Psych Times PTSD and cannabis

Image source: Flickr CC user North Carolina National Guard

The pop culture image of PTSD is one of physical hyperactivity and hyperviolence: the Vietnam vet shooting up a small town or someone hearing a popping noise and screaming. And while there can be an element (or at least an anecdote) of truth in those, the reality is that PTSD is mostly a symptom of a hyperactive mind. It’s a brain that works against the natural tendency to move on, and a mind that never forgets. It is a mind that can go constantly back to the moment of trauma, with the same fear, pain, and adrenaline. It isn’t just remembering; it is chemically reliving.  

The nature of cannabis is what has led many to think it might be an effective treatment for PTSD. Due to its chemical makeup, there are those who believe that it can actually help the brain with the normal process of extinguishing bad memories, on a biological level. While this is controversial, there are signs that we may be getting an answer soon. The DEA has just approved a long-term study on the effects that cannabis has on the most public victims of PTSD: combat veterans. This can pave the way toward a broader understanding of, and help for, some of the most vulnerable in our society.

The DEA Approves

It’s a sign of how remarkably quickly the national attitude toward cannabis has changed that the DEA easily approved its use in clinical trials with soldiers. As the Military Times reports:

The Drug Enforcement Administration has given its blessing to a study on the effect of medical marijuana on post-traumatic stress disorder, the first randomized, controlled research in the U.S. for PTSD that will use the actual plant instead of oils or synthesized cannabis.

It’s even more remarkable how unremarkable this seems. Indeed, for people who use cannabis regularly, which is around 20 million people per month, it almost seems like this should have been a no-brainer. After all, for most people, cannabis is used to help them relax.

There is already anecdotal evidence that veterans have long been using marijuana to ease the strains of PTSD. The Military Times reports that many have told researchers regular use of cannabis has allowed them to ease off prescription drugs in favor of a more natural solution. The study, which is being conducted with 76 veterans in Colorado suffering from “treatment-resistant” PTSD, will test both the efficacy and safety of using cannabis. If they find positive results, it could change the way we treat PTSD. Regardless, this is a big step forward for the DEA, which until recently would have, at best, dismissed any such study.

Why Cannabis Can Work

Cannabis has a direct impact on the endocannabinoid center. This is a cluster of receptors in the mammalian (or highest-developed) section of the brain, and they control things like appetite, pain, mood, and memory. The last one, memory, is probably the most important. Because PTSD is memory in a living, fully-realized form. It isn’t a vague recollection; it is the brain pumping the same heightened chemicals that it experienced in the moment of trauma.

Basically, cannabis can reverse that. All humans have “memory extinction”, and that’s not just forgetting your Netflix password or your 5th-grade math teacher. It’s how the brain lets go of these incredibly intense sensations. Think about your most humiliating moment: chances are your gut clenches up, and you have a sort of dizzy and sick feeling. That’s because it is so severe that the physical memory hasn’t gone away. Now think of a lesser one, and a lesser one. Because those weren’t as searing, you don’t have the same problems. Some details might be gone, or you might be able to laugh at it, but you don’t have a neuro-chemical reaction.

Those moments can be analogous to PTSD, only it is incredibly more intense, because the “fight or flight” lizard portion of the brain goes into high gear, and actual physical or mental pain and fear of death can be invoked. But with memory extinction, that can be limited, normalized, even erased, allowing someone to have a normal life. That’s what the testing will try to find out: whether it really works.

Long-Term vs. Symptomatological: Two Good Outcomes

 Few question that, for people with PTSD, cannabis has excellent symptomatological qualities. This means that it treats the symptoms well, but that might not be the end goal. It can be seen more as putting a bandaid on someone who keeps getting cut: maybe it would be better to help them step away from the circular saw?

The point of the research is to see if there are long-term and actual chemical benefits without harm. While the “is pot bad for you?” debate seems pretty settled, the question is if helping treat the symptoms hurts long-term healing.

That means there are three outcomes:

  • Repeated symptomatological usage damages long-term therapy
  • No long-term harm, but no actual treatment of underlying causes, and immediate benefits to day-to-day life
  • Successful treatment of memory extinction blockage

Obviously, the first one is harmful (and we should say that every case is different, so there may be people where this is the case). The second and third one, though, are both great. One of the main difficulties with PTSD is that it interferes with living. If the benefits of cannabis mean that life can move on as normal, then it is a victory for those suffering. Having access to cannabis is an act of kindness, and not, as is so often portrayed, an abdication of responsibility. It is the height of responsibility.

And if there are long-term effects? Then we’d be helping not just veterans, but everyone with PTSD: survivors of sexual assault, abuse, accidents, natural disaster, terrorist attacks, and more, take back their lives, and not be continually revictimized by the chemicals in the brain. And it can also further change the way we talk about cannabis: if the government approves it for veterans, then we should be able to have an honest discussion about opening it up for everyone.