Veterans Day is a day where we honor veterans who proudly served this country, many of whom have fought overseas. For those who were fortunate enough to come home, they may be fighting their own internal battles because of what was experienced during deployment. In addition to injuries (sustained) in war, post traumatic stress disorder, or PTSD, plagues thousands of Veterans. There are resources at the VA, but some of the psychiatry medications may cause serious side effects. Because military veterans are more likely to die by suicide than their civilian counterparts, it is important to find the right course of treatment to reduce this risk.
Post Traumatic Stress Disorder (PTSD)
Post traumatic stress disorder, or PTSD, is a mental disorder that develops as a result of a “shocking, scary, or dangerous experience”. Everyone has a flight-or fight response, but a person with PTSD may feel stressed or alarmed when they aren’t in imminent danger.
PTSD can include four different types of symptoms: re-experiencing, avoidance, arousal and reactivity, and cognition and mood. Re-experiencing occurs in the form of flashbacks, bad dreams, or terrifying thoughts. Avoidance symptoms can include avoiding reminders or thoughts and feelings that can remind you of the traumatic experience. Arousal and reactivity symptoms may lead to being frequently tense, alarmed easily, having angry outbursts, and can impact the ability to sleep.
All three of these symptom types can be triggered by anything that serves as a reminder or a traumatic event or experience. The last symptom type, cognition and mood, may occur as a result of the other three. Signs include difficulty remembering important points of the event, (negative self thoughts or about the world, feelings of guilt, and/or loss of interest in the activities that used to bring joy.
Because a combination of these symptoms can occur for over a month, PTSD can disrupt quality of life and greatly diminish quality of life, which can lead to anxiety, depression, and substance abuse. If there is a struggle with these symptoms, treatment for these symptoms should be pursued to avoid any further distress.
Cannabis as a Remedy
What the Federal Government Says
As of today, marijuana is listed as a Schedule 1 substance under the Controlled Substances Act. When substances are Schedule 1 under the Controlled Substances act, they “are defined as drugs with no currently accepted medical use, a high potential for abuse, and a lack of accepted safety for use of the drug or other substance under medical supervision.” Given there is some available research on the therapeutic efficacy of cannabis, states have legalized medical cannabis, and those states have qualifying medical conditions there seems to be a disconnect between what the federal government legally says about cannabis and what has been discovered in recent years in terms of cannabis therapy.
In the last month, there was a pardon for all federal drug offenses, however, most drug offenses are at the state level. This was most likely done for the states to follow suit. There was also talks of the government reviewing cannabis as a Schedule 1 drug, because, as of now, it is listed as being just as dangerous as heroin, LSD, quaaludes, and ecstasy. Hopefully within the near future, the medical use of cannabis can be accepted at the federal level so that not only veterans but those who currently serve can get access for their qualifying conditions, including, but not limited to, PTSD.
What Science Says
In several states, PTSD is a qualifying condition for medical cannabis. This is due to its ability to alleviate some of its serious symptoms. Symptoms are due to triggers in everyday life. Triggers, something that negatively impacts the emotional state by causing distress, are what mainly cause the symptoms of PTSD. The main goal of treatment is to extinguish these triggers.
The endogenous cannabinoids, or internal cannabinoids, and cannabinoids consumed from cannabis products can potentially reduce the stress response and perceived threat. The endocannabinoid system may regulate traumatic memories. CBD is helpful in this regulation. As an anti-anxiolytic, the research suggests it reduces fear response when a fear memory is being remembered (long term or suppressed) by stopping the long lasting form of the memory and increasing the suppressed response of the memory.
Keep in mind that CBD may work best after remembering a traumatic event, but could have no effect after hours of remembering this event. When used correctly, CBD can disrupt new and old fear memories. CBD may also have the ability to reduce stress-related anxiety, which is shown in how it supports the formation of new nerve cells within the hippocampus (a crucial area of the brain that regulates stress response).
The hippocampus in the brain not only has an effect on memory, but also on emotions. THC has an effect on this area of the brain which may be helpful in diminishing fear responses, stimulating the cannabinoid receptors in the brain. Insomnia and nightmares are also symptoms of PTSD that might be helped with THC, in certain strains. This is due to the endocannabinoid system’s possible ability to boost sleep and the decrease of the REM (rapid eye movement) phase of sleep, which is where dreams usually occur.
