Study on Δ9-THC Treatment for Posttraumatic Stress Disorders (PTSD) (THC_PTSD)

This study is currently recruiting participants.
Verified on July 2011 by Hadassah Medical Organization

First Received on August 25, 2009. Last Updated on July 6, 2011 History of Changes
Sponsor: Hadassah Medical Organization
Information provided by: Hadassah Medical Organization
ClinicalTrials.gov Identifier: NCT00965809
Purpose
Stress Disorder (PTSD) is a chronic and debilitating anxiety disorder which is widespread in every social level and is very prevalent in outpatient and inpatient settings.

A recent open-label study showed that the synthetic cannabinoid receptor agonist Nabilone had beneficial effects abolishing or greatly reducing nightmares that persisted in spite of treatment with conventional PTSD medications. Furthermore, a big number of patients suffering from chronic PTSD report using smoked marijuana because its tranquilizing effect and sleep quality improvement. According to clinical and epidemiological data different derivates from the cannabis plant are illegally and pervasively consumed by PTSD patients in order to reduce distress.

The aim of the proposed study is to broaden the previous observations and to measure the extent to which Δ 9-THC will bring to significant improvement on the full spectrum of PTSD symptoms.


Condition Intervention Phase
Posttraumatic Stress Disorders
Drug: Tetrahydrocannabinol
Other: Placebo
Phase IV

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Caregiver, Investigator)
Primary Purpose: Treatment
Official Title: Double Blind, Placebo-Controlled Trial of THC as add-on Therapy for PTSD

Resource links provided by NLM:

MedlinePlus related topics: Anxiety Post-Traumatic Stress Disorder
Drug Information available for: Tetrahydrocannabinol
U.S. FDA Resources

Further study details as provided by Hadassah Medical Organization:

Primary Outcome Measures:
Clinician Administered PTSD Scale [ Time Frame: Baseline and end o ftreatment ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
Nightmare Frequency Questionaire Score [ Time Frame: Baseline Weeks 3 &6 (EOS) ] [ Designated as safety issue: No ]

Estimated Enrollment: 70
Study Start Date: October 2009
Estimated Study Completion Date: April 2012
Estimated Primary Completion Date: December 2011 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
ACTIVE THC: Experimental
Subjects will take 5MG of THC in 6 drops of olive oil orally.
Intervention: Drug: Tetrahydrocannabinol
Drug: Tetrahydrocannabinol
Five mg. of THC in 6 drops of olive oil orally twice a day for 6 weeks.
Placebo: Placebo Comparator
Subjects will take 6 drops of olive oil orally twice a day from an identical vial than those in the active arm
Intervention: Other: Placebo
Other: Placebo
Subjects will take 6 drops of olive oil orally twice a day from an identical vial than those in the active arm

Eligibility

Ages Eligible for Study: 19 Years to 60 Years
Genders Eligible for Study: Both
Accepts Healthy Volunteers: No
Criteria
Inclusion Criteria:

Outpatients between the 19-60 years of age with a diagnosis of PTSD.
Women must not be currently pregnant and must use a reliable method of contraception for the duration of the study.
Subjects must be on stable medication (4 weeks minimum) for their PTSD (symptomatic despite current treatment), must be able to provide written informed consent, must be able adequately understand and comply with the study's instructions and protocol .
Exclusion Criteria:

Those not meeting the inclusion criteria and those not able to give informed consent.
Women who are currently pregnant or nursing.
Those at immediate risk of harming self or others; those who have a clinically significant medical illness or other significant psychiatric illness;
currently abusing alcohol or drugs;
currently being treated with an investigational medication or medication that is contraindicated with cannabinoids;
have a known allergy to cannabis-based products.


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Source: http://clinicaltrials.gov/ct2/show/NCT00965809?term=ptsd+cannabis&rank=1

Trial to Treat Post-traumatic Stress Disorder (PTSD), Addiction, and Virtual Reality

This study is currently recruiting participants.
Verified on June 2011 by Duke University

First Received on August 19, 2010. Last Updated on June 28, 2011 History of Changes
Sponsor: Duke University
Collaborators: Department of Defense
Telemedicine and Advanced Technology Research Center
Information provided by: Duke University
ClinicalTrials.gov Identifier: NCT01186315


Purpose
Eligible veterans with post-traumatic stress disorder (PTSD) and problems with addiction will be randomly assigned to one of two treatment conditions. All participants will undergo exposure therapy, a gold standard behavioral treatment for PTSD for 10 weeks. In addition to exposure therapy, some participants will be randomly assigned to receive (1) virtual reality (VR)-based exposure to cues for marijuana, cocaine, heroin, cigarette, and/or alcohol use, and (2) cellular phone-based reminders of learning (extinction reminders, or, ERs) to VR exposure (available 24 hours per day/7 days per week) to high-risk contexts for drug use. The main hypothesis is that those participants who receive exposure therapy + VR/ERs will demonstrate less substance use and lower PTSD symptoms during treatment, at post-treatment, and at follow-up than those participants who only receive exposure therapy.


