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Cannabis and Anxiety: A Critical Review
Alexander Beletsky1, Cherry Liu1, Bryson Lochte2
1Riverside Community Hospital (RCH), San Diego, CA, USA.
Medical Cannabis and Cannabinoids
|February 26, 2024
Summary
Anxiety may lead individuals to use cannabis for self-medication, rather than cannabis use causing anxiety disorders. This systematic review suggests self-medication is the most plausible explanation for the cannabis-anxiety link.
Area of Science:
- Psychiatry
- Neuroscience
- Public Health
Background:
- Cannabis use has been linked to anxiety disorders, but the causal relationship remains unclear.
- Cannabis can produce both anxiety-reducing and anxiety-inducing effects.
- Understanding the association between cannabis use (CU) and anxiety disorders (AD) is crucial for public health and clinical practice.
Purpose of the Study:
- To systematically review the literature on the relationship between cannabis use/disorder and anxiety.
- To investigate potential causal pathways, including causality, common factor theory, and self-medication hypothesis.
Main Methods:
- A critical systematic review of published literature was conducted.
- Searches included MEDLINE using terms related to anxiety and cannabis.
- Studies encompassed case reports, reviews, observational, preclinical, and clinical research.
Main Results:
- Meta-analysis indicated a correlation between cannabis use (OR=1.24) or cannabis use disorder (OR=1.68) and anxiety.
- PATH analysis supported the self-medication hypothesis as the best explanatory model.
- Causal interpretations were deemed less plausible, with limited support for common factor or reciprocal feedback theories.
Conclusions:
- The association between cannabis and anxiety is best explained by individuals with anxiety using cannabis for self-medication.
- A direct causal link where cannabis use leads to anxiety disorders is less likely.
- Further research is needed to fully elucidate the complex interplay between cannabis use and anxiety.
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