A top reason why many people turn to cannabis is stress management. But PTSD is more than “stress.” For those with post-traumatic stress disorder (PTSD), access to medical cannabis can make the difference between becoming overwhelmed by hypervigilance, and living a normal life among family and friends. One doctor has seen the transformative powers of cannabis firsthand. Dr. Mike Hart has been successfully treating PTSD with medical cannabis and lifestyle interventions for three years. Here are some of the things he’s learned:
Cannabis: A Potentially Safer Alternative to Conventional Pills
PTSD is a natural response of the body to extreme trauma. Patients with PTSD experience a variety of debilitating symptoms. The disorder continues the “fight or flight” response beyond the time it is necessary. Some symptoms include night terrors and hypervigilance, which can be compared to looking over your shoulder for an attacker 24-hours a day. This, according to Dr. Hart, can make even simple tasks like walking through a crowd overwhelming.
According to the U.S. National Center for PTSD, seven out of every 100 people develop symptoms of post-traumatic stress. Most people don’t associate Canada with PTSD, but the nation has some of the highest rates of PTSD, with an estimated 9.4 percent of the population experiencing the disorder.
Standard treatments for PTSD include various forms of psychotherapy, and prescription medications including Prozac, Paxil and Zoloft. After several years of experience, Dr. Mike Hart has developed alternative treatments for PTSD, and also chronic pain and neurological conditions. His treatment methods include medical cannabis and rigorous lifestyle interventions.
Why Treat PTSD With Cannabis?
Dr. Hart’s primary inspiration to investigate medical marijuana to treat PTSD was the opioid epidemic. Many of his patients were using opioids. Not only were they experiencing the threat of addiction, they weren’t getting relief of their symptoms, either.
The patients were experiencing opioid side effects, including a lot of fatigue, a lot of constipation, low sex drive, and many other lesser symptoms. Dr. Hart started thinking that cannabis was a much better, safer alternative. He researched more information and received training, eventually discovering a wealth of research showing that medical cannabis could relieve PTSD symptoms.
Dr. Hart now works with the Canadian cannabis advocacy group, Marijuana for Trauma. His practice now formally assesses and heals veterans with PTSD, with medical cannabis treatments and lifestyle interventions. The U.S. Veterans Administration states there are no studies showing any benefit to PTSD patients from medical cannabis, but this is not the case. A team of Canadian and American medical researchers found evidence in 60 medical journals that showed Cannabis for Therapeutic Purposes (CPT) has potential to improve mental health and recommended that more systematic research be conducted.
Medical Cannabis Components: CBD and THC
It’s well-known that cannabis is a powerful painkiller. However, that’s not all it can do. Unlike many conventional PTSD treatments, which include powerful sedatives, antidepressants, and anti-anxiety medications, two different cannabis compounds have been shown to treat PTSD in several unique ways.
How Does CBD Help PTSD?
The two compounds in question are cannabidiol (CBD), which is a cannabinoid that does not cause a psychoactive “high,” and tetrahydrocannabinol (THC). THC is the primary psychoactive in cannabis.
Post-traumatic stress is primarily focused on learned fear. When you have more learned fear, it causes the hypervigilant state, as well as nightmares that can be so severe they become night terrors.
Some evidence shows that CBD can reduce learned fear by three different mechanisms. According to Dr. Hart, “anytime you’re helping to reduce learned fear, you’re helping to get to the root of that particular problem, so that’s why it can be so effective.” Cannabis not only reduces the runaway fear response in those with PTSD, but has many other tangible benefits as well. Taking calming CBD prior to therapy sessions also helps to put patients at ease and enables them to better respond to counseling.
Whether or not people with PTSD take any type of medication, including medical marijuana, calming down enough to participate in therapy is crucial, because therapy has been proven effective to help people with PTSD. A number of studies have shown that receiving therapy soon after traumatic events (within 6 weeks) can help reduce later symptoms. Those with PTSD know that symptoms may occur years after the precipitating event or events. The calming effects of CBD (which doesn’t produce a “high”) seem to help in gaining benefit from therapy sessions.
How does THC Help PTSD?
While there are several reasons why CBD is effective in treating PTSD, evidence shows that psychoactive THC has some unique benefits as well. Studies have shown that patients who’ve been diagnosed with PTSD are physically deficient in something called anadamide. Anandamide has been termed “the bliss molecule”. The body naturally manufactures “endocannabinoids,” which are body chemicals similar to those found in cannabis. We release anandamide when we exercise. A good example of this is the “runner’s high” which is caused by a burst of anandamide.
How much less anandamide do people with PTSD have than those without the condition? Only 50% of normal levels.
THC and anandamide are similar in structure and engage the same cell receptor sites in the human body.
According to Dr. Hart, “when you give someone THC, THC tends to replace those levels of anandamide. That’s why some patients experience blissful states when they use THC for the first time, because they are replacing their levels of anandamide.”
Use of medical cannabis helps to correct a deficiency. Dr. Hart explains that “often when you correct a deficiency, whether it’s a hormone or a vitamin, doesn’t matter what it is, you’re going to get results.”
An Herbal Approach for PTSD
Every patient has unique, individual needs. Dr. Hart has developed an herbal-inspired approach for patients with PTSD, which uses a regimen of CBD during the day and THC at night.
Patients can receive the calming benefits of CBD during the day, without any THC effects that can interfere with normal daily activities. Dr. Hart seeks to limit THC use in the daytime because he knows that it can cause some short-term memory problems and cognitive problems.
His goal with his patients is to improve their functional outcome, so he wants to make sure that he’s treating the symptoms of PTSD, and he also wants to make sure that he’s actually improving their overall functioning and quality of life.
Dr. Hart says, “it’s great if someone has severe hypervigilance and they’re able to live their day without experiencing that symptom. But it’s more gratifying to myself and my patient if that patient is able to go out and perform and function and do something, and commit to a higher level.”
THC is considered a more powerful sleep aid than CBD, which has some sleep benefits, but not as many. THC in the evenings helps to increase healing sleep, and reduces nightmares and the more serious form: night terrors. Restful Sleep is crucial for healing of physical and psychological symptoms.
Medical Cannabis is Just One Piece of the Puzzle
Though cannabis has vast medical potential, it is just one piece of the puzzle. While different cannabinoids can help reduce learned fear and temporarily correct an imbalance in the endocannabinoid system, Dr. Hart says that the plant is most beneficial when integrated with significant lifestyle changes, including diet and exercise.
Because anandamide is released during exercise, patients with PTSD should get out and move. In order for the body to make anandamide, a diet rich in healthy fats is also necessary.
“Following a healthy diet” is the “cornerstone of overall health and well-being,” says Dr. Hart.
A healthy diet and exercise are the cornerstone of Dr. Hart’s treatment for PTSD. Medical cannabis, including CBD during the day and modest doses of THC at night, provides the patients with the help they need to benefit from the diet, exercise and therapy that will help them to heal over the long-term. Dr. Hart recommends working with an experienced physician when trying medical cannabis to heal and recover from PTSD.