Research on CBD (Cannabidiol)

CBD For Veterans and PTSD

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PTSD is more common than most people think. This article from US News gives these statistics:

  • About 11 to 20 out of every 100 veterans (or between 11 and 20%) who served in operations Iraqi Freedom and Enduring Freedom have PTSD in a given year.
  • About 12 out of every 100 Gulf War Veterans (or 12%) have PTSD in a given year.
  • About 15 out of every 100 Vietnam veterans (15%) were currently diagnosed with PTSD when the most recent study of them (the National Vietnam Veteran Readjustment Study) was conducted in the late 1980s. It’s believed that 30% of Vietnam veterans have had PTSD in their lifetime.

In other words, in wars that have been fought since 1955, involving over 11 million total American soldiers, more than 1.6 million cases of PTSD exist per year. Although there are treatments for PTSD, the effectiveness level is only around 60%, with only 20-30% of patients achieving complete remission, according to the National Institutes of Health (NIH). Additionally in that research by the NIH, it showed that the comorbidity rate of Major Depressive Disorder (MDD) and PTSD is 52%.

So, what more can be done? CBD, or cannabidiol, is becoming an increasingly popular option for veterans. Cannabidiol is a “cannabinoid”, or compound, commonly found in cannabis (often hemp). It is a non-psychoactive compound that doesn’t provide a “high” that marijuana, or THC, does. CBD is becoming more and more researched, but obviously doesn’t have the research that a lot of mainstream pharmaceuticals have.

In regards to PTSD, and many other issues that CBD has been researched for, one of the primary conclusions is involving the endocannabinoid system. The NIH defines the endocannabinoid system as a:

“lipid signalling system, comprising of the endogenous cannabis-like ligands (endocannabinoids) anandamide (AEA) and 2-arachidonoylglycerol (2-AG), which derive from arachidonic acid. These bind to a family of G-protein-coupled receptors, called CB1 and CB2. The cannabinoid receptor 1 (CB1R) is distributed in brain areas associated with motor control, emotional responses, motivated behaviour and energy homeostasis. In the periphery, the same receptor is expressed in the adipose tissue, pancreas, liver, GI tract, skeletal muscles, heart and the reproduction system. The CB2R is mainly expressed in the immune system regulating its functions. Endocannabinoids are synthesized and released upon demand in a receptor-dependent way. They act as retrograde signalling messengers in GABAergic and glutamatergic synapses and as modulators of postsynaptic transmission, interacting with other neurotransmitters.”

This study, published by the NIH in 2019, showed a 91% decrease in PTSD symptom severity. This was evidenced by a lower PCL-5 score at 8 weeks. In that same 8 week period, the mean total PCL-5 score decreased 28% from 51.82 to 37.14. Almost more importantly than these results was that CBD was well tolerated, and no patients discontinued treatment due to side effects. Additionally, as a side note, it was found that CBD appeared to offer relief in patients reporting frequent nightmares from the PTSD.

Another study by the NIH showed even more evidence that CBD may be beneficial for veterans suffering from CBD. It states that:

“When inhaled or delivered orally or transdermally, cannabinoids (the psychoactive components of unrefined marijuana and various derivative products) activate endogenous cannabinoid receptors, modulating neurotransmitter release and producing a wide range of central nervous system effects, including increased pleasure and alteration of memory processes.”

Most people view the alteration of memory processes as a bad thing. However, for those with PTSD, their memory is what haunts them the most. The study continues:

“Those effects provide a pharmacologic rationale for the use of cannabinoids to manage the three core PTSD symptom clusters: reexperiencing, avoidance and numbing, and hyperarousal. A literature search identified 11 articles pertaining to cannabis use by military veterans who met standard diagnostic criteria for PTSD. Cross-sectional studies have found a direct correlation between more severe PTSD symptomatology and increased motivation to use cannabis for coping purposes, especially among patients with difficulties in emotional regulation or stress tolerance. Data from 4 small studies suggested that cannabinoid use was associated with global improvements in PTSD symptoms or amelioration of specific PTSD symptoms such as insomnia and nightmares. Large well-designed controlled trials are needed in order to better delineate the potential role of cannabinoids as an adjunct or alternative to conventional approaches to PTSD management.”

