Post-traumatic stress disorder (PTSD)

Post-traumatic stress disorder (PTSD) is a mental health condition that may develop after experiencing or witnessing a traumatic event. Symptoms may include:

• Flashbacks
• Difficultly sleeping
• Nightmares
• Severe anxiety

For some people, these symptoms can interfere with daily life.

Data shows that around 13 million Americans experienced PTSD in 2020. It’s estimated that about 8 out of every 100 women (8%) and 4 out of every 100 men (4%) will experience PTSD at some point in their life. Veterans are more likely to develop PTSD compared to the general population.

Emerging research shows that the compounds in cannabis may help relieve some symptoms of PTSD, including anxiety and trouble sleeping.

Research on cannabis for PTSD

Studies on cannabis and PTSD are limited but growing.

People who have experienced childhood trauma may have fewer cannabinoid receptors, which are proteins that balance important bodily functions like mood, stress response, and inflammation. This may limit the effects of cannabis. Meanwhile people who experience trauma in adulthood may actually have an increase in cannabinoid receptors, which can boost the effects of cannabis.

Research shows that cannabinoids in cannabis, like tetrahydrocannabinol (THC) and cannabidiol (CBD), may reduce PTSD symptoms. Medical cannabis could also be helpful for treatment-resistant PTSD.

A 2020 study found that people with PTSD who used cannabis reported fewer symptoms compared to non-users. In another study, people who were given 300 milligrams (mg) of CBD experienced reduced anxiety when recalling a traumatic event.

Terpenes in cannabis, including pinene, limonene, linalool, myrcene, and beta-caryophyllene, have anti-anxiety, antidepressant, and anti-inflammatory effects. However, most research on these therapeutic effects are from animal studies, so more human studies are needed.

Researchers are finding that medical cannabis may help people with PTSD rely less on prescription medications and recreational substances, including antidepressants, benzodiazepines, and alcohol. A 2023 study showed that people with PTSD and/or anxiety who used medical cannabis were able to reduce the use of benzodiazepine drugs to manage anxiety symptoms.

It’s common for people with PTSD also to experience anxiety, depression, insomnia, or chronic pain. Some studies show that cannabis may help manage these issues. For example:

• CBD may help reduce anxiety and improve sleep.
• THC may help alleviate pain and intrusive thoughts.

These effects make cannabis a potentially valuable addition to a well-rounded PTSD treatment plan.

Using cannabis for PTSD

Many people turn to cannabis to manage PTSD symptoms. That said, it’s not a one-size-fits-all solution.

Some find that cannabis is helpful for calming anxiety and improving sleep. Others may not like how it makes them feel. Personal preferences, the type of product, and the dosage can all play a role in how you respond to cannabis.

At Leafwell, we’ve observed that PTSD is one of the most common conditions people seek medical cannabis for. If you’re considering medical cannabis, it’s important to consult a healthcare professional who can make the right recommendations for you.

Benefits

Cannabis has some potential benefits for people with PTSD, including:

• Improved sleep: Cannabis, particularly strains with higher THC content, may help reduce nightmares and enhance the quality of sleep.
• Reduced anxiety: CBD-dominant strains may help calm anxiety without causing a high.
• Fewer intrusive thoughts: Some people report fewer flashbacks and intrusive memories when using cannabis.

Risks and side effects

As with any medication, medical cannabis for PTSD comes with certain side effects.

• Memory issues: High doses of THC can affect short-term memory.
• Dependence: For some people, regular use may lead to cannabis use disorder.
• Increased anxiety: High doses of THC may worsen anxiety.
• Worse outcomes: One study shows worse outcomes in people with PTSD who use medical cannabis, although the clinical significance of this study is unclear.
• Temporary effects: Some studies suggest that the effects of cannabis for PTSD may be short-lived.
• Drug interactions: Cannabis can interact with benzodiazepines and some types of antidepressants and increase the risk of side effects. If you use medical cannabis for PTSD, work with your doctor to make any necessary adjustments to your other medications.
• Lack of clinical trials: Only a few placebo-controlled trials have been done to determine the effectiveness of cannabis for PTSD.

Is it legal?

The legal status of cannabis varies by state. In many states where medical marijuana is legal, PTSD is a qualifying condition for a medical cannabis card with a doctor’s recommendation.

Caregivers can often obtain cannabis for a minor who has a qualifying condition in most medical cannabis states.

Best strains and products for PTSD

Cannabis comes in a variety of product types.

• Inhalable products like vaporizers and cannabis flower can deliver relief within minutes, though the effects are often short-lived.
• Edibles may need 1 to 2 hours to work, but the effects can last for several hours.
• Tinctures are not as potent as edibles but can take effect within 30 minutes and provide long-lasting relief.

For people with PTSD, the best cannabis strains tend to be those that can reduce anxiety and improve sleep. Because high doses of THC may worsen anxiety for some, strains and products high in CBD, with low-to-moderate levels of THC, are ideal.

Strains (aka cultivars)

A number of cannabis strains can help ease PTSD symptoms. Experiment with these options to find one (or more) that best suits your needs.

