Cannabis or Prescription Drugs: Which is Better for Treating PTSD for Military Veterans?

Cannabis as a treatment for PTSD has received a good deal of attention recently, as the plant sees increasing acceptance around the world for its medical benefits in addition to recreational use. In Canada, PTSD is among the ailments for which medical cannabis is commonly recommended. For military veterans, in fact, the cost is covered by Veterans Affairs and over 10 thousand vets have taken advantage of this benefit thus far. If you’re a military veteran dealing with this condition yourself, you might wonder; how does medical marijuana compare to more traditional treatments for post-traumatic stress disorder? As cannabis’s potential to treat a variety of conditions is explored, PTSD is among those for which it appears quite promising, but it is still natural to wonder if prescription drugs or cannabis is the better choice.

What is PTSD?

Post-traumatic stress disorder, aka PTSD, is a debilitating condition that disrupts normal day-to-day life. Common symptoms can include terrifying nightmares, debilitating anxiety, and disturbing thoughts that seem outside of the sufferer’s control. People with PTSD are also likely to show avoidant behaviors—taking effort to avoid recalling the traumatic event, and even avoiding places and activities that remind them of it. The condition is always a response to a severely traumatic experience, something military veterans are far more likely than most of us to experience firsthand. This is particularly true for those who have been through combat. Regardless of the cause it is a serious condition, but for veterans especially, PTSD can be fatal—suicide among Canadian combat vets has claimed more lives than combat itself, according to a 2014 article.

Traditional PTSD treatments

Knowing the severity of the condition, if you’ve experienced trauma as a military veteran, you should not attempt to deal with it alone—treatment is available and strongly recommended.

The traditional treatments for PTSD almost always include some form of psychotherapy. Working with a therapist can help you to develop healthy methods of coping with your trauma. There are a number of therapeutic models that have been found to be effective, including Cognitive Processing Therapy (CPT) and Prolonged Exposure Therapy (PET).

In addition to talk therapy, you might also benefit from medication. You could be prescribed antidepressants, especially selective serotonin reuptake inhibitors (SSRIs) like Paxil or Zoloft. SSRIs are well-tolerated by most people who use them, though you and your physician might need to try a few different meds before you find the one that works for you.

For short-term relief of anxiety, you could also be prescribed anti-anxiety medication but due to their high potential for abuse, these meds aren’t usually meant to be taken for the long-term.

Typical side effects of medications for PTSD

While SSRIs and other antidepressant medications have helped a lot of people and they may be very effective for you, no medication is without side effects. Some of the more common include:

  • Insomnia

  • Drowsiness

  • Nausea

  • Changes in appetite/undesired weight loss or gain

  • Lower libido, erectile disfunction, or difficulty achieving orgasm

That’s not an exhaustive list, and your own reaction will vary, of course. You may even experience no or very low side effects. Often, switching to a different SSRI or a lower dose can substantially reduce or eliminate side effects as well, so be sure to talk to your doctor about any unwanted effects that you notice when taking these (or any) medications.

Another issue common to most, if not all SSRIs is withdrawal symptoms when medication is stopped. For this reason, you should never stop taking them without medical supervision. Should you decide to stop taking antidepressants, your doctor will have you taper off from them slowly and you may still feel some discomfort when you do stop completely.

In addition to SSRIs, which often do help to reduce anxiety overall, you might also be prescribed benzodiazepines for short-term or occasional “as-needed” use. These commonly-prescribed anti-anxiety medications are not meant to used daily for long periods. Because they are a sedative, drowsiness is an expected effect. They do become less effective with continued use and can be addictive. And if you drink alcohol, you should not do so while taking benzodiazepines as the combination can be fatal.

Cannabis as a PTSD treatment

While SSRIs have been in use for many decades for depression and have shown to help many PTSD sufferers, medical marijuana for PTSD is a relatively recent idea. Due to its long history of illegality, studies of cannabis’s effectiveness as a PTSD treatment have been few. Nonetheless, recent studies have been conducted and medical weed is showing a great deal of promise.

In one Canadian study, people with post-traumatic stress disorder who did not use cannabis had a high likelihood of experiencing major depressive episodes and high incidences of “suicidal ideation”—having thoughts of suicide, with or without a plan to carry it out.

What is remarkable in the study, though, is the comparison with those with PTSD who did use cannabis. The non-cannabis consumers had seven times higher likelihood of major depressive episodes, and they were 4.7 times more likely to have suicidal thoughts.

While there are other serious symptoms that come along with PTSD, these two are arguably the most concerning. Of all symptoms, these are the ones that are most likely to prove fatal. Though the study did not show a definitive causal link between cannabis use and decreased incidences of depression or suicidal thoughts, the strong correlation makes it worth considering if you have PTSD, particularly if you’ve had major depressive episodes or thoughts of suicide.

How does cannabis help with PTSD?

The cannabis plant contains at least 113 active chemical compounds known collectively as cannabinoids. Of those, the best known and most studied are tetrahydrocannabinol (THC)—the compound recreational users know for the high it produces—and cannabidiol (CBD), a non-psychoactive cannabinoid best known for its pain-relieving and anti-anxiety properties.

An interesting fact about cannabinoids is that they are not unique to the cannabis plant. Our own bodies, in fact, produce their own versions of these compounds, known as endocannabinoids. We all have our own built-in cannabinoid receptors that are stimulated by our endocannabinoids, and they also respond to “exogenous” cannabinoids from medical marijuana.

Interestingly, people suffering with PTSD have been found to have significantly lower levels of some endocannabinoids, especially one known as anandamide. Anandamide is a sort of natural antidepressant that is also known to impair memory. While memory impairment can be seen as a negative, for those with PTSD who repeatedly “relive” painful memories, this is a significant benefit.

Another benefit of cannabis for many is that it is known to inhibit dreaming. As nightmares are a very common symptom of PTSD, this can be very helpful in allowing patients to sleep through the night without being awakened by terrifying dreams.

Cannabis as a medical treatment, for PTSD as well as a variety of other ailments, is still relatively new. Studies are ongoing, but have been promising thus far. As of now, it is best seen as an adjunct to traditional prescription medications. It can provide additional relief when those meds aren’t quite enough and for some it can even help to reduce some of the side effects of prescription drugs.

Is cannabis right for my PTSD symptoms?

If you’re a Canadian military vet considering medical cannabis to treat your PTSD symptoms, you can fill out our Patient Assessment Form here. It’ll only take you a few minutes. We look forward to helping you.