Is marijuana an effective treatment for anxiety?

From the Guidelines

Marijuana is not recommended as a first-line treatment for anxiety due to its potential to worsen anxiety in some individuals and its associated risks of dependence, cognitive effects, and legal issues. While some users report temporary relief from anxiety symptoms when using cannabis, particularly strains high in CBD and lower in THC, research shows mixed results 1. For anxiety treatment, it's better to start with evidence-based approaches like cognitive behavioral therapy, mindfulness practices, and if needed, medications such as SSRIs (like sertraline 50-200mg daily) or benzodiazepines (like lorazepam 0.5-2mg as needed) under medical supervision.

Some key points to consider:

• Limited available evidence suggests that older adults who use cannabis may be at higher risk for behavioral health issues, including anxiety and depression 1.
• Cannabis use may have a deleterious effect on adolescent brain development and well-being, and is associated with conditions that include neuropsychological and neurodevelopmental decline, elevated risk for psychotic disorders in adulthood, higher risk for later depression, and suicidal ideation or behavior 1.
• Cannabis carries risks of dependence, cognitive effects, and legal issues in many places, and its use may impair one’s ability to drive because it affects reaction time and coordination 1.
• If considering marijuana for anxiety, it's essential to consult with a healthcare provider first, start with low doses of CBD-dominant products if appropriate, and monitor your response carefully 1.

Overall, while marijuana may provide temporary relief for some individuals with anxiety, its potential risks and lack of standardization make it a less desirable treatment option compared to evidence-based approaches.

From the Research

Marijuana and Anxiety

• The effectiveness of marijuana as a treatment for anxiety is a topic of ongoing research and debate 2, 3, 4, 5, 6.
• Some studies suggest that cannabidiol (CBD), a non-psychoactive compound found in marijuana, may have anxiolytic effects in healthy volunteers and clinical populations 2, 3.
• However, the current evidence is insufficient to support CBD as a first-line treatment for anxiety, and more research is needed to fully understand its effects 2, 3, 4.
• The use of THC-dominant products for anxiety is also ambiguous, with some individuals experiencing relief and others experiencing exacerbation of anxiety symptoms 2, 3.
• THC can also impair driving and cognitive function, highlighting the need for caution when using marijuana for anxiety treatment 2.
• A systematic review of controlled trials found insufficient evidence to support the use of cannabinoids for managing affective disorders, anxiety disorders, or PTSD 3.
• Survey data suggests that cannabis may be effective in reducing anxiety, but clinical trials have yielded equivocal findings 4.
• The interaction between CBD and other medications, such as citalopram, is also an area of concern, with potential for increased adverse events 5.
• Overall, while some studies suggest that marijuana may have anxiolytic effects, the current evidence is not sufficient to support its use as a treatment for anxiety, and more research is needed to fully understand its effects 2, 3, 4, 5, 6.

Key Findings

• CBD may have anxiolytic effects in healthy volunteers and clinical populations 2, 3.
• THC-dominant products may exacerbate anxiety symptoms in some individuals 2, 3.
• The interaction between CBD and other medications, such as citalopram, is an area of concern 5.
• Survey data suggests that cannabis may be effective in reducing anxiety, but clinical trials have yielded equivocal findings 4.
• More research is needed to fully understand the effects of marijuana on anxiety 2, 3, 4, 5, 6.

Study Limitations

• Many studies have small sample sizes and methodological flaws 3, 4.
• The current evidence is insufficient to support the use of cannabinoids for managing affective disorders, anxiety disorders, or PTSD 3.
• More high-quality clinical trials are needed to fully understand the effects of marijuana on anxiety 2, 3, 4, 5, 6.