• ACDC: This high-CBD strain may help reduce anxiety without a high.
• Blue Dream: This offers a balance of calming and mood-lifting effects.
• Granddaddy Purple: This is known for its relaxing and sleep-inducing effects.
• Haleigh’s Hope: Another high-CBD, low-THC strain that could ease anxiety
• Purple Hindu Kush: This option is rich in terpenes like limonene, beta-caryophyllene, pinene, and linalool, which could be ideal for relieving stress and anxiety

CBD:THC Ratios

Products with 1:1 CBD:THC ratio may help lower anxiety and improve sleep without strong psychoactive effects.

Veterans who use 1:1 CBD:THC products have reported improvements in PTSD symptoms. Medical cannabis cardholders who used high-CBD products experienced fewer nightmares and early awakenings.

It’s best to experiment with different CBD:THC ratios to find what works for you.

• 1:1 CBD:THC: This balanced ratio promotes relaxation and mild euphoria.
• 20:1 CBD:THC: This ratio can lower anxiety without causing intoxication.
• 5:1 CBD:THC: This ratio can be helpful for mild symptom relief with minimal psychoactive effects.

Terpenes

Many terpenes in cannabis have anti-anxiety properties. Here are some of the most prominent cannabis terpenes that can help manage PTSD:

• Beta-caryophyllene: Has anti-inflammatory and anti-anxiety effects
• Limonene: Has mood-lifting and stress-relieving
• Linalool: Is known for its calming and anti-anxiety properties
• Myrcene: Can be found in many relaxing strains; helps with sleep
• Pinene: Has relaxing, stress-reducing properties

Flavonoids

Flavonoids may help manage symptoms associated with many neurological conditions, including anxiety.

• Cannflavin A, B, and C: May offer anti-inflammatory properties
• Kaempferol: May help reduce stress and promote relaxation
• Quercetin: May have anti-inflammatory and antioxidant effects

More about PTSD

PTSD can develop after traumatic events, such as:

• Abuse or trauma
• Natural disasters
• War

Symptoms of PTSD vary but often include hypervigilance, emotional numbness, and avoidance of reminders of the trauma.

Diagnosis usually involves a thorough evaluation by a mental health professional. PTSD is usually a lifelong condition, but it can be managed with the right treatment approach. While PTSD has been classified as one of many types of anxiety disorders, it’s now being considered as a standalone mental health condition.

Other treatments for PTSD

PTSD treatment usually consists of a combination of therapies. While cannabis can help manage symptoms, it’s typically used alongside traditional treatments for a well-rounded approach.

Traditional therapies

Several therapies can help manage PTSD symptoms, including psychological treatments and medications.

• Cognitive-behavioral therapy (CBT): This type of therapy helps you learn how to reframe negative thoughts.
• Eye movement desensitization and reprocessing (EMDR): This technique helps reduce the emotional impact of traumatic memories.
• Medication: Frequently prescribed medications include antidepressants like selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). Options may include sertraline (Zoloft), paroxetine (Paxil), fluoxetine (Prozac), and venlafaxine (Effexor).

Natural and alternative therapies

Complementary treatments and herbal supplements may help with some PTSD symptoms.

• Yoga and meditation: Can help promote relaxation and stress reduction
• Acupuncture: May help reduce PTSD symptom severity
• Herbal supplements: Valerian root and chamomile may ease anxiety and promote relaxation

Cannabis as part of your treatment plan for PTSD

Cannabis is not a cure for PTSD, but it can be a helpful addition to an overall PTSD treatment plan. If you’re considering cannabis to help with PTSD, speak with a healthcare professional at Leafwell. Together, you can  explore whether a medical cannabis card may be right for you. Building a supportive network, including therapy and peer groups, is also essential for managing PTSD.

Frequently asked questions

Get the answers to common questions about marijuana for PTSD.

Does marijuana make PTSD better or worse?

Many anecdotal reports and studies show that medical cannabis can help manage some symptoms of PTSD, including irritability, sleep disturbances, intrusive thoughts, anxiety, and depression.

However, some studies on cannabis for PTSD show worse outcomes. Or, depending on the product, the positive effects may be short-lived. Cannabis use disorder is another concern.

More studies are needed to fully understand the risks and benefits.

Is sativa or indica better for PTSD?

That depends. Every strain has a unique cannabinoid and terpene profile. Some people who have PTSD prefer certain cannabinoids and terpenes over others to help manage symptoms. Experiment with different sativa and indica strains to find what brings you the most relief.

Is marijuana good for people with PTSD?

It can be. Research shows that cannabis may help ease certain PTSD symptoms like anxiety, insomnia, and muscle tension. Ask your doctor if medical cannabis is the right choice for you.

Can you get a marijuana prescription for PTSD?

Your doctor can’t prescribe marijuana, but they can make a recommendation for a medical cannabis card. Check if your state considers PTSD a qualifying condition for medical cannabis.

Does cannabis interact with any PTSD medications?

Yes, cannabis can interact with certain sedatives (like benzodiazepines) and some types of antidepressants. You may need to reduce your intake of some types of medication, particularly sedatives, if you are using medical cannabis. This is because cannabinoids like CBD can affect the liver’s ability to process many types of sedatives, increasing the risk of side effects.

Reducing your medication should be done under a doctor’s supervision.

Resources

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