Cannabidiol: A potentially revolutionary treatment for PTSD

PTSD, or Posttraumatic Stress Disorder, is a psychiatric disorder that can occur following the experience or witnessing of a life-threatening event. Military combat, natural disasters, terrorist incidents, serious accidents, or physical or sexual assault in adult or childhood are all incidents that could trigger Posttraumatic Stress Disorder. Most survivors of trauma return to normality given a little time however, some people will have stress reactions that do not go away on their own, or may even get worse over time. These individuals may develop PTSD. People who suffer from PTSD often relive the experience through nightmares and flashbacks. They often have difficulty sleeping and feel detached or estranged, and these symptoms can be severe enough and last long enough to significantly impair the person’s daily life.

Limited efficacy of current pharmacotherapies for PTSD indicates that improved pharmacological treatments are needed. And, neurobiological research points to cannabinoids as possible therapeutic agents of interest. Moreover, observational reports indicate that there is growing popular interest in the therapeutic use of cannabinoids for the alleviation of trauma symptoms.

This topic was covered at the recent Cannabis Science Conference in Portland, Oregon by Dr Philip Blair, Senior Medical Director, Elixinol. His talk showcased the current science and clinical experience in using CBD as an effective treatment for PTSD. An area of research that Dr Blair is actively involved in. 

To learn more about the work being done to tackle PTSD using CBD, we recently spoke to Dr Blair in a short interview. As well as an interview, He also kindly provided us with a list of references for anyone who’s interested in reading more about CBD and PTSD, which can be found at the end of this article. 

JR: Could you please provide us with an overview of the work you do at Elixinol?

PB: As Medical Advisor for Elixinol, I have two customer advocacy roles, one is outwardly facing and one is internal. First, from customers to conferences, I directly educate and work with Elixinol customers and medical professionals. Using my 30 years of medical care and research, I help people understand when and if CBD is right for them or their patients. Internally, I ensure the CBD product Elixinol offers in 22 countries (including the UK) is scientifically sound, in other words, I ensure that we use science in the development of our products. 

JR: What led you to investigate the use of CBD to treat conditions like PTSD? 

PB: Over 3.5 million Americans experience PTSD. PTSD costs billions per year in healthcare and lost productivity but for me it's personal. As a former US Army Colonel, I’ve seen my share of combat-related trauma, but as a doctor, I’ve also witnessed trauma-related PTSD as well. PTSD victims relive their trauma experience, the sights, the sounds, the smells as if they were actually there again, on a regular basis. PTSD is literally a living hell. Long ago, I suspected that PTSD wasn’t a mental disorder, but a physical one, which meant there could be a treatment. I started investigating and researching PTSD patients. What I found was indeed, PTSD sufferers have distinct chemical markers in their brain and, what I also found was that we could change those chemical markers and create relief for PTSD patients. It turns out, PTSD IS treatable, and potentially even preventable by simply providing high-quality CBD. I’ve seen first-hand in my pre-clinical trials CBD's positive effects. Including reduced anger, reduced anxiety and jumpiness, reduced drug dependency, increase in quality of sleep, increased feelings of well-being and more. From a medical perspective, there’s no doubt in my mind, CBD is a non-addictive, non-psychoactive, incredibly viable treatment for PTSD patients.   Feel free to watch the “Lightning Talk” I gave at Women Grow in Denver a few months back (video below).

JR: What does current clinical and scientific evidence say about the impact of CBD on human health?

PB: We actually know quite a lot, there are volumes of data. First and foremost, we know the endocannabinoid system (ECS) exists. This means we have a natural need for cannabinoids and we know it affects almost every other system in our body including the nervous system. The importance of the ECS suggests we’ve barely scratched the surface of the potential benefits to cannabinoids. We’re seeing clinical trials around the world, Israel, in particular, is leading the world in research, but the National Institute for Health is also doing some great work. For example, we know clinically, CBD reduces dependency on opioids. We know CBD has anti-cancer properties. We know CBD has anti-inflammatory and anti-pain properties, even in small doses. We know CBD changes the chemical makeup in the brain after physical and emotional trauma. The efficacy of CBD is further enhanced by the race by pharmaceutical companies to create patentable, chemical replications of CBD. 

JR: What are the next steps in developing CBD as a validated, effective treatment option?

