Does marijuana decrease stress levels in patients with PTSD?
Marijuana and the topic of its effects and whether it should be legalized or not is a popular controversy. Advocates for legalization claim that there are multiple benefits for medical cannabis use, such as treating PTSD patients to reduce their symptom severity and many others. With growing interest in marijuana and its benefits across the world, more knowledge on its composition and effects are vital to ensure that misuse doesn’t become dangerous.
Multiple studies have been done on the topic of the correlation between marijuana use and PTSD symptom severity. With varying results, there is significant evidence supporting both sides of the argument. This encourages the fact that more studies need to be conducted to gain a more definitive answer. However, it is evident that marijuana may reduce stress levels in patients with PTSD.
Two studies on the effects of cannabinoids on the brain on the consolidation of a traumatic event show that marijuana can be used as a sort of therapy. One of the studies discussed tested the specific cannabinoid and glucocorticoid receptors and their reactions in the amygdala and hippocampus. The other studied the effects of enhancing endocannabinoid signaling and blocking corticotrophin releasing receptor in the amygdala and hippocampus. Both these studies were very specific and had positive results.
The findings of the first study suggested that the basolateral amygdala is an area of action of cannabinoids and glucocorticoids in moderating consolidation of traumatic memory in a rat model with PTSD.1 The findings also showed the specific receptors that are activated and deactivated in the amygdala and hippocampus when being treated with cannabinoids for PTSD. The findings of the second article also suggested that enhancing endocannabinoid signaling in the amygdala and hippocampus produced a favorable spectrum of effects.
Marijuana dependence is shown to moderate the effect of PTSD on trauma reactivity in substance dependent patients. One of the studies explored the role of marijuana dependence in the relationship between PTSD and subjective and biological emotional reactivity in response to a stressful situation. The findings of the study showed that patients with PTSD who were also marijuana dependent may experience changes in their emotional processing in response to said stressful situations.2 This dampens their emotional reactivity in order for them to not have triggering symptoms.
Studies show that with moderate amounts on a regular basis, PTSD symptoms in patients were reduced. One such study explored the moderating role of the tendency to engage in strategies to reduce unpleasant personal experiences in the PTSD–cannabis dependence relationship. This study was conducted among a sample of patients with PTSD in residential substance abuse treatment. Another study reported and statistically analyzed psychometric data on PTSD symptoms.
Both of these studies showed evidence for marijuana reducing PTSD symptoms. The studies showed that they are consistent with evidence that marijuana use may serve an avoidant role among individuals with PTSD3 and that cannabis is associated with drops in PTSD symptom severity in some patients.4 Both the studies had positive findings that supported the affirmative side of this argument, but also stated that more experiments and studies are crucial for a more definite and well-rounded answer.
Some studies show that PTSD patients who use marijuana with expectations regarding their symptoms decreasing experienced no relief, or their symptoms worsened. One study surveyed over 650 male combat veterans who used marijuana to treat their symptoms. These studies not only discuss the dangers of developing a substance use disorder, but the issue of the patients then resorting to other dangerous and potentially harmful drugs to alleviate their disorder.
The results of this study showed combat-exposed veterans who use cannabis appear to use more as the magnitude of their PTSD symptoms and the expectations of cannabis-induced relief of those symptoms increase.5 Not only did marijuana consumption not help them, but their symptoms got worse and in turn, their drug intake also got heavier. Veterans reported expecting marijuana-related improvement of all types of symptoms, but significantly more relief from symptoms of intrusion than hyperarousal, followed by avoidance and then numbing.5
Another study also showed that starters and continuing users of marijuana had significantly higher measures of PTSD symptom severity at follow-up tests compared to patients that have either never used marijuana or have stopped. Marijuana consumers also showed significantly higher measures of violent behavior at follow-up than all other groups.6
Some studies also show that treating PTSD with marijuana while having substance use disorders (SUD) and/or cannabis use disorder (CUD) is ineffective. One study conducted a test on the effects of cannabis on patients with PTSD as well as SUDs. Another study did a CUD diagnosis and observed changes in PTSD symptoms over time after discontinuation. This study claimed to present the first evidence of a potential relationship between problematic cannabis use and PTSD symptoms. This indicated that individuals with a CUD are likely to experience lower levels of change in PTSD symptoms over time.7
Some studies show that patients aren’t benefitted nor harmed by marijuana treatments. However, if the patient continues using marijuana to a point where they develop a CUD, then they will also experience lower or no levels of change in the severity of their symptoms. One of the studies stated that there were no significant positive nor negative associations between cannabis use and end-of-treatment PTSD symptom severity.8 These results support the argument that there are no effects to marijuana treatments. This study also stated that cannabis use was not linked to symptom outcomes at end-of-treatment across participants.8 This again shows that there was no correlation between cannabis use and positive nor negative symptom progress.
