PTSD and Cannabis; Conflicts Between Research and Implementation
“Imagine knowing something about yourself more than you know anything, and at the same time knowing how unreal it is. This part of you has such a hold on you, that you cannot for the life of yourself feel its grasp until it is too late, then it has you and you are no longer yourself. Imagine a watery consciousness slipping away and thinking who was that? And, you already know the answer, as it dissipates like smoke on the wind. In that moment of realization comes the instantaneous realization of your being, slipping away” (Lee, 2008).
The DSM-5 states that Post Traumatic Stress Disorder is triggered by exposure “to actual or threatened death, serious injury, or sexual violation, exposure must result from directly one or more; experiencing the traumatic event, witnessing the traumatic event in person, learning that the traumatic event occurred to a close family member or close friend (with the actual or threatened death being either violent or accidental) or experiences first-hand repeated or extreme exposure to aversive details of the traumatic event (not through media, pictures, television or movies unless work-related)” (American Psychiatric Association, 2013). Those impacted by PTSD continue to relive disruptive thoughts, feelings, and sensations related to their experiences long after the event has ended. This can leave individuals feeling isolated, estranged from family, friends and peers, and individuals may have strong, negative reactions to sounds, sights, and touch.
According to the U.S. Department of Veterans Affairs, the estimates surrounding PTSD diagnosis in the military are; about 31% of Vietnam veterans, 20% of Iraqi war veterans, 11% of veterans of the war in Afghanistan and as much as 10% of the Gulf War (Desert Storm) veterans. (MedlinePlus, 2009).
“Sometimes I need to share with someone who will listen and validate what happened to me was real. If I do not do this I might convince myself, again, that I made it all up, that it just did not happen. I do not need solutions, I do not need answers. I just need to be heard to know what I am feeling matters, that it is real” (Lee, 2008)
Post-traumatic stress disorder (PTSD) has more often been brought into the public eye by discussion of its effects on war veterans, but deeper discussion surrounding medical treatment and side effects of medicine is often neglected. War Veterans who suffer from PTSD often take antidepressants and sleep-aids. These medications often come with a well-documented list of risks and side effects, such as high rates of abuse of medication, as well as withdrawal symptoms if the medication is stopped. Though these antidepressants and sleep-aids will treat symptoms of PTSD, many will require additional medication to combat their side-effects, even when “these pills are paired with talk therapy, more than 60% of patients continue to maintain a PTSD diagnosis”(Ansari, 2016). The neglect towards finding better, and updated treatment for PTSD has caused many patients to suffer even more with what should be minimal impact from current medication; as the point of medication is to ease the symptoms, rather than create more difficulty for patients.
Though marijuana legalization spreads, there is still a stigma attached to cannabis use for medicinal purposes. In the early 20th century, cannabis was made illegal due to discussion around its potential for addiction, but also cultural ties in various minority groups that had newly immigrated to the United States. Laws surrounding its restriction stem from the science surrounding its potentially addictive properties, but are also deeply embedded in sociocultural disparities and issues surrounding the early 20th century. However, over time, discussion surrounding the use of marijuana in medicinal settings has opened up and allowed for progression and testing (Burnett, 2014). Research approved by the Drug Enforcement Administration (DEA) has been done in small populations of diagnosed veterans in order to assess how medical marijuana can impact, and lessen symptoms, while simultaneously eliminating concerns about side-effects of pre-existing medication. Currently only 6 states allow for citizens suffering from the disorder to obtain medical marijuana, while as of June 2016, 25 states and The District of Columbia allow for medical marijuana usage. One study claims the perks of medical marijuana as “versatile and fast acting, less addiction and withdrawal, and affordable trauma treatment” (Ansari, 2016) . These claims are based on high success rates seen from prescribing medical marijuana to help patients overcome addiction, and the flexibility of choosing from “hundreds of cannabis strains…each possessing unique medical benefits…users are in complete control of their dosage…patients can start and stop (medical marijuana usage) as they please without any noteworthy repercussions” (Ansari, 2016). The fewer risks associated with using medical marijuana are apparent with its use for other illnesses, but have also been shown in PTSD research done with our Veterans.
