A shocking, scary, or dangerous event can cause the body to develop post-traumatic stress disorder (PTSD). It is natural to feel fear during and immediately after a traumatic situation. Split second decisions are made in the “fight or flight” response. But, when a person does not recover naturally from a trauma, the long-term effects can be devastating.

Step One: Talk to your Organic Remedies Pharmacist

If you have been diagnosed with PTSD and are considering medical marijuana therapy, Organic Remedies Pharmacist Shannon Ye says, “Information gathered from non-professional sources may not always provide the best results. Treatments can greatly differ among patients. Efficacy is closely tied to finding the appropriate dose and strains.”

While the most studied type of medications for treating PTSD are antidepressants, which may help control symptoms including sadness, worry, anger, and feeling numb inside, medical cannabis may also be helpful in alleviating many different symptoms as well. Other common problems associated with PTSD, that may be helped by medical cannabis, include loss of sleep and nightmares.

The National Institute of Mental Health says medical professionals and patients should work together to find the best medication or medication combination, as well as the right dose. Ye agrees that this is important with medical cannabis as well, saying, “For example, a dose too high in THC and pinene may worsen PTSD related symptoms therefore agitating anxiety and irritability. Having a traumatic experience from cannabis may not only worsen PTSD symptoms, but may also prevent a patient from trying cannabis again in the future.”

Individualized Therapy

The NIMH also recommends psychotherapy, or “talk therapy,” for people with PTSD, but stresses every patient is different. What works for one, often does not work for another. “I always ask the patient about their goals of therapy and what dosage forms they may feel most comfortable using,” says Ye.  “Although more research is needed, there is evidence that supports cannabis alleviates difficult to treat symptoms of PTSD such as insomnia, nightmares, anxiety, and irritability. There is also evidence that cannabis can help a PTSD patient experience a "trigger" without an associated terror response.”

Not having that terror response to a particular “trigger” is key in treatment. Ye says, “The success in treating symptoms may be due to PTSD patients having changes in their endocannabinoid system. However, it is not realistic for patients to expect medical cannabis to cure their PTSD as it is not a substitute for conventional treatment.”

PTSD is Personal

PTSD diagnosis is based on many factors including re-experiencing symptoms, avoiding certain things, and changes in mood and cognition. With so many things to consider, both patient and pharmacist can work together to find a way to improve the quality of life.

Ye says every case is one-of-a-kind, “As an example, one of my recent patients I spoke to was suffering PTSD due to a car accident from 2 years ago. Ye says the symptoms were paralyzing, “They were experiencing anger that led to blackouts and anxiety that caused panic attacks when in a car. They have noticed significant improvement in managing PTSD symptoms since starting cannabis.”

Finding the Right Combo

Ye says finding a particular strain for PTSD patients is important but when she digs deeper into therapy, Ye finds hope in the terpenes. “It may be best to avoid strains high in pinene, as the alerting effects may be anxiety-provoking and memory-enhancing to past trauma. However, strains higher in linalool may be anxiolytic and calming.

With an Organic Remedies’ Pharmacist guidance, quality of life reports continue to improve with the help of cannabis. Ye’s patient from the car accident is getting results from a higher CBD strain during the day. “Any 1:1 (CBD/THC) may be a suitable option, especially during the day. Limonene is an uplifting, antidepressant terpene that may be preferable during the day as well.”

With quality of sleep ranking high in PTSD patients another treatment may help at night. Ye says, “higher THC indica-dominant "Kush" and "Purple" strains may be effective towards the evening in treating sleep disturbances.”

An Organic Remedies pharmacist is always available to answer questions.