There is significant evidence for both sides of this argument. Studies show that cannabinoids block certain receptors and dampens emotional reactivity, which in turn, lessens the severity of PTSD symptoms. More studies show that many patients are benefitted by marijuana treatments and they report significant decreases in their stress and anxiety levels. However, some studies also show that cannabis treatments can worsen symptoms. As the patient’s symptoms worsen, their intake is increased until they develop a cannabis-use-disorder (CUD). Studies show that patients with CUDs experience lower levels of change in their symptoms, or don’t experience any changes at all. Some others also state that there is actually no benefit, nor harm as cannabis is not directly correlated with PTSD symptoms at all. However, like all medication, certain individuals experience different effects at different levels since no one is the same. These results clearly show that different people can either benefit from marijuana, develop worse symptoms, or not have any effects at all. Taking into consideration all the factors and study results, more research, experiments and studies need to be conducted to achieve a more thorough answer.
1. Shoshan, N. & Akirav, I. The effects of cannabinoid receptors activation and glucocorticoid receptors deactivation in the amygdala and hippocampus on the consolidation of a traumatic event. Neurobiol. Learn. Mem. 144, 248–258 (2017).
2. Aisenberg, N., Serova, L., Sabban, E. L. & Akirav, I. The effects of enhancing endocannabinoid signaling and blocking corticotrophin releasing factor receptor in the amygdala and hippocampus on the consolidation of a stressful event. Eur. Neuropsychopharmacol. 27, 913–927 (2017).
3. Bordieri, M. J., Tull, M. T., McDermott, M. J. & Gratz, K. L. The moderating role of experiential avoidance in the relationship between posttraumatic stress disorder symptom severity and cannabis dependence. J. Context. Behav. Sci. 3, 273–278 (2014).
4. Greer, G. R., Grob, C. S. & Halberstadt, A. L. PTSD Symptom Reports of Patients Evaluated for the New Mexico Medical Cannabis Program. J. Psychoactive Drugs 46, 73–77 (2014).
5. Earleywine, M. & Bolles, J. R. Marijuana, Expectancies, and Post-Traumatic Stress Symptoms: A Preliminary Investigation. J. Psychoactive Drugs 46, 171–177 (2014).
6. Wilkinson, S. T., Stefanovics, E. & Rosenheck, R. A. Marijuana use is associated with worse outcomes in symptom severity and violent behavior in patients with posttraumatic stress disorder. J. Clin. Psychiatry 76, 1174–1180 (2015).
7. Bonn-Miller, M. O., Boden, M. T., Vujanovic, A. A. & Drescher, K. D. Prospective investigation of the impact of cannabis use disorders on posttraumatic stress disorder symptoms among veterans in residential treatment. Psychol. Trauma Theory, Res. Pract. Policy 5, 193–200 (2013).
8. Ruglass, L. et al. Impact of Cannabis Use on Treatment Outcomes among Adults Receiving Cognitive-Behavioral Treatment for PTSD and Substance Use Disorders. J. Clin. Med. 6, 14 (2017).
9. by MJG, compiled. Hemp History Timeline on RediscoverHemp.com. RediscoverHemp 7 (2015).
I selected my topic for a variety of reasons. I strongly believe that marijuana could be a revolutionary drug with multiple medical benefits if more thorough research and experiments are conducted. As someone with a passion for helping people medically, I envision the advantages humankind can extract from the beneficial components of the drug. Starting from the treatments done on PTSD patients, I believe that more enlightenment on the drug could help us to understand it better and hopefully cater it to heal multiple diseases and conditions. Marijuana has been used for centuries as a herbal remedy throughout the world. In fact, the earliest use of marijuana and hemp dates back to 4000 B.C, where it was used in ancient China and Chinese-occupied Turkestan9. With no recorded deaths resulting from overdoses (ever) in history, the fact that marijuana is classified at the highest drug classification alongside harsh drugs like cocaine and heroin seems astounding. This also significantly limits the amount of legal research and experiments that can be conducted. I believe that starting off with PTSD patients, as more recognition is received to marijuana as a medical drug rather than a “dangerous illicit substance”, the benefits can be thoroughly explored and new medical breakthroughs can be achieved.
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