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New MMJ Era 

PTSD set to go forward as MMJ qualifying condition along with legal challenge

This new year marks the beginning of a new era in Arizona's medical marijuana community. Post-traumatic stress disorder (PTSD) became a qualifying condition for the state's Medical Marijuana program as of Jan. 1 after more than two years of legal battles between the Arizona Department of Health Services and the Cannabis Nurses Association (CNA) led by Heather Manus. This momentous occasion represents the first time a condition has been added to the program narrowly passed by Arizona voters in 2010.

The PTSD medical marijuana research championed by former UA researcher Sue Sisley is now set to move forward in Colorado. However, here in Arizona, despite Sisley's research to treat veterans with PTSD, the state is moving forward to allow medical marijuana for those diagnosed with the condition.    

PTSD becomes the first mental health condition approved for medical cannabis in our state. Arizona Department of Health Services Director Will Humble added an unusual caveat to the approval of PTSD: he is requiring that a physician writing a recommendation also certify that the patient is receiving conventional treatment for their PTSD. This additional requirement of the patient and physician relationship is unique within the Arizona Medical Marijuana Act, because no other condition has such a stipulation and legal challenges to the requirement have been filed by Ken Sobol, pro bono attorney for the CNA. The conventional treatment required can be "talk therapy" but often is pharmaceuticals such as antidepressants, mood stabilizers and anti-anxiety products.

"Conventional" treatments have demonstrated limited success treating mental illness and often come with unwanted side effects. When a person suffers from PTSD they feel out of control of their behaviors; they sometimes hear voices; they suffer from hyper-arousal, have flashbacks, sweats, and panic attacks. It truly is a debilitating condition. Those that have found their way to cannabis report a quieting of the voices, an inner peace that allows them to function more normally.

The ease of titration and rapid onset of symptom relief that comes from inhaled methods of use leads most PTSD patients to smoking or vaporizing their cannabis treatments. Indicas have been shown to be most effective with this crowd, but with cannabis one size does not fit all; trial and error is the order of the day. Some PTSD patients find relief using edible products to aid with sleep. Some patients find sativas to be superior for their condition, although this should be tried after other strains have been shown to be ineffective or over sedating.  

Israeli scientists are conducting research to determine exactly how cannabis works on PTSD. PTSD causes inhibition of neurons located in the brain, specifically the prefrontal cortex, the amygdala, and the hippocampus. These are the areas of the brain responsible for memory and decision making. One function of the endocannabinoid system is to mediate cellular memory. People who experience a traumatic or high stress event may have a hard time getting past certain triggering events due to suppressed memory cells. These memories are suppressed to block out unwanted information relating to the stressful event. Cannabinoids help to stimulate cellular signaling of neurons, allowing the stressful memories to be processed. With the help of cannabis, patients can begin to deal with the issues from a less guarded, vigilant position. As good experiences and memories begin to replace the triggering events and bad experiences in the patient's consciousness the hippocampus can begin to safely process and store information without feeling threatened from a triggering event.

Dispensaries across the state will begin seeing the PTSD patient population in the coming weeks.

The treatment of PTSD with medical marijuana is effective for the patient and rewarding for the doctors and dispensary employees who serve them. Rarely has there been a patient population so deserving of our help.

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