Condition Intervention
Substance Use Disorders
Posttraumatic Stress Disorder
Behavioral: Prolonged Exposure Therapy
Behavioral: Prolonged Exposure therapy + VR/ER

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Single Blind (Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Developing a Computer-Based Intervention to Enhance Behavioral Treatments for PTSD and Addiction

Resource links provided by NLM:

MedlinePlus related topics: Injuries Post-Traumatic Stress Disorder Wounds
U.S. FDA Resources

Further study details as provided by Duke University:

Primary Outcome Measures:
Acceptability/feasibility (e.g., retention) of the novel intervention [ Time Frame: 10 weeks + 6 month follow-up ] [ Designated as safety issue: No ]
Acceptability/feasibility of exposure therapy + VR/ER will be evidenced by rates of session attendance, retention, and exit interview ratings

Change in PTSD symptoms [ Time Frame: Pre treatment, 10 weeks, post treatment, 6 month follow-up ] [ Designated as safety issue: No ]
Self-report measures of PTSD symptoms [e.g. The Davidson Trauma Scale (DTS)]and interview measures [e.g. Structured interview for DSM-IV, Axis I (SCID-I), Clinician Administered PTSD Scale (CAPS)]

Change in substance use [ Time Frame: Pre Treatment, Post 10 Week Treatment, and 6 month Follow Up ] [ Designated as safety issue: No ]
Self report measures of substance use: (e.g. Fagerström Test for Nicotine Dependence, Smoking Effects Questionnaire, Alcohol Craving Questionnaire, Heroin Craving Questionnaire, Cocaine Craving Questionnaire) and Interview Measures: [e.g. Structured Clinical Interview for DSM-IV, Axis I (SCID-I); Addiction Severity Index (ASI); Time Line Follow-back Assessment Method]


Secondary Outcome Measures:
Biochemical measures [ Time Frame: Pre Treatment, Post Treatment, Follow Up, During 10 weeks of Treatment ] [ Designated as safety issue: No ]
Urinalysis testing is done using the Biosite Diagnostics Triage Meter Plus within 24 hours for cocaine, marijuana, opiates, amphetamines, and benzodiazepines. Will be thrice weekly during 10 weeks of treatment.
Breathalyzer is done Pre Treatment, Post Treatment, Follow Up and before sessions during treatment.


Estimated Enrollment: 60
Study Start Date: December 2008
Estimated Study Completion Date: November 2012
Estimated Primary Completion Date: November 2012 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Prolonged Exposure therapy: Active Comparator
These treatments include repeated exposure to intrusive trauma-related memories in a safe and structured manner designed to reduce emotional arousal and facilitate processing of trauma-related memories.
Intervention: Behavioral: Prolonged Exposure Therapy
Behavioral: Prolonged Exposure Therapy
These treatments include repeated exposure to intrusive trauma-related memories in a safe and structured manner designed to reduce emotional arousal and facilitate processing of trauma-related memories.
Other Name: Exposure Therapy
Exposure therapy + VR/ER: Experimental
prolonged exposure therapy plus virtual reality (VR) based cue exposure/extinction software and cellular phone-based computerized extinction reminder (CER) technology for use in high-risk situations outside treatment sessions.
Intervention: Behavioral: Prolonged Exposure therapy + VR/ER
Behavioral: Prolonged Exposure therapy + VR/ER
The therapy includes repeated exposure to intrusive trauma-related memories in a safe and structured manner designed to reduce emotional arousal and facilitate processing of trauma-related memories and adding in virtual reality (VR)-based exposure to cues for marijuana, cocaine, heroin, cigarette, and/or alcohol use & CER used outside treatment sessions in response to VR exposure (available 24 hours per day/7 days per week) to high-risk contexts for drug use
Other Names:
virtual reality
exposure therapy
CER
VR
cell-phone based computerized extinction reminder

