Can Medical Cannabis Help PTSD?
Recently, Elevate Holistics’ Aspen Jewel and Dr. Merchant went live on FB to discuss and answer viewer questions about post traumatic stress disorder (PTSD), specifically medical marijuana and PTSD. Tyler Merchant, DO is one of our wonderful and compassionate cannabis doctors at Elevate Holistics. In addition to performing patient MMJ card evaluations, he’s the medical director of Holistic Family Medicine and Obstetrics LLC, located in Sedalia, MO.
Dr. Merchant’s Experience with PTSD Patients
While he is not a psychiatrist, Dr. Merchant has seen his fair share of people living with PTSD. According to him, “With PTSD, and to be upfront with everybody here who’s listening in, I am not a PTSD expert, focused just on PTSD. That’s not my sole expertise, and I’m not a psychiatrist. I’m a family doctor, but I work a lot with patients with mood disorders and traumas.”
After listening to his experiences and insights, it’s obvious that Dr. Merchant has some super-helpful knowledge and understanding to share from a doctor’s perspective. In this post, you’ll find out what he had to say when Aspen asked him if MMJ could help people suffering from PTSD.
The Importance of PTSD Therapy
Aspen (Elevate Holistics): How can pharmaceutical cannabis help a PTSD patient?
Dr. Merchant: So that’s a great question, Aspen. And I’ll actually one up you on that. I would even extend this to people who have never tried meds. Why? Here’s why: There’s no free lunch. It’s just like anything else. There’s nothing in life without risks. And there’s nothing in life that’s going to have all the pros and no cons. But what we know is that depression, anxiety, and PTSD are all difficult to treat.
But hands down when studies have looked at medications vs. therapy and counseling, whether that’s from a marriage and family therapist, a licensed counselor, licensed clinical social worker, whatever title that person has, but someone in the mental health field … Hands down therapy is more effective than drugs. So, unless I have somebody who flat out just refuses therapy, I challenge them. I push them just a little. Why? It’s not that it’s not their choice. It’s their goal and really mine when I’m trying to help them. It’s let’s give you the best opportunity for improvement. Let’s make your life better.
Maladaptive Behaviors (Avoiding PTSD Triggers)
Next, the cannabis doctor talks about how therapy is important as part of the treatment. Otherwise, people may develop harmful behaviors by avoiding things that may trigger them, even if they are on medication.
Dr. Merchant: And if they’re going to skip over therapy, just like with anxiety, I’m not saying that they can’t be controlled or at least helped significantly with meds. But a lot of us develop whether it’s in PTSD or anxiety disorders, or even depression really, people start subconsciously developing and building what we call maladaptive patterns. So, for example, if somebody feels anxious in crowds. Well then maybe they just stop going out. Now that can help in certain circumstances where somebody is not being triggered repeatedly.
But also think about how much, for example, the COVID crisis has hurt people so far. My unofficial estimate is I’ve seen an uptick in about 50% in the rate of depressed and anxious patients I’ve seen. Now why? Most of them have already had pre-existing conditions. But think about just what we do to go out.
We will oftentimes just give someone a hello, or we’ll run to the grocery store and get something. Or maybe we didn’t plan to go to a movie, but it just sounded like a good idea so we did. Anything that disrupts the schedule or that somebody is subconsciously doing to avoid trauma can further isolate them.
Then we remove an element of human interaction that can be very validating and positive. Because no matter how many trust issues people have with others after trauma, there’s usually at least somebody out there that can give somebody even a simple smile. Or to say, hey, how are you doing? And that human interaction is vital.
You Can’t Eliminate All Discomfort with Weed
Dr. Merchant goes on to explain that patients and doctors should not expect medical marijuana or any form of treatment to eliminate all the discomfort.
Dr. Merchant: So getting your thoughts out, getting your emotions out, is important. For one of the greatest things, especially for people who are well-motivated and who really try. People who are on the intellectual side or maybe even those that feel emotional but really like to problem-solve. Therapists and docs can teach stress reduction techniques. They can teach you the ability to not necessarily avoid discomfort, but how to deal with it. Because the reality is, it’s the same counseling that I give for somebody who has chronic pain, who has anxiety, who has depression, or who has PTSD.
And this sounds extremely pessimistic. And I own that. But I say look, if your goal is to eliminate all of your discomfort, we’re both going to fail miserably. And that’s with cannabis or not. I tell people if your goal is perfection, you’re already beating yourself up. Don’t push that. Now there’s nothing wrong with aiming high, but make your goal reasonable. So if somebody’s goal is, I want to just go outside, walk to the mailbox, get the mail, and go back inside. That may be more attainable for somebody than, I’m going to go downtown for a parade. That’s probably not the best first choice.
Numbing PTSD Is not the Goal
While he empathizes with the desire to numb the pain, Dr. Merchant reminds us that numbing ourselves will often make the problem worse.
Dr. Merchant: So then when we’re talking about things like cannabis or even prescription meds … Another big thing is please don’t try to just numb yourself. That’s a tendency, and it’s perfectly understandable. No one likes pain. Well, I guess some people do, but that’s a discussion on its own. But it’s normal to want to avoid that pain. But if we don’t learn to try to push past it and see what it signifies and we just try to slap on a problem, we can actually make it worse.
And I think that’s probably why rates of alcoholism, rates of drug abuse, rates of overdose, rates of suicide. Even if it’s not suicide attempts, self-harm rates are significantly higher in people with PTSD. So I always encourage people to take kind of a spokes on the wheel approach. Or I usually say, just reach out and grab the damn wheel. Wherever you’re going to grab the wheel, you’re going to be close to a spoke somewhere.
Some People Should Not Use Medical Cannabis
Dr. Merchant discusses how MMJ is not a cure-all and that doctors should not prescribe it for certain patients.
Dr. Merchant: Just think of all of the options that you have on a smorgasbord. And if we put the stuff that’s absolutely a no go, you got somebody that has a deadly allergic response to eggs. Well, you take eggs off the salad bar and you keep the rest. People can pick and choose. With marijuana again, just like with meds and with therapy, there is no free lunch. So there are people who should not use marijuana.
And I want to be a clear upfront. There maybe exceptions to these rules in rare circumstances. But pregnant women, breastfeeding women, people who have psychosis or true paranoia, because people with PTSD can feel a little bit paranoid without having actual paranoid delusions. If you’re having hallucinations—I don’t mean flashbacks—I mean you’re seeing or hearing voices that are not really there. Those people are at extreme risk for being in a decompensated state, which increases the risk of self-harm. So those people I do recommend against cannabis. Bipolar disorder is one of those gray zones.
Medical Cannabis Can Help People with PTSD
Dr. Merchant: Sometimes the irritability comes from being on edge and having that physical feeling, because who wants to be feeling like you’re wired up all the time. So that can get better. I certainly have patients who sleep very well, or at least significantly better with marijuana. And most people tolerate it pretty darn well.
Recap: Can MMJ Treat Post Traumatic Stress Disorder?
- Dr. Merchant stresses how important therapy is for PTSD patients.
- Avoiding PTSD triggers can create harmful habits.
- Medical weed won’t take away all your problems.
- Numbing PTSD symptoms with Medical Cannabis or any drug should not be the goal.
- Some people should not use cannabis, such as pregnant women, breastfeeding women, or patient with psychosis.
- Medical marijuana can help alleviate symptoms of PTSD and help them to relax and sleep better.
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