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Treating anxiety with cannabis requires careful consideration. There are many types of anxiety caused by a complex multitude of reasons or triggers. 

Each type of anxiety may require a different type of cannabis based medicine. Anxiety can also evolve over time, requiring you to adapt your therapeutic treatments. 

Patients and their doctors will often take a ‘test and learn’ approach to find the most effective treatment for your specific condition and personal biochemistry. 

Current research suggests that cannabis based medicine doesn’t offer a long term solution for anxiety to the same degree as psychotherapy or front line medications might. It’s not a cure but it can be used as a useful tool to reduce debilitating symptoms of anxiety and provide temporary relief so you can get on with your day and foster positive habits. 

Treating your anxiety effectively with cannabis requires you to find the best product, dose, delivery mechanism and regime for you personally. It’s important to be aware of these variables and tweak them accordingly as you test different options. The wrong strain or excessive doses has the potential to exacerbate your anxiety with negative side effects. 

This article will summarise some guidelines and research to help you consider options available to you.

Potential Benefits

When used correctly, cannabis based treatments have been reported to help with: 

  • Insomnia or sleep issues related to anxiety 
  • Social anxiety 
  • Agoraphobia 
  • Panic disorder
  • PTSD 
  • Phobias

Research 

Finding the right balance of CBD:THC

Many of cannabis’ medicinal properties come from the 100 plus cannabinoids contained in the plant. Two of the best known cannabinoids are THC and CBD but each cannabinoid has its own medicinal benefits. There are also over 700 strains of cannabis and each one of them contains different quantities of each cannabinoid which in turn will offer different benefits for patients.

Research shows that high doses of CBD can reduce anxiety whereas high doses of THC can worsen it.

Anyone who might have experienced paranoia or anxiety smoking marijuana recreationally may have fallen victim to excessive THC consumption. Often cannabis strains cultivated for recreational use have been purposely bred to be high in psychoactive THC and low in CBD to maximise their intoxicating effect.

Cannabis strains grown to treat anxiety are often chosen because they are conversely naturally high in CBD with a moderate to negligible amount of THC to maximise the calming properties of the CBD. 

The amount of THC any individual can consume without negative side effects depends on their personal biochemistry and tolerance built up by frequency of use. 

So should you just choose a CBD only product without any THC? CBD only products (also known as CBD isolates) can possibly help with anxiety but may not be as effective without the presence of some THC as well all the other compounds found within the plant.

Widely acclaimed research by Israeli scientists Shimon Ben-Shaba and Raphael Mechoulam demonstrates that CBD is more effective when taken in conjunction with the other hundred plus cannabinoids (including THC), fatty acids and essential oils that the plant naturally produces. The theory, known as the ‘entourage effect’ suggests choosing a ‘full spectrum’ CBD product with THC to enhance the benefit of CBD for people suffering from anxiety. 

(You can find out more about full spectrum CBD and the entourage effect in this article: What is full spectrum CBD)

Studies showing the effective use of CBD for a variety of anxiety related conditions

There are a number of promising studies that have researched the effects of CBD rich medications for depression and anxiety. 

In a trial conducted by the University of Sao Paulo, one dose of 600 mg of CBD was administered to a number of participants with Social Anxiety Disorder (SAD) before a public speaking test, with other participants being given a placebo. 

Those who were pretreated with CBD displayed significantly reduced anxiety, discomfort, and cognitive impairment during their speech performance.

Participants with SAD who were given a placebo rather than CBD were observed to be significantly more anxious, with higher levels of discomfort and cognitive impairment.

In addition, a study conducted by researchers at the New York University School of Medicine about the effectiveness of CBD oil for anxiety found that doses between 300 to 600 mg of CBD reduced levels of anxiety that had been experimentally induced. 

The team also found evidence that CBD may enhance fear extinction, and as such may be useful in the treatment of conditions like post-traumatic stress disorder (PTSD).

The study concluded that there is evidence that CBD can reduce anxiety behaviours related to a number of disorders, including SAD, generalized anxiety disorder (GAD), obsessive compulsive disorder (OCD), panic disorder (PD), and PTSD.

