. Unfortunately, cannabinoids beyond THC and CBD aren’t always tested for, so this can make it difficult to determine a product’s effects.
So, how does a person get an idea of what product to use for PTSD? Essentially, look at the test results. Although cannabinoids beyond THC and CBD are not always tested for, THC and CBD ratios and terpenes usually are. Whilst this is not perfect, it is a good place to start.
THC, CBD, CBG, and CBN may be of particular use for PTSD. THC and CBN can both be used to help get to and stay asleep, so if insomnia or Fourth of July fireworks are causing problems, look for a product that includes either of those. Some CBD can be used to help improve mood and reduce inflammation.
Limonene, bisabolol, myrcene, pinene, beta-caryophyllene, and humulene may be helpful terpenes. These terpenes can help a PTSD sufferer get to sleep and can reduce inflammation, too. Those who suffer from a lack of sleep (insomnia) have higher amounts of inflammatory proteins, known as cytokines, in the body. Reducing the level of cytokines can help reduce inflammation, improve mood, and help get a person to sleep.
However, the above terpene profile may not necessarily be ideal for daytime use. During the day, more CBD may be utilized, so a CBD:THC ratio of 1:1, 2:1, or 3:1, with a mixture of limonene, pinene, and beta-caryophyllene (less of myrcene, linalool, bisabolol, and humulene) for mood-improving effects.
THC, CBN, myrcene, linalool, bisabolol, and humulene may be a better mixture at night – taken 30-60 minutes before bed, to help get to and stay asleep. Most would suggest starting off slow and low – about 2-2.5 mg of THC in tincture form. Some would suggest vaping a small amount of cannabis (which could be one, two, or three puffs) to help reduce anxiety and help get to sleep, combined with a small amount of tincture to help stay asleep. This depends very much on the individual, and some may need higher doses of THC.
Those who suffer from PTSD may be able to tolerate more THC compared to other conditions associated with anxiety. This is because those with PTSD have a lack of anandamide available in the body, and THC can help increase the level of anandamide available in the body via inhibition of the enzyme that breaks down anandamide, fatty acid amide hydrolase (FAAH).
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Using Cannabis for PTSD – Overall
PTSD is a serious problem for many people, and especially women and men who serve their country. Although there is a lack of placebo-controlled studies on using cannabis for PTSD, much of the literature so far suggests that cannabinoids could prove to be a very useful treatment for PTSD. The main issue is that there is no magic cure for PTSD. Cannabis, like any other medication, can treat only the symptoms. When it comes to treating mental health conditions, combining cannabinoids with therapy is ideal for efficacy. If you’d like to learn more about how medical marijuana or CBD can help PTSD, our doctors are available to answer any questions you have.
Written by Dipak Hemraj, Chief Research Officer (CRO)