RESOURCES

From National Institute of Mental Health:

• Some factors that increase risk for PTSD include:
• Living through dangerous events and traumas
• Getting hurt
• Seeing another person hurt, or seeing a dead body
• Childhood trauma
• Feeling horror, helplessness, or extreme fear
• Having little or no social support after the event
• Dealing with extra stress after the event, such as loss of a loved one, pain and injury, or loss of a job or home
• Having a history of mental illness or substance abuse

Some factors that may promote recovery after trauma include:

• Seeking out support from other people, such as friends and family
• Finding a support group after a traumatic event
• Learning to feel good about one’s own actions in the face of danger
• Having a positive coping strategy, or a way of getting through the bad event and learning from it
• Being able to act and respond effectively despite feeling fear

Free Brochures and Shareable Resources

https://www.nimh.nih.gov/health/publications/helping-children-and-adolescents-cope-with-disasters-and-other-traumatic-events/

https://www.nimh.nih.gov/health/publications/post-traumatic-stress-disorder-ptsd/

https://www.nimh.nih.gov/get-involved/education-awareness/shareable-resources-on-ptsd

https://www.ptsd.va.gov/index.asp

https://www.ptsd.va.gov/professional/treat/txessentials/clinician_guide_meds.asp

https://medlineplus.gov/posttraumaticstressdisorder.html

 

June is Alzheimer’s and Brain Awareness Month, so we turn our spotlight on this insidious disease and how medical cannabis may help. While there is a wealth of information about Alzheimer’s Disease, treating it, living with a loved one coping with it, and helping those afflicted are continuing challenges. The Centers for Disease Control and Prevention is teaming up with the Alzheimer’s Association in the Healthy Brain Initiative. The American Association of Retired People also offers a free “Staying Sharp Brain Health Assessment” in June.

Warning Signs

Common signs of AD are often first noticed by the person affected. Memory changes as we age, but certain types of memory loss are not typical. The CDC offers these guidelines for early assessment. People with one or more of these 10 warning signs should see a doctor to find the cause. Early diagnosis gives them a chance to seek treatment and plan.

·        Memory loss that disrupts daily life: forgetting events, repeating yourself or relying on more aids to help you remember (like sticky notes or reminders).

·        Challenges in planning or solving problems: having trouble paying bills or cooking recipes you have used for years.

·        Difficulty completing familiar tasks at home, at work, or at leisure: having problems with cooking, driving places, using a cell phone, or shopping.

·        Confusion with time or place: having trouble understanding an event that is happening later or losing track of dates.

·        Trouble understanding visual images and spatial relations: having more difficulty with balance or judging distance, tripping over things at home, or spilling or dropping things more often.

·        New problems with words in speaking or writing: having trouble following or joining a conversation or struggling to find a word you are looking for (saying “that thing on your wrist that tells time” instead of “watch”).

·        Misplacing things and losing the ability to retrace steps: placing car keys in the washer or dryer or not being able to retrace steps to find something.

·        Decreased or poor judgment: being a victim of a scam, not managing money well, paying less attention to hygiene, or having trouble taking care of a pet.

·        Withdrawal from work or social activities: not wanting to go to church or other activities as you usually do, not being able to follow football games or keep up with what’s happening.

·        Changes in mood and personality: getting easily upset in common situations or being fearful or suspicious.

We turn to Organic Remedies’ Pharmacist, Nick Signorella for answers to how therapy with medical cannabis may help. “A lot of our treatment with Alzheimer’s has to do with symptom management. Specifically, marijuana can help with food intake, agitation, sleep, and overall mood.” Signorella adds, “THC can help to increase food intake, help with agitation at lower doses, improve sleep, and improve mood/depression at lower doses.”

AD symptoms that may respond to cannabis include, sleep problems, paranoia, anxiety, dysphoria, pain, poor appetite, and weight loss. Signorella says AD patients may live a better lifestyle by examining a medical marijuana therapy. “For example, THC can inhibit acetylcholinesterase through the CB1 receptor, which theoretically could help to minimize the decline in cognitive function.” Signorella goes deeper, “Additionally CB2 receptor levels are increased in Alzheimer’s patients. The anti-inflammatory effects from CBD activating the CBD2 receptor could help reduce inflammation and neurotoxicity associated with Alzheimer’s.”

Dosage

Signorella would advise AD patients to turn to the many newly created cannabis delivery options including tinctures and capsules. But, he says, “caution should be used with higher doses of THC as this can actually cause increased agitation and disorientation. In general, the starting dosage for agitation and sleep should be around 2.5-5mg of THC depending on experience. CBD on the other hand can help with agitation, typically at lower doses, usually starting around 5mg of CBD.”  He adds, “I would typically start with a 1:1 ratio of THC:CBD, around 2.5mg or 5mg of each. It would depend on the specific patient, but generally lower to moderate doses of both THC and CBD would be used.”

