Post-traumatic stress disorder (PTSD) is a type of anxiety disorder that causes flashbacks, nightmares, and avoidance behavior. While there are limitations to treatment, natural alternatives have become potential treatment options. With that, some are using cannabis for PTSD.

What is Cannabis?

Cannabis (or marijuana) is a psychoactive substance that’s utilized for both medicinal and recreational purposes. It contains several chemical compounds compounds known as cannabinoids. The most recognizable of these being tetrahydrocannabinol (THC), the compound responsible for a marijuana “high.” ¹

The cannabis plant breaks down into three kinds of strain varieties: Sativa, Indica, and Hybrid (a blend between the two).

Most people smoke cannabis, but there other ways to consume it. For example, you can eat it through baked goods, mix it into teas, or vape it.

What are Cannabinoids and Terpenes?

Cannabinoids are chemical compounds naturally found in the cannabis plant. They are similar structured to the endocannabinoids found in our bodies. This allows them to have their effects when we consume them.

The most common cannabinoids are:

• Tetrahydrocannabinol (THC)
• Cannabdiol (CBD)
• Cannabigerol (CBG)
• Cannabinol (CBN)

THC is the most notable for its psychoactive qualities. They bind to the brain’s internal pleasure receptors and change certain functions, such as our ability to learn, concentrate, and perform complex tasks. It also provides a generally euphoric or calming sensation within the body. ²

Terpenes are what give cannabis its aroma and flavoring. Terpenes are molecules that bind to the cannabis plant and provide different effects in the body. Such sensations include analgesic, anti-anxiety, and anti-inflammatory properties. ³

Indica or Sativa for PTSD?

The cannabis plant comes in a variety of strains, each of which can provide different effects. These strains are categorized into the following:

• Sativa – Generally uplifting and euphoric effects.
• Indica – Generally relaxing and sedative effects.
• Hybrid – A combination of the two.

When it comes to cannabis for PTSD, Indicas are believed to better for symptoms. However, some may find the Sativas to be more beneficial as they induce creativity.

How Does Cannabis Affect the Body?

When you consume cannabis, there is a natural change occurring in the body. The most impactful effect of cannabis occurs within the brain, where THC attaches itself to dopamine receptors. Dopamine is the chemical messenger within the brain and the body that elevates moods and sends and receives messages from the brain to the nervous system. ⁴

Beyond this, cannabis has a very natural effect within our bodies which is why so many use it. Within each of us is an endocannabinoid system (ECS) which creates chemical compounds similar to cannabinoids. When we consume cannabis, the plant’s compounds directly attach themselves to receptors and, in turn, produce effects.

These effects have allowed cannabis to potentially combat certain health conditions, including: ⁵

• Anxiety
• Cancer
• Chronic pain
• Depression
• Inflammation
• Nausea
• Sleep disorders

Can You Use Cannabis for PTSD?

Since legalization, more people utilize cannabis for recreational purposes. That being said, people may be able to use cannabis as a natural alternative to calm symptoms of various mental health conditions, such as anxiety, depression, paranoia, and PTSD.

The potential health benefits of cannabis include:

• Decreased stress
• Increased appetite
• Relaxation

There are also reports that cannabis can help ease PTSD symptoms. More specifically, ease the responses to traumatic events and flashbacks.

What Does the Research Say?

While the U.S. has become more cannabis-friendly, it also allowed for an increase in research. Admittedly, this research is thin. However, studies have shown promise in cannabis’ ability to reduce stress, anxiety, and depression.

• A 2015 review found military veterans who used cannabis reported reduced anxiety and insomnia and improved coping ability. ⁶

• A 2016 study found that cannabis can lower the risk of PTSD, severe depression, and suicidal ideation. This is notable as PTSD holds the potential to promote depression and suicidal thoughts. ⁷

• A 2016 study found that drugs that interact with the ECS may help reduce PTSD symptoms following a memory extinction period. ⁸

• A 2018 study found that taking CBD immediately following a traumatic event could make it difficult for the brain to develop memories. ⁹

Still, one study found cannabis to be beneficial, but not nearly as effective as most assume. ¹⁰

Cannabinoids and Terpenes for PTSD

It’s recommended to use cannabis flower rather than concentrated oils or tinctures. The reason being that flower has an array of terpenes, flavanoids, and phytonutrients which may be lost in extraction processes. According to VeriHeal, the most best cannabis strains for PTSD relief are:

Sunset

Sunset is an Indica-dominant hybrid strain of cannabis. Its primary effects offer a relaxing, almost sedative, high. Sunset can help ease anxiety, which is a major reason it’s suggested for PTSD.

It includes the terpenes linalool, caryophyllene, and humulene. Linalool has anticonvulsant, antidepressant, and antianxiety properties. Caryophyllene and humulene has inflammatory and stress relief components.

Dakini Kush

Dakini Kush is an Indica strain, widely known for its relaxing high and its impact on treating pain, migraines, and anxiety.

It contains the terpenes myrcene, caryophyllene, limonene, and humulene. Myrcene, which commonly found in mangoes and thyme, has antibiotic, anti-inflammatory, and sedative effects. Limonene, a terpene commonly in lemons, has mood-boosting and anti-inflammatory effects.

Zkittlez

Zkittlez is an Indica-dominant hybrid strain that provides a creative, euphoric, and relaxed high. It also may help soothe anxiety and counteract depressive feelings.

Its contains the terpenes caryophyllene, humulene and linalool. The terpenes of this strain contain antianxiety and stress relief components.