A systematic review that included 10 different studies suggests that it may particularly decrease sleep disturbances and nightmares. THC may be mildly synergistic with CBD, but proceed with caution as THC can have some anxiolytic effects. If indica strain causes a relaxing effect on the body, finding one with a lower THC:CBD ratio may be better for treating the symptoms of PTSD.
What Veterans Say
After fighting in Operation Phantom Fury and coming back home after his injuries, he started to show signs of PTSD after his shoulder reconstruction surgery. He went to the VA for treatment where he was prescribed various medications. When he was on these medications, “he became a shell of himself”.
Eventually he tried cannabis and was slowly able to get off of all the prescribed medications to not only treat his PTSD, but the pain caused by his injuries. Because he was able to treat some of the serious symptoms of PTSD, he was able to stay calm in a public setting and his personality became more comparable to who he was before the attack. He is now an advocate for cannabis use in the veteran community and cannabis research.
Janos “Johnny” Lutz
Sometimes the help that’s needed will be prohibited and may cause issues with benefits or the stigma attached to its lack of legality. In the documentary, they touch upon the “lawful” ways of treatment and the alternative way, meaning cannabis, for their PTSD. The mother of Marine, Johnny, mentioned that he may not have tried cannabis because it was illegal. Instead, when he was diagnosed with PTSD and traumatic brain injury, he was prescribed a “dangerous cocktail” of about 18 different medications, one of which was Klonopin.
The doctor included not to prescribe this drug in his chart without notifying the family because of his increased risk of suicide. After being taken off the Klonopin and all of the other prescriptions, except for a low dose of morphine, taken as needed. He started to get back to his old self until something triggered his PTSD again. Johnny went back to the VA and was prescribed Klonopin and more morphine. That week, Johnny took his own life.
The stories within this documentary gives us an inside look at It also shows that what might be prescribed may be legal, but the major side effects should be taken into account. If the goal is to minimize the chance of making symptoms worse, it may be beneficial to look for alternative therapies.
Getting and Finding Help
PTSD is not just limited to soldiers, but (to anyone who has had a traumatic experience that affects their ability to function normally in everyday life. Cannabis may be a helpful aid in treating the extreme responses to triggers, however, using cannabis alone will not cure PTSD. PTSD may have better improved outcomes when used together with cognitive behavioral therapy and progressive exposure (gradual exposure that uses relaxation exercises when anxiety levels are too high). If you are taking prescription medications to treat PTSD, please reach out to your doctor before consuming cannabis to avoid any drug interactions.
If you or someone you know could be (struggling in a mental health crisis), you can chat online with Suicide and Crisis LifelineLink, or call/text 988 to speak to a trained crisis counselor who can help with mental health-related distress.
If you are a Veteran, or are concerned about one, call 988, then press “1” to speak with a responder qualified to support Veterans. You can also text 838255 or chat online with the Veterans Crisis Line (https://www.ptsd.va.gov/gethelp/crisis_help.asp).
Strains that May Help with PTSD Symptoms
Blue Dream– may be abundant in myrcene, pinene, and caryophyllene. These terpenes altogether, with the help of cannabinoids may elicit a relaxed effect while boosting mood. This may be a THC heavy strain, so if becoming anxious is a problem, please low dose first.
Cannatonic– mostly CBD dominant with a lower THC content, Cannatonic could provide a milder high while reducing anxiety and causing a soothing effect. This may be a better option for those more sensitive THC.
Northern Lights– will usually feature a larger amount of the terpene myrcene, which can be beneficial for sleep. It may also be higher in THC so this may be a strain that should be used at night before bed.
OG Kush– primarily will have an abundant amount of the terpenes myrcene, limonene and caryophyllene, and a good amount of linalool. All together they may create a relaxed yet uplifting effect to possibly fight the symptoms of depression and anxiety caused by PTSD. This strain may be higher in THC so start slow so there’s less of a chance for anxiety inducing effects.
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About the Author
As a certified medical marijuana specialist and medical education coordinator at Best Dispensary, Brejohnna Castorina was able to turn her curiosity for cannabis into a career. She is a student at the University of Maryland obtaining a Master’s degree in Medical Cannabis Science and Therapeutics and has a background in Food and Nutrition Management. She is an advocate for cannabis education and believes that learning more detailed information will lead to the de-stigmatizing, responsible use, and federal legalization of cannabis so that everyone who needs it will have access. She is also a self-proclaimed amateur cannabis chef and enjoys finding new and creative ways to infuse everyday meals.