07 August 2015

Cannabis and Good Mental Health: Anxiety

Cannabis sativa L., an annual herbaceous plant (i.e., a herb) is a very effective and natural remedy for many mental health conditions including addiction, anxiety, depression, insomnia, migraines and many mood disorders. The movement to legalise cannabis for medicinal use across the United States (US) and in countries like Australia has renewed the discussion about how it affects the brain, and whether it might be useful in treating psychiatric disorders.

Studies have linked the long-term abuse of substances such as alcohol, cocaine and heroin with a decrease in the brain’s overall production and release of dopamine. This is because most 'drugs of abuse' cause damage to brain cells that produce dopamine. Cannabinoids, however, are neuroprotectant and do not increase dopamine by decreasing uptake, the pharmacological mechanism of action of drugs of abuse, such as cocaine. And a 2012 study found that long-term cannabis consumption does not result in permanent changes in dopamine levels.

A large body of research has examined the association between cannabis use and various mental health problems. Research in this area has produced fairly consistent evidence linking cannabis use with psychotic symptoms and more mixed findings linking cannabis use with anxiety and depression, however, many studies have failed to control for important confounding factors, such as health problems that pre-dated the onset of regular cannabis use and co-occurring use of tobacco, alcohol and 'hard' drugs. 

Some reviews carried out over the past 20 years suggested that regular cannabis use during adolescence may be associated with an increased risk for developing depressive symptoms although the evidence remained somewhat mixed. For example, two longitudinal studies found that adolescent cannabis use was no longer significantly associated with an increased risk for later depression after controlling for several other risk factors, such as IQ, other substance use, family disadvantage, early life stressors and even deviant peers. The often cited studies are, Early onset cannabis use and psychosocial adjustment in young adults, Fergusson & Horwood, 1997 (New Zealand) and Cannabis use and depression: a longitudinal study of a national cohort of Swedish conscripts, ManriqueGarcia et al., 2012 (Sweden). Other contradictory findings have also been reported; one cross-sectional study found that individuals who used cannabis approximately once per week reported less depressed mood, more positive affect and fewer somatic (relating to the body as distinct from the mind) complaints than non-users (Decreased depression in marijuana users, Denson & Earleywine, 2006).

In contrast to studies on depression, very few longitudinal studies have found a significant relation between early cannabis use and the subsequent development of anxiety disorders (see Cannabis use and risk of psychotic or affective mental health outcomes: a systematic review, T H M Moore et al, 2007 and, Cannabis and anxiety: a critical review of the evidence, Crippa et al, 2009). For example, one longitudinal study that used biannual assessments of cannabis use between ages 15 and 17 found no evidence that chronic use was related to a lifetime diagnosis of anxiety disorders during the early to mid-20's (Trajectories of marijuana use from adolescence to young adulthood: predictors and outcomes, Windle & Wiesner, 2004).

Long-term cannabis users cite relaxation and stress relief as primary reasons for use. However, longitudinal studies often combine depressive and anxiety disorders when investigating mental health outcomes associated with cannabis use e.g., A longitudinal study of cannabis use and mental health from adolescence to early adulthood, McGee, Williams, Poulton, & Moffitt, 2000 (New Zealand), making it difficult to identify the unique relation between cannabis and anxiety symptoms.

Anxiety disorders come in many different forms; some of the more common are Agoraphobia, Generalised Anxiety Disorder (GAD), Obsessive Compulsive Disorder (OCD), Panic Disorder, Post-traumatic Stress Disorder (PTSD), Social Anxiety Disorder (SAD) and specific Phobia. Anxiety disorders make it increasingly difficult to function in society and corrupt millions of people's lives, diminishing their quality of life. Nearly 20% of the US population (in Australia it is nearly 15%) is affected by various anxiety disorders, with current treatments for anxiety disorders using around one-third of the United States' mental health bill budget, it has become increasingly pressing to find alternatives for the treatment of anxiety. In Australia, the proportion of people with an anxiety disorder who used services for mental health problems was overall two-fifths (37.8%) of people with anxiety disorders.

Mild anxiety is sometimes a side-effect of initial cannabis use, but more people experience mood-elevating effects, as well as relaxation, which allows anxiety sufferers, in particular, to lead a more normal life. While benefiting from the medicinal effects of cannabis, some patients at the Victorian Cannabis Buyers Club in Canada suffered bouts of anxiety. Most simply took a few sniffs of black pepper to receive almost immediate relief. Others reported chewing on black peppercorns for relief within an hour. Medical cannabis also causes a desirable 'slowing' down of thought processes, which can help to break up some of the upsetting cyclical thought patterns which can plague anxiety sufferers. 

Modern medicine relies heavily on pharmaceuticals to treat anxiety, regardless of the negative side effects. Benzodiazepines, the most common class of anti-anxiety medication (Valium, Xanax etc), lowers brain activity to temporarily relieve anxiety but are far too risky for those with less severe anxiety, and when paired with the adverse effects, the demand for safer treatment has become a pressing issue.

