Does Cannabis Help Anxiety?

Every day after work, Tim*, a 27-year-old nonprofit from New York City, does the same to help deal with the anxiety he’s struggled with since childhood.

As soon as he gets off the subway, he pulls out a joint hidden in an odor-proof container in his backpack, lights it up, and puffs as he walks to his Queens apartment.

“I wouldn’t say it cures my anxiety, but it helps manage it,” Tim said. “It kind of keeps me on the level.”

Many Americans, like Tim, smoke, vape, or otherwise use cannabis to unwind after a stressful day or to cope with anxiety, one of the most common mental health problems in the United States.

But while marijuana can reduce anxiety in some people, it can make it worse in others — especially if the drug is highly potent.

Researchers don’t yet fully understand whether marijuana reduces or scares.

“The bottom line when it comes to anxiety is that we still have a lot more to learn about it,” said Devan Kansagar, professor of general internal medicine at the Oregon Health & Science University School of Medicine. “We really don’t know.”

However, a number of variables have been identified that determine how cannabis makes people feel in the short term.

For one, a person’s mental health prior to using the drug can affect whether they feel anxious after taking it, as research shows that cannabis can amplify the emotions a user is already feeling.

Sex can also be a factor. According to a 2020 study, among infrequent cannabis users, women are more likely to feel anxious, nervous, or restless after using the drug.

“A person’s gender potentially influences every aspect of cannabis use,” said Esther Choo, professor of emergency medicine at Oregon Health & Science University School of Medicine. For that reason, she said, “gender differences are not surprising.”

However, she cautioned that “the science is not unanimous about what these differences are. The medical literature does not provide a clear basis to suggest, for example, that women are consistently more prone to experiencing intense or negative symptoms, such as anxiety, from cannabis use compared to men.”

The type of cannabis consumed plays a significant role, mainly because different strains have different concentrations of tetrahydrocannabinol (THC), the main psychoactive ingredient in marijuana.

“If you look at one of these rigorous studies where you compare an active ingredient in cannabis to a placebo and look at anxiety, you see that at a given dose, participants show a decrease in anxiety compared to a placebo,” Ziva said Cooper, director of the UCLA Center for Cannabis and Cannabinoids.

“But when you get to a higher dose, people actually report more anxiety compared to a placebo.”

How people consume cannabis also plays a role in whether the drug reduces or worsens anxiety.

THC enters the bloodstream and reaches the brain much faster when a person smokes or vapes marijuana than when they eat a weed gummy or pot brownie.

And once THC reaches the brain, the chemical binds to molecules called cannabinoid receptors on neurons, altering the normal flow of communication within the brain and body, resulting in a high.

Inhaling cannabis smoke can make a person feel this high in a matter of minutes, while, according to the National Institute on Drug Abuse, THC takes its full effect 30 minutes to an hour after consuming a marijuana-infused food or beverage.

“In some situations, someone may use an oral product, such as Like an edible, not realizing it takes a while to feel an effect and taking more because he thinks he hasn’t taken enough,” Cooper said in an email. “This can lead to a situation where the person is exposed to high levels of THC, making them more likely to feel unwell, impaired, intoxicated and anxious.”

According to the Centers for Disease Control and Prevention, cannabis is a complex plant with over 100 different cannabinoid compounds. THC is just one of them. And the combination of these compounds in the cannabis a person uses can also affect how anxious they feel while using it, Cooper said.

Another cannabis compound is cannabidiol, or CBD, found in the cannabis sativa plant. Like THC, CBD is a psychoactive compound or one that affects the mind, but it is non-intoxicating, meaning that while it may have a sedative effect, it does not induce a high like THC does.

One study found that CBD actually prevents THC and other cannabinoids from binding to certain receptors in the brain, reducing the effects of THC on a person’s mind or mood.

And there is a growing body of preclinical research to support this The potential of CBD to treat anxiety disorders.

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But while cannabis could prove to be a treatment for anxiety in the future, some experts stress that just taking the drug or any other anti-anxiety medication is recommended, is only a short-term solution.

Beatriz Carlini, an associate professor at the University of Washington, told The Hill that cognitive behavioral therapy, or mindfulness-based therapies, can offer longer-term help for people with anxiety.

*Name has been changed for anonymity reasons