Effect of Marijuana on PTSD Patient Stress Levels

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.

References

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).

Topic Justification:

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.