From the Guidelines
Chronic cannabis use is associated with fatigue, as evidenced by significant clinical toxicities, including fatigue, reported in a 2024 guideline by the Journal of Clinical Oncology 1. Regular, long-term cannabis users commonly report experiencing fatigue, lethargy, and decreased energy levels. This association appears stronger with heavy use patterns and may worsen with higher THC concentrations. Some key points to consider include:
- The fatigue effect typically develops gradually over time with continued use
- The mechanism involves THC's impact on brain regions controlling motivation and energy regulation, particularly the dopamine reward system
- Cannabis can disrupt sleep architecture by reducing REM sleep, leading to poor sleep quality despite longer sleep duration
- Cannabis use can also affect mitochondrial function, potentially reducing cellular energy production To manage cannabis-related fatigue, the following strategies may be helpful:
- Reducing consumption frequency
- Choosing lower-THC products
- Taking tolerance breaks
- Maintaining good sleep hygiene
- Staying physically active It is essential to weigh the potential benefits of cannabis use against the risks of fatigue and other clinical toxicities, as noted in the 2024 guideline 1.
From the Research
Chronic Cannabis Use and Fatigue
- The relationship between chronic cannabis use and fatigue is complex, with some studies suggesting that cannabis use can decrease fatigue, while others indicate that it may contribute to fatigue in certain individuals 2, 3, 4.
- A study published in 2022 found that 91.94% of people experienced decreased fatigue following cannabis consumption, with an average symptom intensity reduction of 3.48 points on a 0-10 visual analog scale 2.
- However, another study published in 2014 noted that frequent and prolonged use of cannabis can be detrimental to both mental and physical health, including mood disorders, exacerbation of psychotic disorders, and neurocognitive impairments, which may contribute to fatigue 3.
- A 2011 review of the adverse effects of cannabis found that the most frequently reported adverse effects include mental slowness, impaired reaction times, and accentuation of anxiety, which may also contribute to fatigue 4.
- In contrast, a 2024 study found that chronic cannabidiol (CBD) administration mitigated excessive daytime sleepiness and fatigue in patients with primary hypertension, suggesting that CBD may have a positive effect on fatigue 5.
- Another 2024 study found no longitudinal associations between cannabis use and cognitive impairment, including fatigue, in a clinical sample of middle-aged adults using cannabis for medical symptoms 6.
Factors Influencing the Relationship Between Cannabis Use and Fatigue
- The magnitude of the effect of cannabis on fatigue and the extent of side effects experienced likely vary with individuals' metabolic states and the synergistic chemotypic properties of the plant 2.
- The method of cannabis consumption, such as smoking or vaping, may also influence the relationship between cannabis use and fatigue 2.
- Individual differences in cannabis use patterns, such as frequency and duration of use, may also play a role in the development of fatigue 3, 4.
- The presence of underlying medical conditions, such as primary hypertension, may also influence the relationship between cannabis use and fatigue 5.