Stress and anxiety can make a big impact on quality of life. And Americans have some of the highest levels of stress in the world. Between family, financial and work concerns, worries over the state of the environment, tension from the contentious political culture, or now fears surrounding Covid-19, it’s easy to get caught up and overwhelmed in distressed and anxious feelings these days. Amongst the many coping mechanisms for this stress – from therapy, to prescription medication, to cracking open a beer at the end of a hard day, few solutions have received as many raised eyebrows as smoking or vaping cannabis.
While many utilize cannabis as a way to relax and reduce anxiety, many doctors, researchers and former cannabis dabblers are skeptical of its ability to do this because of one well known side-effect of cannabis – its ability to induce paranoia.
But a new study is bringing added insight to this old question. Researchers from The University of New Mexico decided to investigate and found that inhaled cannabis is far more likely to reduce symptoms of anxiety than to cause them. Since this study looked at cannabis use in states where cannabis is legal, researchers even hypothesize that cannabis’ past reputation for bringing on paranoia may have had more to do with individuals’ worries over getting caught with an illegal substance, than from any strong chemical impact of the drug.
To study cannabis’ impact on anxiety, these researchers analyzed data from a real-time cannabis effects recording application called Releaf App. The Releaf App is available for free, and cannabis users are able to utilize it to record their cannabis experiences. They are able to record factors like what symptoms they are experiencing before they use cannabis, what cannabis products they are using, how well the cannabis helped with their symptoms, and whether it caused any side effects. They can even record variables about their use, like how long the session lasted, how they used the cannabis, or the levels of different cannabinoids like THC or CBD in the product.
Keeping track of this data can help cannabis consumers to figure out which products and ways of using cannabis are most helpful for them, and which might provoke negative side effects. Of course, it can also be valuable data for researchers. Those who use the app are notified when they sign up that their sessions’ data might be used anonymously for research purposes.
For this study, researchers focused on sessions where the respondents reported distress related symptoms before using cannabis – specifically anxiety, stress and agitation/irritability. They also focused on cases using smoked or vaped cannabis flower – the most common way people use cannabis. Ultimately, they analyzed 2,306 cannabis administration sessions by 670 individuals.
The results of the analysis painted a picture of cannabis that is much more relaxing than its reputation for paranoia would predict. Researchers found that some distress related symptoms, whether it was anxiety, stress or irritability/agitation, decreased in 95.51% of cannabis use sessions. In stark contrast, these negative symptoms only increased in 2.32% of sessions (with no change in 2.16% of sessions).
Cannabis users did report some negative side effects related to anxiety and distress (such as feeling anxious, irritable, paranoid, or restless) but this occured in less than 13% of cases. Positive side effects (such as feeling chill, comfy, happy, optimistic, peaceful, or relaxed) were much more common, occurring in 66% of sessions. The infamous side effect of paranoia was actually one of the two least likely side effects in the study – occuring in only 4% of cases. Having the positive side effect of relaxation was the most common reported side effect, and occurred in 66% of cases.
The authors noted that while cannabis can have some negative side effects “the side effects reported in the current study were relatively less severe than the more serious medical and sometimes societal problems caused by some conventional prescription (e.g., benzodiazepines and barbiturates) and nonprescription (e.g., alcohol) drugs most used for treating common forms of distress.”
Interestingly, the one strong correlation with increased relief from these distressing symptoms was using cannabis with higher levels of THC. In fact, for every percentage point increase in THC levels, researchers saw symptom relief improve by 0.02 points. Longer sessions with cannabis were also tied to increased relief. While both CBD and THC have shown potential for relieving anxiety, in other studies, differing CBD levels did not seem to impact reported anxiety levels here. Some evidence also suggested that sativa strains of cannabis might be less likely to relieve distress related symptoms than those strains labeled as indica or hybrid.
Of course, the study wasn’t without its limitations. Because researchers analyzed data from uncontrolled at-home cannabis sessions, they relied on participants to accurately report factors involved in their cannabis use, which might not be as accurate as if researchers were monitoring these factors themselves. It was also impossible to create any sort of double blinded procedure since there was no placebo group. Still, one benefit of this study design was that it allowed researchers to study cannabis use, as it actually occurs, with cannabis products from the legal cannabis market.
The authors concluded that cannabis flower is an effective and fast-acting anti-anxiety medication, but also added that “it can also produce negative side effects that may exacerbate momentary symptoms of negative affect in a small minority of sessions.” They explain that the results suggest patient-directed cannabis therapy can be beneficial as a mid-level anxiety treatment, saying “thus, despite the conventional wisdom that smoking cannabis makes one paranoid, we found consumption much more likely to be associated with relaxation and sense of calm, with users most likely to report feelings of peacefulness, optimism, and happiness.”