_This publication is based on a Human Services course I am taking at A-B Tech, HSE-210 with Autumn Wallen. The course has a central research thesis, βIs Cannabis an effective treatment for PTSD?β Weβve never established a shared understanding of what PTSD is. Iβd like to attempt to attempt to create that through a video lecture presentation on why the βP,β or βPostβ in PTSD is not accurate_ Think of this as a primer and loving letter to a client, to guide through a personal inquiry: Is cannabis an effective treatment for my trauma-based condition? In this short book, we will look at research findings, considerations, media publications, and much more, to help someone make an informed, evidence-based decision. There are no agendas or conflicts of interest here, for or against cannabis use. Though I have been a daily cannabis user on and off for the entirety of my adult life. This could be a tool for a concerned love one, or someone struggling who has never used before, or someone who is a regular user of cannabis wondering if itβs a good idea to stop. These perspectives are American and Western centric.They are white-centric and over-represent the Wounded Warrior trope, while Black History gets left out as a different understanding of the PTSD that affects millions of African Americans at home.
Should I be using cannabis to treat a trauma-based condition? 1 Should I be using cannabis to treat a trauma-based condition? 1 Table of Contents 3 Table of Contents 3 Abstract: 4 Abstract: 4 Chapter 1: Post Traumatic Stress Disorder 5 Chapter 1: Post Traumatic Stress Disorder 5 Definition and Symptoms 5 Definition and Symptoms 5 History 5 History 5 The Vietnam War Hypothesis 5 The Vietnam War Hypothesis 5 Beyond the βPostβ 6 Beyond the βPostβ 6 Chapter 2: Health and Wellness 7 Chapter 2: Health and Wellness 7 Overview 7 Overview 7 2.2 Role of the Endocannabinoid System in Stress Response 7 2.2 Role of the Endocannabinoid System in Stress Response 7 2.3 Potential Mechanisms of Cannabis in Alleviating PTSD Symptoms 7 2.3 Potential Mechanisms of Cannabis in Alleviating PTSD Symptoms 7 Chapter 3: Current Research 8 Chapter 3: Current Research 8 3.1 What is Cannabis? 8 3.1 What is Cannabis? 8 3.2 Effectiveness of Cannabis in Reducing Hyperarousal Symptoms 8 3.2 Effectiveness of Cannabis in Reducing Hyperarousal Symptoms 8 3.3 Risks, Side Effects, and Safety Considerations 8 3.3 Risks, Side Effects, and Safety Considerations 8 3.4 History of Cannabis 8 3.4 History of Cannabis 8 Chapter 4: Effective Treatments that are not Cannabis 9 Chapter 4: Effective Treatments that are not Cannabis 9 4.1 Getting our Survival Needs Met 9 4.1 Getting our Survival Needs Met 9 4.2 Taking Action and Improving our Environment 9 4.2 Taking Action and Improving our Environment 9 4.3 Community Service & Volunteering 9 4.3 Community Service & Volunteering 9 4.4 Support Groups, Social Media 9 4.4 Support Groups, Social Media 9 4.5 Helpful Therapy Modalities 9 4.5 Helpful Therapy Modalities 9 4.6 Psychedelic Therapies 9 4.6 Psychedelic Therapies 9 Chapter 5: Laws and Ethics 10 Chapter 5: Laws and Ethics 10 5.1 Current Legal Status of Cannabis in United States as of September 2023 10 5.1 Current Legal Status of Cannabis in United States as of September 2023 10 5.2 Challenges and Barriers to accessing Cannabis-based treatments 10 5.2 Challenges and Barriers to accessing Cannabis-based treatments 10 5.3 Ethical Concerns Surrounding Cannabis Treatment for PTSD 10 5.3 Ethical Concerns Surrounding Cannabis Treatment for PTSD 10 Chapter 6: Experiences 11 Chapter 6: Experiences 11 6.1 Positive Effects 11 6.1 Positive Effects 11 6.2 Testimonials: Satisfaction and Quality of Life 11 6.2 Testimonials: Satisfaction and Quality of Life 11 6.3 Challenges and Risks 11 6.3 Challenges and Risks 11 Could I be using cannabis to cope with traumatic stress in unhealthy ways? 13 Could I be using cannabis to cope with traumatic stress in unhealthy ways? 13 Am I using cannabis to cope in unhealthy ways? 13 Am I using cannabis to cope in unhealthy ways? 13 What might some research faux pas be when researching medical Cannabis use? What about PTSD/Traumatic Stress? 13 What might some research faux pas be when researching medical Cannabis use? What about PTSD/Traumatic Stress? 13 Why Appreciating Bugs Helps Me Reframe Addiction 16 Why Appreciating Bugs Helps Me Reframe Addiction 16