PB: CBD is already a viable and legal treatment option around the globe. There are already chemically derived CBD pharmaceutical products in the USA and Brazil allows doctors to prescribe CBD for seizures. What I want people to know is organic, naturally derived, high-quality CBD is available in 22 countries around the globe. It’s accessible right now for everyone from fitness enthusiasts to cancer patients. I also want medical professionals to know CBD is a low-risk, high-reward treatment option for their patients. I’ve never seen a case where CBD couldn’t provide positive benefits, but I also respect the needs for medical professionals to do what they think is right for their own patients and patient’s histories. I work directly with medical professionals, doctors, nurses, physical therapists so they have the latest information to determine whether CBD is right for their patients or not. I also work directly with patients who are doing their own research on treatment options for their condition or wellness goals. 

Dr Philip Blair was speaking to Jack Rudd, Senior Editor for Technology Networks.  

References

1. Neumeister, A., Normandin, M. D., Pietrzak, R. H., Piomelli, D., Zheng, M. Q., Gujarro-Anton, A., ... & Ropchan, J. (2013). Elevated brain cannabinoid CB1 receptor availability in posttraumatic stress disorder: A positron emission tomography study. Molecular psychiatry, 18(9), 1034. 

2. Lu, A. T., Ogdie, M. N., Järvelin, M. R., Moilanen, I. K., Loo, S. K., McCracken, J. T., ... & Cantor, R. M. (2008). Association of the cannabinoid receptor gene (CNR1) with ADHD and post‐traumatic stress disorder. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics, 147(8), 1488-1494.

3. Stern, C. A., Gazarini, L., Takahashi, R. N., Guimaraes, F. S., & Bertoglio, L. J. (2012). On disruption of fear memory by reconsolidation blockade: evidence from cannabidiol treatment. Neuropsychopharmacology, 37(9), 2132.

4. Kindt, M., & van Emmerik, A. (2016). New avenues for treating emotional memory disorders: towards a reconsolidation intervention for posttraumatic stress disorder. Therapeutic advances in psychopharmacology, 6(4), 283-295.

5. Hong, S., Zheng, G., & Wiley, J. W. (2015). Epigenetic regulation of genes that modulate chronic stress-induced visceral pain in the peripheral nervous system. Gastroenterology, 148(1), 148-157.

6. Lee, J. L., Bertoglio, L. J., Guimarães, F. S., & Stevenson, C. W. (2017). Cannabidiol regulation of emotion and emotional memory processing: relevance for treating anxiety‐related and substance abuse disorders. British Journal of Pharmacology.

7. Rossignoli, M. T., Lopes-Aguiar, C., Ruggiero, R. N., da Silva, R. A. D. V., Bueno-Junior, L. S., Kandratavicius, L., ... & Szawka, R. E. (2017). Selective post-training time window for memory consolidation interference of cannabidiol into the prefrontal cortex: Reduced dopaminergic modulation and immediate gene expression in limbic circuits. Neuroscience, 350, 85-93.

8. El-Remessy, A. B., Al-Shabrawey, M., Khalifa, Y., Tsai, N. T., Caldwell, R. B., & Liou, G. I. (2006). Neuroprotective and blood-retinal barrier-preserving effects of cannabidiol in experimental diabetes. The American journal of pathology, 168(1), 235-244.

9. Campos, A. C., Ferreira, F. R., & Guimarães, F. S. (2012). Cannabidiol blocks long-lasting behavioral consequences of predator threat stress: possible involvement of 5HT1A receptors. Journal of psychiatric research, 46(11), 1501-1510.

10. Das, R. K., Kamboj, S. K., Ramadas, M., Yogan, K., Gupta, V., Redman, E., ... & Morgan, C. J. (2013). Cannabidiol enhances consolidation of explicit fear extinction in humans. Psychopharmacology, 226(4), 781-792.

11. Lee, J. L., Bertoglio, L. J., Guimarães, F. S., & Stevenson, C. W. (2017). Cannabidiol regulation of emotion and emotional memory processing: relevance for treating anxiety‐related and substance abuse disorders. British Journal of Pharmacology.

12. Jurkus, R., Day, H. L., Guimarães, F. S., Lee, J. L., Bertoglio, L. J., & Stevenson, C. W. (2016). Cannabidiol regulation of learned fear: implications for treating anxiety-related disorders. Frontiers in pharmacology,