Smoking Some Weed to Deal with PTSD? – Ecstasy May Be the Better Choice

Via on May 21, 2010

http://www.digitaljournal.com/img/8/7/8/i/3/9/0/o/Macro_cannabis_bud.jpg

I used to smoke weed – a lot of weed. Back in my teen years. From the time I woke up until the minute I went to sleep, I was high. I even went to jail briefly for trying to grow my own personal supply (the judge didn’t quite see the “can do” spirit in my endeavor).

One thing I noticed from spending several years of my life in a literal cloud of smoke was that all development stopped. My emotional life was stunted, my physical skills were stunted (possibly costing me a career as a soccer player), and my relationships were stunted.

That was 25 years ago – haven’t smoked since then. [Update: I should have mentioned this before - I was suffering PTSD from the sudden death of my father when I was 13 - and using weed to self-medicate the grief and the other symptoms of PTSD.]

Since I last used, the potency of marijuana has increased substantially (from 10-15% THC in what we grew back in the 80s to as much as 25-30% THC now – The highest concentration of THC found in a single sample was 37.2%). The imbalance brought about by increasing THC without increasing the other cannibnoids, some of which are actually good for the brain has resulted in a substantial increase of psychosis in users. At particular risk are teens who smoke, becoming more likely to suffer psychosis later in life (typical age of psychotic onset is 18-35).

John McGrath, MD, PhD, FRANZCP; Joy Welham, MAPs; James Scott, MBBS, FRANZCP; Daniel Varghese, MBBS, FRANZCP; Louisa Degenhardt, PhD; et al. (2010). Association Between Cannabis Use and Psychosis-Related Outcomes Using Sibling Pair Analysis in a Cohort of Young Adults. Arch Gen Psychiatry. 2010;67(5):440-447.

We know that there are many psychological effects of marijuana use (and possible mental health issues, as already noted), such as the following:

  • distorted sense of time
  • paranoia
  • magical or “random” thinking
  • short-term memory loss
  • anxiety and depression

As a further example, people with social anxiety disorder, such as myself, are much more likely than an average person to smoke weed. We do not expect that getting high makes the SAD better, however, we actually expect to make it worse, which it does. People with anxiety issues should not smoke weed – and yet they do so much more than other people, knowing that it actually makes cognitive and behavioral issues worse.

In addition to decreased testosterone in men and short-term memory damage, there are other issues with chronic use according to the Gale Encyclopedia of Psychology (2nd ed., Gale Group, 2001):

THC has been found to destroy cells in the hippocampus, a part of the brain that is important in the formation of new memories. Psychologically, chronic use of marijuana has been associated with a loss of ambition known as amotivational syndrome.

Considering all we know, it’s amazing that anyone would consider using weed for Post-Traumatic Stress Disorder (PTSD), which is an anxiety disorder. But that is exactly the topic of a recent NPR story on Morning Edition. Here is some of the story:

Can Marijuana Ease PTSD? A Debate Brews

The Department of Veterans Affairs finds itself in a difficult position because some vets want to use marijuana to treat symptoms of post-traumatic stress disorder. Pot possession remains illegal under federal law. The VA says that as a federal agency its doctors can’t recommend using it.

The problem is especially acute in New Mexico, where one-fourth of the state’s more than 1,600 medical marijuana patients are PTSD sufferers.

‘Medical Cannabis Saved Our Marriage’

Paul Culkin of Rio Rancho, N.M., traces his PTSD back to 2004 when he was in Kosovo and part of an Army bomb squad. A car crashed into a business. The manager was inside trying to put out a fire. Culkin went in once to try to get him to leave, but he wouldn’t go.

“The second time when I went in to get him out of there — that’s when the car bomb exploded and the glass hit me,” Culkin says.

He recovered from the physical wounds, but years later the trauma of that moment can come back without warning.

“Sometimes you’ll see a car that’s just not in the right place and it’ll send me back to that thinking that it could, possibly, be a car bomb,” Culkin says.

Culkin started avoiding social situations and was quick to anger. He says the treatment he’s received from the VA — mostly counseling and antidepressant medication — has helped. But, he says, marijuana also works well to relieve his anxiety.