Detailed Description:
Veterans with post-traumatic stress disorder (PTSD) and problems with addiction need a wider array of treatment options than what is currently available. The present project offers the promise of a complementary approach that uses computer-based interventions to augment exposure therapy for veterans with both PTSD and substance use disorders (SUDs). If this new intervention is found to be efficacious in the present project, it would provide an alternative to standard treatment for a growing number of veterans who are at risk for lifetime problems with PTSD and addiction, but who may be unwilling to begin usual psychotherapy. This direct way of training new behavior in the clinic and extending learning into the real world is missing in treatments for many medical and psychiatric conditions. As such, the impact of this project could extend into treatment of a wide variety of other chronic conditions for which more powerful new treatments are needed. Veterans will be recruited from the Durham Veterans Affairs Medical Center (Durham VAMC) and local community.

Participants (N = 60) meeting full criteria for current diagnoses of both PTSD and at least one SUD will be recruited through the Durham Veterans Affairs Medical Center (Durham VAMC). Participants will be randomly assigned to one of two treatment conditions-exposure therapy alone or exposure therapy + virtual reality (VR)-based exposure to cues for marijuana, cocaine, heroin, cigarette, and/or alcohol use, and (2) cellular phone-based reminders of learning (extinction reminders, or, ERs) to VR exposure. Matching between treatment groups will be based on age, gender, severity of PTSD and substance use. In addition, to control for differential dropout and other changes in treatment due to cell phone use in the VR/ER condition, participants in the control condition also will carry cell phones, and will be randomly called three times a day via the automated server (same as the VR/ER condition). These calls will be completed for assessment only, to obtain real time self-reports of substance use and cravings (without the ER). Comprehensive assessments will be conducted at pre-treatment, 10 weeks (post-treatment), and at a 6-month follow-up.

The goals of this project are to examine the acceptability and feasibility of the complementary treatment and evaluate the effects of the complementary intervention on PTSD and substance use.

Eligibility

Ages Eligible for Study: 18 Years to 65 Years
Genders Eligible for Study: Both
Accepts Healthy Volunteers: No
Criteria
Inclusion Criteria:

Meets SCID-I criteria for PTSD; criterion A stressor must be deployment related, and substance dependence; primary substance of abuse is cocaine, heroin, alcohol, cigarettes, or marijuana
Must be a Veteran
Consents to outpatient treatment for PTSD and drug addiction
Exclusion Criteria:

Full criteria met for current manic episode or psychotic disorder through using SCID-I interviews
Pregnant at time of treatment
IQ less than 70; unable to give consent; can not read
current and chronic absence of shelter
impending jail/prison for more than three weeks
Court order to treatment, court order to treatment or to jail, or agency order to treatment or loss of child custody (due to inability to freely drop-out of treatment)
Refuses to discontinue current mental health or drug abuse behavioral treatment (i.e., psychotherapy) or random assignment
Suicide attempt or self-harm in the past 6 months
Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT01186315

Contacts
Contact: Sherika Oliver, BA 919-684-1131 sherika.oliver@duke.edu
Contact: Nathaniel R Herr, PhD 919-684-6714 nathaniel.herr@duke.edu

Locations
United States, North Carolina
Duke University Medical Center Recruiting
Durham, North Carolina, United States, 27710

Principal Investigator: Zachary Rosenthal, PhD

Sponsors and Collaborators
Duke University
Department of Defense
Telemedicine and Advanced Technology Research Center

Investigators
Principal Investigator: Zachary Rosenthal, PhD Duke University

Source: http://clinicaltrials.gov/ct2/show/NCT01186315?term=ptsd+cannabis&rank=2

CB1 Studies, Ongoing and Completed Trials

I found this when studying the reasearch data from completed trials of the CB1 receptor.


"Substances called endocannabinoids, which have many of the same effects of marijuana, bind to CB1 receptors. Animal studies show that when CB1 receptors are blocked, the animals consume less alcohol."
http://clinicaltrials.gov/ct2/show/NCT00075205?term=cb1&rank=6



CB1 trials ( look at the study results if posted)
http://clinicaltrials.gov/ct2/results?term=cb1


