[Editor’s Note: Cannabis has many uses, not the least of which is treating anxiety and depression. Much treatment is self-help, but Dr. Tishler offers real help to his patients. We need empirical research on this important topic.]
There’s a stigma that cannabis makes some users anxious, paranoid, or even depressed. But many patients are looking to pot to treat these conditions.
Even the world’s most seasoned tokers have experienced the overwhelming and frightening feeling of THC-induced anxiety. We’ve all taken a hit (or consumed an edible) too many, inadvertently thrusting our stoned minds into a vortex of bleak thoughts, or even raising unsubstantiated questions like why is everyone looking at me right now?
Thus, while cannabis has been proven to be beneficial for a wide range of medical conditions, one might assume that it doesn’t offer much relief for mood-related disorders like depression and anxiety.
In fact, most past research suggests that ganja has an adverse effect on these conditions. And, besides the veteran-backed emergence of treatment for PTSD, most states don’t allow physicians to recommend cannabis for these other types of mood disorders.
Regardless of those anecdotal inklings some cannabis users have about the terrifying effect pot can have on anxiety and depression, new research suggests that more patients may be seeking treatment for mood-related disorders than any other medical classification, including pain-related conditions.
In a recent study conducted by CB2 Insights, researchers found that over 34 percent of patients seeking medical cannabis were aiming to alleviate mood-related disorders like anxiety, depression, PTSD, and others. Pain-related conditions were a close second, encompassing 33 percent of the patients that took part in the evaluation.
“We went into this study with a clear mind, and we actually believed that pain would be at the top,” says Dan Thompson, the chief marketing officer of CB2 Insights. “We wanted to look at what the second, third, and fourth most prominent primary conditions were, and how big of a discrepancy there was between them. The fact that mood-related disorders bubbled to the top was a surprise to us, so the report kind of came just from that.”
In the report, CB2 Insights assessed nearly 500 patients across multiple states over a four-week period. The findings were essentially published to highlight the fact that, outside of PTSD, most states with medical legalization don’t list mood-related disorders as a qualifying condition.
Currently, only seven states and Washington DC allow certified healthcare practitioners to provide a medical recommendation for patients to treat any condition with cannabis, so long as the doc deems it an appropriate remedy.
In Massachusetts, one of the few states that actually allow physicians to endorse Mary Jane-use at their own discretion, Dr. Jordan Tishler believes he’s had substantial success in treating depression and anxiety with small doses of medical-grade greens.
A Doctor Who Knows How to Get Patients in the Right Mood
Dr. Tishler runs the New England-based medical cannabis clinic InhaleMD, and also founded the Association of Cannabis Specialists, an organization that promotes education and advocacy in regard to medical cannabis care. He’s also a firm believer that, in a small and controlled dose, THC-heavy flower can be extremely beneficial for patients suffering from depression and anxiety.
“If you use a lot of cannabis, it generally makes their mood or anxiety worse,” says Tishler, bluntly. “But on the other hand, if people use very small amounts of cannabis, we find it can actually benefit their mood and anxiety. So, my approach with patients is very low dose in the evening, which effectively creates a period of intoxication that dissipates over the course of the night, but the benefits to mood persists throughout the next day.”
To ensure that those suffering from anxiety and depression obtain proper treatment, Tishler gets extraordinarily specific with each patient. Although dispensaries are technically not obliged to follow a doctor’s orders when it comes to dosages, the Massachusetts-based cannabis specialist tells each patient exactly what to get, when to use it, and how to use it.
For mood-related disorders like anxiety and depression, he’ll often recommend a small dose of THC-laden bud right before bedtime.
“There are Benzos, which we try not give people too often because they can be highly dangerous,” Tishler told us. In that case, generally speaking, the low dose of cannabis in the evening is enough to replace the Benzos. And I’ve seen this. I’ve also seen people come in on Klonopin, and over time, we’re able to wean them right off of that.”
While he doesn’t necessarily subscribe to the idea that cannabis can fully replace antidepressant medication in every case, Tishler sees remarkable benefits to using medical-grade ganja as a supplement to reduce opioid dependencies and help deal with the negative side effects of SSRIs.
“The side effects to SSRIs include weight gain, the feeling of not having any joy, and there’s also a whole bunch of sexual side effects for both men and women. Interestingly, cannabis can help offset those side effects so that if you need to be on an SSRI… using cannabis as a supplement can make the whole thing work better,” he explains.
The Future of Research on Mood-Related Disorders and Medical Cannabis
One of the main issues with past studies on how cannabis impacts these two particular mood-related conditions is that doses were not typically controlled or administered properly. In turn, this created a stigma that cannabis has an adverse effect on anxiety and depression.
But to Tishler, all this means is that we need to conduct better research, and that starts with implementing more controlled dosing regimens.
“Particularly with regard to the mood disorders, the amount of cannabis is so critical,” he says. “I think that when we look at this older literature and see that the results are totally mixed, if we could go back and actually control what people are getting, then we would really be able to demonstrate that low doses are beneficial and higher doses are nonbeneficial. We’d be able to find that breakpoint.”
Unfortunately, as long as cannabis remains illegal on the federal level, it will be difficult to conduct this research in a proper manner. But according to Thompson of CB2 Insights, he believes that will likely change once Big Pharma – for better or for worse – finally situates itself in the budding cannabis space.
“They’ll either do so to protect themselves or as an understanding that it’s time to collaborate with it,” says Thompson. “Whatever the motivation, Big Pharma will absolutely enter the cannabis space.”
Although Thompson doesn’t necessarily believe cannabis will be a replacement for opioids, he does believe it can be used in tandem to reduce opioid usage. And the same goes for with antidepressants. “Trying to find that balance of how traditional Pharma can work with cannabis in an integrated treatment plan,” he says, “is certainly the future.”