To be legal in New Mexico, he had to go outside the VA system and pay for another doctor and a psychiatrist to recommend him for the state’s medical marijuana program. Then he spent more than $1,500 to set up a small growing operation in his garage.

Paul Culkin with his wife, Victoria, and daughter

Enlarge Jeff Brady/NPR Victoria Culkin says that her husband Paul’s marijuana use saved their marriage.

Culkin says he doesn’t usually smoke the marijuana, instead choosing to dissolve an extract in hot chocolate or tea so he can control the dose better.

His wife, Victoria, says the marijuana has made a big difference.

“He’s a different person. He’s a better person. He’s more open. He’s more communicative,” she says. “At one point, we almost got a divorce, and I can honestly say that I think medical cannabis saved our marriage and our family.”

Sounds great, doesn’t it? Weed saved his marriage. But then there is the medical point of view:

“There is no solid evidence that cannabinoids — that marijuana — is, in itself, an effective treatment for post-traumatic stress disorder,” says Dr. David Spiegel, director of the Stanford Center on Stress and Health. “Before anyone can claim that, there needs to be some more solid research on that topic.”

Spiegel says recovery from trauma begins with the victims regaining control, over both their bodies and their mental reactions to the traumatic event. Smoking marijuana could make that more difficult, he says.

“The last thing you want is to be losing control at a time when you’re remembering an event in which you lost control,” Spiegel says.

According the National Institute of Mental Health, the following are the three main groupings of symptoms for those with PTSD:

1. Re-experiencing symptoms:

  • Flashbacks—reliving the trauma over and over, including physical symptoms like a racing heart or sweating
  • Bad dreams
  • Frightening thoughts.

Re-experiencing symptoms may cause problems in a person’s everyday routine. They can start from the person’s own thoughts and feelings. Words, objects, or situations that are reminders of the event can also trigger re-experiencing.

2. Avoidance symptoms:

  • Staying away from places, events, or objects that are reminders of the experience
  • Feeling emotionally numb
  • Feeling strong guilt, depression, or worry
  • Losing interest in activities that were enjoyable in the past
  • Having trouble remembering the dangerous event.

Things that remind a person of the traumatic event can trigger avoidance symptoms. These symptoms may cause a person to change his or her personal routine. For example, after a bad car accident, a person who usually drives may avoid driving or riding in a car.

3. Hyperarousal symptoms:

  • Being easily startled
  • Feeling tense or “on edge”
  • Having difficulty sleeping, and/or having angry outbursts.

Hyperarousal symptoms are usually constant, instead of being triggered by things that remind one of the traumatic event. They can make the person feel stressed and angry. These symptoms may make it hard to do daily tasks, such as sleeping, eating, or concentrating.

A major element of the symptoms is the hyperarousal, which the weed might help (since it makes users sleepy), but there is also the emotional blunting (made worse by weed), the feeling of being on edge/anxious (made worse by weed, over time), trouble remembering the trauma, which might seem great, but slows the healing (made worse by weed), and bad dreams or flashbacks of the event (made worse by weed, just as negative LSD flashbacks are more likely when high).

Antidepressants and talk therapy (and more recently EMDR) are the common treatments. The effectiveness is not the best – and it takes years when it is effective, which is why the military is looking at other approaches.

One new approach getting a lot of attention in the last few years (though not from the military) is treating PTSD with MDMA, more commonly known as ecstasy, E, X, and so on.

Psychiatrists that have administered MDMA to anxiety patients have noted that it promotes emotional engagement; strengthens the bond between the patient and doctor, known as the therapeutic alliance; decreases emotional avoidance; and improves tolerance for recall and processing of painful memories.

According to Johansen and Krebs, “MDMA [Ecstasy] has a combination of pharmacological effects that…could provide a balance of activating emotions while feeling safe and in control.”

They suggest three possible biological reasons why ecstasy could help individuals with PSTD. First, Ecstasy is known to increase the release of the hormone oxytocin, which is involved in trust, empathy, and social closeness.