Rank Status Study
1 Completed PET Imaging of Cannabinoid CB1 Receptors Using [18F]FMPEP-d2
Conditions: CB1; Cannabinoid; PET; [18F]FMPEP-d2; Brain Imaging
Intervention: Drug: [18F]FMPEP-d2
2 Recruiting PET Imaging of Cannabinoid CB1 Receptors Using [11C]MePPEP
Condition: Healthy
Intervention: Drug: [11C]MePPEP
3 Recruiting Imaging Cannabinoid CB1 Receptors in Schizophrenia
Condition: Schizophrenia
Intervention:
4 Recruiting Imaging Cannabinoid CB1 Receptors in Alcohol Dependence
Condition: Alcoholism
Intervention:
5 Recruiting Cannabinoid Receptor (CB1) Agonist Treatment in Severe Chronic Anorexia Nervosa
Condition: Anorexia Nervosa
Interventions: Drug: dronabinol; Drug: placebo
6 Completed Rimonabant to Reduce Alcohol Consumption
Conditions: Healthy; Alcohol Drinking
Intervention: Drug: SR141716 (Rimonabant)
7 Completed Antagonistic Interaction CB1-paracetamol
Condition: Pain
Intervention: Drug: Rimonabant and Paracetamol and placebo
8 Completed Neurobiology of Cannabis Dependence
Conditions: Cannabis Dependence; Cannabis Withdrawal
Interventions: Drug: rimonabant; Drug: placebo
9 Recruiting Effect of Rimonabant on Weight Gain and Body Composition in Adults With Prader Willi Syndrome
Condition: Prader-willi Syndrome
Interventions: Drug: rimonabant; Drug: placebo
10 Completed Imaging of Cannabinoid Receptors Using New Radioactive Tracer
Condition: Healthy
Intervention: Drug: [(11)C]MePPEP
11 Completed Efficacy and Safety of Surinabant Treatment as an Aid to Smoking Cessation (SURSMOKE)
Condition: Smoking Cessation
Interventions: Drug: surinabant (SR147778); Drug: placebo
12 Completed Phase 1 Pharmacokinetic Study Of CP-945598 In Patients With NASH
Condition: Non-Alcoholic Steatohepatitis(NASH)
Interventions: Drug: Active treatment; Drug: Placebo
13 Terminated Efficacy and Safety of AVE1625 as a Co-treatment With Antipsychotic Therapy in Schizophrenia
Condition: Schizophrenia
Interventions: Drug: AVE1625; Drug: placebo
14 Unknown † Use of Cannabinoids in Patients With Multiple Sclerosis
Condition: Multiple Sclerosis
Intervention: Drug: Sativex
15 Completed Evaluation of the Antipsychotic Efficacy of Cannabidiol in Acute Schizophrenic Psychosis
Condition: Schizophrenia
Interventions: Drug: Cannabidiol; Drug: Amisulpride
16 Recruiting Efficacy Study of Nabilone in the Treatment of Diabetic Peripheral Neuropathic Pain
Condition: Diabetic Neuropathies
Intervention: Drug: Nabilone, flexible dosing
17 Completed Antagonist-Elicited Cannabis Withdrawal
Conditions: Cannabis; Dependence
Interventions: Drug: THC; Drug: Rimonobant; Drug: Rimonabant
18 Completed Evaluation of the Efficacy of Cesamet™ for the Treatment of Pain in Patients With Diabetic Peripheral Neuropathy
Condition: Diabetic Neuropathies
Intervention: Drug: Cesamet™ (nabilone)
19 Completed Evaluation of the Efficacy of Cesamet™ for the Treatment of Pain in Patients With Multiple Sclerosis
Condition: Multiple Sclerosis
Intervention: Drug: Cesamet™ (nabilone)
20 Completed Evaluation of the Efficacy of Cesamet™ for the Treatment of Pain in Patients With Chemotherapy-Induced Neuropathy
Conditions: Peripheral Neuropathy; Antineoplastic Combined Chemotherapy Protocols
Intervention: Drug: Cesamet™ (nabilone)

============================================

These studies have a wealth of information about the current progress studying the CB1 receptor. the National Institute on Drug Abuse (NIDA) is actively trying to find evidence of the Neurobiology of Cannabis Dependence. They have yet to post their findings as it could open a floodgate of changes in legislation to reschedule cannabis. Cannabis is non-toxic, but reprogramming the public's view of its efficacy and use in modern treatments will take a sledge hammer to the face before its legalized.

Information is our sledgehammer - what are you going to do with it?

Cannabis Eases Post Traumatic Stress

Cannabis Eases Post Traumatic Stress

By Tod Mikuriya, MD

Originally published in O'Shaughnessy's, Spring 2006

William Woodward, MD, of the American Medical Association, testifying before Congress in 1937 against the Prohibition of cannabis, paraphrased a French author (F. Pascal, 1934) to the effect that “Indian hemp has remarkable properties in revealing the subconscious.” A Congressman asked, “Are there any substitutes for that latter psychological use?” Woodward replied, “I know of none. That use, by the way, was recognized by John Stuart Mill in his work on psychology, where he referred to the ability of Cannabis or Indian hemp to revive old memories —and psychoanalysis depends on revivification of hidden memories.”


