Post-traumatic-stress disorder (PTSD) is a psychiatric disorder affecting over 3 million people in the United States annually. PTSD develops in some people who have experienced or witnessed a traumatic event. Survivors of abuse, natural disasters, life-threatening accidents, assault, combat, or similar traumatic events are vulnerable to developing PTSD.

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Cannabis has been recently implicated in both the exacerbation and treatment of PTSD symptoms. It is difficult to identify the precise role cannabis plays in the progression of PTSD because it isn’t clear if patients use cannabis to relieve worsened symptoms, or if cannabis use causes symptoms to get worse. Additionally, the exact role cannabis plays at the molecular level continues to be elusive. 

Extremely Limited Cannabis Use May Help PTSD

Researchers at RAND Healthcare, a research organization that concentrates on salient health issues and health care policy including opioids and mental health, developed a protective behavioral strategies for marijuana (PBSM) scale that enumerates risk-mitigating strategies people can follow to avoid problematic cannabis use.  Those strategies include the following:

  • Use marijuana only among trusted peers
  • Avoid use while spending time with family
  • Avoid using marijuana before school or work 
  • Avoid using marijuana to cope with emotions such as sadness or depression 
  • Limit use to weekends 
  • Only purchase marijuana from a trusted source
  • Avoid using marijuana habitually 
  • Use a little and then wait to see how you feel before using more
  • Avoid mixing marijuana with other drugs 
  • Avoid using marijuana in public places
  • Take periodic breaks if it feels like you are using marijuana too frequently
  • Buy less marijuana at a time so you smoke less
  • Have a set amount of times you take a hit
  • Avoid methods of using marijuana that can make you more intoxicated than you would like 
  • Only use one time during the day/night
  • Limit the amount of marijuana you smoke in one sitting 
  • Avoid using marijuana before engaging in physical activity

These 17 recommendations place an important emphasis on limiting the frequency and quantity of cannabis consumption.

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Honestly, they might seem impractical or over the top. However, the relationship between cannabis and mental health is still being studied, so it isn’t exactly clear how different doses or strains of cannabis can exacerbate or attenuate mental health disorders.

A 2018 Cannabis (Research Society on Marijuana) study by RAND researchers Eric Pedersen, Margo Villarosa-Hurlocker, and Mark Prince analyzed the effect of the aforementioned PBSM’s impact on young adult veteran cannabis users.

The study included 784 participants between the ages of 18 and 34 who were veterans of the Air Force, Army, Marine Corps, or Navy. The data was collected from a survey completed by the participants, who used response options 1 (never) - 6 (always) to report their fidelity to the PBSM scale.

Pedersen et al. found that the use of PBSM resulted in fewer cannabis-related consequences including too much time spent using cannabis, lethargy, and loss of motivation. Additionally, Pedersen et al. found that veterans who had PTSD but who did not use PBSM were at the greatest risk of experiencing those cannabis-related consequences.

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The study supports the idea that consuming a limited amount of cannabis using the 17 recommendations outlined in the PBSM scale may protect PTSD patients from experiencing negative effects associated with cannabis use.

The study does not explain the molecular mechanisms of cannabis on a brain affected by PTSD since they were conducted by behavioral scientists.

The studies do not clarify the type of cannabis used either. While the overconsumption of THC has been associated with negative psychological effects, CBD is a non-psychoactive component of the cannabis plant that has been associated with positive neurological and psychological outcomes.  

CBD May Reduce the Symptoms of PTSD 

According to a 2018 Frontiers in Neuroscience review by Brazil-based researchers Rafael Bitencourt and Reinaldo Takahashi, CBD’s efficacy as an anxiolytic and therapy for PTSD may have to do with how it inhibits endocannabinoids, neurotransmitters that send messages to the brain.

In a healthy ECS, these endocannabinoids promote homeostasis. However, aberrant ECS activity can disrupt a range of physiological and neurological functions.

CBD seems to play a role in restoring balance without producing the side effects associated with comparable therapies.

It should be noted that this research was conducted in rodents and still needs to be studied in humans.

To better understand how CBD affects PTSD, researchers will need to conduct double-blind, placebo-controlled trials.

Should You Use Cannabis if You Have PTSD? 

There is some anecdotal evidence that cannabis can attenuate the symptoms of PTSD without producing the side effects that come with many conventional therapies. However, the research evidence is not conclusive enough to establish the clinical use of cannabis for the treatment of PTSD at this time.

If you have PTSD and are interested in pursuing cannabis as an alternative therapy, the only recommendation we can give is that you first consult with your doctors. THC has been implicated in the early onset and exacerbation of psychosis in vulnerable groups.

It is also well-known for inducing anxiety and paranoia when consumed in high doses. Since the onset of these symptoms are unpredictable and extremely contingent on the individual person consuming cannabis as well as the chemical composition of the cannabis they are consuming, it is best to take the safe route and talk to the appropriate medical professionals.

This information is presented for educational purposes only, and is not intended to diagnose, treat, cure or prevent any medical condition.  Please always consult your own doctor.