Can you Smoke Out Stress? Treating America’s Anxiety Problems with Cannabis
Table of Contents
As Cannabis Sativa continues its reintegration across western society, medical cannabis and cannabinoid-based therapies are gaining popularity in the traditional pharmacopeia. With anxiety and stress disorders being the most prevalent mood disorder in the modern world, affecting over a third of the population, it’s no surprise cannabis is being sought after as an alternative treatment 1,2.
Treating anxiety with cannabis is far from an exact science and quite complicated as some cannabis products actually induce anxiety for unknown reasons 2.
The “Big Fear”: Cannabis Induced Anxiety is Cannabis Culture’s “Bigfoot”
While the anti-anxiety effects of cannabis have been recognized in modern scientific literature for decades, the mechanism is far from being clearly understood 3. The perplexing phenomenon of cannabis-induced anxiety and paranoia is considered cannabis culture’s “Bigfoot” 4; an unsubstantiated yet socially pervasive urban-legend. Indeed, many cannabis products have paradoxically been known to both “attenuate or exacerbate anxiety and fear-related behaviors” 2.
Luckily, science and medicine have also caught on and isolated the component in cannabis with clearly established anxiolytic properties (CBD or “Cannabidiol”)!
Better Than Benzos: Cannabidiol (CBD), Nature’s Cannabis-Derived Anxiolytic
Cannabidiol, a novel constituent of the Cannabis Sativa plant, is pharmacologically versatile and has gained recent attention for it’s powerful anxiolytic effects despite it’s uniquely non-psychoactive nature 2,5. As we are beginning to observe and understand the vast range of varying physiological and psychological effects CBD has on the body, its influential effects on emotional regulation are undeniably curious.
Early studies have even revealed that cannabis demonstrates activity on central benzodiazepine receptors, the same part of the brain that drugs like Xanax and Valium act upon 3. However, while cannabis may indeed act on similar parts of the brain as benzodiazepines and alcohol do, it lacks the very unpleasant side effects and potentially deadly withdrawal effects that GABAergic drugs like benzos and alcohol display 6.
Changing the Clinical Landscape: The CBD Revolution
Unlike benzodiazepines, which have since become an unfortunate staple of psychiatric care in the modern world, cannabis (and CBD rich products in particular) lack the abuse and potential for dependency/addiction that benzos carry 7. In fact, patients are readily using cannabis as an alternative treatment for a variety of mood disorders ranging from depression and PTSD to generalized anxiety disorder (GAD) and ADHD, however, with varying degrees of efficacy 8–11.
Successfully Treating Stress and Anxiety With Cannabis Will Take More Research
Cannabis is an extremely diverse plant medicine that is composed of over a hundred cannabinoids and several times as many terpenes 12. Not all strains and formulations are considered optimal for treating anxiety. Indeed, there is even evidence that some products can cause anxiety and patients predisposed to psychotic behavior may be at even greater risk 2. Nonetheless, prime anxiolytic targets, such as CBD, have been successfully identified and are used daily by millions for relief from anxiety and general depression along with pain, seizure control and sleep disorders 13,14.
Looking Ahead to the Shifting Clinical Landscape of Stress and Anxiety Treatment
While further research is necessary to elucidate the exact mechanisms by which patients derive anxiety relief from cannabis, this author believes the therapeutic index and safety profile of cannabis warrant its use over more addictive and potentially harmful pharmaceutical drugs in the treatment of anxiety. As the use and sale of legal CBD products increases, it will be interesting to note how the clinical landscape in the treatment of the most prevalent mood disorder shifts.
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Works Cited
1. Bandelow, B. & Michaelis, S. Epidemiology of anxiety disorders in the 21st century. Dialogues Clin. Neurosci. 17, 327–335 (2015).
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3. Antianxiety effect of cannabis: involvement of central benzodiazepine receptors. – PubMed – NCBI. Available at: https://www.ncbi.nlm.nih.gov/pubmed/3002503. (Accessed: 19th April 2019)
4. Emerson, S. Marijuana-Induced Anxiety Is Weed Culture’s Bigfoot. Motherboard (2017).
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9. Cooper, R. E. et al. Cannabinoids in attention-deficit/hyperactivity disorder: A randomised-controlled trial. Eur. Neuropsychopharmacol. J. Eur. Coll. Neuropsychopharmacol. 27, 795–808 (2017).
10. Yarnell, S. The Use of Medicinal Marijuana for Posttraumatic Stress Disorder: A Review of the Current Literature. Prim. Care Companion CNS Disord. 17, (2015).
11. Cannabidiol as a Potential Treatment for Anxiety Disorders. Available at: https://www-ncbi-nlm-nih-gov.ezproxy.rush.edu/pmc/articles/PMC4604171/. (Accessed: 12th January 2019)
12. Russo, E. B. Taming THC: potential cannabis synergy and phytocannabinoid-terpenoid entourage effects. Br. J. Pharmacol. 163, 1344–1364 (2011).
13. Corroon, J. M., Mischley, L. K. & Sexton, M. Cannabis as a substitute for prescription drugs – a cross-sectional study. J. Pain Res. 10, 989–998 (2017).
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