Can Cannabis Prevent and Treat Traumatic Brain Injury?
Traumatic Brain Injury, or TBI, is a serious condition usually caused by an external blow to the head that can cause severe and often chronic symptoms. These symptoms can be cognitive, behavioral, movement related, speech and visual impairing, mood altering, involve painful headaches, and even cause gastrointestinal issues.
Each year in just the U.S., nearly 52,000 people die from TBI and 80,000 sustain severe disabilities. Compare that to car fatalities (32,675) and homicides (14,196), which combined claim fewer lives. Moreover, 5.3 million people in the U.S. live with TBI-related disabilities, a number comparable to those living with Alzheimer’s disease.
How Cannabis Can Slow Traumatic Brain Injury Damage
While effective therapies to treat ongoing TBI symptoms have been difficult to come by, thanks to researchers like Prof. Yosef Sarne of Tel Aviv University, we’ve discovered that cannabis may prevent long-term brain damage by administering THC before or shortly after the injury. In fact, Israel Defense Force (IDF) practitioners administer CBD or low-dose THC as a first-line treatment to IDF soldiers – and even enemy combatants – who suffer brain trauma.
Sarne and his team published their results in 2013, where they demonstrated that administering just a fraction of the amount of THC that would be found in a typical cannabis joint anywhere from one to seven days prior to, or one to three days after an injury, induces the biochemical processes necessary to protect critical brain cells while preserving long-term cognitive function.
Can Cannabis Help People Currently Suffering From TBI?
Given the success found in Israel utilizing cannabis to halt TBI in its tracks, it begs the question: can cannabis help persistent TBI symptoms?
Anecdotally, many patients and their families report success. The daughter of one patient wrote in a Reddit forum:
“My father suffered severe TBI for years. He used to sit around hating his life all day. Once he started using marijuana, he changed a lot. He was able to get off some of his meds, start eating more, go outside, enjoy music, laugh at a movie, sleep at night, less anxiety in the day, less body pain. The list goes on and on.”
We hear many success stories like this, but these are, of course, anecdotal. Thus far, there aren’t any notable clinical trials demonstrating the efficacy of cannabis to treat ongoing symptoms in TBI patients. Unfortunately, even outside of cannabis research, phase II/III clinical trials of potential treatments haven’t demonstrated any consistent improvements in outcomes.
The lack of cannabinoid-focused trials is likely due in part to the federal government’s long-standing position that cannabis is a “substance [with] no currently accepted medical use” and “a high potential for abuse” – a position that has long frustrated scientists who are forced to navigate significant bureaucratic obstacles to conduct high-quality rigorous studies.
Nonetheless, despite the federal government’s position, there is some evidence that at least lends support to speculation that cannabis-derived treatments may be beneficial:
“Effect of Marijuana Use on Outcomes in Traumatic Brain Injury” (UCLA Medical Center, 2014):
In a three-year retrospective review of 446 separate cases of similarly injured patients, researchers found traumatic brain injury (TBI) patients who had a history of cannabis consumption possessed increased survival rates compared to non-consumers (97.6 percent survived surgery, versus 88.5% of those who didn’t consume cannabis).
“[O]ur data suggest an important link between the presence of a positive THC screen and improved survival after TBI,” the researchers concluded. “With continued research, more information will be uncovered regarding the therapeutic potential of THC, and further therapeutic interventions may be established.”
“Endocannabinoids and Traumatic Brain Injury” (Mechoulam, 2007):
This Israeli study points to research that demonstrates:
“…the [endocannabinoid] system…has the ability to [positively] affect the functional outcome after TBI by a variety of mechanisms.”
“The Therapeutic Potential of the Cannabinoids in Neuroprotection” (Grundy RI, 2002):
This review shows that in experimental models:
“…various cannabinoids rescue dying neurons in experimental forms of acute neuronal injury, such as cerebral ischaemia and traumatic brain injury.”
Positive results in experimental models don’t always translate to human subjects, hence the desperate need for more research. But, as early research shows promise and we know cannabinoids demonstrate neuroprotective effects in a variety of neurological conditions, there’s no excuse not to prioritize further research.
Further, because TBI is a condition affecting a highly complex, intricate system like the brain, successful strategies will likely involve more than a single “magic bullet.”
