Doctors Get New Clinical Guidelines for Managing Chronic Pain With Cannabis, Courtesy of Canadian Researchers
by Bethan Rose
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by Chane Leigh
PTSD can have far-reaching effects on health, functionality as well as on quality of living, which is why having access to effective treatment is so important. If you are living with PTSD or are living with someone who has PTSD, you would have first-hand experience with how challenging it can be getting through life on a daily basis – especially in such an already-stressful world. Let’s have a quick look at PTSD and then have a look at which cannabis strains would be best for you.
Post-traumatic stress disorder (PTSD) is a mental health condition that is developed following a traumatic event and can cause difficulty in adjusting to and coping with life after the event. When an individual is exposed to, learns of, or is indirectly or directly threatened by a traumatic event, the body releases stress-related hormones to boost energy in preparation for the fight or flight response. Over time it rewires brain anatomy and neurotransmitters into a hyper-responsive state.
The traumatic shock can lead to the development of acute stress disorder, and if symptoms last for more than one month, the diagnosis becomes PTSD. Ongoing symptoms include:
These result in substantial life impact and disability and could lead to other health and social problems (StatPearls).
Many people recover from traumatic events naturally, but when they do not, they get stuck in fight or flight mode. Chronic PTSD results in people who are not able to recover due to maladaptive coping. The long-term outcomes depend on how well the individual can cope with stress, avoid substance abuse, have social support, and stick to treatments. About 30% recover eventually, and 40% recover with treatment.
Fortunately, cannabis can help those with PTSD by potentially reducing stress and many of the symptoms. In short, cannabis is able to help those with PTSD by binding to the body’s endocannabinoid system receptors plus other mood-boosting receptors, which play a key role in maintaining harmony in the body.
When deciding on what cannabis to purchase, it is important to seek out the correct cannabinoid profile in order to get the best for your money. PTSD patients should look for full-spectrum products. Purchasing the cannabis bud (the flower) will be optimal because it allows you to benefit from the terpenes and all the cannabinoids.
Full-spectrum means you can tap into the benefits of the entourage effect. When you purchase isolated or even broad-spectrum cannabis products, you lose out on certain cannabinoids and terpenes due to the extraction process involved in making the products.
Your cannabis chosen for consumption will need to contain at least tetrahydrocannabinol (THC) and cannabidiol (CBD) in order to receive optimum relief. THC is intoxicating but is a vital component for pain management alongside CBD. If you do not want to be intoxicated by THC, look for strains that are low in THC and higher in CBD, but the strain should still contain both. Full-spectrum hemp tinctures may be recommended to people sensitive to THC and/or smoking cannabis.
In preclinical studies, CBD and THC have demonstrated abilities in modulating fear learning and fear extinguishing by enhancing a deficient endocannabinoid system in PTSD. CBD and THC could also assist PTSD management by targeting symptoms such as anxiety, depression, pain, appetite stimulation, and reducing inflammation. THC can boost your mood, and CBD can help with improving sleep, reducing nausea as well as alleviating stress.
A long-term, 1-year clinical study published in 2022 prospectively followed 150 PTSD patients in two groups: dispensary cannabis consumers and non-cannabis-using patients (controls). The promising results showed that “cannabis users reported a greater decrease in PTSD symptom severity over time compared to controls…Participants who used cannabis were 2.57 times more likely to no longer meet DSM-5 criteria for PTSD at the end of the study observation period compared to participants who did not use cannabis.” (Cannabis and Cannabinoid Research)
However, there aren’t any randomized placebo-controlled trials published yet to date. So stay tuned for stronger and larger PTSD research in the future.
Terpenes are responsible for the scent and contribute to the color of the cannabis plant, but they also each contribute their own benefits. So, when considering cannabis for your chronic pain, it is important to choose cannabis with terpenes in full-spectrum, natural flower, or “live” concentrates.
Again, flower and full-spectrum products will be ideal since they contain all cannabis compounds, including all cannabinoids, terpenes, flavonoids, and a host of organic good stuff. Cannabis flower is naturally full-spectrum, as is hemp but carries less than 0.3% THC.
Terpenes have not been directly studied in the context of PTSD, but many have anti-anxiety effects that can synergize with cannabinoids. A caveat of anti-anxiety terpenes is that they are also sedating in large quantities because the same receptor causes both.
Here is a quick overview of the major terpenes and some of their effects that can benefit PTSD sufferers.
| Name | Scent | Benefits |
| Myrcene | Musky and Earthy | Reduces inflammation and chronic pain. Anxiolytic, sedating, possible sleeping aid. |
| Limonene | Citrus | Improves overall mood as well as alleviates stress and anxiety, with sedating effects. |
| Linalool | Floral and Spicy | Reduces inflammation and relieves depression. Anxiolytic, antidepressant, anti-stress, sedative. |
| Caryophyllene | Spicy and Peppery | Reduces inflammation as well as alleviates stress and anxiety. Selective CB2 receptor agonist without psychoactivity, antidepressant, anxiolytic, and stress-reducing. |
| Pinene | Pinewood | Acts as an anti-inflammatory and boosts memory. Anxiolytic, sedative, and potentially antidepressant, may be useful in insomnia. |
| Humulene | Spicy, Woody, and Earthy | Acts as an anti-inflammatory, alleviates pain, and is antibacterial. Cannabimimemetic and cannabis synergistic. |
The following strains are recommended based on the fact that they offer full-spectrum benefits thanks to the holistic compound contents, which need to include CBD and its derivatives, THC and its derivatives, as well as contains the terpenes myrcene, limonene, caryophyllene but most importantly, linalool. When picking strains for PTSD, it is important to remember that while THC content is important for the best benefits, one should avoid too much THC potency as it would increase anxiety instead of decreasing it.
Note: The content on this page is for informational purposes only and is not intended to be professional medical advice. Do not attempt to self-diagnose or prescribe treatment based on the information provided. Always consult a physician before making any decision on the treatment of a medical condition.
This article was originally published on 1/20/21. Updated on 5/24/23.
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