Does cannabis help with anxiety?

Anxiety is the second most common condition for which medicinal cannabis is prescribed, second only to chronic pain. This trend highlights the growing interest in exploring cannabis as a potential treatment for anxiety disorders. However, does cannabis really help with anxiety, or does it pose more risks than benefits?

Cannabinoids and the endocannabinoid system

The most notable cannabinoids are tetrahydrocannabinol (THC) and cannabidiol (CBD). THC is the primary psychoactive component responsible for the “high” associated with cannabis use, while CBD is non-psychoactive and is often used for its potential therapeutic benefits, such as reducing anxiety and inflammation.

Cannabinoids interact with the ECS by binding to cannabinoid receptors. THC primarily binds to CB1 receptors in the brain, affecting mood, memory, and perception, potentially inducing anxiety or reducing it depending on the dose and individual. CBD, on the other hand, interacts less directly with cannabinoid receptors but can influence the ECS by increasing the availability of endocannabinoids and interacting with other receptors, such as serotonin receptors, which are known to regulate mood and anxiety. This interaction suggests that cannabinoids can modulate anxiety levels through multiple pathways.

Research findings on cannabis for anxiety relief

Several studies support the use of cannabis, particularly CBD, for anxiety relief. Research from the University of Colorado Boulder indicates that CBD-dominant products are effective in reducing anxiety without the risks associated with THC. Participants using CBD reported significant reductions in perceived anxiety and tension without experiencing the paranoia or cognitive difficulties often linked to THC use. The study emphasised that CBD’s anti-inflammatory properties might contribute to its anxiolytic effects.

Another study highlighted in Cannabis Health News corroborated these findings, suggesting that CBD could provide meaningful anxiety relief, both acutely and potentially long-term, without the dependency risks associated with prescription medications.

Contrary evidence exists, suggesting that cannabis, especially THC-dominant products, might not be effective for anxiety relief and could potentially exacerbate symptoms. A critical review in the Journal of Translational Medicine found that while many users turn to cannabis for anxiety, a significant minority report worsened anxiety symptoms, particularly with higher doses of THC. This aligns with findings that THC can induce anxiety, panic, and paranoia in some users, underscoring the importance of dosage and individual response.

Dosage and strain considerations

Proper dosing of cannabis is crucial for both therapeutic and recreational users. Underdosing can lead to ineffective treatment, leaving conditions like anxiety untreated, while overdosing can cause adverse effects such as paranoia, intense anxiety, and even hallucinations. It’s important to start with a low dose and gradually increase it until the desired effects are achieved. For example, a common recommendation is to start with 2.5 mg of THC for beginners and wait for at least two hours before taking more. This approach helps to avoid the potential risks associated with both underdosing and overdosing, ensuring a safe and effective experience.

Cannabis strains are generally categorised into Indica, Sativa, and hybrids. Indica strains are typically known for their calming effects, making them more suitable for nighttime use and for alleviating anxiety and insomnia. Sativa strains, on the other hand, are more energising and are often recommended for daytime use to combat depression and fatigue. Hybrid strains combine elements of both Indica and Sativa, providing a balanced effect that can be tailored to specific needs.

When choosing cannabis strains and dosages for anxiety relief, it is advisable to start with CBD-rich strains or those with low THC content to minimise the risk of adverse psychoactive effects. Strains like ACDC, Harlequin, and Cannatonic, which are high in CBD, are often recommended for anxiety. For dosing, starting with a low amount (e.g2.5 mg of THC or 5 mg of CBD) and gradually increasing it while monitoring the effects can help in finding the optimal dose without experiencing negative side effects. Always consult with a healthcare provider to tailor the dosage and strain to your specific condition and medical history.

By carefully selecting the appropriate strain and dose, users can effectively manage anxiety while minimising the risks associated with improper cannabis use.

Individual variability and risks of cannabis use for anxiety

Individual responses to cannabis for anxiety can vary widely due to several factors. Genetics play a crucial role, as specific genes can influence how one metabolises THC and CBD, the primary compounds in cannabis. For instance, variations in genes like CYP2C9 and COMT can affect THC metabolism, potentially altering its anxiolytic effects. Additionally, personal tolerance levels and mental health history are significant. People with a history of mental health disorders, such as social anxiety, may experience different effects and are more prone to cannabis misuse.

Short-term risks:

While some find relief from anxiety with cannabis, others may experience increased anxiety or paranoia, particularly with high THC strains. These immediate side effects can include:

• Heightened anxiety
• Panic attacks
• Psychosis

Especially in individuals predisposed to anxiety disorders. The impact can vary depending on the strain, dosage, and individual sensitivity.

Long-term risks:

Long-term cannabis use poses several risks, including the potential for dependency. Chronic use may lead to:

• Cravings
• Withdrawal symptoms
• Depression
• Anxiety

Regular users might also experience cognitive impairments and motivational deficits over time.

Addiction

Cannabis addiction is a real risk, especially for those using it to self-medicate for anxiety. While marijuana can provide temporary relief, it can lead to psychological dependence, increased anxiety, and memory loss. About 6% of U.S. users develop cannabis addiction, and the risk is higher among those who start young or use high-potency strains.

Signs of cannabis addiction include continued use despite negative effects, social or relationship problems, withdrawal symptoms when not using, and cravings. People might also withdraw from activities to use marijuana or fail in attempts to quit.

Rehabilitation options for cannabis addiction include therapy, support groups, and medical treatment. Seeking professional help is crucial as it can address both the addiction and any underlying mental health issues, providing a comprehensive approach to recovery.