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Could Cannabis Eventually Replace Anti-Anxiety Medications?

October 10, 2017
(Martin Dimitrov/iStock)
A recent study thought to be the first of its kind has found that regular cannabis use may make a person less prone to anxiety over time, even when sober.

The study, published in the medical journal Psychopharmacology, found that people who use cannabis daily or almost daily had a blunted stress reaction when exposed to a high-stress situation after a period of abstinence from marijuana. While non-cannabis users reported feeling anxious and experienced elevated levels of the stress hormone cortisol when stressed, chronic cannabis users reported lower levels of anxiety, and their cortisol levels remained the same under high stress as they they were under no stress.

“The potential effects of cannabis on stress do appear to extend beyond the period of intoxication.”
Dr. Carrie Cuttler, study co-author

The research involved 40 people who had used cannabis chronically over the previous year and 42 people who’d used cannabis no more than 10 times in their lives and not at all in the previous year. All participants abstained from using cannabis from 12 to 18 hours prior to the study.

“Based on our findings, the potential effects of cannabis on stress do appear to extend beyond the period of intoxication,” Dr. Carrie Cuttler, a researcher and clinical assistant professor at Washington State University and co-author of the study, told Leafly.

“But,” she cautions, “We’re not yet comfortable saying whether that muted stress response is a good thing or a bad thing.”


Cannabis and Post-Traumatic Stress Disorder (PTSD)

We do know that too much cortisol is definitely a bad thing. It’s been associated with everything from anxiety and depression to digestive issues, heart disease, insomnia and memory problems. But too little cortisol can also be problematic, since the hormone helps us tap into stored energy and respond appropriately to stressful situations.

Cuttler says further research is needed to determine whether the lowered cortisol response exhibited by chronic cannabis users is ultimately therapeutic or detrimental when it comes to managing anxiety long-term. She adds that they did, however, make a promising finding regarding cannabis and dependency.

“We looked at the withdrawal symptoms of chronic users to see if they experienced heightened levels of and cannabis cravings when stressed,” she reveals, “and surprisingly, we didn’t find any evidence that they did.”

Anxiety disorders are the most common mental illness in the US. An estimated 40 million American adults, or just over 18% of the population, are affected by anxiety disorders every year.

Benzodiazepines like Xanax and Klonopin are often prescribed for short-term relief from acute anxiety and panic attacks. While they’re incredibly effective in the short term, side effects can include fatigue, confusion, and disorientation, and tolerance and dependency can develop quickly — in 2015, over 8,000 Americans died by overdosing on benzodiazepines.

Selective serotonin reuptake inhibitors (SSRIs) like Prozac and Zoloft are often prescribed for long-term relief from anxiety disorders, but they come with their own long lists of potential negative side effects ranging from insomnia and drowsiness to headaches, low libido, and increased risk of suicidal thoughts.

Anxiety is also among the most commonly cited reasons for cannabis use, and research suggests that it has relatively few negative side effects, low potential for addiction and virtually no risk for an overdose. But because it remains classified as a schedule 1 drug at the federal level, little research has been done to investigate the long-term therapeutic potential of cannabis to treat anxiety—until Cuttler’s recent study.


Here’s What the National Academy’s Medical Cannabis Report Actually Says

Next, Cuttler and her colleagues plan to repeat the study with a longer period of cannabis abstinence to see whether their findings still hold true. They also eventually hope to replicate the study with rats to confirm their findings.

“One of the limitations of this research is that we can’t ethically manipulate who uses cannabis daily and who does not,” Cuttler explains. “So while our research indicates that they have a blunted stress response, it could be that people who are already less prone to stress are also more prone to being chronic cannabis users. With rats, we can manipulate both stress and cannabis.”

Another recent study published in Pharmacological Research found that cannabidiol (CBD) may enhance the efficacy of the neurotransmitter GABA, which works to counteract and calm the chemicals triggered by cortisol in the brain’s anxiety response, like glucose. While high doses of THC actually have the potential to cause increased anxiety, CBD is non-intoxicating, so it doesn’t carry the same same risk.


Why Does Cannabis Cause Paranoia in Some But Helps Anxiety in Others?

While all of this emerging research is promising, Cuttler emphasizes that when it comes to anxiety, neither marijuana nor pharmaceuticals should ever be the first course of treatment.

“As a psychologist, I believe Cognitive Behavioral Therapy (CBT) is the ideal treatment for anxiety,” she says. “In the short term, anti-anxiety meds and CBT have equivalent outcomes, but long-term, the effects of eight to 10 CBT sessions outlast those of medications without any of the negative side effects. I see cannabis the same way — it may help treat the symptoms of anxiety, but it won’t address the root cause.”