Common side-effects of Benzodiazepines / Tranquillisers

  • Drowsiness, lack of energy
  • Clumsiness, slow reflexes
  • Slurred speech
  • Confusion and disorientation
  • Depression
  • Dizziness, lightheadedness
  • Impaired thinking and judgment
  • Memory loss, forgetfulness
  • Nausea, stomach upset
  • Blurred or double vision

Long-term benzodiazepine use is not encouraged in Australia. Because of the many safety concerns linked to anti-anxiety drugs, other medications for treating anxiety have gained in popularity. The alternatives to anti-anxiety tranquilisers include antidepressants. However, for years we’ve been told that depression is caused by low serotonin levels in the brain. In the first quarter of 2015, Psychiatry Professor David Healy of the Hergest Psychiatric Unit in Bangor, North Wales, warned that only through marketing a complete myth have the most common antidepressant drugs, SSRIs including Prozac, come to dominate how the medical field treats serious depression. That myth, says Healy, is that depression is caused by an imbalance of the neurochemical serotonin in the brain. While studies show that SSRIs affect serotonin levels in the brain, and that taking SSRIs relieves symptoms of depression, damage is done when this is spun into an easy explanation for patients. "For doctors, it provided an easy shorthand for communication with patients. For patients, the idea of correcting an abnormality has a moral force that can be expected to overcome the scruples some might have ... especially when packaged in the appealing form that distress is not a weakness." Healy says the medical establishment has done a poor job of explaining how SSRIs became popular in the first place: The reason was not for their efficacy, but because they were safer in larger doses. Taking tranquilisers remains a better treatment, although overdosing on them is obviously dangerous. And now, patients have trouble going off SSRIs: "The number of antidepressant prescriptions a year is slightly more than the number of people in the Western world. Most (nine out of 10) prescriptions are for patients who faced difficulties on stopping, equating to about a tenth of the population."

A 2011 study, Neural basis of anxiolytic effects of cannabidiol (CBD) in generalized social anxiety disorder, used functional neuro-imaging and showed cannabidiol (CBD) was associated with significantly decreased subjective anxiety. These results showed that CBD reduced anxiety in Social Anxiety Disorder (SAD) and indicates CBD as a possible answer. The low psychoactivity of CBD makes it a preferred and safer alternative to pharmaceutical drugs that cause numerous negative reactions in the body such as drowsiness and medication hangover. There is a great need for more study on the use of all cannabinoids as anti-anxiety treatments so more people can benefit from cannabis' medicinal value. The following is a small selection of some other scientific studies related to cannabis, cannabinoids and the anxiolytic (anti-anxiety) effects, available on PubMed:

Inhalation is the fastest way to deliver cannabinoids to the bloodstream, which is why many prefer smoking or vaporising their herbal preparation. But while this method of delivery works fast, smoking anything exposes lungs to multiple chemicals and poses many of the same respiratory health risks as smoking tobacco cigarettes. Vaporisers markedly reduce the harms by not delivering 'combustion chemicals' to the lungs during inhalation. For those lucky enough to live in a jurisdiction that allows dispensaries for the purchase of medicinal cannabis, the Hemp Edification Cannabis Strain Guide 2015 recommends the following for their anxiolytic effects:

8 Ball Kush, 9 Pound Hammer
A-10, Abusive OG, ACDC, Ace of Spades, Afghan Big Bud, Afghan Kush, Afghan Kush x Black Domina, Afghan Skunk, Afghani, Afghani Bullrider, Afghani Goo, Afghooey
Big Bang (severe sufferers), Blackberry Hashplant, Blackberry Kush, Blueberry, Blue Cheese, Blue Chunk, Blue Cross, Blue Dream, Blue Moon Rocks, Blue Moonshine, Blue Satellite, Bog Sour Bubble, Bubblegum, Burmese Kush, Burmese Pure
C99 x Great White Shark, Casey Jones, Catalyst, Cheese, Cinderella 99, Cindy's Sister, CIT, Chocolope
Durban Poison
Fieldale Haze, Firecracker
Girl Scout Cookies
Jack Herer, Juicy Fruit
M-39, Mango x Northern Lights #5, Maui Diesel, Medicine Man (aka White Rhino), MK Ultra, Moonshine, Morning Star, Mr Nice GuyNew York Sour Diesel, Nirvana Northen Lights x Big Bud, Nirvana White Widow, Northern Lights
Oak Goo, OG Berry, Ogre, Orange Cream
Peak 19, Purple God, Purple Kush
Shiskaberry x Dutch Treat, Shiskaberry x Hash Plant, Sour Diesel, Space Princess, Strawberry Cough, Super Impact, Super Silver Haze
Tangerine Dream, Trainwreck
Wakeford, Wonder HazeXJ-13

In conclusion, medical cannabis should be of note to all those suffering from an anxiety disorder. Cannabis provides a safe, natural alternative to the loaded-with-side-effects (dangerous), oft-times habit-forming, pharmaceuticals traditionally prescribed which actually damage body and mind with long term use. Many people suffering from one health condition or another take more than one medication (poly-pharmacy) these days, and all too often they interfere with each other (contra-indications) which can exacerbate health problems. Of course, when considering any sort of medication, be it cannabis or otherwise, you should be sure to consult with your physician, naturopath or other health care worker, first, if able. Medicinal cannabis is a natural, non-toxic and sometimes even more affordable and absolutely a much safer way to help treat an anxiety disorder.


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