Medicinal marijuana, cannabinoid medicine or medical cannabis, is a growing treatment modality for multiple health challenges. This article will focus on one aspect, anxiety and anxiety-like behavior. At the Magaziner Center for Wellness, we believe in the healing properties of medical cannabis for many of our patients.The Magaziner Center for Wellness is an authorized provider for this therapy.
Are patients getting accurate information about the helpfulness of cannabinoids?
What we do find in many people is an uncertainty or confusion about the recommendation to use cannabinoid medicine or medical cannabis. This is a somewhat common problem throughout many primary and medical marijuana practices. A 2020 study written in the Journal of primary care and community health (1) reveals some of the problems of understanding cannabis in medical treatment. This study focused on primary care physicians and patients in Vermont and their understanding of the treatment.
“The purpose of this research was to identify current use and perceptions of cannabinoids, including Tetrahydrocannabinol (THC) and cannabidiol (CBD), in adult primary care patients in Vermont. An anonymous written survey was given to 1009 Vermont primary care patients aged 18 years and older.”
“(The research findings surrounded) patient-reported and included use of CBD and THC products, perceived helpfulness for certain medical conditions, knowledge of CBD and THC, perceived knowledge of their provider, and concerns regarding cannabis legalization.”
Only 18% of patients reported their provider as being a good source of information regarding cannabis.
45% of adult primary care patients reported using cannabinoids in the past year. Only 18% of patients reported their provider as being a good source of information regarding cannabis.
Cannabis is helpful for conditions such as anxiety and depression, arthritis, pain, sleep, and nausea.
Of the patients who used cannabis in the past year, a majority reported it helpful for conditions such as anxiety and depression, arthritis, pain, sleep, and nausea.
Primary care providers need to be knowledgeable about cannabinoids to best support patient care.
Conclusions: “Primary care providers need to be knowledgeable about cannabinoids to best support patient care. In addition, with a significant number of patients reporting cannabinoids helpful for medical conditions common in primary care, it is important that research continue to identify the potential benefits and harms of cannabis.”
Good and effective treatment options for patients suffering from anxiety and trauma-related disorders
A 2019 research study published in Current psychiatry reports (2) discusses the problems of finding good and effective treatment options for patients suffering from anxiety and trauma-related disorders. Here is what the researchers wrote:
“Psychological treatments are often limited or temporary in their effectiveness, while medications can lack efficacy or have unwanted side effects in a considerable number of patients. Psychological therapies can also be combined with medications to enhance treatment synergistically, but some medications can interfere with these therapies. Better options are therefore urgently needed for treating these disorders.
With the decriminalization of cannabis, availability of cannabis-derived chemicals (i.e. cannabinoids), and anecdotal evidence for the anxiolytic (anxiety reducing) potential of cannabinoids all becoming ever more widespread, it is important to take stock of the empirical evidence to determine if cannabinoids can live up to their hype as an option for treating anxiety-related disorders in the future.”
In February 2020, a research team in Spain wrote in the European neuropsychopharmacology: the journal of the European College of Neuropsychopharmacology:(3)
“Cannabis use induces a plethora of actions on the Central Nervous System via its active chemical ingredients, the so-called phytocannabinoids. These compounds have been frequently associated with the intoxicating properties of cannabis preparations. However, not all phytocannabinoids are psychotropic, and, irrespective of whether they are psychotropic or not, they have also shown numerous therapeutic properties.
These properties are mostly associated with their ability to modulate the activity of an intercellular communication system, the so-called endocannabinoid system, which is highly active in the Central Nervous System and has been found altered in many neurological disorders.
“. . . diseases such as schizophrenia and related psychoses, anxiety-related disorders, mood disorders, addiction, sleep disorders, post-traumatic stress disorder, anorexia nervosa”
Specifically, this includes the neuropsychopharmacology field, with diseases such as schizophrenia and related psychoses, anxiety-related disorders, mood disorders, addiction, sleep disorders, post-traumatic stress disorder, anorexia nervosa and other feeding-related disorders, dementia, epileptic syndromes, as well as autism, fragile X syndrome (a developmental disorder highlighted by delays in talking, anxiety, and hyperactive behavior) and other neurodevelopment-related disorders.”
Taking stock of the evidence to determine if cannabinoids can help people with anxiety
A December 2019 study (4) published in the Journal of the American Pharmacists Association evaluated the current evidence on the safety and efficacy of cannabidiol (CBD) in anxiety and anxiety-related disorders.
