Medical Marijuana Treatment for Post Traumatic Stress Disorder

Stacy Phillips

Academy for Arts, Science and Technology

Health Science 3

Mrs. Johnson

February 16, 2017

Introduction
 Today, hundreds of thousands of servicemen and women and recent military veterans

have seen combat. Many have been shot at, seen their comrades killed, or witnessed death up

close; events such as these can lead to Post Traumatic Stress Disorder, more commonly known as

PTSD. The U.S. Department of Veterans Affairs estimates that PTSD afflicts almost 31 percent

of Vietnam veterans, as many as 10 percent of Gulf War (Desert Storm) veterans, 11 percent of

veterans of the war in Afghanistan, and 11-20 percent of Iraqi war veterans. (How Common is

PTSD?, 2016, October 3). Post Traumatic Stress Disorder affects everyone differently, but many

veterans commonly experience symptoms of anxiety, hypervigilance, insomnia, depression,

flashbacks and nightmares, headaches, chronic pain, and hypertension. As of now, there is no

cure for PTSD but there are treatments, such as prescription medicines, therapy, and

psychotherapeutic interventions for dealing with symptoms, but for some veterans these

treatments do not help them deal with their PTSD or the medications are causing additional

problems. In recent years, medical marijuana has been introduced as a viable, alternative

treatment for veterans dealing with Post Traumatic Stress Disorder due the fact that medical

marijuana acts on cannabinoid receptors in cells that alter neurotransmitter release in the brain

and helps to lessen the symptoms associated with PTSD. (Cannabis for psychotic disorders,

2015). Due to this there has been an increase in the numbers of veterans advocating for the use of

medical marijuana and for the increase in doctors prescribing medical marijuana as a treatment.

Background on Post Traumatic Stress Disorder

Post Traumatic Stress Disorder is mental health problem that some people develop after

experiencing or witnessing a life-threatening event, a natural disaster, a car accident, or sexual

assault. Post Traumatic Stress Disorder can happen to anyone, for example, having a very intense

or long-lasting traumatic event, such as combat, or getting injured during the event can make it
more likely that a person will develop PTSD. There are four main types of symptoms of PTSD,

but they may not exactly be the same for everyone because each person experiences symptoms in

their own way. The first type of symptoms are called reliving the event or re-experiencing

symptoms; this is when a person may have bad memories, nightmares or experience flashbacks

of the traumatic event. The second type of symptoms involve avoiding situations that remind a

person of the event; a person experiencing these type of symptoms may try to avoid situations or

people that trigger memories of the traumatic event or avoid talking or thinking about the event.

The third type of symptoms involve having more negative beliefs and feelings; these symptoms

may affect the way a person thinks about themself and others may change because of the trauma.

A person may feel guilt or shame or may not be interested in activities that they used to enjoy or

may feel numb or find it hard to feel happy. The person may also feel that the world is dangerous

and that no one can be trusted. The fourth type of symptoms involve feeling keyed up, which is

also called hyperarousal, these symptoms include being jittery or always alert and on the lookout

for danger, having trouble concentrating or sleeping. A person might suddenly get angry or

irritable, may startle easily, or act in unhealthy ways like smoking, using drugs and alcohol, or

drive recklessly. (What Is PTSD?, 2016, October 4). For many veterans dealing with PTSD, it is

because of them experiencing combat and being in combat zones and for many they deal with

most or all of the types of symptoms listed above. Treatment options for PTSD include

prescription medications, therapy and psychotherapy.

Treatment Options for Post Traumatic Stress Disorder

Post Traumatic Stress Disorder affects everyone differently; due to this there are multiple

ways to deal with the symptoms of PTSD, the most common treatments are prescription
medications, therapy and psychotherapy. Because PTSD may be related to changes in the brain

and the unbalancing of certain chemicals in the brain that are linked to a persons ability to

manage stress, many doctors prescribe selective serotonin reuptake inhibitors (SSRIs) and

serotonin-norepinephrine reuptake inhibitors (SNRIs) to veterans suffering from PTSD. SSRIs

and SNRIs such as Sertraline (Zoloft), Paroxetine (Paxil), Fluoxetine (Prozac), Venlafaxine

(Effexor) are antidepressants and anticonvulsants that help balance certain chemicals in the brain.

