Exploring the Evidence: Cannabis and Mental Health Treatment
Written on
Chapter 1: Understanding the Demand for Alternatives
In the United States, disorders characterized by negative emotions, like depression and anxiety, are prevalent. According to the Anxiety and Depression Association of America, around 40 million adults experience anxiety disorders. As a result, antidepressants are among the most commonly prescribed medications. While these drugs can be effective for many, they also come with side effects and may diminish in effectiveness over time, prompting individuals to seek alternative forms of relief.
Increasingly, many are turning to medical marijuana. A survey conducted in 2016 found that 58% of medical cannabis users in Washington state utilized it for anxiety relief, with similar numbers reporting its use for depression. Notably, 12.7% of participants indicated they were using cannabis in place of their prescribed antidepressants. This trend underscores a significant demand for alternative treatments and a belief in the therapeutic potential of marijuana.
However, the scientific backing for cannabis as a treatment option remains scant. A recent meta-analysis published in The Lancet Psychiatry highlights the limited clinical research available on this topic. The study investigated the effects of cannabis on six different mental health disorders, revealing a stark gap in our understanding of medical marijuana's potential benefits.
This analysis did not include new experiments. Instead, the authors employed a meta-analytic approach to synthesize existing research. The essence of meta-analysis lies in its ability to aggregate findings from various studies to establish a consensus. By applying statistical methods, researchers can combine results into a cohesive conclusion, which often provides stronger insights than individual studies.
The authors selected six mental health conditions to scrutinize: Depression, Anxiety, ADHD, Tourette Syndrome, PTSD, and Psychosis. They meticulously searched scientific literature databases for studies relating cannabis to these conditions. After filtering the results based on strict criteria, they narrowed their focus to 83 relevant Randomized Controlled Trials (RCTs), the gold standard in medical research.
The subsequent step involved evaluating and grading the evidence's robustness. RCTs began with a "high quality" rating but could be downgraded to "moderate," "low," or "very low" based on various factors. This thorough process allowed the authors to analyze the collective evidence for each disorder.
Section 1.1: What the Research Revealed
Despite the rigorous evaluation, the findings were largely disappointing. The term "positive" here indicates proof of an effect, not necessarily favorable outcomes. In the cases of Depression, ADHD, and Tourette Syndrome, no evidence was found to support any impact from cannabinoids, although the evidence quality was rated as "low" or "very low" due to methodological limitations.
Anxiety
A combination of pharmaceutical-grade THC and CBD showed slight efficacy in alleviating anxiety symptoms compared to a placebo; however, the effect size was minimal, and the quality of evidence was rated as "very low." None of the studies specifically targeted anxiety, as they were primarily conducted on patients with chronic conditions who recorded anxiety symptoms as a secondary measure. The variability in study results further complicated the conclusions drawn.
The evidence for isolated CBD was slightly more favorable. Two RCTs examining pharmaceutical-grade CBD for social anxiety indicated no significant impact compared to placebo.
Post-Traumatic Stress Disorder (PTSD)
Only one RCT investigated cannabinoids' effects on PTSD. While no evidence suggested that THC-CBD could reduce episode intensity, it did show some reduction in nightmares and "improved global functioning," though this evidence was graded as "low" due to inconsistencies.
Psychosis
Understanding psychosis requires distinguishing between positive symptoms (like hallucinations) and negative symptoms (such as lack of pleasure). One RCT focused on THC-CBD for treating psychosis found no change in positive symptoms but a notable worsening of negative symptoms. Additionally, cognitive functioning significantly declined following cannabinoid treatment. Isolated CBD did not affect either symptom type but showed improvements in overall functioning.
Adverse Events and Withdrawals
The authors assessed the likelihood of side effects among cannabinoid users. THC was associated with more adverse effects and higher dropout rates from studies than placebo, yet no significant difference was observed compared to other active medications. This evidence was rated as "low to moderate," as most participants did not have underlying mental disorders.
Chapter 2: Implications of Findings
The overarching conclusion of this analysis is the alarming lack of understanding regarding cannabinoids' use for mental health treatment. As the authors state, "To our knowledge, this is the most comprehensive systematic review and meta-analysis examining the available evidence for medicinal cannabinoids in treating mental disorders and symptoms. There is a notable absence of high-quality evidence where mental disorders are the primary target of treatment."
This does not imply that cannabis lacks therapeutic potential; however, the current evidence is insufficient. Given the increasing reliance on cannabis for mental health relief, there is an urgent need for more comprehensive research.
Highlighting this knowledge gap is crucial for several reasons. First, individuals may be exposing themselves to risks without adequate benefit, as cannabis could exacerbate certain conditions, such as psychosis. This analysis serves as a wake-up call for those considering cannabis for mental health issues.
Additionally, the existing lack of clarity affects policy decisions. The absence of federal regulations leaves states to determine which conditions qualify for medical marijuana use. Currently, 29 states permit its use for PTSD, 8 for Tourette Syndrome, and only 1 for anxiety, indicating that these decisions may not be scientifically grounded.
Lastly, this knowledge void empowers individuals against unsubstantiated claims. The illegality of cannabis has resulted in minimal regulation, leaving consumers to navigate the risks and benefits independently. By emphasizing the current limitations in understanding, individuals can better evaluate the messaging they encounter and make informed choices.
This first video explores the relationship between cannabis and mental health, providing insights into the complexities of using marijuana for therapeutic purposes.
The second video serves as a guide for mental health professionals on addressing medical cannabis use in treatment, offering valuable perspectives on patient care.
More from the No BS Guide:
- Is Cannabis Putting Your Bones At Risk? Research from the University of Edinburgh suggests caution.
About the Author:
- Brandon Lowry, PhD, is a digital nomad and freelance writer specializing in cannabis, science, health, and travel. He also serves as an editor at Midnight Mosaic Fiction.