In short, it is found that cannabinoids, such as CBD, may help the reason that a lot of veterans have PTSD. It is important to understand that CBD is just one of over 100 cannabinoids found in hemp. Some of the other cannabinoids include cannabidiolic acid (CBDA), Cannabinol (CBN), Cannabigerol (CBG), and Cannabichromene (CBC). The combination of these cannabinoids is known as the entourage effect, which, in short, means that more is better. Dr Raphael Mechoulam is known as “The Father of Cannabis”. He is the scientist that discovered you can actually isolate THC and CBD from the cannabis plant. He also is the one who termed the phrase “Entourage Effect”. This article from CNN explains Mechoulam’s opinion on which is better.

“Here is the important point. Mechoulam, along with many others, said he believes all these components of the cannabis plant likely exert some therapeutic effect, more than any single compound alone. While science has not yet shown the exact role or mechanism for all these various compounds, evidence is mounting that these compounds work better together than in isolation: That is the “entourage effect”.

This can be thought of, in basic terms, when looking at an orange. An orange contains high levels of vitamin C, but also has a lot of other beneficial items including B-6, folate, magnesium, phosphorus, etc… There are a lot of products on the market that “isolate” the CBD from the other cannabinoids, which are known as “isolates”. These are generally over 99% CBD. This would be compared to taken a vitamin C capsule, instead of eating an orange.

The impact of this has been well documented. One of the best examples is in this study by Pharmacology and Pharmacy. It revealed that CBD isolate has a bell-shaped dose-response for most diseases/issues/ailments/body functions. In other words, there is a peak amount for every person, and then more CBD can actually create less of an impact on that certain ailment. However, when looking at full-spectrum products, it was a linear response. They tested up to 100mgs of full spectrum product at a time and saw no side effects besides dry mouth. The more the person took, the better the results.

Interestingly, the San Diego Veterans Affairs (VA), began recruiting patients in March of 2019, for a more wide-scale study involving CBD and veterans. This study included $1.3 million of funding for 136 veterans from all service areas. Dr. Mallory Loflin, a research scientist with VA and assistant professor of psychiatry at the University of California, San Diego, is leading the study. “Loflin says past research suggests that CBD can increase extinction learning in PTSD. This has to do with people “unlearning” unhelpful responses and behaviors they’ve developed in the wake of trauma. This, she says, could boost the speed and effectiveness of prolonged exposure therapy, which helps patients gradually work through their traumatic memories. She says CBD could also ease insomnia and over-arousal. Those types of effects are beneficial on their own, but they could also further boost Veterans’ engagement and retention in treatment.” This study is expected to be complete in September of 2023.

As more mainstream studies occur, it will be interesting to see if the results continue to show promise for those suffering from PTSD – especially veterans. Although the studies have been small so far, if CBD and other cannabinoids, can increase the effectiveness from 60% to 90%+, that would help hundreds of thousands of veterans. Meanwhile, the use of cannabinoids is intriguing to say the least.

This article is the story of a veteran that has used CBD, stopped using CBD, and started again. In a nutshell, he started using CBD in 2015 and found that it helped him feel better all around, including sleeping better and feeling less anxious. Then he moved to an area where he didn’t have access to CBD. In 2016, he wrote a suicide note, drank every ounce of alcohol in his house, and tried to kill himself. For over two years, he battled with how to help his PTSD. In December of 2018, he was able to use CBD again. He concludes by saying this, “I am not here to tell you that cannabis is the magic pill we are all looking for. It will not fix you. It will not magically heal all your ailments. But I will tell you this: while CBD continues to help me with my anxiety, sleep, aches and pains and racing mind, it hasn’t fixed me; I had to choose to change. What CBD has done, however, is help me to fight all the things that blocked me from making those adjustments happen.”

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