Breaking the Stigma: How CBD is Helping First Responders Cope with Stress and Trauma
Published by Matt Shales, Director MediCann Clinics 10 min readBreaking the Stigma: How CBD is Helping First Responders Cope with Stress and Trauma
First responders, including police officers, firefighters, and paramedics, face a broad range of physical and psychological challenges. Chronic pain, post-traumatic stress disorder (PTSD), anxiety, and depression are common conditions experienced by first responders. These conditions can negatively impact their work, personal life, and overall well-being. Opioids are commonly used to manage chronic pain, and antidepressants are used to manage anxiety and depression. However, these drugs have several side effects, and there is a risk of dependence or addiction. This has led to an increasing interest in alternative therapies for managing these conditions, one of which is CBD.
What is CBD?
CBD is one of the many compounds found in hemp and marijuana plants. Unlike tetrahydrocannabinol (THC), the other prominent compound found in these plants, CBD does not cause a “high.” CBD interacts with the body’s endocannabinoid system (ECS), which regulates various physiological processes, including pain, mood, and appetite. CBD can bind to ECS receptors and help regulate these processes.
The Potential Benefits of CBD for First Responders
While there has been an increase in research on CBD in recent years, the historical legal and social landscape surrounding the use of CBD has constrained the ability to obtain quality human trial results. Despite this, CBD has shown promising potential to address many of the issues first responders face including pain management, anxiety, depression and PTSD.
Chronic Pain
First responders often experience chronic pain due to their physically demanding jobs. CBD oil has been shown to reduce pain and inflammation. CBD interacts with cannabinoid receptors, and the combination helps reduce pain, inflammation, and swelling.
A 2018 meta-analysis of randomized controlled trials found that CBD was associated with significant reductions in pain scores in individuals with chronic pain conditions.1
Another systematic review and meta-analysis published in 2020 found that CBD was effective in reducing pain in patients with chronic non-cancer pain. However, the authors noted that the quality of the evidence was low and further research is needed to confirm these findings.2
CBD is believed to work by interacting with the body's endocannabinoid system, which plays a role in regulating pain sensation. It is also believed to have anti-inflammatory properties that may help reduce pain and swelling.3
Anxiety and Depression
Anxiety and depression are common mental health disorders among first responders. CBD has been shown to have anxiolytic and antidepressant properties. CBD interacts with serotonin receptors, which regulate mood, and helps regulate serotonin levels, thereby alleviating symptoms of anxiety and depression.
A 2015 review of preclinical and clinical studies found that CBD had anxiolytic (anti-anxiety) effects in animal models and humans, and may be a promising treatment for anxiety disorders.4 Another study published in 2019 on 72 adults with anxiety and sleep disorders found that CBD improved both anxiety and sleep scores over the course of a month.5
The perceived mechanism of action of CBD in reducing symptoms of anxiety and depression is not yet fully understood. However, there are several theories on how CBD may work.
CBD is believed to interact with serotonin receptors in the brain, which play a role in regulating mood, anxiety, and stress. A 2018 study found that CBD increased the activation of serotonin receptors in animal models, which may help to reduce anxiety and depression symptoms.6
CBD has also been shown to stimulate the growth of new brain cells, a process called neurogenesis. This may help to reduce symptoms of depression, as depression is associated with a decrease in the production of new brain cells.
Finally, CBD is thought to interact with the body's endocannabinoid system, which plays a role in regulating mood, appetite, and sleep. By modulating the endocannabinoid system, CBD may help to improve symptoms of anxiety and depression.7
PTSD
Post-traumatic stress disorder (PTSD) is a mental health condition that can develop after experiencing or witnessing a traumatic event. While traditional treatments for PTSD, such as psychotherapy and medications, can be effective, there is emerging evidence to support the use of CBD as a natural alternative. A 2019 study of 11 people with PTSD found that CBD improved sleep and reduced symptoms of hyperarousal.8
The exact mechanism by which CBD reduces symptoms of PTSD is not yet fully understood. However, several theories have been proposed, including CBD's effects on the endocannabinoid system, the HPA (hypothalamic-pituitary-adrenal) axis, and memory processing.
The endocannabinoid system plays a role in regulating stress, anxiety, and fear responses, which are all heightened in people with PTSD. CBD is thought to interact with the endocannabinoid system, which may help to reduce these symptoms.
