It is reported that 9.2% of Canadians will experience PTSD in their lifetime¹. In honour of PTSD Awareness Day on June 27, Aurora recognizes those who are suffering from this illness.

What is PTSD? 

PTSD, or Post-Traumatic Stress disorder can be characterized by intrusive distressing memories, persistent negative thoughts, avoidance of stressful triggers and persistent symptoms of hyperarousal (irritability, feeling jumpy, difficulty sleeping, etc).² PTSD can develop from experiencing, witnessing, or learning about a traumatic event³. 

Women are reported to be twice as likely to develop PTSD in comparison to men⁴. PTSD is also more prevalent among first responders, and those exposed to specific traumas, such as combat exposure or interpersonal violence^5,6. Currently, there remains a lack of effective treatment for PTSD, with standardized treatment resulting in only 20-30% of individuals showing full recovery⁷. 

Cannabis continues to be explored as an effective treatment option for PTSD. One survey study examining legal cannabis use in the USA and Canada, found PTSD or trauma was the third most common mental health reason for seeking out medical cannabis¹⁴. Additionally, managing PTSD or trauma with cannabis was associated with its use for anxiety or depression, with the latter two being the first and second most common mental health reasons for using medical cannabis¹⁴. 

What Science Says About CBD and PTSD 

Studies have shown the usefulness of CBD in treating PTSD. A retrospective case series published in The Journal of Alternative and Complementary Medicine found that CBD significantly decreased PTSD symptom severity in 91% of patients⁸. 

And in a double-blind placebo-controlled study examining the reduction of fear-associated memories in healthy volunteers, CBD inhaled before or after extinction training of fear memories resulted in decreased recall of these fear-associated memories later⁹.  

A newly published study identified CBD as being helpful in reducing anxiety and cognitive impairment in patients with PTSD caused by nonsexual trauma but did not find the same effects in patients with PTSD caused by sexual trauma¹⁵. The study suggested that CBD’s anti-anxiety effects in PTSD patients is dependent upon the type of trauma the patient experienced¹⁵. 

Emerging evidence in pre-clinical research also supports the potential usefulness of CBD in treating symptoms of PTSD^10,11. 

What Science Says About THC and PTSD 

THC dominant products have shown therapeutic efficacy in the treatment of PTSD related symptoms too. For example, in an open-label study, oral administration of plant-derived THC (twice a day) increased sleep quality, decreased nightmare frequency, and reduced hyperarousal in patients with chronic PTSD¹².  

References: 

1. Dückers MLA, Alisic E, Brewin CR. A vulnerability paradox in the cross-national prevalence of post-traumatic stress disorder. British Journal of Psychiatry. 2016;209(4):300-305.   
2. American Psychological Association. Guideline Development Panel for the Treatment of Posttraumatic Stress Disorder in Adults. February 24, 2017. Accessed May 16, 2021. https://www.apa.org/ptsd-guideline 
3. National Institute of Mental Health. Post-Traumatic Stress Disorder. 2020. Accessed May 16, 2021. https://www.nimh.nih.gov/health/publications/post-traumatic-stress-disorder-ptsd/  
4. Ozer EJ, Best SR, Lipsey TL, Weiss DS. Predictors of posttraumatic stress disorder and symptoms in adults: A meta-analysis. Psychological Bulletin. 2003;129(1):52-73.   
5. Breslau N, Chilcoat HD, Kessler RC, Davis GC. Previous exposure to trauma and PTSD effects of subsequent trauma: Results from the Detroit area survey of trauma. American Journal of Psychiatry. 1999;156(6):902-907.   
6. Cougle JR, Resnick H, Kilpatrick DG. Does prior exposure to interpersonal violence increase risk of PTSD following subsequent exposure? Behaviour Research and Therapy. 2009;47(12):1012-1017.   
7. Berger W, Mendlowicz M v., Marques-Portella C, et al. Pharmacologic alternatives to antidepressants in posttraumatic stress disorder: A systematic review. Progress in Neuro-Psychopharmacology and Biological Psychiatry. 2009;33(2):169-180.   
8. Elms L, Shannon S, Hughes S, Lewis N. Cannabidiol in the Treatment of Post-Traumatic Stress Disorder: A Case Series. The Journal of Alternative and Complementary Medicine. 2019;25(4):392-397. 
9. Das RK, Kamboj SK, Ramadas M, et al. Cannabidiol enhances consolidation of explicit fear extinction in humans. Psychopharmacology, 226(4), 781-792  
10. Campos AC, Ferreira FR, Guimarães FS. Cannabidiol blocks long-lasting behavioral consequences of predator threat stress: Possible involvement of 5HT1A receptors. Journal of Psychiatric Research. 2012;46(11):1501-1510.    
11. Uribe-Marĩo A, Francisco A, Castiblanco-Urbina MA, et al. Anti-aversive effects of cannabidiol on innate fear-induced behaviors evoked by an ethological model of panic attacks based on a prey vs the wild snake Epicrates cenchria crassus confrontation paradigm. Neuropsychopharmacology. 2012;37(2):412-421.    
12. Roitman P, Mechoulam R, Cooper-Kazaz R, Shalev A. Preliminary, Open-Label, Pilot Study of Add-On Oral D 9-Tetrahydrocannabinol in Chronic Post-Traumatic Stress Disorder. Published online 2014. doi:10.1007/s40261-014-0212-3 
13. Cahill SP, Lunn SE, Diaz P, Page JE. Evaluation of Patient Reported Safety and Efficacy of Cannabis From a Survey of Medical Cannabis Patients in Canada. Frontiers in Public Health. 2021;9:626853. doi:10.3389/fpubh.2021.626853 
14. Leung J, Chan G, Stjepanović D, Chung JYC, Hall W, Hammond D. Prevalence and self-reported reasons of cannabis use for medical purposes in USA and Canada. Psychopharmacology (Berl). 2022;1:1-11. doi:10.1007/S00213-021-06047-8/FIGURES/3 
15. Bolsoni LM, Crippa JAS, Hallak JEC, Guimarães FS, Zuardi AW. The anxiolytic effect of cannabidiol depends on the nature of the trauma when patients with post-traumatic stress disorder recall their trigger event. Brazilian Journal of Psychiatry. Published online March 14, 2022. doi:10.1590/1516-4446-2021-2317