Anxiety And Medical Marijuana
How Does Marijuana Affect Anxiety?
Most people can relate to getting higher than expected from ingesting cannabis and suffering from increased feelings of anxiety and paranoia. Whether it was you or a friend, the experience can be traumatizing for patients susceptible to anxiety attacks and paranoia. While this is certainly not the norm of marijuana use, there are certain factors that can exacerbate the feeling, and patients need to be aware of the risks associated with first-time use or heavy-consumption of marijuana. Just like any other medicine, dosing, social environment, and strains can all have varied effects on the patient’s reaction. Therefore, it is imperative for patients to track their dosages and keep track of which strains work the best for them.
How to Properly Dose Marijuana
We understand that this may be the first time patients are using marijuana; and if it is not their first time, it may be the first time it will become a regular occurrence within their lives; with higher THC percentages than most people are accustomed to. According to a study that tested the THC and CBD content in street marijuana, in 2014 the average street marijuana tested at 12% THC. Compare this to medical marijuana, which can reach up to 35% THC.
Once you visit with a doctor, based on the new patient intake form and a short discussion of your symptoms, they will put together a treatment plan to ensure that you are taking the proper dosage and using the particular strains that should work best. Of course, over time, the dosage will need to be changed as your body becomes acclimated and stores THC in fat, and that can be quite concerning for patients that worry about having a negative reaction to their medicine.
There is evidence that marijuana’s interaction with the neurotransmitter GABA can be utilized to counteract feelings of anxiety; GABA levels are what are targeted by benzodiazepines, the most common anti-anxiety drug prescribed. Endocannabinoids have been found to modulate GABA activity that resembles those of other GABA-mediated drugs. Furthermore, research has shown that marijuana can also lower cortisol, which is the stress hormone.
Moreover, CBD displays characteristics of reducing anxiety while also positively affecting serotonin levels. Research has shown that with both human and animal subjects, anxiety was significantly decreased in subjects who received CBD, as opposed to a placebo. In another study, it was shown that CBD is effective in relieving social anxiety - even during public speaking.
As the evidence has revealed, CBD is the main component that our patients dealing with anxiety should be searching for, although low-concentrated THC strains will also be ideal. The main consideration when choosing a strain should be dictated around a balanced CBD/THC ratio that works for you.
What Strains of Marijuana Work Best For Anxiety?
Generally, you want to aim for a THC/CBD ratio of at least 1:1 (THC:CBD). Another thing to understand is the role that terpenes play in reducing anxiety.
Terpenes are the fragrant essential oils secreted from the cannabis plant. You'll want to keep an eye out for terpenes such as linalool, myrcene, and bisabolol, according to Leafly:
Linalool: primarily found in indica-dominant strains and also in lavender, this terpene has anti-anxiety and sedative properties. Linalool-rich strains include Lavender, LA Confidential, and Master Kush.
Myrcene: found in mangoes, myrcene is an antioxidant, a muscle relaxant, a potent analgesic, and even has sedative properties. Myrcene-rich strains include Pure Kush, White Widow, and Jack Herer.
Bisabolol: this terpene is recently being investigated more thoroughly, revealing that it includes anti-irritant properties. Popular bisabolol-rich strains include Headband and Master Kush.
The Apothecarium provides a guide for the ideal ratio:
THC-dominant options (0:1) will provide varying degrees of psychoactivity. THC induces appetite, reduces inflammation, reduces nausea and vomiting, and can provide relaxing and/or cerebral effects. Adverse effects may include tachycardia, anxiety, and paranoia. These can be reduced by introducing CBD into the equation.
A 1:3 ratio of CBD to THC results in some psychoactivity while minimizing THC’s unwanted side effects, producing a calming sensation with reduced anxiety, stress relief and exhibiting anti-inflammatory properties. This ratio can act an as advanced pain reliever with the synergistic benefits CBD and THC provide.
A ratio of equal parts CBD to THC (1:1) is considered highly effective for pain relief, anxiety, spasticity, fibromyalgia, insomnia, nausea, and appetite stimulation. This ratio shows promise in relieving symptoms associated with Multiple Sclerosis and may be able to kill certain cancer cells and inhibit tumor growth. A 1:1 can be a good starting point for many due to the multitude of conditions it may treat with minimal impairment.
Higher CBD options, such as 2:1 or 3:1, may be an ideal ratio for combating autoimmune disorders, gastrointestinal issues such as Crohn’s and colitis, arthritis, and psoriasis with little to no psychoactivity.
CBD dominant ratios of 25:1 or 1:0 (hemp-derived CBD) offer no psychoactivity and may be most effective for curbing high anxiety, depression, seizures, psychosis, PTSD, and neurodegenerative conditions such as Parkinson’s and Huntington’s Disease. “
What To Do If You Get Too High
You can not only prevent these feelings of anxiety, but even counter them! There are a few different things suggested:
Use a low-THC and/or high-CBD strain. With a significant amount of CBD in a strain, the CBD will actually compete with THC to bind to endocannabinoid receptors, meaning that the CBD will block the uptake of THC into your system while still providing medical benefits.
Start with a small dosage and work your way up. While this may seem obvious, the effects of marijuana can often be delayed for a multitude of reasons, but will eventually take effect. This is especially true of consumable products and topicals, as the process to breakdown the cannabinoids and feel the effects of the marijuana can often take anywhere from 30 minutes to an hour and a half to kick in. Vaporizable products offer better dosage control compared to these products, as the effects are more immediate and don’t last as long.
Find a comfortable environment. When using THC, you do have to remember it is a mind-altering compound. When you are under the effect of marijuana in an uncomfortable environment, this can often compound that feeling of discomfort and anxiety. Curl up and watch a movie, go out and play with the kids or pets, read your favorite book - do what makes you happy and comfortable! A common yoga breathing technique used for relaxation is the 4-7-8 breath: sitting comfortably, empty your lungs with a full breath out the mouth; then, take a deep breath in through the nose (with mouth closed) for 4 seconds, hold your breath for a count of 7 seconds, and slowly exhale through your mouth for 8 seconds. Repeat this process until you feel calm and relaxed.
Find the right strains for your conditions - and keep track of which strain works! The most powerful thing about medical marijuana treatment is it allows the patient vastly more freedom and control over their treatment and goals. We are always here for support, but nobody is going to understand the effects each strain has on you better than you. Having trouble with high-THC strains? Try using an indica strain, which has a much more balance ratio of THC to CBD. Avoid using sativa strains that are characterized by high-THC and low-CBD balance.
And just remember, if you do have an episode of anxiety, it will pass. It's not permanent, and depending on the method of ingestion, it can be over within a few hours. It can be a scary feeling, and one that we want all of our patients to avoid. If you are ever in doubt, consult with a resource; whether you give our Patient Support Center a call, call the dispensary where you bought the product, or use the resources provided in this article. You are not alone - due to prohibition blocking medical marijuana research, we’re all figuring this out together.