In reviewing eight medical studies the research team assessed the role of CBD in the anxiety response of healthy volunteers; for generalized anxiety disorder; for social anxiety disorder; and for the anxiety component of posttraumatic stress syndrome.
In the studies, “CBD was administered orally as a capsule or as a sublingual spray and as either monotherapy or adjunctive therapy. Doses varied widely, with studies employing fixed CBD doses ranging from 6 mg to 400 mg per dose. Various anxiety assessment scales were used in the studies to assess efficacy, with CBD demonstrating improved clinical outcomes among the instruments. In general, CBD was well-tolerated and associated with minimal adverse effects, with the most commonly noted adverse effects being fatigue and sedation.”
CONCLUSION:”CBD has a promising role as alternative therapy in the management of anxiety disorders. However, more studies with standardized approaches to dosing and clinical outcome measurements are needed to determine the appropriate dosing strategy for CBD and its place in therapy.” The researchers pointed out that the studies they examined did not include findings in panic disorder, specific phobia, separation anxiety, and obsessive-compulsive disorder.
The researchers give a fact based opinion of the role of CBD in anxiety disorders, noting that dose and patient selection are very important aspects of the treatment success. We agree.
Can cannabidiol reverse anxiety-like behavior in late teens?
A November 2019 study in the journal Frontiers in psychology (5) suggests that the accumulated scientific evidence indicates that cannabidiol (CBD) reverses anxiety-like behavior. To test this suggestion, this Japanese study examined teenagers with social anxiety disorder (SAD).
Thirty-seven 18–19-year-old Japanese teenagers with SAD and avoidant personality disorder received, in a double-blind study, cannabis oil (17 study participants) containing 300 mg CBD or placebo (20 study participants) daily for 4 weeks.
SAD symptoms were measured at the beginning and end of the treatment period using the Fear of Negative Evaluation Questionnaire and the Liebowitz Social Anxiety Scale. CBD significantly decreased anxiety measured by both scales. The results indicate that CBD could be a useful option to treat social anxiety.
Findings: “In all, the results of the current study provide evidence for anxiolytic effects of repeated CBD administration in teenagers with social anxiety disorder.”
Understanding the therapy
In the study published in Current psychiatry reports (6) cited above, the research team suggested cannabinoid-related medicines could be used in various ways to treat anxiety disorders. Possibly as adjuncts to first-line depression and anxiety medications,SSRI (Selective serotonin reuptake inhibitors) or SNRI (Serotonin–norepinephrine reuptake inhibitor) treatment. Cannabinoid-related medicines could be an improvement over benzodiazepines, which have abuse liability, a less favorable side effect profile. The researchers point out, more studies should be performed to determine true benefit.
At the Magaziner Center, we will start with a complete history and physical exam performed by a licensed health care provider. You will also receive comprehensive and holistic evaluation of your medical health, not just given a medical marijuana card. This is just one of many tools we offer to help support you in your health. You will receive a customized program on the appropriate delivery method and cannabis strain-specific recommendations from our medical staff. Our process insures that you are on the right path with the usage of this herb as a true medicine.
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1 Wershoven N, Kennedy AG, MacLean CD. Use and Reported Helpfulness of Cannabinoids Among Primary Care Patients in Vermont. Journal of Primary Care & Community Health. 2020 Aug;11:2150132720946954.
2 Skelley JW, Deas CM, Curren Z, Ennis J. Use of cannabidiol in anxiety and anxiety-related disorders. Journal of the American Pharmacists Association. 2019 Dec 19.
3 Fernández-Ruiz J, Galve-Roperh I, Sagredo O, Guzmán M. Possible therapeutic applications of cannabis in the neuropsychopharmacology field [published online ahead of print, 2020 Feb 10]. Eur Neuropsychopharmacol. 2020;S0924-977X(20)30036-5. doi:10.1016/j.euroneuro.2020.01.013
4 Papagianni EP, Stevenson CW. Cannabinoid Regulation of Fear and Anxiety: an Update. Curr Psychiatry Rep. 2019 Apr 27;21(6):38. doi: 10.1007/s11920-019-1026-z. PMID: 31030284; PMCID: PMC6486906.
5 Masataka N. Anxiolytic Effects of Repeated Cannabidiol Treatment in Teenagers With Social Anxiety Disorders. Front Psychol. 2019 Nov 8;10:2466. doi: 10.3389/fpsyg.2019.02466. PMID: 31787910; PMCID: PMC6856203.