Kristina Marusic's Bio Image

Kristina Marusic

Kristina Marusic is a journalist focusing on LGBT equality, social and environmental justice, and politics. Her work has appeared in the Washington Post, Slate, Vice, and other national publications.

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  • Kenny Hotz

    It is pretty hard to OD on Benzo’s. They fail to mention that 99.9999% of the benzo deaths were paired with opioids and opiods alone are far easier to OD on. CBD and CBG is awesome for anxiety, not pot in general. Not sure why they didnt include peopel with actual anxiety/panic disorders in this very small trial because THC has the opposite effect on me. I’m not against legal pot at all but 1 hit from this 20-30% THC, no CBD stuff sends me into fight or flight. I am not alone in this reaction and it happens to people who dont have a disorder at all.

    • justadbeer

      Yes, different strains have different experiences. You are not alone at all. Find a product that works for you. It’s not always about the THC. Maybe something with low THC and a one-to-one CBD/THC ratio. On another note, a study of only 40 people will get little attention from anyone.

      • Kenny Hotz

        Thanks I do have go to strains that are low THC, high CBD. Pot is 90+ drugs though, not just one, and they speak of it as if it is.

        • justadbeer

          Yeah. Your right. It is a wonder drug though. The wife was in and out of the hospital a total of over 400 days in a two year period. Had her on everything they could think of. Chemos of various types failed. Finally my kid and I convinced her to try RSO. She hasn’t had a hospital visit in a year.

          • Bramael gnome

            Marijuana saves lives, you got that right!

            Here’s to many more years without hospital visits, take care.

          • Kenny Hotz

            Glad to hear it. I make RSO for people and it helps them a lot. I have to stick to CBD isolate or very low THC strains. I am always glad to hear it helping someone though.

    • Joseph Muhammad

      Benzos fuck up your system. They are garbage.

      • Kenny Hotz

        I never said anything different from that. My comment was on the ability to OD on benzos alone.

    • Allie

      It is not THAT difficult to OD on benzos, though you are right that a combination of opiates and benzodiazepines are a big problem.
      I don’t think your percentage is quite right, but you make a good point that benzodiazepines are not in the same category as opiate pain relievers. Benzos on their own, prescribed by a doctor, are far less likely to cause major harm – the combination of opiates and benzos is much more likely to cause an accidental overdose. Also, it is easy to OD on benzos if you are attempting to OD on benzos. They can be addictive. I use them anyway because I am healthier with than with out. MMJ has helped me with lots of things, but not my high levels of anxiety. Just as there’s no single antidepressant that works for everybody, no one medication or substance works the same for everyone.

      The larger problem with benzos is that they are much more likely to kill from withdrawal – it is as dangerous as a very heavy drinker quitting alcohol cold turkey. Seizures and other potentially harmful reactions can cause severe damage if not outright death. Benzo withdrawal can be filled with terrible pain and suffering. That is one similarity they have to opiates.

      Again, they have their place. None of this is ideal; nothing fixes everything for everyone. We will always have people suffering. I can’t imagine cannabis as a total and complete replacement for anti-anxiety meds, but it’s an option for some people. Giving patients choices – that is the best thing happening!

  • Barbara Baldwin

    Do you really think pharma is going to let that happen?

    • sunsetair

      they will do everything in their power against it. At the same time, the government is salivating for all the million of dollars of new tax revenues.

      • Lucy Daniels

        True, they will let it happen, but I feel the taxes and charges will be too high for some growers and consumers. The government isn’t interested in offering natural and beneficial health care products to the public here, they want to make sure that if anyone is making money on marijuana its them. Which is why we need to be up to date, fully informed and legally aware of whats happening at all times.I have seen many people get into trouble just because they didn’t have the proper papers or a medical card on them which is easy enough to get online and saves you a lot of hassle with the authorities. Moreover you are allowed to grow your own plants, which is something we all should start doing so that we are not so dependent on anyone or any government agencies in the future.

