According to the CDC, an estimated 1.7 million people sustain a traumatic brain injury annually in the United States. Of those, approximately 52,000 die, 275,000 are hospitalized and 1.365 million (about 80%) are treated and released from the hospital to live with the effects. Traumatic brain injury is usually the result of a violent blow or jolt to the head or body. Unlike a broken bone or punctured organ, a brain injury has the potential to affect all areas of the injured individuals’ life—including their personality. As you can probably imagine, recovering from a brain injury is very different from recovering from other types of injuries—no two brain injuries are exactly the same, which means that every recovery process is slightly different as well. It’s safe to assume that any individual who has suffered a TBI will require rehabilitation, however the extent of the rehab necessary will be dependent on how severe the TBI is. While there is no specific medication for TBI, many patients are prescribed diuretics to help reduce intracranial pressure, anti-convulsants to prevent seizures, anti-anxiety medication, anti-depressants and muscle relaxants to help alleviate symptoms. For those that would prefer an alternative to all these pills, studies indicate that cannabis may be effective. Since March is Brain Injury Awareness Month, we at Hopegrown decided this would be a great time to shine a spotlight on TBI and how cannabis could be beneficial for individuals living with TBI. 

What is TBI?

As we mentioned above, traumatic brain injury occurs when an individual sustains a serious blow or jolt to the head or body. Many TBIs are the result of accidents, but they are also particularly common amongst those serving in the military. The Defense and Veterans Brain Injury Center estimates that approximately 13,000 service members and veterans are diagnosed with TBI each year. TBI is classified into two categories—mild and severe. For a brain injury to be classified as mild, loss of consciousness and confusion/disorientation must last less than 30 minutes. MRI and CAT scan results will typically appear normal for these individuals, but they may experience symptoms such as headache, memory issues, difficulty thinking, mood swings, short attention span and frustration. While it’s definitely better to have a mild TBI than a severe one, these individuals and their caretakers still experience drastic changes in their day to day life and most must manage their symptoms for the rest of their life. A severe brain injury is classified as such when the individual loses consciousness for more than 30 minutes and experiences memory loss for more than 24 hours post-injury. For these individuals, the deficits are decidedly worse than those with mild TBI—many lose function of their limbs, experience changes in speech (or are unable to speak at all), lose the ability to think or experience intense emotional issues. A TBI diagnosis, whether mild or severe, radically changes the individuals’ life as well as the lives of those who are close to them. Recovery can range from months to a lifelong process, depending on the extent of the injury.

Is cannabis a viable option?

Due to cannabis’ Schedule I classification, there have been no human clinical studies conducted in the United States on the efficacy of cannabinoids for TBI; however, there have been several animal studies conducted in Israel that show promise. Prof. Esther Shohami of the Hebrew University of Jerusalem conducted a study entitled “The role of CB2 receptors in the recovery of mice after traumatic brain injury” which examined why 2-AG levels increase after a trauma and how targeting the CB2 receptor could improve brain recovery, corticospinal tract recovery and motor skills for individuals with TBI. Shohami and her team determined that the increased 2-AG levels were a defense mechanism of the body meant to protect the brain in the event of injury, but when a TBI occurs the amount of 2-AG that is naturally produced by the body isn’t sufficient. This is where cannabinoids and targeting the CB2 receptor come in—Shohami purports, “The brain creates protection; we wanted to mimic what the brain does, and we wanted to do it better.” From here, Shohami modeled synthetic molecules after 2-AG to specifically target the CB2 receptor to avoid the psychoactive effects that occur when the CB1 receptor is activated. The rats that received the synthetic molecules experienced improvement in their corticospinal tract (a neural pathway that starts in the brain and runs down the length of the spine—it is responsible for the body’s motor control) and their overall motor skills. Another study conducted by Professor Yosef Sarne of Tel Aviv University indicates that the administration of THC before or shorty after a brain injury may prevent long-term brain damage. The results were published in 2013 and essentially said that a small amount of THC, even just a fraction of what is typically found in a joint, administered 1-7 days before or 1-3 days after a brain injury “induces the biochemical processes necessary to protect critical brain cells while preserving long-term cognitive function.” While this is helpful if you happen to be taking THC before you get injured or immediately after, what about the individuals who were diagnosed years ago? Can cannabis help them? Many researchers believe that CBD could prove more beneficial than THC for individuals who have been living with a TBI for any extended period. Over time many individuals build up a tolerance to THC and its neuroprotective effects, but this is not the case with CBD because of how it interacts differently with the endocannabinoid system. While most of the evidence of CBD’s efficacy for individuals with TBI is anecdotal in nature, it still shows promise. A patient of Dr. Allan Frankel of GreenBridge Medical who was in a bad car accident and experiencing memory loss began taking CBD and after 4-6 weeks of consistently taking the cannabinoid, she began to see improvements in her cognitive function and her memory returned to what it had been before the accident. As we mentioned earlier in the article every brain injury is different, so this particular patient’s experience with CBD may not be the same as your’s—but in a time where most of our information about the medical benefits of cannabis is still anecdotal, experiences like this let us know that it’s at least worth trying. 

Researchers agree that further studies need to be conducted for us to better understand how THC and CBD help the brain heal after a TBI. Based on what we do know, it stands to reason that the anti-inflammatory properties of cannabis likely play a large role in the improvements in motor skills and cognitive function that TBI patients have experienced. Many of the symptoms of TBI are caused by inflammation in the brain and corticospinal tract, so when THC and CBD are able to reduce that inflammation patients are seeing symptom improvement. Hopefully over the next few years we continue to see progress made into understanding TBIs and the role cannabis can play in the recovery process. If you or someone you know is interested in utilizing medical cannabis for a TBI, we recommend talking to your doctor before making any changes to your current treatment plan. To find a doctor in your area that has a background in medical cannabis, use the Hopegrown search bar at the top of the page! 

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