Because people with PTSD often report feeling emotionally disconnected and unable to benefit from the supportive presence of family and friends or therapists – a situation that is likely to contribute to the development and maintenance of the disorder – use of ecstasy might also help ameliorate these symptoms, suggest the authors.

“By increasing oxytocin levels, MDMA may strengthen engagement in the therapeutic alliance and facilitate beneficial exposure to interpersonal closeness and mutual trust,” they write.

There are literally dozens of papers on this – none of which reporting any negative side effects of note.

However, one risk factor is that MDMA can deplete serotonin levels in the brain (neurotoxicity), leading to depression, but the administration of alpha lipoic acid and other antioxidants can completely eliminate this issue (by the way, apparently THC is also neuroprotective in MDMA use, but the two would mostly cancel each other out in treating PTSD).

Supervised MDMA therapy is where we should be looking for treatment – not to smoking weed, which simply makes the issue worse in the long term and only serves to mask the symptoms. MDMA, on the other hand, treats the underlying issues and need not be used long term to be useful. Seems like the better choice all around.

About William Harryman

I am a writer/editor, fitness trainer, integral coach, and a graduate counseling psychology student. I blog at Integral Options Cafe and The Masculine Heart. I am an occasional contributor to Elephant Journal.

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30 Responses to “Smoking Some Weed to Deal with PTSD? – Ecstasy May Be the Better Choice”

  1. Thank you for your honesty and interesting look at PTSD. I think, unfortunately, a great deal of depressed people utilize pot to cure their depression. I've seen many friends get stuck in this place and can say that I was too.

    It also seems that some people react differently to the substance. I know some very intelligent and successful people who don't seem to be stunted by the use of marijuana.

    Great article.

    • Thanks for the support – I'm taking a beating over at Facebook.

      I'm not really anti-weed – healthy people can no doubt use it responsibly. But people with PTSD are not healthy – alcohol abuse, drug abuse, and/or domestic violence are all a part of untreated PTSD for many people.

      Peace!

  2. rachel says:

    A colleague of my parents has been doing studies using MDMA to treat Vietnam Vets, who have tried every other treatment out there, unsuccessfully. The last time I heard a presentation, it appears it's working, really well. Giving people their lives back.

  3. Herb says:

    You are a conservative idiot and you are weaving your opinion into what comes across as fact. It is nearly impossible to get permission to do a legitimate scientific study on the effects of marijuana. Many have tried and failed. Many of the widely accepted studies were done under absurd conditions to achieve desired negative results like brain cell damage (similar to what you get from alcohol). The problem is they had to force feed marijuana smoke into lab rats at a rate no one could voluntarily or consciously consume. Thus the results were not realistic. Excess of anything causes negative results, heck you can overdose on Vitamin A and die. You can't overdose on marijuana, that has been proven. Check into it, please. You can however overdose on nicotine, alcohol, E, and every prescription pharmaceutical among many other things. Not pot though. I too have social anxiety and my Senior year in H.S. began dealing with what I now know was PTSD as a result of nearly being in the car for a burger run (no pot involved, only beer) with four people that ended with two dead. Had I been in the car I would have been in the lap belt and would have wound up paralyzed. They were going well over 120 mph. I self medicated with alcohol and eventually Liquid Ny@#)l just so I could sleep through the night terrors over the next two years. It wasn't until I stopped drinking and started smoking pot daily I dealt with my issues. I managed a restaurant baked every day all day and most people didn't even know I smoked pot and were astonished to find out I did. Could I havve done the same on scripted meds or booze? No. Pot has positive effects, it's been proven. I did a ten year study on myself. Slept soundly every night, dealt with stress calmly every day, and (pleasant added benefit) stopped having indigestion from everything I ate. Stop generalizing from factoids and open your eyes. Marijuana is an herb, just like basil, mint, oregano and the like. X is manufactured so is booze, Xanax and every other side affect laden legal substance people use and abuse to deal with things like PTSD. Vets deserve the best. And from my real world experience/experiment. That's POT! Incidentally, five months ago I quit cold turkey because I had to get away from my alcoholic pill head business partner and lost my income stream. Any tremors or detox? Nope not a single negative thing happened. No sleeplessness, no cravings. Nothing. Smoked pot for five solid years, all day every day without fail. Not one withdrawal second after quiting. Stop posting propaganda!!!

