When it comes to anxiety, does cannabis help or hurt? SWEET JANE asks a few experts for their take on the topic.
You take a marijuana edible or a couple hits of a joint, and you feel relaxed, relieved of any stress and anxiety you may have been feeling that day. You’re chilling. However, a friend of yours takes the same dose and they grow anxious, paranoid. They are a ball of worry and nerves–and decidedly not chilling.
Why does the exact same type and quantity of cannabis affect two people differently? And what does that mean if you’re using marijuana to get anxiety relief?
That question is particularly relevant in these anxious times, when many of us are learning to accept a new normal with the existence of the coronavirus pandemic. In states with legal cannabis, dispensaries largely remain open, as most states consider them essential businesses.
However, the answer to why cannabis may relieve anxiety in some while causing it in others isn’t easy to come by. One reason is that, in America, marijuana remains federally illegal, making it difficult for researchers to study. Another factor is the nature of the plant itself.
The Human/Plant Interaction
“There’s a very human interaction between this most human of plants and us,” says Dr. Jack McCue, a Portland-based medical cannabis consultant who served as medical editor of the 2017 book Cannabis Pharmacy. “It’s not predictable from one day to the next, one cultivar to the next. It could be the same plant under different growing conditions. It’s infinitely complicated.”
McCue surmises that consumers who report feeling less anxious from marijuana may actually be experiencing something else: stress relief. Stress often makes people anxious, and the pleasurable, euphoric effects of weed may alleviate that.
“Or they’re getting pain relief and that’s making them less anxious,” McCue says. “Or they’re sleeping better and that’s making them less likely to be anxious.”
The ritualistic aspect of consuming cannabis may also contribute to its relaxing effects, he asserts.
“Rolling a joint, dipping in your stash, deciding which strain you’re going to [consume] this time, lighting up, inhaling, smelling smoke — it’s a ritual that’s similar to sitting down and having a Coke and just chilling out,” he says.
Using cannabis is also often a social activity, he points out “You’re passing a joint around, hanging out with people, talking, which is a nice way to reduce stress to and make you less anxious,” McCue says.
Research on the link between marijuana and anxiety has been slowly emerging in recent years. For instance, a January study in the Journal of Cannabis Research found anxiety, along with paranoia, to be among the most common adverse reactions to cannabis. Panic attacks were found to occur less often but were rated by study participants as one of the most distressing side effects.
Frequency + Expectations
However, according to one of the study’s authors, Washington State University researcher Carrie Cuttler, “It’s difficult to predict who’s going to experience these reactions and how adverse the reactions are going to be.”
The study did find those most likely to have negative side effects in general were people who consume less frequently, did it to fit in with peers, showed symptoms of cannabis consumption disorder, or had sensitivity to anxiety. Cuttler was also involved in a 2018 study, published in the Journal of Affective Disorders, that found cannabis reduced anxiety and stress by 58% in participants immediately after consumption. But the researchers were unable to determine what exactly predicted that relief.
“It’s pretty difficult to say why some people experience heightened anxiety and why other people experience anxiety relief,” Cuttler says. She sometimes wonders whether a person’s expectations before they [consume] marijuana affects how they experience the drug. Cuttler thinks it is probably not a good idea to consume cannabis if you’re worried about becoming paranoid. She hopes to one day study that.
THC dosages may play a role in anxiety, according to a 2017 study in the journal Drug and Alcohol Dependence. In this study, cannabis with lower doses of THC relieves stress while higher doses increases negative emotions. But there are other factors to consider, according to Harriet De Wit, a professor of psychiatry and behavioral neuroscience at the University of Chicago.
“It’s also related to the amount of prior [consumption]. People become tolerant to THC,” she says “It’s really unpredictable. From occasion to occasion, we can’t always predict how the drug will affect people … it could be their preexisting mood, what they’ve consumed in the last five days.”
De Wit also wonders if people who report anxiety relief, experienced that anxiety in the first place because they were having a mild withdrawal of sorts related to their previous cannabis consumption; and she hypothesizes that marijuana’s sedative-like effects — how it makes people sleepy, for instance — might mask any anxious feelings.
Given all the uncertainties that still exist regarding the science on cannabis and anxiety, what should consumers do to make sure they experience the effects they desire?
“There’s not really a one-size-fits-all approach for anxiety,” says Kevin Harbison, district manager for the Verilife marijuana dispensaries in New York and Pennsylvania and a pharmacist by training. “A lot of it depends on what the patient has been doing up to this point, whether they’re familiar with cannabis or cannabis-naive, or what meds they might be taking.”
Harbison generally advises people seeking anxiety relief to start with CBD, or cannabidiol, a cannabis ingredient that doesn’t have the intoxicating effects of THC. CBD may help with anxiety when consumed in low doses, on a maintenance level, whereas THC is more of a “quick-fix” option.
“Finding the right balance is key,” he added. “But it’s trial and error. There’s no specific playbook.”
Photograph by Tonik via Unsplash