From the Guidelines
Cannabis is not a safe and effective treatment for any psychiatric condition due to its potential to worsen psychiatric symptoms and increase the risk of psychosis, particularly in individuals with a personal or family history of psychotic disorders. The evidence from recent studies, such as the 2024 position paper from the American College of Physicians 1, highlights the potential health risks associated with cannabis use, including mental health problems, chronic respiratory issues, and cardiovascular events. While some studies may suggest potential benefits of cannabis for certain psychiatric conditions, the evidence is limited and inconsistent, and the risks associated with its use cannot be ignored.
The active compounds in cannabis, particularly THC, can trigger anxiety, paranoia, or psychosis in some individuals, and regular use can lead to dependence and cognitive impairments. Furthermore, the composition of medical-grade cannabis products can vary widely, making dosing unpredictable and increasing the risk of adverse effects. Established psychiatric treatments, such as FDA-approved medications and psychotherapy, have stronger evidence bases and should be considered first-line approaches.
Key points to consider when evaluating the use of cannabis for psychiatric conditions include:
- The potential for cannabis to worsen psychiatric symptoms, particularly in individuals with a personal or family history of psychotic disorders 1
- The risks of dependence and cognitive impairments associated with regular cannabis use
- The variability in composition of medical-grade cannabis products, which can make dosing unpredictable
- The availability of established psychiatric treatments with stronger evidence bases, such as FDA-approved medications and psychotherapy.
In light of these considerations, it is recommended that individuals with psychiatric conditions consult with a healthcare provider to discuss potential risks, benefits, and alternatives based on their specific condition and medical history, rather than relying on cannabis as a treatment option.
From the Research
Effectiveness of Cannabis as a Treatment for Psychiatric Conditions
- The relationship between cannabis use and mental health is complex, with studies reporting both positive and negative treatment outcomes 2.
- Cannabis-based medications, including THC and CBD, have shown promise in improving symptoms of mental disorders, but not necessarily leading to remission 3.
- The evidence for cannabis's treatment efficacy varies widely across different conditions, with some studies suggesting it may be effective in treating chronic pain, epilepsy, and post-traumatic stress disorder (PTSD) 4, 5.
Safety of Cannabis as a Treatment for Psychiatric Conditions
- Negative clinical outcomes associated with cannabis use are often related to delta-9-tetrahydrocannabinol (d9-THC) exposure, while non-intoxicating cannabinoids like cannabidiol (CBD) may have a more favorable safety profile 2.
- Side effects of cannabis-based medications have been reported, but severe adverse effects are relatively rare 3.
- Cannabis use has been associated with increased severity of psychotic symptoms and the risk of acute agitation and aggressive behavior in some studies 6.
Individual Factors Influencing Cannabis-Related Outcomes
- Youth and individuals with a family history or genetic liability for psychiatric disorders may be at higher risk for negative outcomes associated with cannabis use 2.
- More research is needed to fully understand the unique effects of cannabis use related to sex and older age 2.
- The level of evidence for the use of medical cannabis among people with disabilities varies greatly, with a clear lack of methodologically sound studies 5.