(Medications for PTSD, 2016, April 19). Many treatment plans for PTSD involve a person

participating in some type of therapy or psychotherapy as well as taking medications. Many

veterans treatment plans involve them taking prescribed medications and going to support

groups or to sessions with a psychiatrist or their treatment plan involves a type of psychotherapy.

Psychotherapy, or counseling, involves the veteran meeting with a therapist. There are different

types of psychotherapy including cognitive behavioral therapy (CBT) which has shown to be the

most effective treatment for PTSD. There are different types of CBT, such as cognitive therapy

and exposure therapy. One type is Cognitive Processing Therapy (CPT) where a person learns

skills to understand how trauma has changed their thoughts and feelings and that changing how

they think about the trauma can change how they feel. Another type is Prolonged Exposure (PE)

where the person talks about their trauma repeatedly until memories are no longer upsetting. This

helps the person get more control over their thoughts and feelings about the trauma. The person

also goes to places or do things that are safe, but that they had been staying away from because it

reminded the person of the trauma. A similar kind of therapy is called Eye Movement

Desensitization and Reprocessing (EMDR), which involves focusing on sounds or hand

movements while the person talk about the trauma they have experienced, this helps the brain

work through the traumatic memories. (What Is PTSD?, 2016, October 4).
 Problems with Common Treatments

The problem with the previously mentioned treatments is that they do not always work

for everyone, since PTSD is such a wide ranging problem and affects each person differently.

Medications may not deal with all the symptoms a person has, a person might not be able to take

certain medications for one symptom because it is not supposed to be taken medication for

another, or a person might become desensitized to some medications after taking them for a long

time period. Some medications that are supposed to help with one symptom such as anxiety or

depression may cause side effects such weight gain, increase cholesterol, or change in appetite

which causes the person to have to take more medications. Therapy and psychotherapy may help

veterans cope with their traumatic experiences but neither can completely eliminate symptoms of

PTSD. Also in some cases a veteran may not believe in the treatment a doctor has prescribed to

him or her which causes the treatment to not work as well as it should.

Medical Marijuana as a Treatment

Due to the problems experienced with traditional treatment methods, an increasing

number of United States veterans have turned to using marijuana as a treatment for coping with

their symptoms of Post Traumatic Stress Disorder. A growing number of veterans have started

speaking out about the benefits of using marijuana as a treatment in place of medications such as

SSRIs and SNRIs. One example of this is U.S. Army infantryman Jose Martinez; he lost both

legs, his right arm and his left index finger to a land mine in 2012 in Afghanistan then in

December of 2015, he broke his maimed left arm when his car flipped over after hitting black

ice in the high desert near his Apple Valley, Calif., home. During all this doctors prescribed him

with pills for both PTSD and for his wounds. "I started taking so many prescription pills," he

recalls, "I was numb to the world." Over time, he ended up replacing those pillsup to 150 a
day, he sayswith marijuana.. He says marijuana has stayed his pain and tamed his demons.

"My brain's telling me to freak out because I'm missing my limbs, but when I'm on cannabis, it

tells me to calm down, you're O.K., you're fine," Martinez says. Not only does it soothe the

phantom pain of his missing limbs, but it also eases a racing and apprehensive mind riven with

PTSD. "It relaxes me and helps me sleep at night," he says. "I'm so super-vigilant, and it really

calms my anxiety, which can shoot up when I'm around a lot of people I don't know."