Table of Contents
Chapter 1: Post-Traumatic Stress Disorder 1.1 Definition and Symptoms 1.2 History and Origins 1.3 Beyond the βPostβ Chapter 2: Health Considerations 2.1 Overview of the Endocannabinoid System 2.2 Role of the Endocannabinoid System in Stress Response 2.3 Potential Mechanisms of Cannabis in Alleviating PTSD Symptoms Chapter 3: Current Research 3.1 What is Cannabis? 3.2 Effectiveness of Cannabis in Reducing Hyperarousal Symptoms 3.3 Risks, Side Effects, and Safety Considerations 3.4 History of Cannabis Chapter 4: Effective Treatments that are not Cannabis 4.1 Getting our Survival Needs Met 4.2 Taking Action and Improving our Environment 4.3 Community Service & Volunteering 4.4 Support Groups, Social Media 4.5 Helpful Therapy Modalities 4.6 Psychedelic Therapies Chapter 5: Laws and Ethics 5.1 Current Legal Status of Cannabis in United States as of September 2023 5.2 Challenges and Barriers to accessing Cannabis-based treatments 5.3 Ethical Concerns Surrounding Cannabis Treatment for PTSD Chapter 6: Experiences 6.1 Positive Effects 6.2 Testimonials: Satisfaction and Quality of Life 6.3 Challenges and RisksAbstract:
While cannabis has gained attention as a potential treatment for post-traumatic stress disorder, it is essential to approach its use with a client-focused mindset and base our understanding on research and evidence. This small book has provided an overview of the subtopics surrounding cannabis as a treatment for PTSD, including its potential benefits, limitations, legal considerations, and client perspectives. It is important to consult healthcare professionals and consider individual circumstances before considering cannabis therapy for PTSD.Chapter 1: Post Traumatic Stress Disorder
Definition and Symptoms
From Mayo Clinic: Post-traumatic stress disorder (PTSD) is a mental health condition that's triggered by a terrifying event β either experiencing it or witnessing it. Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event. Most people who go through traumatic events may have temporary difficulty adjusting and coping, but with time and good self-care, they usually get better. If the symptoms get worse, last for months or even years, and interfere with your day-to-day functioning, you may have PTSD. Getting effective treatment after PTSD symptoms develop can be critical to reduce symptoms and improve function. https://www.ncbi.nlm.nih.gov/books/NBK207191/box/part1_ch3.box16/History
Post Traumatic Stress Disorder or PTSD, was coined under that name, after the Vietnam War. It was used to describe the type of psychological turmoil and disorder soldiers would experience coming back from war combat. At the time, the way we understood traumatic stress, was that it was an after response to experiencing something horrific. This was not a new phenomenon. We had known this as Shellshock during World War I. There have been references to this condition in documentation going back to ancient times. There was something notable and different about the Vietnam War that I think highlights the meaning of this condition.The Vietnam War Hypothesis
I believe that many of the Veterans of the Vietnam War with clinical PTSD struggled with a cognitive dissonance of having been sent to die for a βbad warβ and witnessing atrocity unfold. And the public consciousness of the Vietnam War needing to end was thanks to Information Technology. The War in Vietnam was known to be the first televised war. From a living room, one could see the atrocities unfolding, the political demonstrations against the draft consignment, how the moral narrative for the war was fraught with lies and the toll on human life. When someone returns from a war, there is often the self-justification that they fought for a higher principle of what they believe in, and that there was a purpose to the violence committed and endured. Through greater Information Technology, this was a position impossible to hold anymore. No soldier in any war or any front will see themselves as the βbad guys.β They are fighting for principles and their nationalities and see their side as the side of goodness or divinity. To be confronted with the idea of having fought for something evil is devastating to most people. Itβs a world shattering realization to have everything you loved and believed to be true upended.Beyond the βPostβ
