A Psychiatrist's Caution: Rethinking the Role of CBD and THC in Anxiety and Depression
By Brittany Albright MD, MPH, addiction psychiatrist with Sweetgrass Psychiatry
Cannabis products are found everywhere and are commonly advertised as helping individuals with mental health conditions. Do they really work though?
In my psychiatric practice, I often encounter patients curious about alternative treatments for mental health conditions, particularly Cannabidiol (CBD) and Tetrahydrocannabinol (THC). Both compounds, derived from cannabis plants, have been touted for their potential mental health benefits. However, as a medical professional grounded in evidence-based practice, I must emphasize caution. This post aims to discuss the concerns surrounding the use of CBD and THC for treating anxiety and depression, focusing on the lack of comprehensive research and regulatory oversight.
Understanding CBD and THC
CBD is known for its non-psychoactive properties, while THC is the main psychoactive component of cannabis. Both interact with the body’s endocannabinoid system but in different ways, influencing mood, perception, and cognition.
The Limited Research on CBD and THC
The primary issue with recommending CBD and THC for anxiety and depression is the lack of extensive, controlled clinical trials. Most studies to date are preliminary, with many focusing on animal models or small human samples. This lack of robust research makes it difficult to validate their efficacy and safety in treating these complex mental health conditions.
Unregulated Market and Product Variability
Both CBD and THC products suffer from a lack of regulation. In countries or states where they are legal, these substances are not uniformly regulated for purity, concentration, or quality. This inconsistency poses significant risks, including potential contamination or inaccurate labeling.
Potential Risks and Side Effects
While some people might experience relief with CBD or THC, others may face adverse effects. THC, in particular, can exacerbate anxiety or induce paranoia in some individuals and has been associated with psychotic disorders. It can also trigger manic episodes and psychosis in individuals with bipolar disorder. The potential for dependency with THC is also a concern, especially in those with a history of substance use disorders. Interactions with other psychiatric medications are another critical consideration. Additionally, it is not safe to drive on THC products.
There is abundant research on the harms of THC on the developing brain and we strongly advise adolescents and young adults to refrain from THC use.
Legal and Ethical Implications
The legal status of CBD and THC varies widely, and in many places, THC remains illegal. As a healthcare professional, it is my duty to adhere to legal and ethical guidelines, which means being cautious about substances that have not received regulatory approval for medicinal use.
Advocating for Evidence-Based Treatments
Given the current state of research, my approach favors well-established treatments for anxiety and depression. These include various pharmacological options and psychotherapies that have undergone rigorous testing and regulatory scrutiny.
Conclusion
While the exploration of CBD and THC in psychiatry is an exciting prospect, the current lack of comprehensive research and regulatory oversight cannot be overlooked. As a psychiatrist, my priority is the safety and well-being of my patients, which means relying on treatments supported by solid evidence. I urge those considering CBD or THC for anxiety or depression to consult with healthcare professionals and approach these substances with caution.
Contact Sweetgrass Psychiatry in Mount Pleasant, SC today if you are interested in getting help for your anxiety, depression, mood disorder, or substance use disorder.