(Thompson, M., 2016). Another example like is of Iraqi veteran Jake Scallan who joined the Air

Force at the age of 21 and was deployed to Iraq in 2009 to serve as part of the security forces at a

joint base compound. His duties included manning a security tower with a sniper rifle and going

on patrols, often at night, outside the perimeter. In 2010, he was diagnosed with post-traumatic

stress disorder, spinal injuries and traumatic brain injury and Was treated in the VA health-care

system for depression and anxiety as well as for other symptoms of PTSD and was put on a

regiment of anti-anxiety, anti-psychotic drugs. After he started using cannabis as treatment for

PTSD, Scallan found it allowed him to get better sleep as well as perspective on his thoughts and

behaviors. He said his primary-care doctors are generally supportive of his cannabis use, but do

not give him any guidance due to marijuana's continuing classification as an illegal substance on

the federal level. Scallan now works for the Santa Cruz Veterans Alliance, managing the gardens

and engaging in what he calls 'horticultural therapy and provides veterans with cannabis and the

support system they need to help them navigate their medical issues. (Baine, W., 2016, May 9).

There are many other stories such as these showing how an increasing number of veterans are

turning to medical marijuana as a treatment for PTSD symptoms due to traditional treatments no

longer working and how they are advocating for the increase legalization and distribution of

medical marijuana.
 The Science Behind Medical Marijuana Treatment

Research has shown that medical marijuana can be useful in the treatment of pain,

compounds in marijuana, either individually or combined with others, affect cannabinoid

receptors in the brain and elsewhere, influencing the user's physiology and mental state.

Researchers Margaret Haney, Ph.D., of the Division on Substance Abuse at Columbia University

Medical Centers Department of Psychiatry, and A. Eden Evins, M.D., of the Center for

Addiction Medicine at Massachusetts General Hospital and Harvard Medical School, researched

therapeutic as well as recreational use of cannabis and concluded that Consistent with a

potential therapeutic effect, oral cannabinoids such as dronabinol, which is a synthetic version of

tetrahydrocannabinol (THC), have been shown to reduce the response to fear stimuli and trauma-

related symptoms in people with PTSD. In addition, nabilone reduces nightmares and improves

sleep, according to two trials, and a retrospective study of nabilone shows promising results for

PTSD-related nightmares. Cannabinoid agonists may do more than provide symptom relief,

because they specifically target some of the root causes of PTSD symptoms, Haney writes. There

are many cannabinoid (CB1) receptors in amygdala hippocampal cortico striatal circuits that

have a role in anxiety, emotional learning and fear-related memories. There are also CB1

receptors in the hippocampus, mediating the retrieval of fear memories. (Knopf, A., 2015,

pages 4-5). When inhaled or delivered orally or transdermally, cannabinoids activate endogenous

cannabinoid receptors, modulating neurotransmitter release and producing a wide range of

central nervous system effects, including increased pleasure and alteration of memory processes.

Those effects provide a pharmacologic rationale for the use of cannabinoids to manage the three

core PTSD symptom clusters: reexperiencing, avoidance and numbing and hyperarousal.

(Betthauser, K., Pilz, J., & Vollmer,, L. E. 2015).

 Conclusion

There is still debate over whether medical marijuana is a good alternative treatment for

Post Traumatic Stress Disorder because of the limited amount of long term clinical trials and

research into the subject. Although, based on the research that has been conducted and first hand

accounts of veterans suffering from PTSD, medical marijuana may possibly be a viable treatment

method, in conjunction to therapy, for coping with the symptoms of PTSD. Because symptoms

of PTSD vary in severity and type from veteran to veteran, medical marijuana may possibly be

used for coping with multiple symptoms instead of veterans using many different medications all

at once. Instead of using many different medications that can cause side effects such as increased

depression, anxiety and an increase in cholesterol, medical marijuana could be used to deal with

the all symptoms. Also instead of taking multiple medications that may interact dangerously with

each other, a veteran could take just medical marijuana to cope with their symptoms.

References

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cannabis. Santa Cruz Sentinel (CA).

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