I think that the term Post Traumatic Stress Disorder (PTSD) is an outdated way to think about trauma. The word "post" suggests that the traumatic event happened and is over, but this is not always the case. For many people, trauma is an ongoing experience that can have a lasting impact on their lives. There are several ways someone can experience a Traumatic Stress Disorder without it following that linear timeline. A common example with conventional Post Traumatic Stress Disorder: someone who has experienced a traumatic event may continue to have flashbacks or nightmares about it, even years later. They may also avoid situations that remind them of the event, or have difficulty trusting others. The term βOngoingβ or βComplexβ PTSD has been proposed to better describe when that traumatic event is recurring, and not completed. This term acknowledges that trauma can be a long-term, ongoing experience, and that the symptoms of PTSD can last for years or even decades. The term "Pre-TSD" has also been proposed to describe the experience of someone who is anticipating a traumatic event. For example, someone who is facing a life-threatening illness or who is in a war zone may experience symptoms of PTSD even before the event happens. These terms are still being debated, but they offer a more accurate way to describe the experience of trauma. They also help to raise awareness of the fact that trauma is not a one-time event, and that it can have a lasting impact on people's lives. If you want to expand how you understand trauma, I highly encourage watching or reading Dr. Joy Degruy Learyβs Post Traumatic Slave Disorder. That link goes to a free and publicly available lecture on Youtube. Sheβs awesome. I promise itβs worth the hour and twenty minutes, you will learn so much. Or if you only have a few minutes, here is Dr. Joyβs six minute interview with AJ+. _Joy Degruy Leary, & Robinson, R. (2018). Post traumatic slave syndrome : Americaβs legacy of enduring injury and healing. Joy Degruy Publications Inc._ _https://www.joydegruy.com/post-traumatic-slave-syndrome_ _(please take the opportunity to view an awesomely made and accessible business website, and consider supporting Dr. Joy Degruyβs work.)_Chapter 2: Health and Wellness
Overview
2.2 Role of the Endocannabinoid System in Stress Response
The endocannabinoid system (ECS) is a complex network of neurotransmitters and receptors that plays a role in a variety of physiological processes, including stress response. When the body is under stress, the ECS is activated and helps to regulate the body's response to stress. The ECS is made up of two main components: endocannabinoids and cannabinoid receptors. Endocannabinoids are molecules that are produced naturally in the body, and cannabinoid receptors are proteins that are found on the surface of cells. When endocannabinoids bind to cannabinoid receptors, they can activate a variety of cellular responses. One of the main ways that the ECS regulates stress response is by affecting the release of neurotransmitters. When the body is under stress, the ECS helps to inhibit the release of stress hormones, such as cortisol and adrenaline. This can help to reduce the body's physical and emotional response to stress. The ECS also plays a role in regulating the immune system. When the body is under stress, the ECS helps to suppress the immune system. This can help to prevent the immune system from overreacting to stress and causing inflammation. The ECS is a complex system that plays a vital role in regulating stress response. By understanding how the ECS works, we can better understand how stress affects the body and how we can manage stress more effectively. In addition to its role in regulating stress response, the ECS is also involved in a variety of other physiological processes, including appetite, pain, sleep, and mood. The ECS is a promising target for the development of new treatments for a variety of diseases and conditions, including pain, inflammation, and mental health disorders.2.3 Potential Mechanisms of Cannabis in Alleviating PTSD Symptoms