For including that reference to Mill (1867) in the list I have been compiling of conditions amenable to treatment by cannabis, I was ridiculed by Drug Czar Barry McCaffrey in 1996. I stand by its inclusion, of course, and in the 10 years since California physicians have been approving cannabis use by patients, I have found myself appreciating and confirming Mill’s insight with every report that cannabis has eased symptoms of post-traumatic stress disorder.

PTSD As a Dissociative Disorder

PTSD—a chronic condition involving horrific memories that cannot be erased—is a dissociative identity disorder. The victim’s psyche is fragmented in response to contradictory inputs that cannot be resolved.
Dissociative identity disorders are expressed in bizarre or inappropriate behaviors with intense sadness, fear, and anger. Repression or “forgetting” of the experiences may develop as a coping mechanism.
When traumatic or abusive experiences cannot be integrated into normal consciousness —as in the case of the Jekyl-Hyde behaviors of abusive parents or caregivers— creation of separate personalities or identities may occur.


For example, the woman who was molested by a family member may have both superfically-compliant and repressed-raging identities. The persona that’s presented to the world can be swept away when a stimulus calls forth the overwhelming rage.


Such fragmenting of the individual personality causes tremendous stress. The psyche is incomplete because of repression and denial. The person tries to appear normal and logical but in fact is in turmoil, angry and depressed. The inability to deal directly with emotional issues results in ongoing splitting and compartmentalization of the personality —and in extreme cases, multiple personalities, hysterical fugue (a separate state of consciousness that the individual may not recall), blindness, paralysis, and other functional disruptions.


In 1994 the term “Multiple Personality Disorder” was replaced with the more widely applicable “Dissociative Identity Disorder.” As an article (by Foote et al) and editorial (Spiegel) in the April 2006 American Journal of Psychiatry attest, it is only relatively recently that PTSD has been characterized as a dissociative disorder.


Easement by Cannabis
Approximately eight percent of the >9,000 Californians whose cannabis use I have monitored presented with PTSD (309.81) as a primary diagnosis. Many of them are Vietnam veterans whose chronic depression, insomnia, and accompanying irritability cannot be relieved by conventional psycho therapeutics and is worsened by alcohol. For many of these veterans, chronic pain from old physical injury compounds problems with narcotic dependence and side effects of opioids.


Survivors of childhood abuse and other traumatic experiences form a second group manifesting the same symptoms —loss of control and recurrent episodes of anxiety, depression, panic attacks and mood swings, chronic sleep deficit and nightmares.


The brief case reports in the box at the right of this page, unique though the subjects may be, typify two different forms that PTSD takes, both of which are eased by cannabis. The recurrent nightmares from the vet’s traumatic episode took on a life of their own, causing nocturnal turmoil and dread. The repressed memories of the sexually abused and beaten woman were symptoms of a fragmented, dissociative response to the disorder.
Easement by cannabis helped both —the vet by toning down his reaction to the nightmares and restoration of his sleep, the woman by modulating her emotional reactivity and permitting her to process and integrate the experience and give up the fragmented, dissociative defense mechanisms, which in due course she no longer needed.


Repression and suppression are defense mechanisms that break down when the victim is fatigued and/or hurting and subjected to triggering stimuli. With cannabis, vegetative functions necessary for recovery, growth and repair are normalized.


Practical Treatment Goals
In treating PTSD, psychotherapy should focus on improving how the patient deals with resurgent symptoms rather than revisitation of the events. Decreasing vulnerability to symptoms and restoring control to the individual take priority over insight as treatment goals. Revisiting the traumatic events without closure and support is not useful but prolongs and exacerbates pain and fear of loss of control. To repeat: cathartic revisiting of the traumatic experience(s) without support and closure is anti-therapeutic and can exacerbate symptoms.

Physical pain, fatigue, and sleep deficit are symptoms that can be ameliorated. Restorative exercise and diet are requisite components of treatment of PTSD and depression. Cannabis does not leave the patient too immobile to exercise, as do some analgesics, sedatives biodi-azapenes, etc. Regular aerobic exercise (where injury does not interfere) relieves tension and restores control through kinesthetic involvement. Exercise also internalizes the locus of control and diminishes drug-seeking to manage emotional response.

