PTSD (post-traumatic stress disorder) is a well-known mental health condition that doctors can diagnose 30 days or more after a person goes through certain highly stressful, life-changing experiences. Individuals affected by this condition can experience a range of symptoms that seriously interfere with their ability to function or feel mentally/emotionally secure. In a study published in March 2014 in the journal Drug and Alcohol Dependence, researchers from several U.S. institutions explored the question of why people diagnosed with PTSD have a tendency to use cannabis (marijuana, hashish). They concluded that PTSD sufferers often use the drug in an attempt to offset serious problems with sleep disturbances.
Prior to 2013, PTSD belonged to a group of mental illnesses defined by the American Psychiatric Association (APA) as anxiety disorders. However, in May of that year, the APA put the condition in a separate illness category and changed some of its defining criteria. Currently, an individual diagnosed with PTSD must witness or directly or indirectly experience a traumatic event capable (or seemingly capable) of causing severe or violent injury or death. He or she must also have symptoms such as unwanted waking or sleeping recollections of the event in question, a compelling desire to avoid reminders of the event in question, a worsening in daily mood or emotional status in the aftermath of trauma exposure and the presence of an unnaturally vigilant or alert mental state sometimes called hyperarousal. In addition to arising 30 days or more after a traumatic event, these symptoms must last for more than 30 days.
PTSD and Sleep Disturbances
PTSD-related sleep disturbances fall under the category of hyperarousal symptoms. According to the U.S. Department of Veterans Affairs’ National Center for PTSD, several factors help explain these disturbances, including a perceived need to stay alert to the development of future threats to well-being, the strain of unusually anxious or “down” thought processes, the effects of certain physical problems common to people affected by PTSD, the re-experiencing of traumatic events in the form of nightmares and the use of alcohol as a coping mechanism to deal with the impact of other PTSD symptoms. There are a number of options available for easing the effects of PTSD-related sleep disturbances. These options include a change in sleeping location, maintenance of a consistent sleeping routine and the establishment of a range of sleep-promoting lifestyle alterations. If necessary, doctors can also prescribe sleep medications for individuals heavily affected by post-traumatic stress.
In the study published in Drug and Alcohol Dependence, researchers from Johns Hopkins University, the Stanford School of Medicine, the University of Pennsylvania and the National Center for PTSD used an examination of 170 PTSD-affected adults to examine the reasons individuals diagnosed with the disorder use cannabis. All of these adults had prescriptions for medical marijuana in California, one of the five states that allow doctors to specifically list PTSD treatment as a reason for issuing a marijuana prescription. The researchers conducted their work, in part, because of prior investigations by other scientists that showed that PTSD users who smoke marijuana may end up using the drug with unusual frequency and thereby increase their risks for developing diagnosable cannabis abuse or addiction (i.e., cannabis use disorder). In addition, no other previous project had fully explored the underlying motivations for cannabis use in PTSD sufferers. After completing their examination, the researchers concluded that people heavily affected by PTSD use medical marijuana more often than people with less severe cases of the disorder. They also concluded that the drug is typically used as a coping mechanism to deal with PTSD’s effects. Both of these conclusions match up with the findings made by earlier research teams. However, the current research team went further by determining that the desire to cope with sleep disturbances is often a prominent or main motivation for cannabis use in PTSD-affected populations.
Significance and Considerations
The authors of the study published in Drug and Alcohol Dependence did not determine if the use of medical marijuana as a coping mechanism for sleep disturbances increases PTSD patients’ chances of developing problems with abuse or addiction. They urge future research teams to take up this question and explore the issue more thoroughly. They also urge future researchers to investigate the usefulness of other treatment techniques (including a form of therapy called cognitive behavioral therapy for insomnia or CBT-I) as alternatives for PTSD patients who have grown accustomed to addressing their sleep disturbances with cannabis use.