Post-traumatic stress disorder (PTSD) and chronic pain are experienced by veterans at disproportionally high levels. In fact, a recent survey showed the rate of PTSD in Canadian veterans ranges from 7.5 to 13 percent – more than ten times that of the general population. Because of this, researchers at St. Joseph’s Healthcare Hamilton are conducting research projects aimed at improving the mental health and wellbeing of Canadian service members and veterans, by focusing on improving existing treatments and developing new interventions.
Dr. Margaret McKinnon studies special populations who have experienced traumatic events causing PTSD, particularly veterans and emergency first-responders.
In 2018, Dr. McKinnon was appointed as the inaugural Homewood Research Chair in Mental Health and Trauma, which was central to the development of a new, national trauma research network to study PTSD. She hopes the new research network – a partnership between St. Joe’s, McMaster University, and Homewood Research Institute – can help us to better understand how emotional trauma has a physical impact on the brain.
Dr. McKinnon’s goal is to expand the research network across Canada in order to leverage collective expertise as a means to improve treatment and outcomes for people experiencing PTSD.
We know relatively little about the effects of moral injury and PTSD in servicewomen and female veterans.
Moral injury can occur as a result of perpetrating, observing, or failing to prevent acts that violate deeply held moral standards – unfortunately, these kind of experiences may occur more often while serving in the military. Studies have shown that military members who experience morally injurious events are more likely to develop PTSD and suicidal ideation, compared to their counterparts who have not been exposed to such events. However, most of the research in this area has only been established from servicemen and male veterans. The effects of moral injury on servicewomen and female veterans have not been adequately studied.
Bethany Easterbrook, a graduate student working under the supervision of Dr. Margaret McKinnon, is set to begin a research project that will shed some light on the effects of morally injurious events experienced by servicewomen and female veterans. Recently, Easterbrook was awarded a Research Institute Studentship Award to conduct this much needed work and begin to fill the knowledge gap. She hopes to improve the identification of treatment targets to reduce mental health consequences of moral injury within this group.
A staggering 41 percent of Canadian veterans reported constant chronic pain – could cannabis be the answer?
Though there is insufficient evidence for the use of cannabis when it comes to PTSD, researchers note there is supportive evidence when it comes to pain. The Centre for Medicinal Cannabis Research (CMCR) is particularly focused on cannabidiol (CBD), the non-psychoactive ingredient of cannabis, for treating chronic pain.
In May 2018, prior to legalization, Dr. James MacKillop addressed the Senate Subcommittee on Veterans Affairs to inform the government on the latest evidence and research efforts on cannabis, noting in particular that we need more randomized controlled trials. Dr. MacKillop is the Co-director of the CMCR, a partnership between McMaster and St. Joe’s.
Unfortunately, randomized controlled trials involving cannabis are lacking, since this type of research was nearly impossible to conduct prior to recreational legalization. There are also many aspects to consider – chemical content varies by strain (THC, CBD, and other cannabinoids), consumption methods differ (smoked, vapourized, ingested), and artificial methods to increase THC concentration may amplify the more harmful effects – all of these factors have to be thoroughly investigated.
Dr. MacKillop and his team are conducting a longitudinal study engaging veterans and other medical cannabis users prior to and following legalization. The goal is to produce scientific evidence on the efficacy of cannabis for treating chronic pain, rather than allowing myth and lore to guide health care decisions.
The CMCR is also critical of the potential acute consequences of cannabis use, such as anxiety, panic, paranoia, etc. Researchers, including Dr. Iris Balodis of the CMCR, shared their thoughts at the Canadian Institute for Military and Veteran Health Forum.
These research endeavours are just some examples of how St. Joe’s is dedicated to supporting research that will aid Canadian service members, veterans, and emergency first-responders affected by PTSD and chronic pain.