To many, medical cannabis is like a pharmacological panacea – a wonder drug which seems to cure any condition. New research is showing that illnesses like epilepsy, PTSD, and disorders involving sleep and appetite can potentially be treated by using this magical plant.
Interestingly, one qualifying symptom to be prescribed medicinal marijuana is anxiety, which affects 1 in 10 people in North America, Western Europe, Australia, and New Zealand. In fact, anxiety is often one of the primary motivators that cause people to turn to cannabis, with studies showing that nearly a third of people who use marijuana do so to reduce anxiety or stress.
Though for some, the thought of using cannabis to treat anxiety may be somewhat confusing.
Many will argue that having a puff of marijuana is a surefire way to induce anxiety, not cure it. And as we've recently seen in Colorado, this is precisely what's happening. More people are being hospitalized for cannabis use, and they're often reporting heightened anxiety and intoxication.
So why does cannabis mellow out some people, while making others paranoid or anxious?
Let's find out.
THC & Me
Marijuana is often used to self-medicate anxiety symptoms, while anxiety is also a prevalent symptom of marijuana use. Understandably, this can be quite confusing to wrap your head around.
However, if you've suffered from anxiety and had a negative experience with cannabis in the past, don't rule the plant out entirely just yet.
The most common reason for a cannabis freak out is typically because that person has just had too much THC – which is also why there's been an increase in cannabis-related hospitalizations recorded in jursidictions where the drug has been legalized.
Most cases of people ending up in the emergency room have been reported to be the result of eating too many edibles. It's believed that due to their slower onset of effects, new cannabis users will end up eating too many edibles as they wait for the effects to come on, before being hit by a tsunami of THC.
THC stands for tetrahydrocannabinol, and is the active compound in marijuana that gets users high. When consumed, cannabinoids like THC bind to receptors in the brain, many of which can be found in the amygdala. This can lead to problems, as the primary function of the amygdala is fear processing.
When we are exposed to something considered scary or dangerous, information about that phenomenon is sent to the amygdala, which then alerts the fight or flight response in our hypothalamus. A fight or flight response typically involves a heightened heart rate and respiration, which can make many people feel anxious.
When you ingest THC, it can trigger the amygdala into behaving in specific ways. Although —given the federal illegality of the drug—we still arent 100% sure how THC interacts with our brains.
Some researchers believe that the level of anxiety you have in your daily life plays a significant role in whether or not cannabis will exacerbate your nerves. If you're a naturally anxious person, that may worsen the effects felt from cannabis.
This is then coupled with how familiar you are with cannabis, as many believe that if you are newer to ingesting cannabis, the THC from the plant can over-stimulate neural pathways and lead to heightened anxiety and paranoia. If you use the drug over a more extended period, THC will have a lessened effect on your neural pathways and lead to a more subtle experience.
Though obviously if cannabis makes you feel anxious, then you won't want to endure this over several occasions to familiarise yourself with the compound to minimize these effects.
Another alternative is microdosing, which may allow users to achieve some of the benefits of marijuana while sidestepping the adverse effects. This view was somewhat confirmed—although more research is still required—by a study performed at the UIC College of Medicine, which involved administering differing doses of THC to volunteers and placing them into stressful scenarios.
The volunteers were then asked to report their stress levels, after undergoing a series of activities such as a mock job interview, a game of solitaire and a small speech about their favorite book or movie to the lab assistants.
The group given the lower dose of THC reported the lowest stress levels after the test, and their stress levels also dissipated the fastest of any group.
Meanwhile, the group who received a larger dose of THC reported that their mood worsened significantly during the challenges, describing the tasks as "challenging" and "threatening."
For those that have had negative cannabis experiences or who are prone to anxiety, starting with a smaller dose may be the best path forward. This way, any adverse effects felt will be minimized and more easily manageable.
Though one recent study from Western University in Ontario reveals that the dose and the regularity of cannabis use may not be as big a deal as many believe. The study was performed on rats and revealed that the "divergent psychological effects" felt by cannabis users could actually be the result of genetics.
The study shows that certain parts of the brain are more sensitive to THC and can yield different results. If it's the front of your brain that's sensitive to THC, known as the anterior region, consuming marijuana will generate positive effects, including reduced anxiety.
If it's the back of the brain, known as the posterior region that's most sensitive to THC, you're likely to experience heightened paranoia and anxiety.
As you can see, there are many small studies with differing results on cannabis use and anxiety. However, this recent study may help explain why some people swear by the healing effects of medicinal marijuana, while others are ending up in the emergency room having a panic attack.
The science around THC and the effect it has on our brains is far from conclusive, and at this point some of it is even contradictory. Do you consume cannabis in lower doses, or do you consume it more often? Is it unfamiliarity which makes you nervous when trying cannabis, or is your brain just not wired to respond positively to the plant?
Unfortunately, as studies are limited, the only way to find out is through experimentation. Speak to your doctor about your symptoms and come up with a medication that's just right for you. This might involve considering different strains as well.
Certain marijuana strains have been linked to reduced stress and anxiety, such as Bubba Kush or Skywalker OG Kush, while others have been linked to worsening anxiety symptoms like Tangerine Dream or CBD Shark.
Each strain has a different composition, with different cannabinoids and varying levels of THC, CBD, and different terpenes present. Certain terpenes, like limonene, linalool, and beta-caryophyllene have each been known to provide soothing effects to users, which may be another important factor for consideration when choosing a strain.
Though you should remember, the reason why people are ending up in the hospital from their edibles is that they're ingesting too much THC. If you're unsure, then you may want to ask your doctor for a particular strain, or cannabis oil that is relatively low in THC and high in CBD.
While CBD is a cannabinoid much like THC, you won't get high from consuming it, and early evidence shows that it may be effective in tackling anxiety. A small 2010 study found that cannabidiol (CBD) could improve symptoms of social anxiety disorder (SAD) by changing the blood flow to the regions of the brain linked to feelings of anxiety.
Other animal studies, such as one published in 2014, found that CBD oil had anti-anxiety and antidepressant effects. And, because CBD can be derived from hemp plants—which are federally legal in the US—CBD products are much more accessible to the general public, while studies are becoming easier to perform.
On top of this, more anecdotal evidence has emerged regarding the calming effects of CBD from high-profile individuals who have publicly come out in favor of the compound. One of these testimonials came from beloved actor, Tom Hanks, who replaced his current pharmaceutical pills with CBD capsules:
"The first time I ever tried CBD was to help soothe my anxiety. I was fed up with taking various pills to try and make me 'better'… It wasn't how I wanted to live my life anymore. So I gave CBD oil a try. It was a huge relief for me to feel like myself, yet the edge was gone," Hanks said.
It's clear there are soothing benefits to cannabis. However, it may require some trial and error to achieve them. The key is to start low and go slow. Have regular conversations with your doctor about how you're feeling and trial different doses, strains, and ingestion methods.
It can also be helpful to write down your experiences with each method of ingestion, for example: "I felt more relaxed after three inhalations of Bubba Kush, but more anxious after that."
After a while, you'll start to find a dose, strain, and method of ingestion that's just right for you.
You'll no longer be curled up on the ground trying to dial 911 while your friends are all laughing as they watch 'Pineapple Express'. Soon you might even be laughing with them.