We’ve probably all heard this: “Weed helps me relax.” “I have a cannabis prescription for my anxiety.” Some clients report getting a lot of benefit from it (which can be a good thing). Other psychedelics like psilocybin and MDMA have increasingly showed benefits for certain mental health difficulties. And cannabis has become increasingly legalized across Western societies. But does cannabis for anxiety and other difficulties really help?
For the classic stereotypical effects on memory and attention, research findings are actually mixed. Studies consistently find negative effects of cannabis on cognitive functioning in the short-term and while intoxicated. But findings of the long-term effects on memory and attention have not been consistent in general (other than negative effects found for those who use regularly earlier in life).
Whether cannabis helps for anxiety really depends on the dose. CBD overall appears to have some benefits. There is also some evidence that THC helps or has no effect on anxiety at lower doses. But evidence mostly finds that THC can actually have negative effects and spur greater anxiety at higher doses.
Interestingly, cannabis does not appear to increase the risk of developing depression, certain forms of anxiety, or PTSD. It may also improve learning and memory for those who experience psychotic disorders. Despite these effects and immediate perceived benefits of cannabis for clients, there are actually multiple negative associations with cannabis and mental health outcomes.
Cannabis appears to increase the risk of developing social anxiety or attempting suicide. It also increases the risk of developing schizophrenia or other psychoses. Heavy cannabis use appears to increase risk of greater symptoms for those with bipolar disorders. Cannabis also lead to increased hospital emergency visits. Findings therefore appear somewhat mixed, but mostly unfavorable for cannabis and mental health.
Developmentally, findings are clear that cannabis has increased risk of negative effects on cognitive development and mental health outcomes across the lifespan for adolescent and young adult use. This is because this phase in development is crucial for neurological development. Cannabis appears to inhibit development of brain regions important for general cognitive functioning, reality testing, and emotion regulation.
Each client is different. Psychiatrist consultation could be beneficial for highly specialized assessment of how cannabis affects your individual client. Many enjoy the psychoactive effects of cannabis, so clients could have resistance to this referral. But Motivational Interviewing often uses medical information about substance effects as a key point. This specialized assessment can provide clarification that may aid current or later behavior change attempts if clients find desire to engage in the change process.