The importance of sound sleep
PTSD often involves irritability and inability to concentrate, which is aggravated by sleep deficit. Cannabis use enhances the quality of sleep through modulation of emotional reactivity. It eases the triggered flashbacks and accompanying emotional reactions, including nightmares.
The importance of restoring circadian rhythm of sleep cannot be overestimated in the management of PTSD. Avoidance of alcohol is important in large part because of the adverse effects on sleep. The short-lived relaxation and relief provided by alcohol are replaced by withdrawal symptoms at night, causing anxiety and the worsening of musculoskeletal pain.

Evening oral cannabis may be a useful substitute for alcohol. With proper dosage, the quality and length of sleep can be improved without morning dullness or hangover. For naïve patients, use of oral cannabis should be gradually titrated upward in a supportive setting; this is the key to avoiding unwanted mental side effects.


I recommend the protocol J. Russell Reynolds M.D., commended to Queen Victoria: “The dose should be given in minimum quantity, repeated in not less than four to six hours, and gradually increased by one drop every third or fourth day, until either relief is obtained, or the drug is proved, in such case to be useless. With these precautions I have never met with any toxic effects, and have rarely failed to find, after a comparatively short time, either the value or the uselessness of the drug.”


The advantage of oral over inhaled cannabis for sleep is duration of effect; a disadvantage is the time of onset (45-60 minutes). When there is severe recurrent insomnia with frequent awakening it is possible to medicate with inhaled cannabis and return to sleep. An unfortunate result of cannabis prohibition is that researchers and plant breeders have not been able to develop strains in which sedative components of the plant predominate.

Modulation, Not Extinction
Although it is now widely accepted that cannabinoids help extinguish painful memories, my clinical experience suggests that “extinguish” is a misnomer.
Cannabis modulates emotional reactivity, enabling people to integrate painful memories —to look at them and begin to deal with them, instead of suppressing them until a stimulus calls them forth with overwhelming force.
The modulation of emotional response relieves the flooding of negative affect. The skeletal and smooth muscle relaxation decreases the release of corticosteroids and escalating “fight-or-flight” agitation. The modulation of mood prevents or significantly decreases the symptoms of anxiety attacks, mood swings, and insomnia.

While decreasing the intensity of effectual response, cannabis increases introspection as evidenced by the slowing of the EEG after initial stimulation. Unique anti-depressive effects are experienced immediately with an alteration in cognition. Obsessive and pressured thinking give way to introspective free associations (given relaxed circumstances). Emotional reactivity is calmed, worries become less pressing.

Used on a continuing basis, cannabis can hold depressive symptoms at bay. Agitated depression appears to respond to the anxiolytic component of the drug. Social withdrawal and emotional shutting down are reversed.
The short-term memory loss induced by cannabis that may be undesirable in other contexts is therapeutic in controlling obsessive ideation, amplified anxiety and fear of loss of control ignited by the triggering stimuli.

Easement Effects of Cannabis
In treating PTSD, cannabis provides control and amelioration of chronic stressors without adverse side effects. Mainstream medicine treats PTSD symptoms such as hyperalertness, insomnia, and nightmares with an array of SSRI and tricyclic anti-depressants, sedatives, analgesics, muscle relaxants, etc., all of which provide inadequate relief and have side effects that soon become problematic. Sedatives, both prescribed and over-the-counter, when used chronically, commonly cause hangovers, dullness, sedation, constipation, weight gain, and depression. See chart at right.

Cannabis is a unique psychotropic immunomodulator which can best be categorized as an “easement.” Modulating the overwhelming flood of negative affect in PTSD is analogous to the release of specific tension, a process of “unclenching” or release. As when a physical spasm is relieved, there is a perception of “wholeness” or integration of the afflicted system with the self. For some, this perceptual perspective is changed in other ways such as distancing (separating the reaction from the stimulus, which can involve either lessening the reaction, as with modulation, or repressing/suppressing the memory; walling it off; forgetting).

The modulation of emotional response relieves the flooding of negative affect. The skeletal and smooth muscle relaxation decreases the sympathetic nervous reactivity and kindling component of agitation. Fight/flight responses and anger symptoms are significantly ameliorated. The fear of loss of control diminishes as episodes of agitation and feeling overwhelmed are lessened. Experiences of control then come to prevail. Thinking is freed from attachment to the past and permitted to fix on the present and future. Instead of being transfixed by nightmares, the sufferer is freed to realize dreams.