Chapter 3: Current Research
3.1 What is Cannabis?
3.2 Effectiveness of Cannabis in Reducing Hyperarousal Symptoms
3.3 Risks, Side Effects, and Safety Considerations
3.4 History of Cannabis
Chapter 4: Effective Treatments that are not Cannabis
4.1 Getting our Survival Needs Met
4.2 Taking Action and Improving our Environment
4.3 Community Service & Volunteering
4.4 Support Groups, Social Media
4.5 Helpful Therapy Modalities
4.6 Psychedelic Therapies
Chapter 5: Laws and Ethics
5.1 Current Legal Status of Cannabis in United States as of September 2023
5.2 Challenges and Barriers to accessing Cannabis-based treatments
5.3 Ethical Concerns Surrounding Cannabis Treatment for PTSD
Chapter 6: Experiences
6.1 Positive Effects
6.2 Testimonials: Satisfaction and Quality of Life
6.3 Challenges and Risks
Should I smoke to treat PTSD?
by April Cyr-Bushwick - Tuesday, August 22, 2023, 11:58 AM Number of replies: 1 No. Not for treating trauma/PTSD. For secondary (often physiological) symptoms, it can be a yes, and very helpful for many people. Talk to your doctor, control your doses, and don't operate heavy machinery. Opt for non-smoking methods whenever possible. I have been a daily cannabis smoker for much of my adult life. For many symptoms, such as migraines, gastrointestinal issues, seizures, and much more, cannabis has lots of evidence to back it as an effective treatment. Post traumatic stress disorder is a general umbrella disorder. It can present in many different ways, and if you are using cannabis, especially smoking cannabis, to treat the trauma, that is a very bad idea. I'd like to dive into many layers of this, one of them being the difference between a Crisis and an Emergency. These are not synonymous ideas. They may have overlap sometimes, but they are distinct and definable terms which if you treat one as if it is the other, it can be very expensive and deadly. When we start looking at Addiction from a Crisis lens, it is very clear that the reasons why people turn to substance use, whether those are physically addictive substances or not, are three main reasons: Isolation, Helplessness, and lack of agency or control to change the conditions which govern our lives. When someone has PTSD, it is very common to turn to substances, especially when there is a lack of other interventions and coping strategies to turn to. The only time when it may be okay to treat PTSD with only a substance like cannabis, is when there are no other resources to turn to or are accessible. This is why we have addiction and why it's such a large crisis that hits everyone of our lives directly and indirectly. Anecdotally when people self-medicate with cannabis, it is not often controlled doses, but uncontrolled habits which can make the underlying issues worse. Using does not make someone a bad person, or a criminal, but it can lead to lots of adverse consequences. In some first-nation cultures, psychoactive substances are viewed as a vortex which can warp us to far-gone places mentally we cannot return from. Cannabis is not a substitute for counseling, therapy, day programs, vocational support, housing, policy reforms, and legal assistance in crisis. Cannabis is a low toxicity substance with no record of any lethal overdoses or highly toxic reactions, however smoking is still dangerous for your health and mental wellbeing. Adults under the age of 25 who begin cannabis habits are at higher risk for developing schizo-type and psychotic disorders. In places where there is no legal and controlled avenue to obtain your medicine, there may be contaminants in your cannabis. If you have kids and smoke indoors, and your children smell like smoke going into school, faculty may be legally required to report your family to Child Protective Services and you may have a abuse and neglect welfare investigation on your hands. In some states if you drive, get pulled over, get drug tested, and test positive for cannabis(which can stay in your fat cells for weeks if not months) you may get charged with driving under the influence. These are often not sound legal arguments, but they can happen in socially regressive areas and cause lots of problems. If there are legal avenues for you to self-medicate in your state, follow them as best as you can. If there are not, please be careful about your medicating. I am not condoning anyone to break laws, though if this is something you need to control symptoms, I am condoning being safe and self-aware about it. Evidence-based vs evidence-informed: Should it decide or should it guide? A safe presumption I have going into this is that most in the Human Services field and professions enter to help people. We want to help our clients and offer effective interventions and resources. This requires research, inquiry, and evidence to back up our approaches. Research findings may not always apply directly to real-life situations.. Even then, an effective strategy may not translate over to a different community, socio-economic strata, or work for every person. Even the best research can't replace a person's knowledge of their own life.. Experts in the field may know which approaches and strategies are most likely to be effective. Finding the right fit requires active collaboration, with the people most affected by decisions having a space at the table. Therefore, I advocate and opt for evidence-informed practice. Let the research guide and inform decisions, however, the ultimate choice is made by the client. It is part of the ethical code of Human Services and Social Work to promote Autonomy and Decision Making. As long as it is not breaking laws or harming others, a client may make an informed decision that others do not agree with.Could I be using cannabis to cope with traumatic stress in unhealthy ways?
