There is a growing body of evidence that suggests medical marijuana may help military veterans and others suffering from post-traumatic stress disorder (PTSD). CannaMD has previously reported that cannabis therapies may be more effective for the treatment of PTSD than current pharmaceutical options, may block certain PTSD-triggering memories, and that long-term marijuana use has been associated with a decrease in the symptoms of PTSD.
Now, Florida’s favorite medical marijuana physicians take a look at the latest research to see how specific cannabinoid ratios affect PTSD treatment. Read on to learn more!
Current PTSD & Cannabis Science
A 2020 study published by Cannabis and Cannabinoid Research reported on a one-year analysis of 150 individuals diagnosed with PTSD who used medical marijuana. Two key findings from this study were that:
* Over the course of one year, cannabis users reported a greater decrease in PTSD symptom severity than non-users, and
* At the end of the study, cannabis users were 2.57 times more likely to no longer meet DSM-5 criteria for PTSD as compared to non-users.
This led the authors to conclude:
This study provides evidence that the types of cannabis available in recreational and medical cannabis dispensaries might hold promise as an alternative treatment for PTSD. [Trials are needed] to determine how different preparations of cannabis impact PTSD and functioning.
The scientists added:
Given the increasing availability and use of cannabis among individuals with post-traumatic stress disorder (PTSD) and the addition of PTSD as an eligible diagnosis in several U.S. medical cannabis programs, the efficacy of dispensary-obtained cannabis needs to be thoroughly examined.
As recognition and acceptance of marijuana’s potential therapeutic benefits for the treatment of PTSD becomes more widespread, the broader question among patients is evolving from “should medical cannabis be allowed?” to “which strains are most effective for my condition?”.
PTSD, CBD, and THC
While there are more than 400 chemical entities and 60 known cannabinoids present in marijuana, it is the two primary cannabinoids – CBD and THC – that have received the most attention for their role in mitigating certain symptoms of PTSD. Studies have shown that CBD can reduce conditioned fear responses in laboratory trials, and anecdotal evidence suggests that individuals with PTSD who suffer from similar “trigger point” responses to remembered traumas may benefit from the CBD content in marijuana.
Research has also demonstrated that THC alone or in combination with CBD can reduce or block the brain’s ability to consolidate and retain fear memories. Reducing or eliminating these retained memories is a key element in the treatment of PTSD. In addition, CBD and THC administered separately or in combination have been shown to facilitate the process of fear extinction, which is the lessening of fear responses triggered by negative or traumatic events.
A report in the peer-reviewed journal Current Opinion in Psychology titled, “Cannabinoids as Therapeutic for PTSD,” provided the following summarized conclusions:
* CBD and THC+CBD modulate fear memory
* CBD may have acute anti-depressive and anxiety-reducing effects
* THC may reduce nightmares
* THC+CBD could reduce insomnia
Research Limitations
Much of the research on the effectiveness of treating PTSD symptoms with various combinations of CBD and THC has been conducted in controlled laboratory conditions using individual derivatives of these cannabinoids rather than full-plant botanical marijuana. And in many cases, these formulations were administered at a lower dosage than what it is estimated medical marijuana patients ingest when they medicate with smoked marijuana. As a result, findings in these controlled conditions do not easily translate to real-world dosage and frequency-of-use practices by individuals who medicate with botanical marijuana from a dispensary.
This issue was addressed in a study published in 2020 by Substance Use & Misuse, which sought to determine the efficacy of various marijuana formulations based on ratios of THC to CBD and the overall potency of these combinations. In an attempt to develop guidelines for appropriate levels and ratios of THC and CBD for various medicinal uses, the study authors undertook a ten-year review of literature that included some 180 research papers on the subject. Ultimately, this effort did not yield any tangible insights on dosages and the most efficacious THC:CBD ratios, leading the authors to conclude:
Minimal, substantial, reproducible conclusions have been made regarding medical cannabis use during the age of legalization in the U.S.A. Evidence demonstrates that scientists have not made conclusive reports on maximum doses for safe therapeutic index of medical cannabis nor thoroughly explored nor rationalized the possible THC:CBD ratios for “best practice” treatment of different disease.
In the absence of codified best practices for treating PTSD with medical marijuana, many patients have created their own therapy routines based on a combination of trial and error and shared advice. Evidence, such as the aforementioned 150-person study, suggests that many of these patients are successfully finding a degree of relief from their self-titrated marijuana therapies and may have identified the specific varieties of botanical marijuana that provides the most effective ratios of THC:CBD for treatment of their individual condition.
New PTSD & Marijuana Research
Additional insight regarding the efficacy and safety of various THC:CBD ratios for the treatment of PTSD comes from a study released in March of 2021. In what the authors described as the first FDA-regulated and randomized placebo-controlled trial of smoked cannabis for PTSD, military veterans diagnosed with PTSD were provided with one of four full-plant marijuana formulations for self-administered therapy. The four concentrations of marijuana used in the study included:
* High THC (approximately 12% THC and <less than 0.05% CBD)
* High CBD (11% CBD and 0.50% THC)
* THC+CBD (approximately 7.9% THC and 8.1% CBD)
* Placebo (0.03% THC and less than 0.01% CBD)
Participants were monitored over a three-week period of marijuana use, after which the authors concluded:
* All three active concentrations of smoked cannabis were generally well tolerated, and
* All treatment groups showed significant improvements in PTSD symptoms.
Because of the short duration of this study, scientists did not attempt to provide additional insights into the relative efficacy of the different marijuana formulations in comparison to each other, and instead merely noted the need for follow-up research.
For current medical marijuana patients seeking relief from the symptoms of PTSD, perhaps the most valuable takeaway from this initial study is that cannabis has been shown to provide symptom relief without demonstrative negative side effects, and that high THC, high CBD, and balanced formulations may all prove effective. This insight alone may be of help to patients who are seeking to either minimize the intoxicating effects of THC in their therapies or select botanicals with a higher level of THC to provide some of the benefits described earlier.