Cannabis and Stress
“Stress occurs when an individual perceives that the demands
of an external situation are beyond his or her perceived ability to cope with
them.” The characterization of human stress and coping response was established
in the 1960s by Professor Richard Lazarus at UC Berkeley (Lazarus 1966)
Elevated stress response can have a profoundly negative
impact on health. Stress induces the production of hormones that elevate heart
rate and blood pressure, stimulates the gut to speed up digestion, and
aggravates many medical conditions.
The “fight or flight” response can be triggered by stress.
Anxiety and depression are often linked to chronic stress. Nearly all cannabis
users not that cannabis helps counteract the effects of stress. However,
because chronic cannabis use is associated with higher blood levels of stress
hormones, such use may risk initiating a cycle of stress release, followed by
increased stress response.
The rise of cannabis use as an intoxicant and euphoriant in
the 20th century certainly parallels the increase in stress-related
disorders in contemporary society.
Anxiety and stress are often thought of as the same
experience. However, many patients are not using cannabis for anxiety, but for
coping and to relieve stress. Anxiety and stress are always listed among the top reasons
for which patients say they use medical cannabis – second only to pain. (Walsh 2013) (Grella 2014)
Acute stress disorder, as defined in psychiatry, is more
concerned with the type of catastrophic events that result in PTSD, and is considerably
different than the way most people experience and describe stress. (Bryant 2011)
Cannabis users score lower on measures of
hypothalamic-pituitary-adrenal (HPA) axis reactivity than non-users, which is a
common measure of acute stress response. However, high doses of cannabis can
trigger HPA axis reactivity and an increase in cortisol production (a steroid
hormone produced in response to stress). (Ranganathan 2010)
Chronic overdosage of cannabis may reduce the ability of
cannabis to reduce symptoms of stress, because of cannabinoid receptor
downregulation. Chronic THC administration downregulates CB1 receptors, and
chronic cannabis users typically exhibit reduced cortisol reactivity. (Somaini 2012) (King 2011)
Male chronic cannabis users typically have higher cortisol
levels than female users.
Research into the role for the Endocannabinoid System and
its relationship to stress are consistent with the observations about
cannabinoids and anxiety. THC can cause anxiety at higher doses and relieve it
at lower doses. CBD can relieve preexisting anxiety and prevent subsequent
anxiety after administration. (Bergamaschi 2011) CBD can modulate and reduce anxiety triggered
by THC. (Todd 2016)
Stress response is mediated by the HPA axis, which consists
of the hypothalamus and pituitary gland within the brain, and the adrenal
glands on the kidneys. The HPA axis is regulated by the endocannabinoid
system. (Robson 2013)
The endocannabinoid system both reacts to stress and assists
with adaptation to stress. (Hillard 2013)
There are animal studies of FAAH and MAGL inhibitors (the
enzymes that metabolize the endocannabinoids anandamide and 2-AG) that show
that inhibiting these enzymes reduces anxiety. (Tambaro 2012) (Fowler 2015)
The HPA regulates all this through the release of steroid
hormones such as cortisol, commonly described by the “stress hormone.”
Endocannabinoid signaling has proven essential in enabling adaptation to
stress. (Hill 2010)
Cannabidiol is quite effects in animal models for reducing
stress-related anxiety and lingering anxiety, after being exposed to stress. (Resstel 2009)
The ability of CBD to reduce stress-related anxiety was
linked to CBD’s ability to encourage nerve production within the
hippocampus. (Campos 2013)
The endocannabinoid system also regulates the creation,
consolidation, and extinguishing of memories associated with stress. (Akirav 2013)
Dosing with Cannabis
for Stress
Always talk to a trusted medical professional who knows
about the endocannabinoid system and cannabis medicine for your personal
condition. Patients report the most effective THC dose for stress relief is
quite small, around 2 mg of THC, whereas CBD is effective for stress at doses
between 2.5 to 5 mg.
Oral or sublingual cannabis is effective for stress relief.
Oral-mucosal and sublingual doses of cannabis products deliver rapid onset and
a more complex “entourage” effect associated with terpenes. If CBD and THC are
used together, a ratio of 2:1 CBD:THC is a good starting point, and the initial
oral dose should be at the lower range (5 mg/2.5 mg CBD/THC). To nearly
eliminate psychoactivity, a 10:1 ratio of CBD:THC is recommended. Patients
report that 5 mg of CBD taken in the morning, then again in the afternoon
before 5 pm, is often sufficient to relieve symptoms of chronic stress.
The most common way for helping to manage life stresses with
medical cannabis is by smoking or vaporizing after work and at bedtime in
relatively small amounts. Single inhalations of small doses of vaporized or
smoked cannabis are often adequate in relieving stress. High CBD cannabis can
be vaporized discreetly during the day without fear of intoxication.
Bubba Kush, purple varieties, and high CBD varieties, such
as Cannatonic or AC/DC, are recommended Typically, mildly sedative THC dominant
chemotypes are effective for relaxation and stress relief. CBD strains are also
effective for relieving attendant anxiety. Terpenes, such as myrcene, linalool,
and limonene, should increase effectiveness, as well, which are associated with
purples, Bubba Kush, and OG Kush.
Information about Cannabis and Stress came from the amazing
book Cannabis Pharmacy: The Practical Guide to Medical Marijuana by Michael
Backes, Andrew Weil, M.D. and Jack McCue, M.D.
You can find this book here