Am I using cannabis to cope in unhealthy ways?
Sometimes cannabis may be really helpful for alleviation of symptoms related to traumatic stress. Sometimes it may keep us in unhealthy patterns and more of a vice in an addiction. Being open to taking breaks to evaluate recovery status is a good thing. Many of the compounds in cannabis, after consumed, store in fat cells in our body for weeks, sometimes over a month. If we are using cannabis more than once a week over a long period, itβs likely building up in your system. Although it may not cause poisoning or typical drug overdose, it can cause various issues, including sleep problems, tiredness, and mood swings.. Sometimes the benefits are diminishing when tolerance builds.What might some research faux pas be when researching medical Cannabis use? What about PTSD/Traumatic Stress?
- For medical studies and experiments, there is generally a requirement of repeatable randomized controlled studies. This would require blind or double-blind conditions, which would be really difficult if the experiment involves smoking cannabis. Oral consumption of a pill, or piece of candy would give the best control on dosage and pharmacology.
- Cannabis is not a standardized substance in that, there are hundreds if not thousands of strains on the market, with different chemical compositions. You would be best off, isolating compounds in Cannabis and administering them in a controlled dose.
- Informed Consent is necessary before administering someone a controlled substance. Many participants may be at risk, either physiologically, psychologically, or socially by consuming cannabis without prior knowledge and agreement. If there are blind or double blind conditions, it's necessary that everybody be aware and lean of the side of being administered cannabis.
- Depending on the participantsβ mental health history and disability status, special care, and consideration may need to be provided in accommodation and accessibility of the trial settings, pre-existing conditions and registration. They'd absolutely need to go through a screening session beforehand.
- Beneficence, or causing no harm to subjects, be it physical or psychological, is important to remember. Fostering and enabling substance dependence among vulnerable people is not ethical. Doesn't matter if it's cannabis, tobacco, or oxycontin. Subjects need to sign a waiver that they understand the risks associated.
- Because of that transparency and full knowledge of what the substance being experimented is, you likely won't get any, or very few participants signing up who have a negative bias towards the substance. This all messes with placebo effects and self-reporting, blind testing, and can sometimes be a conflict-of-interest for accurate and valid results.
- With Traumatic Stress(I'm using that term instead of PTSD), trauma presents in so many ways. It's almost impossible to make a research setting completely safe for trauma survivors, but there are good practices. And we are obligated to do our best based and informed on the most current evidence we have.
- During the screening process, it may be helpful to understand what the personβs home environment is like. Even if they are homeless and transient, what are daily habits and environments? Many wonβt be financially stable enough to spend hours a day in a clinical research setting without being compensated for their time and trouble.
- Panic attacks, meltdowns, and tantrums can be another challenge. Especially if cannabis triggers anxiety in that patient. There needs to be an agreed upon recourse and protocol if the subject has a panic attack or episode. This would lean closer towards a safe word and ways to help calm them clinically, than towards some kind of involuntary commitment (which does not help to build trust or safety). However, if the subject has a history of violent outbursts, that needs to be on contingency.
- Make the space comfortable, maybe have some snacks and refreshments, activities, and a screen device to watch television, or access the internet, or play a video game if it is helpful. The cheaper, easier, but less effective alternative is self-reporting assessments.
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