Effect of Cannabis on Post Traumatic Stress Disorder

This is my review on an article published in a journal distributed freely on the London Metro. See HERE

The original scientific paper is HERE 

Background

Post Traumatic Stress Disorder is a severe anxiety disorder that can develop (sometimes after months) after exposure to any event, physical and/or psychological, that results in psychological trauma, overwhelming the individual's ability to cope.

Traumatic events that may cause PTSD include violent assault, kidnapping, sexual assault, torture, being hostage, prisoner of war, experiencing a disaster, violent automobile accident, being diagnosed with life-threatening illness, bullying, mobbing, etc...

The criteria to diagnose PTSD include

• Exposure to traumatic event - with risk of injury to self or others and intense fear, horror or helplessness towards this event 
• Persistent Re-experiencing such as flash backs, recurring nightmares, intense negative feeling or body reaction towards anything reminding of the event
• Persistent avoidance and emotional numbing: the person avoids thoughts feelings, places, people, behaviors linked to the event, inability to recall event, decreased physical and mental activity
• Persistent symptoms of increased arousal not present before: anger, hypervigilance, concentration, falling or staying asleep
• Duration of symptoms for more than 1 month
• Significant impairment: Decreased social/life/occupational activities

Currently, medical treatments for symptoms management include drugs that hep with relieving nightmares, startle, hyperarousal, moods, aggression, sleep disturbance, anxiety, self mutilation. Other drugs have shown benefit in preventing PTSD or reducing its incidence when given in close proximity to a traumatic event such as Alpha-adrenergic antagonists (Catapres), beta blockers (Inderal), glucocorticoids (hydrocortisone), opiates (morphine).

However, drug abuse, along with alcohol abuse, commonly co-occur with PTSD leading to worsening or hindering of symptoms.

Review

In our body, the cannabinoid system is part of a complex circuitry that regulates anxiety and stress. Previous scientific studies suggested that this could represent a therapeutic target for the treatment of stress- and anxiety-related disorders such as PTSD.

In this article, however, they are not studying the effect of cannabis or other cannabinoids on PTSD but the activation of the cannabinoid receptor using a chemical (remember key- keyhole schematic), albeit not by feeding the rat but by injecting it.

Borrowed from HERE

Although other studies are focusing on the effect of Nabilone (a synthetic cannabinoid that mimicks the effect of cannabis) on PTSD, it would be misleading to jump from findings in this article to the conclusion that cannabis itself prevents PTSD.

Also, this study was carried out on rats, not humans, and although they are a good model from which we can speculate on human science, more studies, clinical trials need to be carried out on patients diagnosed with PTSD.

Their main findings are that by injecting the chemical into the specific region of the rat brain, the activation of the cannabinoid receptor lead to normalization of the behavioral and chemical abnormalities resulting from stress exposure.

They showed that there was an optimal time window during which to do this with up to 24h leading to prevention of some symptoms of PTSD, whereas 48h injection of the chemical after stress exposure was too long to reverse effects of the stress.

Importantly, the authors clearly suggest that the effects of the drug used are not due to a general relaxation effect or to an erasure of the stressful event, since rats were still exhibiting unconditioned anxiety.

They are concluding by saying that the precise mechanism by which the cannabinoid receptor activation prevents PTSD remains to be clarified, that their findings only suggest a crucial contribution of cannabinoid receptor in the region of the brain studied.

I asked a friends of mine Dr Moises Garcia Arencibia ,who's a specialist on the subject, what he thought about this article, here is his answer below:

"From a journalist point of view, it is fair to say that Cannabis may be the cure for traumatic stress. Cannabis activates CB1 receptor, mainly via THC effects, and it has been proved that Nabilone, which mimics the effect of THC, is efficient in humans in the treatment of PTS.

Of course, if you smoke pot, you don't control the dose of THC and other cannabinoids and, besides, you get a lot of undesirable side effects. So, for that reason, the aim is to get compounds as specific as possible, trying to avoid or minimize the side effects."

 NB: THC = The major psychoactive chemical compound of cannabis is Delta-Tetrahydrocannabinol.

My conclusion is that although this article is interesting on a scientific point of view, jumping to the conclusion that cannabis itself - whose main therapeutic effect known by the general public is relaxation - is extremely misleading.

Also ALWAYS bear in mind that any substance should be taken in reasonable doses, any food/chemical/drug/vitamin consumed in large quantities usually leads to the reverse effect than the one intended!

For more information, contact you GP, physician, etc...

If I was too scientific, please let me know, I am trying to improve my writing. Constructive criticism is always welcome. Thanks