Cannabis and Mental Wellness: The Short Answer
CBD and THC act on the body in different ways. THC binds CB1 receptors in the brain. It can trigger anxiety, paranoia, and racing thoughts. CBD does not bind CB1 at that site. Its effect on mood is less clear.
No cannabis product has FDA approval to treat anxiety, depression, bipolar disorder, or insomnia. Epidiolex, a purified CBD liquid, is the only FDA-approved cannabis-derived drug. It treats two rare forms of epilepsy.
What the FDA Has Approved
Epidiolex won FDA approval in June 2018 for Lennox-Gastaut syndrome and Dravet syndrome. Trial doses ran from 5 mg per kg per day to 20 mg per kg per day. Side effects included sleepiness, diarrhea, and rises in liver enzymes.
cannabis and mental health disorders
The FDA has not approved any over-the-counter CBD product for any health claim. Labels on store-bought CBD often list amounts that differ from the bottle contents.
Cannabis Impact on Mental Health: A Comprehensive Guide
THC and Mental Health
THC potency rose over three decades. NIDA reports that average THC in seized cannabis went from under 4% in 1995 to about 15% in 2021. Concentrates can test above 60%.
High-THC products raise the risk of short-term anxiety, panic, and paranoia. People with a family history of psychosis or schizophrenia face higher risk from regular use. Onset age matters. Teens who start use face higher risk than adults who start after 25.
Cannabis Use Disorder
About 3 in 10 people who use cannabis develop cannabis use disorder, per CDC. Signs include cravings, tolerance, and use that continues despite problems at work or home. Withdrawal can bring irritability, sleep problems, and low appetite.
CBD and Anxiety Research
Trial sizes for CBD and anxiety stay small. A 2011 randomized trial gave 600 mg of CBD to people with social anxiety disorder. The CBD group reported lower anxiety during a public speaking task than the placebo group. Other trials used 300 mg or less. Results have not been consistent. Long-term data on daily CBD for anxiety is limited. Most trials ran for a few weeks. No standard dose exists.
Drug Interactions and Side Effects
CBD inhibits the cytochrome P450 enzymes CYP3A4 and CYP2C19. That can raise blood levels of some drugs, including warfarin, clobazam, and certain anti-seizure drugs. Epidiolex labeling requires liver enzyme monitoring.
Common CBD side effects:
- Drowsiness
- Dry mouth
- Diarrhea
- Lower appetite
What Is Not Known
- No dose-response curve for CBD in anxiety.
- No safety data past 12 months of daily use.
- No evidence that CBD treats depression or bipolar disorder.
- No reliable way to compare one CBD brand to another without a lab report.
Federal Law and Product Testing
Cannabis sits in Schedule I under federal law. State laws differ. Hemp-derived CBD with less than 0.3% THC is legal under the 2018 Farm Bill. A useful lab report lists cannabinoid content, pesticides, heavy metals, residual solvents, and microbials. Ask for the batch number and the test date.