Marijuana Abuse and PTSD
What is PTSD?
Post-traumatic stress disorder, or PTSD, is a type of anxiety disorder triggered by a traumatic experience. Causes of PTSD include:
- Experiencing physical, emotional, or sexual abuse, whether as a child or adult
- Surviving a natural disaster, tragic accident, terrorist event, or violence
- Being part of combat, as a soldier or civilian
- Being an emergency responder and working at the site of a disaster
- The sudden death of a loved one
The first month after the traumatic event, symptoms are associated with acute stress disorder (ASD). The person displays three or more symptoms:
- Emotional numbing, detachment, or absence
- Reduction in awareness of surroundings, like being in a haze or fog
- Dissociative amnesia
When these symptoms persist or develop after the first month, this is PTSD instead of ASD. People who suffer PTSD may have nightmares, flashbacks to the event, intense mood swings, aggression, anxiety or fear about specific activities, emotional numbing, depression, suicidal thoughts, and avoidance of thoughts, feelings, or places reminiscent of the trauma. They may also show physical symptoms like headaches, stomach pain or cramping, appetite changes, muscle aches, back pain, and more.
Like other anxiety disorders, PTSD is highly correlated with substance abuse. Co-occurrence of these two conditions may begin when a person attempts to self-medicate their panic and stress, or substance abuse could lead to PTSD if the person experiences trauma caused by the substance abuse, like a car accident.
Many people who suffer from PTSD also abuse alcohol and drugs, particularly central nervous system depressants like marijuana.
Although marijuana is being considered as a potential mental health treatment to ease anxiety in some people who suffer PTSD, the drug may enhance some symptoms associated with PTSD, making the condition worse.
Marijuana’s Effects on the Mind and Emotions
Anyone who abuse marijuana may suffer serious side effects, and the chances of these are increased in those who have PTSD. The drug is a psychedelic substance, and while it does not cause hallucinations, it can alter perception. For people struggling with anxiety, this can lead to a “bad trip.”
Other negative effects from marijuana include:
- Heightened senses
- Changes in mood, including depression
- Altered sense of time
- Trouble with thinking or movement
- Impaired memory
The amount of THC, the intoxicating chemical found in marijuana, has increased in the past several years as growers develop new strains. Most have close to 7 percent THC these days, so this can dramatically increase the high and associated paranoia. About 10 percent of people who use marijuana become dependent on it and struggle with addiction, regardless of the side effects. People who suffer mental health issues like PTSD or other anxiety disorders are more likely to abuse CNS depressants, which may alleviate anxiety for a short time. However, just like with alcohol or opioids, marijuana can actually make depression and anxiety worse over time.
Marijuana and Triggered Stress
While PTSD is triggered by a traumatic event, suffering from other mental health conditions can make PTSD symptoms more intense. Abusing marijuana can trigger other mental health problems, like depression, anxiety, and psychosis, if the individual is predisposed to these problems.
In some instances, pre-existing substance use disorder, including marijuana addiction, can increase the likelihood of developing PTSD after experiencing a traumatic event. Because of how drugs like marijuana rewire the brain, a person who experiences a traumatic event, like a car accident or an assault, may more readily develop PTSD after struggling with acute stress disorder. The brain is not as able to balance neurotransmitter chemistry without the help of drugs, which could lead to a deficit of dopamine or serotonin when it is most needed.
A comprehensive study conducted by the US Department of Veterans Affairs looked at data from 2,276 representative veterans who suffered from PTSD and used marijuana concurrently. Data from 1991 to 2011 showed that marijuana abuse, especially for a long time, was correlated with increased severity of PTSD symptoms, not alleviation, and the drug was concurrently associated with higher levels of violence and other substance abuse.
These results go against anecdotal data, in which symptoms from PTSD, like anxiety or insomnia, are temporarily relieved through marijuana abuse. If the drug is legalized on the federal level for mental health treatment in the future, as many groups are pushing for, it is important to understand that it should be used like other psychiatric medications: for short-term relief of symptoms, so the individual can focus on therapy to treat their mental health.
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Self-Medication of PTSD Symptoms
Among adolescents who suffered both PTSD and substance abuse disorders, exposure to trauma appeared to induce addiction to a drug like marijuana in up to 59 percent of study participants. After suffering from domestic abuse, bullying, sexual trauma, or disaster, adolescents were more likely to begin abusing drugs like alcohol or marijuana to manage PTSD. Drugs change emotional reactions, in some instances numbing sensations and inducing relaxation for a short period.
Cannabis use disorder has been the most diagnosed substance use disorder among veterans since 2009, according to the VA. In 2002, about 13 percent of veterans who suffered from PTSD had a co-occurring marijuana addiction, while in 2014, that percentage rose to 22.7 percent.
Among veterans seeking mental health care, marijuana use and PTSD are frequently self-reported in correlation with each other. As a form of self-medication, marijuana does act on some parts of the brain that lead to feeling relaxed, but these areas are not associated with receptors that will alleviate PTSD symptoms.
The VA study showed that veterans with PTSD had a greater availability of cannabinoid type 1 (CB1) receptors in the brain. These are naturally occurring receptors, although cannabinoids from marijuana will bind to them artificially. Because of this greater availability, very short-term use of marijuana can alleviate some of the stress associated with PTSD; however, long-term use creates tolerance to the drug, so those receptors require more marijuana to function.
Being intoxicated, suffering from cravings, and struggling with aggression and fear all at once makes it much harder for people struggling with co-occurring PTSD and marijuana addiction to hold down a job and maintain healthy relationships. This isolation, in turn, can enhance PTSD symptoms, leading to further drug-seeking behaviors.
Ending an Addiction to Marijuana and Treating PTSD
Studies repeatedly show that people who suffer from PTSD and concurrently use marijuana have a much harder time quitting substance abuse compared to other people struggling with marijuana abuse. Withdrawal symptoms, especially cravings, may feel more intense due to the co-occurring mental health disorder. However, therapy during rehabilitation, particularly Cognitive Behavioral Therapy, has been shown to effectively treat both marijuana addiction and PTSD at the same time.
Rehabilitation programs that focus on treating PTSD and substance abuse at the same time have good rates of success and are imperative for those suffering from co-occurring disorders. One program for female victims of domestic violence showed a 63 percent retention rate among participants. While there were no statistics about abstinence or relapse rates, simply remaining in the program can improve sobriety rates among people with co-occurring disorders.