The Pros And Cons Of Using Cannabis For Ptsd

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joeylittle

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This is not necessarily true. Some people who use cannabis for medical reasons need high THC. Others need lower THC and high levels of other cannabinoids. The levels of cannabinoids in medical marijuana are not based on whether or not someone gets high, but rather how well those cannabinoids act together to alleviate symptoms of typical sufferers of a given disease or disorder. The feeling of getting high is usually short lived compared to the relief provided and is typically mild or non-existent as tolerance increases.
While the understanding of the relationship of THC to CBD is still in its infancy, research-wise, I can stand by the statement that the medical community at large prefers to recommend dosing based on the lowest percentage of THC needed in order to achieve therapeutic benefit. The reason? The psychoactive action of THC still appears to be the most dangerous thing about cannabis. It's incredibly difficult to find reliable data on this, because experience of both prescribers and users has outpaced research. For someone just beginning a medical marijuana regimen, assuming that they will have low tolerance is a pretty safe bet - so the THC content would want to head towards less than 10%. For someone with greater tolerance, aiming between 10-20% can be recommended. A high-tolerance (generally long-term) user might need more than 20% in order to achieve benefits. And hopefully, their tolerance will give them some insulation against the potentially anxiety- and psychosis- inducing effects of high THC.

For context, the University of Mississippi's potency monitoring program reports that in 1993 the average THC content (of a cross-sample, not just medical samples) was 3.4%. By 2012 that number had moved up to 12.3%. Those in search of high-potency marijuana, either for sale or use, medical or non, can now find strains upwards of 30% on the market (from Is Pot Getting More Potent?, PBS news, 4/1014.)

On the other hand, some researchers have begun to emphasize that high THC content allows for a more immediate impact, resulting in better self-regulation by the user. It is possible for someone using low-THC to end up consuming more of the drug than they would have, simply because they do not feel the effects as soon.

There is no evidence that THC causes schizophrenia.
I didn't say there was; merely that there was a link, as you've stated well here:
Rather, there is a correlation of cannabis use, or the use of psychedelics, as a catalyst to full-blown schizophrenia.
Which is the same principle behind cannabis triggering mania in bi-polar individuals, as well. What I think you are wrong on is specifically emphasizing the genetic predisposition aspect - as there still isn't agreement over whether that is a definitive or necessary factor in developing schizophrenia. Or, more simply put - there might be something already in your brain that makes schizophrenia likely, and then any psychoactive agent (including THC) can prompt a schizophrenic event. No-one is sure what that something in the brain is, and there aren't hard numbers on how likely or not this occurrence would be.

I'm happy to be wrong on this, though - can you cite something specifically linking psychedelics to schizophrenia in those with familial history?

Ultimately, I appreciate both your points, the gist being - it's easy to be alarmist about the dangers of cannabis. It was not my intention to skew any of the article in that direction.
 

smogmonster

Learning
While the understanding of the relationship of THC to CBD is still in its infancy, research-wise, I can stand by the statement that the medical community at large prefers to recommend dosing based on the lowest percentage of THC needed in order to achieve therapeutic benefit. The reason? The psychoactive action of THC still appears to be the most dangerous thing about cannabis.

Well, I had a medical marijuana card in California. None of the dispensaries were concerned at all about the level of THC being dangerous in the least. I'm not even sure what this means, exactly. I was a recreational marijuana user for decades, and this is not something that was a problem. It's certainly no more of an issue than any opiod causing feelings of euphoria, in fact far less so.

What I think you are wrong on is specifically emphasizing the genetic predisposition aspect - as there still isn't agreement over whether that is a definitive or necessary factor in developing schizophrenia. Or, more simply put - there might be something already in your brain that makes schizophrenia likely, and then any psychoactive agent (including THC) can prompt a schizophrenic event. No-one is sure what that something in the brain is, and there aren't hard numbers on how likely or not this occurrence would be

I don't have any research specifically to cite, but in all the years and years I smoked with many thousands of people, I never heard of one person developing schizophrenia... ever. This includes my father, a couple of step-sisters (both from entirely different families, and I was adopted), high school friends, college friends, a touring jam band, Grateful Dead fans, electronic music festivals and medical marijuana users in CA, many friends in art and music in CA... You'd think that if it were ever caused by marijuana and not simply triggered, it would have shown up at some point in anyone's personal experience with a friend or acquaintance. I can't find anyone who knows of this happening. Just personal anecdote, but it's like many alarmist claims about marijuana from the Drug War that turned out to be completely unfounded in practice, in the real life of any users.

