Covid-19 is taking a serious toll on mental health. Polls from the CDC and other organizations show that the pandemic has greatly increased mental health issues like anxiety, depression and suicidal thoughts. While struggling with these challenging symptoms, many are losing jobs and access to their previous healthcare, all while being cut off from direct contact with larger support networks of friends and family. It is a perfect storm of factors to exacerbate mental health issues.
Now, a new study from the Journal of Addictive Diseases is highlighting one way that people are trying to cope with the stressful situation – using cannabis.
According to the researchers on the study, medical cannabis users with mental health conditions reported big increases in their cannabis use since Covid-19 began – increasing their use on average by 91%.
The study was conducted by researchers at several universities including The University of Miami, The University of North Carolina, Chapel Hill, The University of Texas, and State University of New York, Brooklyn. These researchers looked specifically at 1202 medical cannabis users who have chronic conditions that they treat with cannabis – aiming to find out how these patients behaviours around cannabis might have changed since the pandemic began. To accomplish this, they used an internet-based questionnaire to ask a sample of adult medical cannabis patients questions about their health conditions and cannabis use.
The participants suffered from a range of chronic health issues including mental health conditions, chronic pain, cardiometabolic conditions, and autoimmune conditions. All had reported medical cannabis use in the last 30 days, with the majority (65.3%) reporting daily or almost daily use.
The researchers were interested in learning about how these patients had changed their behavior around cannabis, and asked specifically about how their dose had changed. Interestingly, around half of the patients reported no change in their dose, while 38.4% reported an increase and only 8.8% reported a decrease.
But those with mental health issues reported the biggest change, with a 91% increase in cannabis use since the pandemic began. This sheds some light on how medical cannabis patients with mental health challenges may be impacted by the pandemic – suggesting that they may be coping through increased cannabis use.
Still, this study is somewhat limited by its survey methodology. Surveys are generally considered to be less reliable than many other types of scientific studies because of the issue of self-reporting bias, where respondents may selectively suppress or exaggerate information. Individuals aren’t always accurate when it comes to estimating changes in their own behavior – even when they try to be.
But these results do make sense in the context of previous studies, cited by the authors, suggesting cannabis use increases in times of stress, trauma and after natural disasters.
One thing the study wasn’t able to tell us, is whether the medical cannabis patients increasing their use saw improvements in their symptoms from using more cannabis. While many medical cannabis users report benefits from using cannabis for mental health conditions like anxiety, depression and PTSD, research has been somewhat inconclusive as to whether cannabis is helpful or harmful for these conditions in the long run.
Some studies show anxiety relieving effects of cannabis, which can even prevent stress before it happens by blunting the body’s reactivity to stressful stimuli. But reviews of the cannabis literature, such as the 2017 report by the National Academies of Science and Engineering, have found that the evidence is fairly weak to support the conclusion that cannabis can be used as a long term anxiety or PTSD treatment. While some evidence points towards its effectiveness, other evidence suggests it could lead to heightened social anxiety symptoms when used for an extended time.
There is also controversy over whether cannabis should be used for depression. Some studies have found that cannabis use – while alleviating depressive symptoms in the short term – can lead to increasingly worse depression over time. But others report more positive results, some showing improvements in depression and others suggesting that the association between increased depression and cannabis use disappears when confounding factors are accounted for.
Part of the inconsistency in the literature could be due to cannabis having biphasic effects. This means that its impacts on anxiety and depression may go in both directions – relieving symptoms in some cases and increasing them in others, usually due to differences in dose. So, even if these patients were previously benefiting from cannabis, it’s unclear whether increasing their dose would result in improved or worsening symptoms.
While treating anxiety, depression and PTSD with cannabis is controversial – with evidence both for and against its effectiveness. Research is more conclusive that cannabis could be harmful for conditions that involve psychosis, like schizophrenia and bipolar disorder, where cannabis’ primary ingredient THC seems to increase symptoms, and risks of developing the condition for those who are genetically predisposed. Still, even with these conditions, researchers are looking into CBD, another cannabinoid in cannabis, as an antipsychotic which may prove to be helpful for managing these conditions when used in an isolated form.
Only more research will tell us whether cannabis can truly be effective for treating mental health conditions – and whether increasing dosage helps or hurts during times of heightened stress. For now, those struggling with mental health issues during the pandemic should talk to their doctor about the best way to approach treatment during these difficult times.