Being healthy in both mind and body is a blessing, no doubt. Just ask anyone who doesn’t have it. It can be torture. Days full of anxiety, distress, depression and to compound all of that, judgement from others. Society the world-over has long stigmatized those whose with ‘non-standard’ mental health. But, thankfully, a change is taking hold and the negative stigma surrounding mental health issues is slowly ebbing while better care and more public awareness campaigns step into the public mix.

American Mental Health Association began a national campaign in 1949 called “May is Mental Health Month.” (See NAMI’s site for more). It may not be May now, but it is a year-round message and we are honored to contribute some ideas from our perspective about where cannabis therapy intersects with mental health disorders, where it may indeed contribute to improved mental health, and where we need to be careful.

THE STIGMA FREE WAY

Like mental health issues, the concept of stigma is a conjoined twin with cannabis. Cannabis too has been shunned and demonized by governments and society alike, despite its long history of use medicinally in various cultures and modalities. Just as the perception of mental illness won’t change if we don’t act to change it, the more we work to normalize cannabis medicine the more we do to reduce the out-dated stigmas attached to it.

In the almost century long aftermath of the irrational scheduling of cannabis as a Schedule 1 narcotic, the study of cannabis as a treatment for mental health disorders is still profoundly underdeveloped. However, there has been progress made and we’d be so bold as to say that the future is looking brighter. As more evidence-based research is explored, we are seeing an increase in positive outcomes of cannabis related treatments. The medical community and wider populous are coming to accept cannabis as a legitimate treatment option for several specific mental health conditions.

THE CHALLENGES:

Long-term, chronic mental health problems are not easy to treat, conventionally or otherwise. The breadth of mental disorders, from Post Traumatic Stress Disorder to Anxiety Disorders to Seasonal Affective Disorder and all that lays in between, makes it impossible to find a single ‘cure-all’. Each patient and disorder must be assessed and treated individually, in its own right.

The currently available pharmaceutical drugs don’t always achieve the mental balance that they strive to, let alone a notable change in symptoms; often resulting in common side effects that can include; insomnia, hallucinations, weight gain, sexual dysfunction, depression and even suicidal thoughts. Unlike cannabis, these treatments can cause a physiological addiction as well as lead to overdose. By comparison cannabis is generally very well tolerated by patients with fewer negative side effects.

Cannabis has been used for centuries for a variety of ailments in various long standing medical modalities eg. ayurvedic and traditional chinese medicine. Only just recently, researchers have begun investigating evidence-based cannabis studies for mental health in earnest. Human and animal studies have shown cannabis to have anxiolytic (anxiety reducing) properties, others have shown positive results when treating PTSD, generalised anxiety disorder (GAD) and schizophrenia.

“The illegality of cannabis is outrageous, an impediment to full utilization of a drug which helps produce the serenity and insight, sensitivity and fellowship so desperately needed in this increasingly mad and dangerous world.”

― Carl Sagan

WHAT WE’VE LEARNED SO FAR

Despite cannabis being long ‘accused’ as a trigger for mental health disorders such as schizophrenia, this study in 2011 shows promising results for CBD (Cannabidiol, a non-psychoactive compound found in cannabis) as a treatment for schizophrenia. The efficacy of CBD (devoid of psychotropic properties) is compared to amisulphride (one of the most common effective drugs for treating schizophrenia). Results showed that CBD is as effective as the conventional treatment, with fewer negative side effects. The researchers highlight the possible anti-psychotic effects of CBD, other evidence we have strongly suggesting CBD has neuroprotective applications makes it clear that investigation is justified and that more research is needed.

Another mental health disorder that is well reported on in both the States and here in Israel is Post Traumatic Stress Disorder (PTSD). Those who suffer from this debilitating disorder can experience symptoms such as night sweats, nightmares, anxiety, flashbacks as well as many other crippling symptoms. Various studies have begun to touch on the therapeutic benefits of cannabis for those with PTSD, in the fields of whole plant, isolates and synthetics.

This study from 2009, using synthetic CBD, shows a significant decrease in PTSD symptoms, specifically chronic nightmares and to a more subjective degree a improvement in sleep quality and duration. This more recent study showed a 75% decrease in clinically measured PTSD symptoms when treated with medical cannabis.

“It is beyond my comprehension that any humane person would withhold such a beneficial substance from people in such great need simply because others use it for different purposes.”

-Stephen Gould

Another fascinating discovery, from Israel’s own Dr. Raphael Mechoulam, indicates that cannabis and the endocannabinoid system can have effects on memory retention. The ability for cannabis to promote healthy memory extinction is a revelation for PTSD patients, whose innate memory extinction abilities are impaired by their trauma. These and other studies create a basis for future research and early methodology.

ON THE HORIZON

Dr. Sue Sisley and Rick Doblin, PhD have been champions in advancing the clinical study of PTSD for many years. A study in this field is being perused by the Multidisciplinary Association of Psychedelic Studies and this is likely to be the largest and most promising research of its kind. Find out more information regarding the MAPS initiative here.

IT’S NOT ALL ROSES

With all this evidence mounting in support of medical cannabis applications in the mental health sector there are still concerns to address. Cannabis use in the developing brain being key among them. Dr. Yasmin Hurd, one of our speakers at CannaTech 2017 addressed cannabis effects on the developing brain in this 2013 research study and in an interview here. Dr. Hurd’s studies indicate the adolescent brain is fair more susceptible to ongoing drug abuse if cannabis has been used recreationally at a young age.

“What drives me is that our research contributes to understanding how the adolescent brain is more vulnerable to different types of substances and how that information can help prevent abuse and develop more targeted treatments.”

-Dr. Yasmin Hurd

A longitudinal study conducted in Australia tracked more than 3000 Australians from birth to age 21. It’s objective was to assess whether age of first use and frequency of use of cannabis can be associated with anxiety and depression in young people. It showed that participants who frequently used cannabis from the age of 15 were 95% more likely to experience symptoms of anxiety and depression into early adulthood. Such evidence as presented in the aforementioned Australian study makes it clear there are valid concerns surrounding young people consuming cannabis, though such studies should not discourage us from delving deeper into research of cannabis as medical treatment for other indications.

Substance abuse has a profound impact on adolescents, families and society as a whole. Dr. Hurd’s goal is to have a greater understanding of neurobiology to create more targeted treatments. We honor her efforts to normalize medicinal cannabis, while continuing the hard work of providing more evidence-based research both for its potential harm and its profound benefit.

“More evidence from larger, well designed trials is needed to clarify the true balance between benefits to harms”

-E. Martin Sanchez

AN IMPORTANT TAKE AWAY

One thing that we can deduce from all research to date is that certain compounds within cannabis can have a profound benefit, while others can have an negative impact on mental illness disorders. Strain and dosage are key components for the future of cannabis treatments in mental health disorders. Just as with conventional treatments there is no one size fits all solution.

People can have mental health disorders, but it does not define who they are. We join the “May is Mental Health Month” movement (even though it may not be May by the time you read this) and encourage patients, practitioners and the public to step out of the darkness and stigma surrounding mental illness and into the light.

We embrace the continued study and research of cannabis medicine as a valid treatment option for all kinds of health disorders.

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