#PTSD and #Alcohol Series (Part 8) – Spliff Time?

PTSD Word MapAs with past common use of alcohol, as a form of self-medication amongst military personnel and veterans, it appears a growing number of people are now using cannabis to ‘treat’ their post-traumatic stress disorder (PTSD). This is according to a recent UCL study* but, as the study also reports, the ‘effective’ use [of cannabis] isn’t backed up by adequate evidence…

The systematic review (above), published in the Journal of Dual Diagnosis, found that; active components of cannabis, “may hold promise as a treatment” [for PTSD]. And in particular, the review also suggests there ‘might be’ some ‘benefits’ for people desperate to realise some relief from their nightmares and disrupted sleep patterns (read more)… prominent symptoms which are reported by many, who are impacted by this often debilitating mental-health condition.

The researchers say there are still many unanswered questions about the safety and efficacy of cannabis-based medications for PTSD, and potential long-term effects such as addiction or a risk of psychosis. (EurekAlert)

But, before serving personnel or military veterans, start rushing out to source a bag of weed, these ‘possibilities’ are not (so far) backed up by any high quality medical evidence. At least none that unequivocally supports the overall efficacy of this treatment. But, as the study’s senior author (Dr Michael Bloomfield, UCL Psychiatry) highlighted; “findings certainly highlight the need for more research, particularly with long-term clinical trials.”

Based on the evidence, we cannot yet make any clinical recommendations about using cannabinoids to treat PTSD. (Dr Michael Bloomfield)

Resorting to Self-Medication

The problematic PTSD issues, faced by many people and not least our military veterans, often result in self-medication of the symptoms (see here). Often, this self-medication results from not having access to the correct/appropriate support. Many believe that treatment and support is unavailable (or non-existent), when it actually is. That said, the limited resources that are available can be difficult to find, access and engage with, for all manner of reasons.

Soldier DrinkingI can see how some individuals might be attracted to exploring the ‘possible relief’ that cannabis could offer, especially if they have struggled to find any other support.

It’s a similar process previously adopted by those who have historically gained solace from alcohol but, is self-medication really the best answer? Or, even such a sensible idea?

This particular personal choice could also present negative consequences, for your career and livelihood. Disciplinary procedures for serving military personnel are likely. Leaving consequences that could leave you unemployed. Probably not such a good idea then… Despite the recent moves from purely punitive measures towards more supportive military policy (see below).

In short, I wouldn’t recommend such a course of ‘self-medication’ for any serving military (army) personnel who must consider the impacts of JSP835 Ch.4 (AGAI-67) etc. at least for now.

PTSD in the MilitarySo what can be done and how, by military personnel and those veterans who suffer from PTSD? The first answer would be… seek professional help. I know, sometimes this is easier said than done.

Many who have already searched for help, or perhaps even attempted to engage with (arguably) inadequate mental-health services, often report difficulties in accessing the support that is available.

Too often, agencies and organisations (both public and third sector) do offer help but they are often unable to provide the ‘immediate’ support, that many see as something that is required. Today, this mostly finds root within sometime inadequate resourcing issues; factors that can be born out of limited funding and/or professional capability… which isn’t so good, especially for the person suffering from PTSD and asking for help. And this appears to be becoming ever more prevalent.

PTSD rates increase in UK military personnel, research suggests: The overall rate of probable PTSD among current and ex-serving military personnel was 6% in 2014-16, compared with 4% in 2004-06. (The Guardian)

Any perceived lack of available support has become something of a rhetorical trope, for many who are searching for help and support.But, organisations who are desperate to secure funding for their important support services are also damaging people’s expectations, around the help and support they may/may not receive. They start to believe all the rhetoric and marketing hype and consequently; they develop low expectations about getting any help… so don’t go looking for the support they clearly need.

Time To Talk

Campaigns like #TimeToTalk, along with others, are now thankfully raising the profile of military mental-health illness. That’s great but; unless the required support structures are put in place (and made available), treating and supporting existing and new patients, with their ‘new’ issues (effectively) will be problematic. Greater understanding is thankfully becoming way more common however; the improved awareness could become an anathema, creating something of an even larger Pandora’s Box.

As with many health issues today, both public and personal, there is so much that we can do as individuals – self-help to get to arrive at a more healthy place, whilst awaiting the help from our statutory and/or voluntary support structures. As mentioned before, self-medication (with alcohol or controlled substances) usually isn’t the best option, or a choice that you should be making, especially if you are still serving in the military.

Irrespective of any individual expectations about support provision; the common traits of personal resilience and ‘mind over matter’ attitudes abound amongst armed-forces personnel. Those attributes exist in abundance and can also be channelled into effective self-care and self-help… given some guidance and support.

Note: I’ve written before about self-medication (see example) for the symptoms and effects of post-traumatic stress disorder (PTSD). This piece is the latest instalment in a series of blogs about possible correlations between PTSD and addictive behaviours.

* C. Hindocha, J. Cousijn, M. Rall & M. A. P. Bloomfield (2019) The Effectiveness of Cannabinoids in the Treatment of Post Traumatic Stress Disorder (PTSD): A Systematic Review, Journal of Dual Diagnosis, DOI: 10.1080/15504263.2019.1652380
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