Searching for Answers

Evidence is not as robust for the treatment of Alzheimer’s, but there is some anecdotal evidence cannabis can be beneficial. Many of the mechanisms in the prescription drug donepezil, commonly used to treat AD, are similar. Signorella says, “overall cannabis can help to improve quality of life for both the patient and caregiver, while potentially help to manage disease progression as well.”

During this June Alzheimer’s and Brain Awareness month, remember your Organic Remedies pharmacist may be able to help!

More info: The Centers for Disease Control and Prevention (CDC) and the Alzheimer’s Association have created the Healthy Brain Initiative’s (HBI) State and Local Public Health Partnerships to Address Dementia: The 2018-2023 Road Map.

 

Thank you, Organic Remedies patients for stepping up and calling your lawmakers! Governor Wolf has extended the COVID Emergency Disaster Proclamation.

What it Means

The extension allows you to still pick up your medical marijuana curbside, to receive certifications via telehealth, purchase up to 90-day supplies, and for caregivers to serve more than 5 patients. All of which are very helpful options for many patients!

This is Temporary!

If you enjoy these services as a Pennsylvania Medical Marijuana patient and want to make them permanent, you must pick up the phone or send an email. We are going to make that simple for you. Please take a moment and urge lawmakers to make these temporary provisions permanent.

There is More to be Done

Right now, with Governor Wolf’s extension, we have an opportunity to make permanent changes.

How Can You Help?

It is easy. A bipartisan bill, HB1024, will allow some of the temporary provisions in the Commonwealth's medical marijuana program to remain after Governor Wolf's Proclamation ends.

We encourage you to contact your state representative and senator to ask them to vote Yea (Yes) on HB1024 to amend Act 16 to allow these changes to remain in place permanently.

Here is a Link to your Lawmaker:

Find Your Legislator - PA General Assembly (state.pa.us)

It is one simple click. Find your Senator or Representative by address, map, or name. Calling and emailing make a difference as often it is the only way your lawmaker is aware of your concern. They are sworn to vote with you, the constituent. Three-to-five minutes right now could make a lifetime of difference for you and all medical marijuana patients in the Commonwealth of Pennsylvania.

Here is What to Say When Calling
“The temporary changes that were made by the Governor during the pandemic to facilitate safety in the medical marijuana program for patients, caregivers and dispensary employees have worked well and need to be made permanent." It is that simple.

Here is What to Say When Writing

"I am writing to ask that you vote "yea" on HB1024 to amend Act 16 and make several temporary changes to the PA Medical Marijuana program permanent. The temporary changes made by the Governor during the pandemic to facilitate safety in the medical marijuana program for patients, caregivers and dispensary employees have worked well and need to be made permanent with an amendment to Act 16.”

You can also contact House Health Committee Chairperson Cathy Rapp at (814) 723-5203 to urge her to move this important bill through her committee.

Among the provisions most beneficial to patients and the overall well-being of the PAMMJ program are:

• Use of telehealth for certification visits.
• Increased maximum number of patients under a caregiver's care.
• Allow for curbside pickups.
• Allow for purchase of a 90-day supply of medicine instead of 30-day supply.

The use of telehealth for certification visits is beneficial to all parties in the program. It keeps costs to patients and doctors lower, and it helps patients who are extremely ill, bedridden, or otherwise have difficulty traveling to access their certifying doctor without enduring pain or trauma.

Allowing caregivers to assist more than five patients helps more patients who require assistance to access their medicine. Often, there is a shortage of certified caregivers (especially in rural areas). Limiting caregivers to only five patients creates a higher demand than what can be supported. This leaves people sick, in pain, and without the medicine that can alleviate some of their symptoms. If caregivers can be assigned to the number of patients they can support, rather than an arbitrary number of patients, the potential for patient suffering is reduced.

Continuing to allow curbside pickups and the purchase of a 90-day supply instead of a 30-day supply helps patients, caregivers, and dispensaries. Curbside pickup is especially helpful for patients with compromised immune systems, limited mobility, or conditions like PTSD, which could be triggered in a busy dispensary. Most prescription medications can be purchased in 90-day supplies; medical marijuana should not be treated differently.