How people use CBPMs

Dosing cannabis effectively for anxiety depends on: 

  1. Which method you use to consume it 
  2. The amounts of CBD and THC in your chosen product

Finding the right method of consumption for you

Flower

Advantages: 

  • With the dried buds of the cannabis flower you have the choice of smoking it or using a quick and easy dry herb vaporizer. 
  • Inhaling cannabis is the quickest way of all the consumption options to get instant relief but you should take a small puff to start with and then wait before taking another hit to get the ideal dose. 
  • High CBD flower is widely available through most UK medicinal cannabis clinics. (Find out more in this article: How to get medical cannabis in the UK for your condition?)

Disadvantages: 

  • Smoking can lead to lung irritation, chronic obstructive pulmonary disease and even some types of cancer especially if cannabis is mixed with tobacco. A dried herb vaporizer is considered to be the least dangerous method of inhaling flower. 
  • Often you will need to break down the cannabis bud before smoking or dry herb vaporizing it which requires you to have a grinder or similar tool. 
  • Smoking cannabis is the most ostentatious way of consuming the plant because it releases the strongest cannabis aroma which may disturb others around you, especially in public spaces.

Pre-filled oil vapes 

Advantages: 

  • Pre-loaded vaporizer capsules don’t require any setup. Usually you screw them onto a vape pen battery and you’re ready to go. 
  • Prefilled vapes used condensed cannabis oil so depending on the brand you can get around 100 doses or inhalations per 1 gram cartridge.
  • Like smoking, vaping enables cannabinoids to be absorbed into the bloodstream rapidly via the lungs so can provide almost instant relief.

Disadvantages: 

  • Although there is no tobacco involved there are still question marks around how healthy vaping thinning agents like propylene glycol and polyethylene glycol are for your lungs in the long term. 
  • Authentic vape cartridges with THC are difficult to find in the UK currently and there are many fake ‘US imports’ on the black market that may be dangerous.

Tinctures 

Advantages: 

  • Tinctures are easy to dose accurately using a pipette. Placing a dose on the capillary rich area under your tongue and holding it there for a few minutes before swallowing allows it to be absorbed into the bloodstream quicker. Be aware it can take up to an hour to feel any effect so wait for longer before increasing the dose. 
  • Tinctures are a longer lasting, slow release method compared to smoking or vaping
  • They are a clean, smoke free methods without any long term health concerns

Disadvantages: 

  • Tinctures are much slower to take effect than smoking or vaping. Any tincture swallowed must be metabolized by the liver before entering your bloodstream although holding it under the tongue does help some of the tincture to bypass this longer process.

Edibles 

Advantages: 

  • Edibles can be a more enjoyable way to ingest cannabis if they are mixed with tasty food or drinks. 

Disadvantages: 

  • Dosing can be difficult to quantify especially when preparing your own edibles as multiple variables during the cooking process can affect the potency of the final product. 
  • Edibles can take up to 2 hour to take effect so they won’t provide instant relief and can make it hard for you to understand whether you have had an adequate dose of need more.

Dosing CBD and THC effectively 

CBD

For high CBD products with zero or negligible amounts of THC, you can dose larger amounts without worrying about the intoxicating effects of THC. 

If you’re vaping or smoking you can puff until you feel anxiety subsiding. The most effective CBD oil dosage for anxiety is thought by many to be between 300 to 600 mg, mostly because these levels have been studied more thoroughly than higher levels.

THC

CBD products with moderate to high amounts of THC are only available with a legal prescription in the UK. You should consult with your doctor about the recommended dosing for your condition.

Risks

Sourcing High Quality CBD Products

It is a good idea to get CBD oil from a lab-tested source, as you can be guaranteed low to zero THC content. This is very important for those who want to use CBD oil to treat anxiety disorders. In addition, licensed CBD oil products manufactured in the UK contain only ingredients from sources that you can trust.

Smoking & Vaping Risks 

Smoking cannabis, especially with tobacco, can lead to chronic obstructive pulmonary disease, lung complaints and some types of cancer. 

Thinning agents like propylene glycol and polyethylene glycol used to make vape cartridges have been linked with lung issues.

Interactions with other anti-anxiety medication & side effects 

If you are currently taking other medication for anxiety you should talk to your doctor before taking a cannabis based product. 

Taking cannabis in combination with sedatives (Ambien, Xanax, Klonopin etc.), MAOIs (tranylcypromine, phenelzine) etc or tricyclic antidepressants can cause increased blood pressure and heart rate to a dangerous level.

Disclaimer: This article is intended for informational purposes only and does not constitute medical advice. Always consult a doctor or other qualified physician before seeking treatment for a medical condition.

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