  4. Thanks for sharing Herb – I referenced actual studies, not "propaganda." For most people, pot is not the answer for PTSD. However, I'm glad it worked for you. No one should have to suffer with the burden of trauma.

  5. Lasara Allen LasaraAllen says:

    The severe and sweeping anti-marijuana bias of this article made it impossible for me to even get to the MDMA part of it. Why spend the bulk of an article about an alternative treatment disproving another? The data offered AGAINST medical use of marijuana made me mistrust anything the author may have to say, or data he may have to offer, regarding MDMA.

    Chemical interactions are different from person to person.

    I have been diagnosed with PTSD and bipolar disorder, and experience – at times – severe generalized anxiety. I was recently prescribed an antidepressant that caused a severe increase in my depressive symptoms. However, I know people who this particular medication works perfectly for.

    Weed does NOT work for me. But it does work for many who are close to me. And I am extremely grateful it does.

    From Mendocino County, CA, the heart of Medical Marijuana revolution,
    -Lasara

    • Lasara Allen LasaraAllen says:

      Addition: I said weed does not work for me. And I know there are many it doesn't work for.

      And, the person I am closest to who has the most precisely medical relationship with marijuana is diagnosed with bipolar disorder with psychotic features, AND generalized anxiety disorder. He uses medical marijuana in addition to four pharmaceuticals he's prescribed.

  6. aDelphinium says:

    Thanks for this article. As more and more veterans return with PTSD, I think it's extremely important to study various modes of treatment. I myself wondered if marijuana were a suitable treatment for PTSD; for me it seemed counterintuitive. I am one of those who had a very bad reaction to pot when I was a teenager. I didn't try pot again until in my forties, thinking, maybe it was because I was so young. I was with friends, I felt secure – but once again, I felt paranoid. The reason this is of relevance is that I was recently diagnosed with PTSD. I wish you hadn't written more about EMDR, because EMDR seems to have excellent results for those suffering from PTSD.

  7. aDelphinium says:

    oops. Correction: I wish you *had* written more about EMDR.

  8. Vitabrevis says:

    I enjoyed your article even though I do take issue with some of the points. Here is how it looks to me; you mentioned that as an adolescent you smoked marijuana without medical supervision and it had numerous effects that where negative and as a result you took it upon yourself to stop. As a result, you have formed some opinion good, bad or indifferent. Then you relay the story of an adult who under the care of a Doctor and Psychiatrist is using marijuana. Now that individual is experiencing positive results and along with his wife testifies to the improvement of his mental health. Then you simply discount it, “Sounds great, doesn’t it?…But then there is the medical point of view:” based on a Doctor’s statement who has had no involvement with that person’s care and a study done on unsupervised adolescents. Individuals who self medicated themselves with marijuana and possibly (more likely) with other illicit drugs that could also have contributed to the “psychosis”.

    I read some of the article since the link required a subscription I found an excerpt at http://www.medpagetoday.com/Psychiatry/Addictions… . What you do not include in your article from the same report is

    “Limitations of the study included: retrospective self-reporting of time since first cannabis use, lack of data on cumulative exposure to cannabis, no clinical validation of nonaffective psychosis diagnosis and lack of use of the instrument at the 14-year follow-up, and loss of participants at the 21-year mark with significant differences in the group lost to follow-up compared with those retained.”

    Not to mention, some of these individuals started smoking marijuana at a very young age and this segment of the population is at an increased risk for adverse reactions to any drug. Just look at the higher incidence of children and adolescents who develop suicidal thinking and behavior while taking antidepressants verses the same population being treated with placebo, it is almost double (1.95 times). http://www.ncbi.nlm.nih.gov/pmc/articles/PMC14032…. The FDA requires a black box warning on their use. Does it mean that no one should benefit because some people react differently to the same drug? Of course not.