I'm happy to be wrong on this, though - can you cite something specifically linking psychedelics to schizophrenia in those with familial history?

Kurt Vonnegut's son Mark had a personal experience with mescaline that triggered schizophrenia in him, and there was a family history. He ended up getting a degree in psychology and doing research on the connection, and it's from reading his book The Eden Express that I first came across this idea. He now leans more towards a bipolar diagnosis, but his diagnosis at the time was schizophrenia, it's very similar or the same as the typical schizophrenic symptoms, and in his mind schizophrenia might be a form of bipolar, not necessarily a separate disease. Again, I don't have specific research to cite, but I know he did research on it, and I've seen it come up in the mailing list of Multidisciplinary Association for Psychedelic Studies (apparently I'm not allowed to post links yet). I'd have to dig for specific research, which I don't have time to do at the moment, but feel free to refute or confirm if you have anything specific.
 

joeylittle

Administrator
This article (from The Verge, 2014), does a better job of summarizing the conversation about cannabis and schizophrenia better than I could:
The Link Between Weed and Schizophrenia is More Complicated Than We Thought

And many of the studies cited in the article do refer to those with a family history, aka genetic predisposition.
You'd think that if it were ever caused by marijuana and not simply triggered, it would have shown up at some point in anyone's personal experience with a friend or acquaintance.
The thing is, no-one can be sure about the causal relationship. Regardless, there are people who have been triggered into various kinds of psychosis through the use of psychoactive drugs - I don't think you are disputing that. What I do think is that it is practical and important to be aware of these things. So, if you are a male between the ages of 15-25 and you have a genetic load of schizophrenia on both sides of your family tree - then perhaps you should skip the weed for awhile. (I'm purposefully describing someone most likely to present with schizophrenia, regardless of their drug use).

I really do trust the studies - they aren't biased by the drug-war propaganda in any way. And there's a great deal of hope in those studies, because if there is a connection between cannabis and schizophrenia that can be identified, then it will follow that there is a treatment option for schizophrenics, to be found in cannabis.

Well, I had a medical marijuana card in California. None of the dispensaries were concerned at all about the level of THC being dangerous in the least. I'm not even sure what this means, exactly. I was a recreational marijuana user for decades, and this is not something that was a problem.
My point is only that THC levels are relevant to those who are new to the drug, do not know their tolerance, and yes, would certainly be better off getting their cannabis through a dispensary rather than on the street. As you say, you used for recreation for a very long time - and things turned out OK for you. It's not that there is a point at which THC is dangerous in any absolute sense. THC is the potency marker for marijuana. If a person walked into the dispensary and said, "Hello, I'm totally new and have never used before, I have a card to help me manage my pain, what would you recommend?" - I'd hope the person dispensing would steer them towards a strain that was modest in its THC levels, or if not, be clear with them about how little to start with if the THC levels are higher.

I've known many users myself, and can agree with you that anecdotally, very few of them have had bad experiences with marijuana. But I do personally know two people who had psychotic episodes while using the drug. There's no way to know what it was mixed with, or what the potency was, because it was street weed.

Ultimately, the article is geared towards PTSD and cannabis - to actually get in-depth with cannabis and schizophrenia, the potential links between schizophrenia and the bi-polar spectrum, whether there is such a thing as schizophrenia at all...it's interesting stuff, but outside the intended scope.

What can't be disputed is that there is correlative data linking psychoactive components and psychosis. There is also data indicating a connection between psychotic disorders and cannabinoids. THC is the primary psychoactive agent in cannabis. And, most importantly: the relationship is not fully understood. So, I still stand by the relevance of including that information as a potential risk for potential individuals. PTSD and bi-polar are often mistaken for one another. If you aren't sure whether or not you are bi-polar, you should be careful with your cannabis use. If you have a heavy genetic load of schizophrenia in your family, you should be careful with your cannabis use. If you have a prior history of psychosis, you should be careful. And to be more specific: you should pay attention to potency, as indicated through THC levels.

If you've got none of those things, and have used marijuana recreationally with no difficulty, then you can reasonably assume that you aren't going to suddenly emerge with full blown schizophrenia. It's all about education.

It's important for an individual to be informed about all the potential negative ramifications of a particular drug. And the more open we can be in these conversations, the less stigmatized both the drug and the disorders will become.
 
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