Can CBD Make You Forget Your Trauma?
Cannabis could be the breakthrough treatment for trauma and PTSD
Post-traumatic stress disorder (PTSD) is a psychiatric illness affecting millions of people. It takes hold after a person has experienced a trauma or a life-threatening event. The symptoms of PTSD negatively impact cognition, mood, emotion, and social ability. Pharmaceuticals and psychiatric therapy have mixed success, with many patients unable to find escape from their condition. We need new therapies that will treat the multi-faceted nature of PTSD symptomology.
Could Cannabis be the Answer?
Cannabinoid medicine is being investigated as a treatment for PTSD because it has both anxiolytic (anti-anxiety) and memory-modifying effects. The most pressing question for researchers to answer now, is when to administer cannabis medicine following a traumatic event. There appears to be an important window of opportunity during which, the administration of cannabis could prevent the development of PTSD.
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This mental health condition is complicated by the fact that not all individuals experiencing a traumatic event will go on to develop PTSD. So, what is it that protects these individuals from developing this debilitating mental health condition?
Could the answer lie in “endocannabinoid tone?” A study (2013) found that there were reduced levels of endocannabinoids in workers and victims who developed PTSD following the 9/11 terrorist attacks on America. Those who did not develop PTSD had normal levels of endocannabinoids. Since this study, additional research has been done to relate the decrease of the endocannabinoid tone to the development of PTSD.
Cannabinoids may exert beneficial effects for PTSD via various mechanisms. These could interfere with memory retrieval process and thus help in preventing the recall of the traumatic memory that led to PTSD. Alternatively, cannabinoids could enhance extinction learning, which is a form of learning that allows the previously anxiety (fear) forming memory to become non-threatening again.
This is likely the most promising aspect of using cannabinoids for PTSD treatment because the psychotherapies that are used employ these same excitation mechanisms. In fact, in several studies using pre-clinical models of PTSD, administration of cannabidiol (CBD) found in the cannabis plant enhanced extinction learning. Furthermore, accumulating clinical evidence in recent years suggests that medical cannabis and cannabinoids are effective in relieving PTSD symptomatology.
The first case report on this topic was published in 2012, involving a 19-year-old patient with severe abuse-related PTSD triggered by flashbacks. He reported to his doctor that consuming cannabis allowed him to maintain cognitive control when he felt the reactivation of the traumatic memories starting. What stunned his physicians even more was that the therapist he was seeing also reported improvement in self-control and stability, even though the therapist was not aware of the patients ‘self-medicating’ with cannabis.
Another study, involving 80 PTSD patients in New Mexico, found that patients using medical cannabis experienced significant symptom severity reduction, including the loss of: re-experiencing symptoms, numbing, avoidance and hyperarousal.
Two other studies explored the synthetic cannabinoid, Nabilone, in PTSD patients. In both studies, more than three quarters of the patients reported a complete cessation of nightmares and a significant reduction in daytime flashbacks. Yet another study, using Nabilone in 58 PTSD patients, reported a significant reduction of PTSD symptoms severity as assessed by the common PTSD questionnaire.
Taken together, the studies conducted with PTSD patients, all highlight that indeed, cannabinoid receptor signaling is a promising avenue of therapeutics for PTSD. The likely reason for this lies in the effect of cannabinoid signaling on the activity of other neurons. When cannabinoid receptors become occupied by cannabinoids (THC, CBD or the synthetic counterparts), this results in down regulation of the activity of the surrounding target neuronal circuits.
Given that in PTSD, neuronal activity is heightened in the centers responsible for fear, anxiety and memory, it can be expected that activation of cannabinoid receptors would prevent the hyperactivation of these neurons, resulting in improved PTSD symptomatology.
At the same time, it is also likely that the reason some individuals develop PTSD after a traumatic event is because their endocannabinoid tone is reduced, and thus they lack the inhibitory signals for the neuronal centers responsible for fear, anxiety and memory. Therefore, we can think of cannabinoid signaling in PTSD as a “breaking mechanism” preventing the acceleration of the fear- and anxiety- associated emotions, providing PTSD patients with much needed relief.