“By working with chronic treatment-resistant veterans, we address a national emergency and limit variability at the potential expense of generalizability,” Rebecca Matthews, a clinical trial leader at Multidisciplinary Association for Psychedelic Studies in Colorado claims. “Further research will be needed to determine if these results will apply to other groups of PTSD sufferers.” (Burke, 2016). Even within the scope of PTSD among Veterans, the levels of anxiety and depression associated with PTSD vary. There is also a variance in how intrusive memories, flashbacks, nightmares are, and what exactly reminds individuals of the trauma. The trauma involved within individuals of the military varies, and therefore prolonged and careful research must be funded and focused on, so we can properly assess the variance of PTSD and its impact on non-military individuals.
“The sad truth is that the American Public has become blinded to the plight of our vets and this has become evident of the ease to condemn those that commit crimes, and vilify them rather than to actually solve the dilemmas we face. We have become accustomed to ignoring our veterans who have defended our nation, since after WWII we have become your person you love to hate. This is who we are, we who do what you do not want to do and wear the emotional scars and bear your shame” (Lee, 2008).
Although there may be progression in supporting research, there are still hoops to jump when starting dialogue with the public, lobbying for support, drafting bills, and ultimately progressing the state and status of medical treatment for those who suffer from PTSD. The federal government’s position still holds that marijuana has no accepted medical use for treatment, and has a high potential of abuse. In our communities, even gaining support for medical marijuana for general treatment is difficult, let alone using it for PTSD. We need to be able to open dialogue and share current, accurate research data in regards to the effectiveness of medical marijuana in treatment.
Perception of medical marijuana as a stigmatized medicine creates difficulty in conversations progressing cannabis forward as legitimate, and assessable medication for those in need. Patients will feel the brunt of stereotypes surrounding the use of marijuana for recreational use rather than medical use, as well as the belief that marijuana will take a toll on their mental cognition. This leads into issues beyond peers, and progresses into issues in local, state, and federal government that inhibit proper growth, and distribution of medical marijuana. Use of medical cannabis can also impact the ability to get housing, child custody in a court of law.
In the process of obtaining grants, and continuing approval for research; subsequent steps need to be made in understanding PTSD. We must understand how it is treated, and break down preconceived notions of the use of cannabis for medical purposes. In creating dialogue between individuals, and communicating scientifically correct findings, we can not only progress legal processes and ideas surrounding treatment methods for mental disorders, as well as show support to those unaffected by current treatment; if already treatment-resistant patients are responding to cannabis, and have fewer concerns with side-effects compared to current medication, than we need to be able to implement further steps without fear of reproach or discrimination of their disorder or their treatment.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Ansari, F. (2016, September 06). Medical Marijuana Can Help Veterans Battle PTSD. Retrieved from http://observer.com/2016/09/medical-marijuana-can-help-veterans-battle-ptsd/
Burke, M. (2016, September 5). Study: Can marijuana improve PTSD symptoms for veterans? Retrieved from http://www.stripes.com/news/study-can-marijuana-improve-ptsd-symptoms-for-veterans-1.427271
Burnett, Dr M. Reiman A, PhD, MSW. (2014, October 9). How Did Marijuana Become Illegal in the First Place? Retrieved from http://www.drugpolicy.org/blog/how-did-marijuana-become-illegal-first-place
Feature: Post Traumatic Stress Disorder PTSD: A Growing Epidemic / Neuroscience and PTSD Treatments | NIH MedlinePlus the Magazine. (2009). Retrieved from https://medlineplus.gov/magazine/issues/winter09/articles/winter09pg10-14.html
Lee, S. (2008, October 24) Combat PTSD and Memory; Would You Want to Forget the Biggest Most Influential Part of Your Life? Retrieved from http://ptsdasoldiersperspective.blogspot.com/2008/10/would-you-want-to-forget-biggest-most_24.html
