Benefits of Cannabis: Cannabis helps with relieving anxiety, depression, sleep and memory processing issues common in PTSD.
Risks of Cannabis: PTSD patients are at increased risk of developing problematic cannabis use (cannabis use disorder). High dose THC without the use of CBD can intensify anxiety symptoms. The terpene Pinene may cause an increase in anxiety or panic attacks in some individuals and should be generally avoided.
Suggested Initial Therapy: directed for specific symptom control
Panic Attacks: the inhalation route of administration provides fast acting relief
- Terpene Inhalers: BuffaloCo. “REBOOT” Terpenaire™ nasal inhaler. Reduces anxiety in the majority of PTSD patients within minutes. Not impairing or sedating. Very discrete.
- Vape Cartridges: A low pinene CBD dominant or 1:1 CBD:THC cartridge for “stealth” use. Will be more effective and less impairing than a THC dominant mix.
- Flower Mixing: Low Pinene CBD and THC flower mixed in a CBD dominant or 1:1 CBD:THC will be more effective and less impairing than a THC dominant mix.
Anxiety and Depression: these are 24/7 symptoms and are more effectively treated with longer acting sublingual tinctures
Suggested Initial Therapy [Tinctures]: CBD will address baseline anxiety and depression symptoms and should be used as a scheduled medication.
- CBD Tincture: start at 16mg dose of a whole plant extract, use every 12 hours. The CBD will help with depression, anxiety and pain symptoms. Use a low Pinene flower or cartridge “Around” the tincture doses to leverage the entourage effect or an Indica THC tincture starting at a 2.5 mg dose with the CBD tincture.
- Titration of Doses: after 7 days of therapy, adjustment of dose may be considered. Tincture doses are modified based on response. Increase the CBD dose by 25% - 50% for control of anxiety and depression symptoms. Increase THC and CBD if depression is an issue.
- Adjustment of dose should be considered based on the patient’s response every week or two. If side effects are experienced, the last dose administered which was well tolerated should be used.