CBD Can Be Remarkably Effective for TBI
In the meantime, as we continue to learn more about THC and other cannabinoids to treat traumatic brain injury, many physicians believe CBD can be a safe and effective treatment. CBD, a non-intoxicating cannabinoid that possesses neuroprotective, anti-inflammatory, and anti-anxiety properties, could be as close to a “magic bullet” as we have right now. In fact, CBD may be more beneficial than THC. Japanese researchers found cannabidiol (CBD) exhibited stronger antioxidative power than THC without creating tolerance to its neuroprotective effect.
Dr. Allan Frankel, of GreenBridge Medical in Santa Monica, California, believes incorporating small amounts of CBD as a daily nutritional supplement is a safe and sensible adjunct to therapy. “I had a patient recently, a 45 year mother who was in a bad car accident. She experienced memory loss, and hadn’t been making any progress. I suggested CBD,” recounts Frankel. “Within four to six weeks, she made significant progress – her cognitive function improved and her memory returned to normal.” Frankel notes that this is just one of many patients he’s had who have experienced successful recoveries.
While clearly there’s lots of promise in the limited research to date and anecdotal reports, we need to continue developing our understanding of cannabinoid neurobiology in order to most effectively exploit the numerous therapeutic properties of cannabis. We can then, hopefully, unleash the full spectrum of potential benefits cannabis may be able to provide and discover innovative new treatments that could quite possibly help the millions of people who continue to suffer.
Cannabidiol as a Treatment for PTSD and PTSD Comorbid With TBI
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.
|Ages Eligible for Study:||18 Years to 70 Years (Adult, Older Adult)|
|Sexes Eligible for Study:||All|
|Accepts Healthy Volunteers:||No|
- Meets clinical criteria for Posttraumatic Stress Disorder (PTSD) as per Clinician-Administered PTSD Scale for DSM-5 (CAPS-5)
- TBI present (for PTSD+TBI subjects only) as per American Congress of Rehabilitation Medicine (ACRM) definition
- Mild TBI (for PTSD+TBI subjects only) as per Ohio State University Identification Screener
- Able to provide at least 2 locators
- Able to provide informed consent
- Confirmation that the participant is reliably domiciled
- Agreement to abstain from all other cannabinoid use for the duration of the study
- Willingness to use contraception if of childbearing potential.
- History of open head injury
- TBI within the last 6 months
- Moderate or Severe TBI
- SUD in the last 12 months other than mild AUD or nicotine use
- Use of any cannabinoid containing product within the last 1 month
- Positive urine drug screen (Positive for cannabinoids, amphetamine, cocaine, opioids)
- Currently prescribed medications with possible CBD-drug interactions
- Lifetime history of any psychiatric disorder with psychotic features, bipolar disorder
- Exposure to trauma in the last 30 days, including police duty or military service
- Psychotherapy for PTSD or other psychiatric conditions initiated within 2 months of screening
- Not stable for at least 2 months on psychiatric medication, anticonvulsants, antihypertensive medication, sympathomimetic medication, estrogen replacement therapy, medications associated with neurogenesis, or steroid medication
- Active suicide attempt within the past year
- Current significant suicidality (assessed using the C-SSRS), any significant suicidal behavior in the past 12 months, or any history of serious suicide attempts requiring hospitalization, or current significant homicidality.
- Neurologic disorder or systemic illness affecting CNS function (apart from TBI)
- Major medical illness (i.e. cancer or infectious disease.)
- Clinical diagnosis of anemia, advised by physician to avoid blood draws
- Significant laboratory abnormalities, significantly impaired hepatic function, abnormalities in complete blood count or metabolic panel
- Significant allergic reactions to the drug including cannabinoids or sesame oil
- Pregnancy or lactation
- Contraindication to MRI
- Males and females who plan to conceive a child during or two weeks following the study
- Active legal problems likely to result in incarceration within 12 weeks of treatment initiation
- Has a high risk of adverse emotional or behavioral reaction (e.g., evidence of serious personality disorder, antisocial behavior, serious current stressors, and lack of meaningful social support).
- Inpatient psychiatric treatment in past 12 months, with the exception of detox and extended ED stays.
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.