The HPA axis is responsible for regulating the body's stress response. In people with PTSD, the HPA axis is often dysregulated, leading to heightened stress responses. CBD has been shown to modulate the HPA axis, which may help to reduce symptoms of PTSD.
Traumatic memories are a hallmark of PTSD, and the process of memory reconsolidation is thought to play a role in the development and maintenance of PTSD. CBD has been shown to disrupt the process of memory reconsolidation, which may help to reduce the emotional impact of traumatic memories.
Legality in Australia
In Australia, the legal status of CBD (cannabidiol) can be a bit confusing. While CBD is not specifically listed as a prohibited substance in the federal law, it is tightly regulated and can only be obtained with a prescription from a registered medical practitioner.
For first responders who are prescribed CBD by a doctor, it is legal to use it for medicinal purposes in accordance with the prescription. However, it is important to note that any form of cannabis use, including CBD, can potentially impact job performance and may be subject to workplace drug policies and regulations.
Access
Currently, CBD is available only with a prescription from a healthcare professional who has been authorized to prescribe it. This means that patients who wish to use CBD must first consult with a healthcare practitioner, who can evaluate their health status and provide guidance on its appropriate use.
Healthcare practitioners who are authorized to prescribe CBD in Australia include doctors nurse practitioners. Patients can consult with their regular healthcare provider, or seek out a specialized practitioner who is knowledgeable about CBD and its potential therapeutic uses.
In addition to in-person consultations, patients may also be able to access CBD through telemedicine services which allow for remote consultations with healthcare practitioners via video conferencing or other digital platforms. This can be particularly useful for patients who live in rural or remote areas, or who have mobility issues that make it difficult to travel to a healthcare provider's office.
It is important to note that not all healthcare practitioners may be willing or able to prescribe CBD, and patients may need to seek out specialized clinics or practitioners who have experience with CBD and its potential uses. Additionally, patients should always follow their healthcare provider's instructions regarding the appropriate use of CBD, including dosing, administration, and potential side effects.
It is always best to consult with a qualified medical practitioner and employer before using any form of CBD or cannabis as a first responder in Australia. For more information a link to the MediCann Clinics website is below.
References
1. Aviram J, Samuelly-Leichtag G. Efficacy of Cannabis-Based Medicines for Pain Management: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Pain Physician. 2017;20(6):E755-E796. PMID: 28934780.
2. Stockings E, Campbell G, Hall WD, et al. Cannabis and cannabinoids for the treatment of people with chronic noncancer pain conditions: a systematic review and meta-analysis of controlled and observational studies. Pain. 2020 Mar;161(3):662-670. doi: 10.1097/j.pain.0000000000001764.
3. De Gregorio D, McLaughlin RJ, Posa L, et al. Cannabidiol modulates serotonergic transmission and reverses both allodynia and anxiety-like behavior in a model of neuropathic pain. Pain. 2019;160(1):136-150. doi: 10.1097/j.pain.0000000000001386.
4. Blessing EM, Steenkamp MM, Manzanares J, Marmar CR. Cannabidiol as a Potential Treatment for Anxiety Disorders. Neurotherapeutics. 2015;12(4):825-836. doi:10.1007/s13311-015-0387-1.
5. Shannon S, Lewis N, Lee H, Hughes S. Cannabidiol in Anxiety and Sleep: A Large Case Series. Perm J. 2019;23:18-041. doi:10.7812/TPP/18-041.
6. Sales AJ, Crestani CC, Guimarães FS, Joca SR. Antidepressant-like effect induced by Cannabidiol is dependent on brain serotonin levels. Prog Neuropsychopharmacol Biol Psychiatry. 2018 Jan 2;86:255-261. doi: 10.1016/j.pnpbp.2018.06.002.
7. Fogaça MV, Campos AC, Coelho LD, Duman RS, Guimarães FS. The anxiolytic effects of cannabidiol in chronically stressed mice are mediated by the endocannabinoid system: Role of neurogenesis and dendritic remodeling. Neuropharmacology. 2018 Jun;135:22-33. doi: 10.1016/j.neuropharm.2018.03.001.
8. Elms L, Shannon S, Hughes S, Lewis N. Cannabidiol in the Treatment of Post-Traumatic Stress Disorder: A Case Series. J Altern Complement Med. 2019 Mar;25(3):392-397. doi: 10.1089/acm.2018.0437.