With so many negative side effects associated with pharmaceutical treatments, predictably, many Americans have opted to self-medicate with other substances (like cannabis).
As the U.S. marches forward with an increasing number of states legalizing medical marijuana, recreational adult-use, or both, there has been renewed interest in the relationship between cannabis and anxiety. Clearly, a significant percentage of canna-consumers use cannabis to self-medicate for anxiety. Likewise, many people have had a bad experience with cannabis and found that it induced anxiety, or perhaps even a panic attack.
So, what do scientists (and the science) say about cannabis and anxiety? Dr. Ethan Russo, the neurologist who identified and coined the term, “the entourage effect,” wrote about the potential antianxiety effects of cannabis in the book, Cannabinoids as Therapeutics (edited by Dr. Raphael Mechoulam). Russo noted that in India — as far back as 1500 B.C. — cannabis was credited for helping alleviate anxiety and depression. More recently, in 1860, the Ohio State Medical Committee on Cannabis stated: "As a calmative and hypnotic, in all forms of nervous inquietude and cerebral excitement, it will be found an invaluable agent, as it produces none of those functional derangement or sequences that render many of the more customary remedies objectionable.”
No doubt, many people consume cannabis to relax, unwind, and alleviate stress, and there’s nothing wrong with that. Studies of THC (the primary psychoactive constituent and a CB1 receptor agonist) — and, CBD (the primary non-psychoactive constituent and CB1 antagonist) suggest that in acute administration, both can produce antianxiety effects. But, as mentioned, high doses of THC can induce anxiety, even panic attacks.
While consuming a THC-rich cannabis strain to occasionally reduce anxiety may be relatively benign, and possibly beneficial, given the psychotropic properties of THC, few medical practitioners would support the use of high-THC cannabis to treat chronic anxiety. (Of course, no responsible physician should recommend most anti-anxiety drugs for long-term use, given the potential of developing a use disorder.) Irrespective of what substance someone takes to treat anxiety, use should be short-term or occasional so as to avoid potential dependency issues. Likewise, just because cannabis is more benign and less addictive than alcohol, nicotine or other drugs, doesn’t mean it’s completely devoid of risk. Are there any substances that are totally risk-free?