Based on both safety and efficacy, cannabis should be considered first in the treatment of post-traumatic stress disorder. As part of a restorative program with exercise, diet, and psychotherapy, it should be substituted for “mainstream” anti-depressants, sedatives, muscle relaxants, tricyclics, etc.
Case Report:

A 52-year-old retired executive secretary brought her 20-year-old daughter along to her follow-up interview two years after starting cannabis therapy. During her initial visit she had not disclosed fully the causality of her chronic depression with symptoms of PTSD (nightmares, chronic insomnia, dissociative episodes, rage).

She was experiencing loss of emotional control with crisis psychiatric interventions. Hypervigilance characterized her presentation; she described herself as being “all clenched up.”

On follow-up she reported being able to recover and process repressed memories of sexual abuse from age five to 15 by her father (a preacher) and having been beaten by her enraged mother. She reported the diminution and cessation of dissociative reactions to the painful memories. This permitted her to process and resolve —or come to an accord with— these unthinkable memories. Her continuing psychotherapy focused on these issues. She no longer experienced episodes of loss of control. She was able to relax her hypervigilance. Her self-esteem was significantly improved and she seemed happy and optimistic

Her daughter confirmed that her mother was less irritable and more emotionally available since starting cannabis therapy. Both described improvement in their relationship.

Case Report:
A 55-year-old disabled male veteran had been a naval air crewman on patrol during the Vietnam war. A P2V turbo-prop engine failed to reverse properly on landing. A propeller broke loose, pierced the fuselage, and instantly killed his crew mate who was two feet away. He brought a large binder of documentation of the incident.

His PTSD was expressed primarily through a haunting, recurrent flashback nightmares that replayed the traumatic event. Attendant were the feelings of being emotionally overwhelmed. Sleep deficit was a salient aggravating factor for increasing vulnerability. Cannabis restored sleep and controlled nightmares. Depression and irritability had been eased.

============================================

Source: Tod H. Mikuriya, M.D. http://www.mikuriya.com/cw_ptsd.html

additional research: Cannabis Writings: Research, essays, and commentary dating from 1965 to the present. These writings--published and unpublished--highlight Dr. Mikuriya's unique views on medicinal cannabis. With his psychiatric background, Dr. Mikuriya quite often elicits a view that is found nowhere else. http://www.mikuriya.com/can_write.html

Vaporization Page: Vaporization offers the benefits of smoked of cannabis (rapid onset and ability to self titrate) without the harmful effects. Includes pictures, essays, and how-tos, if you are seeking quality information without the vendor hype, this is your place to find it. http://www.mikuriya.com/can_vapor.html

Ethnographic Writings: Written mostly in the '60s, these canabis related ethnographic studies are full of rich and usefull information. http://www.mikuriya.com/can_ethno.html

Marijuana Medical Papers 1869-1972: originally published in 1972, virtually out of print. If the medicinal cannabis movement has a single beginning, this book is it. http://www.mikuriya.com/mmp.html

Since the passage of CCUA in 1996, Dr. Mikuriya has given numerous presentations to a wide variety of groups and organizations on the law and medical marijuana. Some of these presentations have been collected here. http://www.mikuriya.com/ppt.html

Hi, can you reccomend any specific strains or types of oil that might help with PTSD?

Strains that would help PTSD symptoms

chrawnic said:

Hi, can you reccomend any specific strains or types of oil that might help with PTSD?

Click to expand...

Hi chrawnic ~ Instead of narrowing down a strain of what helps, I'd be better telling you what to avoid as most herb strains help ptsd, there are only a few strains that cause adverse reactions.

Adverse reactions:
1. Paranoia
2. Excessive sleep and apathy
3. Temporary memory loss to the point it impairs
4. Fear or panic attack
5. Crying or deepening depression


I suggest staying away from pure sativa's unless your blood levels are high enough to tolerate how strong they can get , and choosing a strain based on what effects you want. I vaporize a oil that is uplifting in the morning and have a different oil that is high in cbd for nights.

I love the chem strains for the body pain relief but most of them are too narcotic to use during the day, and are best reserved for evening doses, unless you find a good hybrid indica that energizes but is potent enough to last.

I did find I couldn't smoke enough herb to really help with my ptsd, I had to ingest my doses and supplement with my labworkx hot oil vaporizer. once I got my blood levels up to a higher and stable level, the symptoms that bothered me most were much more controllable. I don't get high anymore, I can operate normally on doses that would floor the average person. When you think about how our body operates with chemical pain relievers, especially chronic pain meds, we have to be titrated up in doses to get our blood levels stable with the substance and up the dosage when it no longer has the desired effect.

