Cannabis is Perfect Medication for PTSD, suggests Dr. Raphael Mechoulam
Both the UK and the US governments are embroiled in a debate on whether cannabis should be considered a viable medicine for PTSD sufferers. Right now both countries are maintaining their historic resistance to approving ‘an illegal substance for medical use.’
On the heels of last year’s announcement where the US government agreed to allow Veterans Administration (VA) doctors free license to recommend medical marijuana to their patients, last month the US decided to forgo recommending cannabis in the VA system, for soldiers suffering from PTSD, anxiety or similar complaints. That was a major blow to those who were hoping for something better.
As each country, state or municipality legalizes marijuana for medical use, legislators often form advisory panels to determine the science behind disorders that are candidates for inclusion into their treatment recommendations. But since there are few medical studies, if any, these conditions are often disallowed due to no proof that cannabis helps these diseases.
But veterans already know better and have decided to take matters into their own hands and procure weed by hook or crook. Even if it means turning good people into criminals.
The Telegraph ran an article in 2014 titled: ‘SAS hero smuggled cannabis into UK for suffering ex-soldiers after Government failed them, court hears.’
In the UK a retired soldier of the elite Special Air Service (SAS) was arrested for smuggling 2,000 euros worth of cannabis into the UK for his team mates with PTSD and MS, claiming that the British government had abandoned them. The story is similar in the USA where many soldiers have to go to black market sources for their medicine.
This is a tough one. There is no cure for PTSD nor is there anything available in pharmaceuticals that currently offer promise. Except for the possibility of marijuana or cannabis-based substances.
But how do we know what’s effective and what’s not if we do not have proper scientific controlled trials — the gold standard of proof of efficacy for a drug candidate? Well, one way is to first look at the anecdotal cases and see what people are saying about the use of cannabis for PTSD.
Here we see that many veterans use it regularly for traumatic and post-traumatic stress among other things like anxiety or insomnia. It appears to be pretty helpful but it does not provide proof, medically.
FATHER OF CANNABIS RESEARCH WEIGHS IN
However, the father of cannabis research, Dr. Raphael Mechoulam, offers some very thoughtful insights on why cannabis or cannabis-like materials may in fact be tailored to specifically correct the underlying dystopia within the brains of those suffering from this nightmarish condition.
Dr. Mechoulam is the esteemed Israeli scientist who discovered THC as the ‘active’ component in cannabis. Decades later he identified one of the key neurotransmitters within the endocannabinoid (eCB) system and named it anandamide from the Sanskrit Ananda meaning bliss. He had this to say about the possible application of cannabinoid agonists (stimulants) in the treatment of PTSD.
This has to do with the eCB system being integrally related to memory, and specifically to memory extinction.
Dr. Mechoulam explained that an animal which has been administered an electric shock after a certain noise will eventually forget about the shock after the noise after a few days. Mice without cannabinoid systems simply never forget — they continue to cringe at the noise indefinitely.
This has implications for patients with PTSD, who respond to stimuli that remind them of their initial trauma even when it is no longer appropriate. By aiding in memory extinction, marijuana could help patients reduce their association between stimuli (perhaps loud noises or stress) and the traumatic situations in their past. Working with Army psychiatrists, Dr. Mechoulam has obtained the necessary approvals for a study on PTSD in Israeli veterans, and hopes to begin the study soon.
A preliminary study which evaluated the tolerance and absorbability of an oral THC spray was just published by Mechoulam entitled: Preliminary, Open-Label, Pilot Study of Add-On Oral Δ9-Tetrahydrocannabinol in Chronic Post-Traumatic Stress Disorder.
There were mild adverse effects in three patients, none of which led to treatment discontinuation. The intervention caused a statistically significant improvement in global symptom severity, sleep quality, frequency of nightmares, and PTSD hyperarousal symptoms.
Orally absorbable Δ9-THC [5 mg twice a day as add-on treatment] was safe and well tolerated by patients with chronic PTSD.
The next step is a larger follow-up study.
Earlier, the below study was published which supports the use of cannabis in the treatment of PTSD.
In 2014, Greer et al published an article titled “PTSD Symptom Reports of Patients Evaluated for the New Mexico Medical Cannabis Program,” in the Journal of Psychoactive Drugs.#
Results: Greater than 75% reduction in CAPS symptom [constellation of PTSD questions] scores were reported when patients were using cannabis compared to when they were not.
Conclusions: Cannabis is associated with reductions in PTSD symptoms in some patients, and prospective, placebo-controlled study is needed to determine efficacy of cannabis and its constituents in treating PTSD.”
SMOKING IS NOT THE PREFERRED METHOD
Contrary to what you may have read or heard, smoking marijuana to treat the symptoms of PTSD is fine if there is nothing else, but it is not the most effective means to treat anxiety and aversive memories such as those formed in PTSD.
For reliable and truly effective treatment of these conditions it appears that restricting eCB breakdown by way of FAAH inhibition is the best target discovered so far within the eCB system… To this end, Kadmus Pharmaceuticals, Inc. has started to express serious interest in marketing a new FAAH inhibitor they have developed, currently code-named KDS-4103. KDS-4103 appears to have a lot of potential from a pharmacological perspective.
Apparently, this experimental compound produces analgesic, anxiolytic, and anti-depressant effects. But it does not produce a classic cannabis high.
THE PERFECT MEDICATION?
All in all, considering that the kinds of events which usually precipitate PTSD in most individuals often also involve pain, KDS-4103 seems like it may be just about the perfect medication…With the right combination of extinction/habituation therapy and the judicious administration of a FAAH inhibitor like KDS-4103 we have the potential to actually cure many cases of PTSD. For the time being though, symptomological treatments are all we have for more generalized anxiety and depression disorders.
Dr. Mechoulam explains that patients who wish to best treat their PTSD should use low to moderate doses with as stable a blood level as possible for anxiety and depressive symptoms. Taking an oral cannabis dose before bedtime is the preferred method.
…in addition to oral dosing at bedtime, if the goal is to use cannabis to facilitate extinction of the response to PTSD triggers, then small to moderate doses of cannabis vapors should be delivered shortly before planned exposure to the trigger. Employing a series of regular extinction sessions will produce better results than a single session.
And lastly, if cannabis appears to make aversion, fear, or aversive memories worse, then the dosage should be lowered. If feelings of fear do not improve with the lower dose, then discontinue use of cannabis as a fear-extinction aide.
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