Effects of Marijuana on Mental Health: Anxiety Disorders 5 | P a g e
increase anxiety at higher doses. On the other hand, pure CBD appears to decrease anxiety at all doses that have
been tested. There appears to be tolerance to these effects over a short period of time with regular use. There are
individual differences in responses to marijuana that are affected by a variety of factors. Many people report using
marijuana to cope with anxiety, and this may be particularly common among those with social anxiety disorder. Those
who are concerned about marijuana increasing anxiety are unlikely to use it whereas those who use it and find it to be
beneficial presumably continue to use marijuana. Doing so may offer some benefit in the short term, at least in terms
of anxiety, but well-controlled studies indicate that use of marijuana is associated with increased likelihood of
substance use disorders in the future.
References
1. Center for Behavioral Health Statistics and Quality. Results from the 2015 National Survey on Drug Use and Health: Detailed Tables.
Rockville (MD): SAMHSA; 2016. https://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs-2015/NSDUH-DetTabs-2015/NSDUH-
DetTabs-2015.pdf
2. Hasin DS, Saha TD, Kerridge BT et al. Prevalence of marijuana use disorders in the United States between 2001-2002 and 2012-2013.
JAMA Psychiatry 2015;72(12):1235-42.
3. Grucza RA, Agrawal A, Bierut LJ. NESARC Findings on Increased Prevalence of Marijuana Use Disorders—Reply: Consistent With Other
Sources of Information. JAMA Psychiatry 2016;73(5):532-3.
4. Compton WM, Han B, Jones CM et al. Marijuana use and use disorders in adults in the USA, 2002–14: analysis of annual cross-sectional
surveys. The Lancet Psychiatry 2016;3(10):954-64.
5. State Marijuana Laws in 2017 Map. Governing [online magazine] http://www.governing.com/gov-data/state-marijuana-laws-map-medical-
recreational.html
6. Reinarman C, Nunberg H, Lanthier F. Heddleston T. Who are medical marijuana patients? Population characteristics from nine California
assessment clinics. Journal of Psychoactive Drugs 2011;43(2):128-35.
7. Walsh Z, Gonzalez R, Crosby K et al. Medical cannabis and mental health: A guided systematic review. Clinical Psychology Review
2017;51:15-29.
8. ElSohly MA, Mehmedic Z, Foster S et al. Changes in cannabis potency over the last 2 decades (1995–2014): analysis of current data in the
United States. Biological Psychiatry 2016;79(7):613-9.
9. Pacher P, Bátkai S, Kunos G. The endocannabinoid system as an emerging target of pharmacotherapy. Pharmacological Reviews
2006;58(3):389-462.
10. Volkow ND, Hampson AJ, Baler RD. Don't Worry, Be Happy: Endocannabinoids and Cannabis at the Intersection of Stress and Reward.
Annual Review of Pharmacology and Toxicology 2017;57:285-308.
11. Russo E, Guy GW. A tale of two cannabinoids: the therapeutic rationale for combining tetrahydrocannabinol and cannabidiol. Medical
Hypotheses 2006;66(2):234-46.
12. Russo EB. Cannabidiol Claims and Misconceptions. Trends in Pharmacological Sciences. 2017;38(3):198-201.
13. NIDA's Role in Providing Marijuana for Research. https://www.drugabuse.gov/drugs-abuse/marijuana/nidas-role-in-providing-marijuana-
research.
14. Marijuana Plant Material Available from the NIDA Drug Supply Program https://www.drugabuse.gov/researchers/research-resources/nida-
drug-supply-program-dsp/marijuana-plant-material-available-nida-drug-supply-program
15. Atkinson DL. Marijuana’s effects on the mind. In: Compton M, editor. Marijuana and mental health. Arlington (VA): American Psychiatric
Association Publishing, 2016. p. 11-37.
16. Viveros MP, Marco EM, File SE. Endocannabinoid system and stress and anxiety responses. Pharmacology Biochemistry and Behavior
2005;81(2):331-42.
17. Lutz B, Marsicano G, Maldonado R, Hillard CJ. The endocannabinoid system in guarding against fear, anxiety and stress. Nature Reviews
Neuroscience 2015;16(12):705-18.
18. Ruehle S, Rey AA, Remmers F, Lutz B. The endocannabinoid system in anxiety, fear memory and habituation. Journal of
Psychopharmacology 2012;26(1):23-39.
19. Lee CM, Neighbors C, Woods BA. Marijuana motives: Young adults' reasons for using marijuana. Addictive Behaviors 2007;32(7):1384-94.
20. Kristjansson SD, Agrawal A, Lynskey MT, Chassin LA. Marijuana expectancies and relationships with adolescent and adult marijuana use.
Drug and Alcohol Dependence 2012;126(1):102-10.
21. Crippa JA, Zuardi AW, Martín‐Santos R et al. Cannabis and anxiety: a critical review of the evidence. Human Psychopharmacology: Clinical
and Experimental 2009;24(7):515-23.
22. Childs E, Lutz JA, de Wit H. Dose-related effects of delta-9-THC on emotional responses to acute psychosocial stress. Drug and Alcohol
Dependence 2017;177:136-44.
23. Blessing EM, Steenkamp MM, Manzanares J, Marmar CR. Cannabidiol as a potential treatment for anxiety disorders. Neurotherapeutics
2015;12(4):825-36.
24. State-by State MMJ Qualifying Conditions (Leafly.com) https://www.leafly.com/news/health/qualifying-conditions-for-medical-marijuana-
by-state
25. California allows physicians to authorize use of medicinal marijuana for “any other chronic or persistent medical symptom that either (a)
substantially limits the ability of the person to conduct one or more major life activities as defined by the Americans with Disabilities Act of
1990 or (b) if not alleviated, may cause serious harm to the patient’s safety or physical or mental health.” Source:
ftp://www.leginfo.ca.gov/pub/03-04/bill/sen/sb_0401-0450/sb_420_bill_20031012_chaptered.html
26. Sexton M, Cuttler C, Finnell JS, Mischley LK. A Cross-sectional survey of medical cannabis users: Patterns of use and perceived efficacy.
Cannabis and Cannabinoid Research 2016;1(1):131-8.
27. Blanco C, Hasin DS, Wall MM et al. Cannabis use and risk of psychiatric disorders: prospective evidence from a US national longitudinal
study. JAMA Psychiatry 2016;73(4):388-95.