Cannabis Side Effects and Safety

Cannabis can cause several side effects that may conflict with PTSD treatment. Most of these are mild compared to prescription medication. Still, they’re worth keeping an eye out for: ¹¹

• Breathing complications. If you smoke, dab or vape cannabis, long-term and aggressive usage can result in breathing complications.

• Increased heart rate. Smoking cannabis can result in an elevated heart rate. For those with sensitive hearts and cardiovascular complications, it can heighten the chances of a heart attack.

• Intense nausea and vomiting. For those who regularly smoke, there’s a chance of developing cannabinoid hyperemesis syndrome. The disorder causes cycles of violent vomiting, nausea, and dehydration. If it progresses severely, you may need emergency medical intervention. This is a rare consequence of long-term cannabis smoking but does occur in roughly 30% of self-identified long-term heavy cannabis smokers. ¹²

• Increased anxiety and paranoia. This is a regular occurence for newcomers to cannabis but may occur in those who use cannabis for a longer period of time.

As far as safety, there is an importance of utilizing cannabis for the right reasons. It’s vitally important to follow recommendations set by physicians and mental health professionals. Consuming too much cannabis can be detrimental to treating PTSD and may cause symptoms to become more severe.

If you find that cannabis itself doesn’t help with PTSD, you may want to look into CBD for anxiety.

Legality of Cannabis

Many states across the U.S. have legalized marijuana for recreational and medicinal use. This has allowed further research to reveal that cannabis may have benefits for mental health conditions. Still, cannabis remains federally illegal.

In states where cannabis is medicinally legalized, PTSD is usually a qualifying condition. However, some states have limitations in their programs, such as the severity of PTSD and whether or not it’s treatment-resistant. We highly recommend researching your state’s program to learn more about how to obtain medical cannabis.

Cannabis for PTSD Dosage Recommendation

Researchers have found the best dose of cannabis for PTSD is between 1.5 to 2 grams. That dosage guide breaks that down to about 2 to 4 joints per day.

However, you may find that a lesser amount of cannabis works best for you. To track changes in your wellbeing and interactions with other medications, it’s best for a physician to monitor your cannabis use.

References

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² Karila L, Roux P, Rolland B, Benyamina A, Reynaud M, Aubin HJ, Lançon C. Acute and long-term effects of cannabis use: a review. Curr Pharm Des. 2014;20(25):4112-8. doi: 10.2174/13816128113199990620. PMID: 24001294.

³ Sommano SR, Chittasupho C, Ruksiriwanich W, Jantrawut P. The Cannabis Terpenes. Molecules. 2020 Dec 8;25(24):5792. doi: 10.3390/molecules25245792. PMID: 33302574; PMCID: PMC7763918.

⁴ Lupica CR, Riegel AC, Hoffman AF. Marijuana and cannabinoid regulation of brain reward circuits. Br J Pharmacol. 2004 Sep;143(2):227-34. doi: 10.1038/sj.bjp.0705931. Epub 2004 Aug 16. PMID: 15313883; PMCID: PMC1575338.

⁵ Gallily R, Yekhtin Z, Hanuš LO. The Anti-Inflammatory Properties of Terpenoids from Cannabis. Cannabis Cannabinoid Res. 2018 Dec 26;3(1):282-290. doi: 10.1089/can.2018.0014. PMID: 30596146; PMCID: PMC6308289.

⁶ Betthauser K, Pilz J, Vollmer LE. Use and effects of cannabinoids in military veterans with posttraumatic stress disorder. Am J Health Syst Pharm. 2015 Aug 1;72(15):1279-84. doi: 10.2146/ajhp140523. PMID: 26195653.

⁷ Lake S, Kerr T, Buxton J, Walsh Z, Marshall BD, Wood E, Milloy MJ. Does cannabis use modify the effect of post-traumatic stress disorder on severe depression and suicidal ideation? Evidence from a population-based cross-sectional study of Canadians. J Psychopharmacol. 2020 Feb;34(2):181-188. doi: 10.1177/0269881119882806. Epub 2019 Nov 5. PMID: 31684805.

⁸ Berardi A, Schelling G, Campolongo P. The endocannabinoid system and Post Traumatic Stress Disorder (PTSD): From preclinical findings to innovative therapeutic approaches in clinical settings. Pharmacol Res. 2016 Sep;111:668-678. doi: 10.1016/j.phrs.2016.07.024. Epub 2016 Jul 22. PMID: 27456243.

⁹ Bitencourt RM, Takahashi RN. Cannabidiol as a Therapeutic Alternative for Post-traumatic Stress Disorder: From Bench Research to Confirmation in Human Trials. Front Neurosci. 2018 Jul 24;12:502. doi: 10.3389/fnins.2018.00502. PMID: 30087591; PMCID: PMC6066583.

¹⁰ Bonn-Miller MO, Sisley S, Riggs P, Yazar-Klosinski B, Wang JB, Loflin MJE, Shechet B, Hennigan C, Matthews R, Emerson A, Doblin R. The short-term impact of 3 smoked cannabis preparations versus placebo on PTSD symptoms: A randomized cross-over clinical trial. PLoS One. 2021 Mar 17;16(3):e0246990. doi: 10.1371/journal.pone.0246990. PMID: 33730032; PMCID: PMC7968689.

¹¹ Adverse effects of cannabis. Prescrire Int. 2011 Jan;20(112):18-23. PMID: 21462790.

¹² Habboushe J, Rubin A, Liu H, Hoffman RS. The Prevalence of Cannabinoid Hyperemesis Syndrome Among Regular Marijuana Smokers in an Urban Public Hospital. Basic Clin Pharmacol Toxicol. 2018 Jun;122(6):660-662. doi: 10.1111/bcpt.12962. Epub 2018 Feb 23. PMID: 29327809.