A new research study using archival data from Strainprint®, a medical cannabis technology platform, has found evidence that supports the use of medical cannabis as a potential treatment for symptoms of post-traumatic stress disorder (PTSD).
Data from 404 medical cannabis users who self-identified as having PTSD were obtained from Strainprint®, a medical cannabis app that patients use to track changes in symptoms as a function of different strains and doses of cannabis across time. This sample collectively used the app 11,797 times over 31 months to track PTSD-related symptoms. Multilevel models were used to explore long-term consequences of repeatedly using cannabis to manage these symptoms.
The researchers found that inhaled cannabis acutely reduced PTSD symptoms by more than 50%, immediately following use, however the data also suggested that cannabis only provides temporary relief from PTSD symptoms. It therefore may not be an effective long-term remedy as baseline symptoms were maintained over time and dose used for anxiety increased over time, which is indicative of development of tolerance.
Post-traumatic stress disorder (PTSD) is a disorder of recovery following the experience of a traumatic event, characterized by alterations in arousal and reactivity including irritability, sleep disturbances, and hypervigilance; intrusion symptoms including intrusive distressing memories, flashbacks, and nightmares; persistent avoidance of stimuli associated with the traumatic event(s); and disturbances in cognition and mood (APA, 2013).
While a number of effective behavioral treatments are available for individuals with PTSD (e.g., cognitive processing therapy, prolonged exposure), pharmacological interventions typically involve the use of selective serotonin reuptake inhibitors (SSRIs) which generally have small effect sizes and have been associated with various undesirable side effects, low rates of symptom remission, and high rates of dropout (Berger et al., 2009; Cipriani et al., 2018). As such, many organizations recommend therapy as the first-line treatment for PTSD, rather than SSRIs or other pharmacological interventions.
While documented evidence of therapeutic effects of cannabis on PTSD symptoms remains somewhat sparse, emerging evidence indicates that the endocannabinoid system may represent a viable target for treating PTSD. Specifically, there is evidence that PTSD may be related to deficiencies in the endocannabinoid system (Hill et al., 2018; Neumeister et al., 2013) and these deficiencies have been associated with more severe symptoms of PTSD including anxiety and extinction of aversive memories.
Indeed there is now solid evidence that cannabinoids reduce responses to conditioned fear cues, impair retrieval of emotionally aversive memories, and promote the extinction of fear memories suggesting that targeting the endocannabinoid system may hold promise for reducing PTSD-related intrusions and flashbacks.
A recent double-blind placebo-controlled trial found that inhibition of fatty acid amide 31 hydrolase (FAAH; which inhibits the breakdown of the endocannabinoid anandamide) increased levels of anandamide in healthy adults which in turn enhanced fear extinction and attenuated autonomic stress reactivity (Mayo et al., 2019). Other studies into the drug Nabilone have also shown early promise in reducing PTSD symptoms.
While there is clearly more research to be conducted in this space, the growing body of evidence is that medicinal cannabis or cannabinoid-derivative drugs may well have a role to play in the treatment and management of PTSD in the future.
Source | ScienceDirect