    With all drugs and that includes some herbal remedies too, one should weigh the risks verses the benefits not simply look to an absolute, because almost every drug known if not all, have side effects that alter the body in some way. People need to realize that when you take a medication you are attempting to improve upon the functioning of the human body, which is so complex that there are many drugs currently in use where if you looked up the mechanism of action in a medical drug guide or even the manufactures website it will actually say “mechanism of action unknown” how’s that for a confidence boost!

  9. wierdday says:

    Interesting article. I have PTSD (probably mild, but looking at that list of "symptoms", yep, yep, and yep). I smoke marijuana very occasionally (probably a dozen times in the last 10 years), usually while painting (helps get the creative juices flowing, but not to keep them going). I live in NM, so hear often about the trials of those who have been proscribed medical marijuana (if i really wanted to, i could probably be among them), and the difficulties of actually obtaining it, even though we are one of a few states with a program specifically geared toward it. I would agree that marijuana's increased potency is one reason i don't smoke it often. I never did, but i've had singular puffs that would rival my one experience with mushrooms 20 years ago. The idea of using MDMA for PTSD in intriguing, but since all i know about MDMA being one of those people who never tried it but heard a lot of horror stories, is it would have to be seriously moderated. I don't remember a lot of news articles about kids who died from smoking pot, but i do know quite a few about kids who mistakenly overdosed on ecstacy. Having PTSD is enough, i'm far too leary to introduce even more (i take antidepressants out of necessity, and have finally found ONE that works, not because i trust them or their long-term effect on my brain, i probably have PTSD partly b/c i was overprescribed alot of them at a younger age) unknown chemicals into my brain. I'm trying to get back to liking my brain as it is. I'll stick with therapy, antidepressants, and yoga for now. I just wish PTSD sufferers recieved more support and understanding overall.

  10. Hollie says:

    Wierdday and all,
    Yoga is actually an excellent option to support those who suffer from Post-Trauatic Stress (PTS).
    I have written a 20 page research paper on Yoga (maybe I'll send it to Waylon and he could publish part of it…) for PTS and offer 'Trauma Sensitive Yoga' for trauma survivors.
    For more info please see my website: http://www.bloominglotayoga.com.

  11. Brian A. says:

    This is very interesting.My name is Brian im 21.I've been diagnosed with clinical depression and i also have anxiety.I witnessed a very traumatic event 5 years ago and only a year after i witnessed it, my whole life came to a changed.(.Before this occured I used to smoke a lot of weed.Most of the times it was everyday more than once a day.)I dropped out of school quit my job.i didnt know what i was going through.i tried to smoke marijuana to calm myself down but it only made things worse.i didnt know how to respond to it..after a real long time passed till i chose to get sum help..i started seeing a therapist and i was given sertralin and sum other pills to help me sleep better..after a couple of months i started noticing my anxiety getting better..for some reason i stopped going..before any of this i never tried any ecstacy at all..so one day i tried one and i couldnt believe that for the first time in so long i felt so happy and calm..i felt like myself for once.no worries no nothing..anxiety gone..i know it wasnt a good thing to do but i felt like it did me good..at least for the night..Now im signing in back into the therapy programs so i can tthis time stick with this treament..since i have experienced this reaction to ecstac is it okay to bring it up when with the therapist there or should i keep it to myself and go on with the show?also if there is somebody out there who can help me out and give me some advice on how to cope with this can you please email me to CPTBOEKS@YAHOO.COM

    • melinalove says:

      If you're wondering whether your therapist can get you in trouble for your ecstacy use, the answer is No. Please do tell your therapist about your drug use so you can go deeper into finding a lasting and healthy solution to your anxiety. Find a therapist who specializes in trauma. I have healed from complex PTSD and lifelong anxiety and depression, so know that it IS possible. MDMA (ecstacy) can cause you more harm than good in the long-run. Be well!!!

  12. Brian,

    Please go see your therapist – tell him or her about all DRUG use and how you feel about it. You had a good experience, and the therapist can help you feel that way without drugs.

    Be well,
    Bill

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