The use and popularity of medical cannabis (marijuana) is on the rise. Thirty-three states and Washington DC allow for the medical use of cannabis for a variety of conditions from cancer and glaucoma to chronic pain and autism spectrum disorder.
Most of these states have a list of qualifying conditions that the patient must have in order to legally medicate with cannabis. While none of the states recognize anxiety or generalized anxiety disorder (GAD) as a qualifying condition, many states have recently added post-traumatic stress disorder (PTSD) to the list of eligible conditions. Some states allow the medical provider to decide what conditions qualify their patients for medical cannabis.
Is medical cannabis safe?
To date, there have been no deaths that are a direct result of cannabis consumption. As with any medication, there is potential for negative effects of overuse and addiction. Cannabis overdose can produce some unwanted mental and physical effects that are usually manageable by most adults.
In general, medical cannabis is safe when used correctly and in consultation with a medical professional. Please see precautions below for more information about safety considerations.
What does the research say about cannabis and anxiety?
This is where the intersection between medical cannabis and treatment for anxiety gets a little complicated. First, it is important to understand that there is limited research available in the United States.
The research that is available is mixed and shows that cannabis can both help anxiety and make it worse. This is dependent on several factors. Read on to explore some of these factors and learn whether or not medical cannabis might be a helpful addition to your anxiety management strategies.
The relationship between THC and CBD
According to UCLA’s Cannabis Research Initiative, over 100 cannabinoids have been identified in the cannabis plant. Cannabinoids are compounds that are unique to the cannabis plant and interact with the human endocannabinoid system.
The two best known and most researched of these compounds are Delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD).
THC is the compound in cannabis that creates the psychoactive or “high” effect. Evidence from clinical studies shows that low doses of THC may help decrease anxiety and elevate the mood while higher doses of THC may increase anxiety and decrease mood. THC works mostly on cannabinoid receptors (CB1) in the brain and nervous system. It is believed that this may be one of the reasons for its calming effect.
Almost everyone is familiar with CBD. There are many products on the market and available in all 50 states that contain CBD. By law, commonly available products must contain less than .3% THC. CBD is non-psychoactive and does not produce any “high” effects. CBD influences the body to use more of its own cannabinoids (endocannabinoids) and is used for a variety of conditions including anxiety. Some CBD products are better than others.
When THC and CBD along with other compounds from the cannabis plant are used together, it is believed they create an entourage effect. The entourage effect is the theory that the hundreds of compounds in the cannabis plant work together to create a greater medicinal effect than the isolated parts. This is why some people prefer products that contain both THC and CBD. For others, CBD products are more appropriate, especially if there is a need to pass a drug test for employment or a desire to avoid the psychoactive effects of THC.
Medical Cannabis Considerations
1. Know the legal status and laws where you live.
Before considering using medical cannabis, know the legal status and laws in your state. The information in this article should be considered informational and not legal or medical advice.
2. Don’t make the decision alone.
You wouldn’t make the decision to start taking blood pressure medication or change your antidepressant medication without talking to your healthcare provider first. The same consideration should be given to the decision to treat your anxiety with medical cannabis. One area the research seems to agree is that self-medication with cannabis for anxiety and anxiety-related disorders is not advised. Some studies have shown that cannabis can be used successfully to treat some of the symptoms of PTSD but was most effective in the presence of ongoing therapy.
3. Not all strains are the same
There are many different strains of medical cannabis on the market. Since strains can vary from one grower to the next, let’s explore the characteristics of cannabis strains.
Cannabis strains are generally classified as indica, sativa, or hybrid (a mix of the two). Indicas tend to be calming and sedating. Some people like them for pain, anxiety, and issues with sleep. Sativas tend to be more energizing and uplifting but can cause paranoia for some people with certain types of anxiety, especially social anxiety. Hybrids are a mix between the two with widely varying effects depending on whether the strain is more indica or sativa dominant.
Some cannabis strains grown today have a very high percentage of THC, sometimes over 40%. They are mainly grown for the recreational market. As with many medications, more is not necessarily better. Most effective medical strains of cannabis contain between 10% and 20% THC and a higher percentage of CBD than many recreational strains.
4. Find the right route and dose
The most common form of cannabis consumption is smoking. This comes with the additional health effects of smoke inhalation. Cannabis smoke has been shown to contain some of the same harmful chemicals as cigarette smoking. This is why many states do not allow cannabis to be smoked for medical purposes.
Another common way to use medical cannabis is through eating it. Many commercial products are made with pre-measured amounts of THC and/or CBD per serving or dose. These products range from cookies and candies to tinctures and oral sprays. This is one of the easiest ways to know just how much cannabis you are ingesting. Some people prefer “edibles” as they are absorbed more slowly through the digestive tract and produce the desired effects over a longer period of time.
5. High quality medical cannabis
How do you know if you are using a high quality medical product? There are 4 things that you can look for:
- Flower-derived- this ensures that the product is made from cannabis and not industrial hemp;
- Lab-tested – the product should be lab-tested and clearly labeled with the % of the various cannabinoid compounds;
- Organic – to minimize ingestion of toxins into the body; and
- Whole plant – to create the greatest entourage effect.
- Consult with your medical and mental health providers before using medical cannabis.
- Start with the lowest dose and document your symptoms before and during use.
- Keep edibles and all medical cannabis safely away from children. Many edibles look like candy and can cause overdose.
- Talk to your medical professional about medication interactions.
- If you use a medical cannabis product that contains THC, do not operate a vehicle or heavy machinery for the duration of the psychoactive effects.
- Do not use cannabis if you are pregnant.
There are many things to consider when deciding if medical cannabis is the right choice for you. As the number of states legalizing medical cannabis grows so will the data and the research to help make more informed decisions. Until then you can use the best information available, talk with your healthcare provider, and educate yourself.