        • sunsetair

          @disqus_SuRVDLoo8Z:disqus Looking at slowly maturing areas, e.g. Washington state, Nevada, etc, it is getting clear that growers will be huge volume small profit per shipment. Where the add on service providers, that produce the oils, wax, edibles etc will be lower volume but much higher profit margin. If you walk into stores, you find the cannabis buds, even the pre-rolled , are inexpensive. Growing your own will give you a little edge over price, but even with tax on them, pretty much meets or below the street price. I rather pay tax and have the product controlled for ingredient and safety and be legal, than who knows what I get on the street and also be illegal. Also, you can’t compete with the variety of strains you see in the stores with home grown few plants. That said, as long growing home is legal, it is fun to have your own baby. 🙂

  • Beegowl

    Cannabis moves my thinking from dark pessimism to realistic pragmatism. I micro-dose using an anti-anxiety strain, suggested by the bud tender, to enhance my daily 5 mile walking regimen (I’m retired) as it not only helps me appreciate the surrounding beauty of the natural world as I walk, but also helps me to solve problems without the hand wringing. My reading of the literature suggests that it creates new neural pathways and has an impact on other brain functions, disrupting the anxiety and giving me insight into both my physical surroundings and my mental state. This certainly needs more formal research. I quit using both alcohol and cannabis nearly 40 years ago. After suffering a 16 month depression and taking several different prescribed drugs in an effort to alleviate the symptoms (the drugs didn’t work well and caused negative side effects), I emerged from that dark period vowing never to experience it again. In my determination to defeat anxiety and depression, I decided to begin experimenting with cannabis, this time for serious reasons. It works for me and the side effects are, in my opinion, quite positive.

  • ragnarb

    I’m a huge believer in Cognitive Behavioral Therapy also, but good luck finding a therapist that actually practices it, and if so, properly. My daughter, who really requires CBT started self medicating with pot. The rule in my household was/is no pot until you finish school, so her acquaintance with it started after high school. As a result, her use of it was beyond just getting high.She is very particular about the strains she uses. My only issue is that it has kept her from seeking proper therapy. As to CBD; I have replaced my pain meds with CBD tincture made for me from marijuana, not hemp. It has been a G-Dsend. It is a fantastic anti-inflammatory, and look forward to seeing the acceptance it deserves.

    • Bramael gnome

      I am currently using both CBD’S and CBT for PTSD symptoms. I believe the two together are powerful tools, I also suggest that MMJ places you in the most effective state to quickly assimilate CBT routines into your psychy. These are my experiences and I’d love to see if It’s true for others. I live in Canada and have had access to CBT information for over a decade. Everyone needs too be aware of it, even if it’s to check off what they’re doing right.

      Take care

  • George

    AnnCannMed has extremely potent products at good prices too. I use their CBD Rich pills to help with my anxiety and it works wonders! Recommend this company to anyone looking at Cannabis for help!

    • Samantha Cook

      The website is a neat one. Very good company by the way. Cbd Rich oil has literally changed my life. I experience severe chronic pain because of disability. Cbd rich oil came to my rescue. I was able to abandon some strong opiates, and my health is doing just fine. I can recommend enough of this. Highly recommend!

      • Marie33

        Hi there, glad to hear Cbd Oil helped your pain. I take Cannabis Oil w /without Thc I get from a dispensary. It has not helped with my nerve pain and its very expensive. Can I ask what type of “severe chronic pain” you suffer with? You sound like me. I would love to abandon Lyrica. What kind of Cbd Rich oil do you take that has changed your life? Would love to try some..
        Desperate in NY. Thanks…

  • jdisano

    Is there a recommended edible or tincture? Anxiety is a big problem.

  • Silverado

    With Big Pharma making nothing?? Surely you jest young lady. It ain’t gonna happen. It’s not about helping or making someone feel better as much as for them, it’s ALL about control and MONEY.

  • Rina Angeles

    Cannabis has the potential to replace meds and hopefully has far fewer side effects. You just need to find the right strain and dosage. Find a good doctor to guide you. I’d recommend the doctors at onlinemedicalcard

  • handytrim

    Just because CBT is successful for some people it doesn’t necessarily mean it is going to work for everybody. I for one found early sessions to have the complete opposite of the intended outcome. I became more depressed and anxious. Subsequent treatments have had some degree of success but my circumstance hasn’t changed so I often slip back into the same negative cycles that CBT is supposed to help break.

    I also attest to the benefits of cannabis but because I live in a country that still refuses to acknowledge the medicinal benefits of cannabis and will only allow Sativex (cannabis medication!?!) to treat MS spasticity, I am reduced to using unknown strains of varying quality and active compound content. It can be all too easy to consume far too much THC and little CBD and make my anxiety worse. CBD is available (recognised as a medicine by our medical association but still not by the government) but it’s like the wild west and everybody is selling their version of this ‘new’ and wondrous ‘snake-oil’ at ridiculous prices with little to no control and regulation of those products.

    Meanwhile my doctor continues to prescribe various pharmaceuticals that more often than not do more harm than good. Like plugging a hole in a leaky ship with dynamite.

  • odinsleep

    it already is being used for this and has been for decades.
    many people with anxiety disorder use it to self medicate.
    Big Pharma does not like this as it cuts into their billion dollar profits.