The good thing about cbn, cbd, and even thc in marijuana, we can't ever overdose on it or kill ourselves, but it does have a ceiling as to what it can do for us and once we reach that limit, we have to starve our system of it to allow it to have effect again.

The reason I wanted to add this little rant to answer your question is I want people that use herb to help their PTSD to find that area in which herb helps them manage issues better without going over into the area which it stops. Or atleast being able to recognize that point and be strong enough to go without while your body rebuilds its tolerance.

I think anytime we can substitute a natural herb to help us help ourselves and manage our conditions without causing harm to our body is a wonderful thing,..

Excellent article and subject content. I will copy this and add it to my collection of information. God Bless

welcome aboard

mars said:

Excellent article and subject content. I will copy this and add it to my collection of information. God Bless

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Hi Mars and welcome to the farm

There is so much information out now about PTSD and on the core mechanism that modulates the fear reflex of traumatic memories. The CB1 receptor in the endocannabinoid system has been recognized as a therapeutic target for treatment with mary jane ,.. along with exercise, diet plan, sleep regimen and social reintegration.

now if we could only socially integrate using canna-therapy without fear of being killed by our local police :0)

endogenous cannabinoid system

The endogenous cannabinoid system controls extinction of aversive memories

Acquisition and storage of aversive memories is one of the basic principles of central nervous systems throughout the animal kingdom.

The cannabinoid receptor 1 (CB1) and endocannabinoids are present in memory-related brain areas, and modulate memory.


CB1 is required at the moment of memory extinction. Consistently, tone presentation during extinction trials resulted in elevated levels of endocannabinoids in the basolateral amygdala complex, a region known to control extinction of aversive memories. In the basolateral amygdala, endocannabinoids and CB1 were crucially involved in its long-term depression.

Endocannabinoids facilitate extinction of aversive memories through their selective inhibitory effects on local inhibitory networks in the amygdala.

Source:
Here is a study on mice that shows the endogenous cannabinoid system has a central function in extinction of aversive memories.

I have PTSD and find the science behind some of this stuff very fascinating. I know that the use of psychedelics is associated with PTSD treatment, so it's not surprising that MMJ would be.

clampy said:

I have PTSD and find the science behind some of this stuff very fascinating. I know that the use of psychedelics is associated with PTSD treatment, so it's not surprising that MMJ would be.

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Hi Clampy ~ welcome to the farm


Glad to get my fellow farmers talking about their experience with ptsd and of course any related experiences treating it with anything.

I prefer the natural route but know we all can't get access to medical quality herb on a reliable basis without putting ourselves and our family in extreme jeopardy from law enforcement abuse.

herbs have been around many eons before we came into existence or decided to outlaw one and marijuana will be around many more eons long after our civilization collapses.

I firmly believe we have cannabinoid receptors for the specific reason to receive cannabis or one of its isolated extracts.

same as we have opiate receptors that are used in pain management

psychedelics have been around even longer from mushrooms and cactus. I've heard them called spirit journey substances that can heal the mind as they bring one in to full consciousness or out of it in some doses, lol.


vape tyme

Hi everyone,
Sometimes my condition won't allow medicine(doc pills) to work, it rejects them by vomiting and generally make you worse. My doc said to try and take min amount and try and not take painkillers as it could increase the pain.
Enters our magical green angel and it isn't reacting with me and is getting rid of the pain with no damage (i vipro).
All I can say is I hope all the people that are suffering will one day be entitled instead of just the people who seek it out in dark car parks!!
:volcano:

midnightfarmer said:

Hi everyone,
Sometimes my condition won't allow medicine(doc pills) to work, it rejects them by vomiting and generally make you worse. My doc said to try and take min amount and try and not take painkillers as it could increase the pain.
Enters our magical green angel and it isn't reacting with me and is getting rid of the pain with no damage (i vipro).
All I can say is I hope all the people that are suffering will one day be entitled instead of just the people who seek it out in dark car parks!!

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Hi Midnightfarmer ~ welcome to the farm brother

Thanks for your report on cannabis helping you with your ptsd symptoms and overall quality of life. I know it sucks hardcore being forced to have a chem only diet being forced down our throats.

We have a natural right to the personal use of herbs, unfortunately we live in a police state forcing an overworked police force to be weed wardens.


take care and keep your blood levels up with natural herbs instead of chems