Anxious consumers are looking for help, and pot companies have promoted their products as an answer
Lots of people with anxiety are counting on cannabis’s ability to treat their symptoms. There’s a problem: The science shows that it probably doesn’t help, and it may make those symptoms worse.
Cannabis companies have promoted their products as helpful for anxiety, making for a potentially lucrative market. Anxious consumers have turned to weed and edibles for relief as treatments for their ailments have become harder to find. The number of available and affordable therapists badly lags demand and traditional medications don’t work for everyone.
Driving both users’ and businesses’ hopes is a belief that pot can make us less anxious. Yet little independent scientific evidence shows that cannabis is an effective treatment for anxiety problems, and some studies have found it can worsen symptoms. Researchers say this is particularly true for products high in THC, the substance responsible for marijuana’s intoxicating effects.
A survey last year found that nearly two-thirds of people said they would prefer to use cannabis rather than pharmaceuticals to treat a medical issue, according to the survey conducted by the Harris Poll on behalf of cannabis company Curaleaf of almost 2,000 adults who were at least 21 years old. And among the 54% of respondents who said they had ever used cannabis, 41% of them said they consumed cannabis to reduce anxiety.
“I have patients who use it every day. They say it really helps,” said Dr. Beth Salcedo, a psychiatrist and medical director of the Ross Center in Washington, D.C., who specializes in treating anxiety disorders. “My message is that if it were really working for you, you wouldn’t be here with me.”
When Salcedo talks with patients about what their anxiety was like before cannabis, she said they usually report that their anxiety is unchanged. Any transient relief they feel may be due in part to marijuana’s high, she said.
The messaging
Cannabis companies have promoted the idea that their products can help anxiety. That’s a potentially lucrative market for an industry where profits have fallen short of many entrepreneurs’ lofty expectations.
Legal cannabis revenue was expected to reach $30 billion a year by now, according to estimates from Harvard University economist Jeffrey Miron. It is only half that figure. Earlier bets on selling legal pot as a salve for pain and post-traumatic stress disorder haven’t proved as profitable as hoped.
Irwin David Simon, chief executive of Tilray Brands, the first cannabis company to trade publicly on a major U.S. stock exchange, said in an interview he thinks cannabis can be a useful alternative to pharmaceuticals for many conditions, including anxiety. He said it’s a promising market that produces repeat customers.
“Is it to replace alcohol? Pain for cancer patients? Sleep? Anxiety? I think it’s absolutely for all of the above,” he said.
Busy Philipps, the actor, author and influencer, described using marijuana for her panic attacks and anxiety in a 2021 live-streamed event that was sponsored by Curaleaf, the largest cannabis company in the U.S.
“I immediately felt better but present and myself, but, like, the anxiety attack, the edge had been taken off. I was calm,” said Philipps, a mother of two. “I didn’t feel messed up or anything. I could still hang with my children and still be a mom and still make mac and cheese.”
Curaleaf said Philipps wasn’t paid for her appearance. Through a publicist, she declined to comment.
Busy Philipps, the actor, author and influencer, described using marijuana for her panic attacks and anxiety in a 2021 live-streamed event that was sponsored by Curaleaf. PHOTO: EVAN AGOSTINI/INVISION/AP
Joining Philipps on the webcast was Stacia Woodcock, then a pharmacist and dispensary manager for Curaleaf. During the event, Woodcock said that anxiety, as well as autoimmune disorders and arthritis, can overwhelm the endocannabinoid system in the brain and body. (This system is involved in learning, memory, mood and many other functions.)
“So you supplement with cannabis and it brings your body back into balance,” said Woodcock, according to the video recording.
Woodcock said in an email that she recalls that the intention of the webcast was to “discuss the stigma of cannabis use and its potential benefits for some people,” and not as a promotion of it as a treatment for anxiety. Woodcock is no longer employed by Curaleaf full-time but works as a pharmacist for the company on contract.
Curaleaf’s former chief executive, Joseph Bayern, mentioned anxiety several times when talking to investors about the company’s plans to grow its market.
“Bringing in people who are currently consuming alcohol or using products in the health and wellness market for things like sleep or anxiety, or going all the way to the prescription drug market for the use of opioids for chronic pain relief, I mean that is a huge addressable marketplace,” Bayern told investors in March 2021, according to a transcript of the call.
Anxiety is one of the most common symptoms that visitors to Curaleaf’s dispensaries are looking to address, according to a company spokeswoman. She noted that several states have made anxiety a qualifying condition to receive a medical marijuana card.
Curaleaf doesn’t target people with anxiety or promote cannabis specifically for anxiety, she said, and recommends that people consult with a doctor before choosing cannabis to address any specific need, she said.
Bayern, the former CEO, said he stands by his belief that cannabis “can be used as a natural alternative to prescription drugs and alcohol” and that he has spoken to hundreds of people who have shared stories of cannabis helping with anxiety, pain relief and PTSD. Curaleaf declined to provide a comment from its current CEO.
Product guidance
At the same time, cannabis companies train their retail staff—dubbed “budtenders”—to recommend products depending on customers’ needs, ailments or moods.
Anne Hassel became a budtender at a Massachusetts dispensary in 2015 because she believed then that pot could help people suffering from various medical conditions. PHOTO: ANNE HASSEL
Anne Hassel became a $15-an-hour budtender for a New England Treatment Access dispensary in 2015, leaving a higher-paying job as a physical therapist because she believed pot could help people suffering from various medical conditions.
“This was my dream job,” she said. “I was very evangelical about it. I really believed.”
Hassel, 56, worked at the Northampton, Mass., dispensary until 2017, when she quit over what she perceived as dangerous sales practices by her employer; she has since spoken out against the cannabis industry. Hassel said company materials stated that NETA couldn’t give medical advice. She said budtenders also received a chart from management recommending ways to guide customers toward certain pot products depending on their ailment. The Wall Street Journal reviewed both documents.
The chart, labeled “NETA product guidance,” advised budtenders to suggest products with high levels of THC for stress that manifests with headaches and lower-THC indica strains for customers trying to “get away from anxiety meds or sleeping meds.”
Kevin Fisher, a NETA founder, said he couldn’t comment because he is no longer affiliated with the company. A spokesman for NETA’s owner, cannabis company Parallel, said, “We have serious concerns about the accuracy of the information you have received and have no further comment.”
The science
Two recent studies show the potential problems with treating anxiety with cannabis.
Cannabis use was significantly associated with increased odds of developing anxiety conditions, according to a review of research published in 2020 in the Canadian Journal of Psychiatry. Recent cannabis use was associated with more severe symptoms in people with anxiety and mood disorders, according to another review published in 2018 in the Journal of Clinical Psychiatry.
The industry has funded its own studies.
In one study published in 2022, researchers affiliated with Harvest Medicine, a chain of cannabis clinics and a telehealth service in Canada, found that people using medical cannabis for anxiety saw clinically significant improvement on a measure of anxiety.
In some surveys, cannabis users have reported that they have felt relief from anxiety symptoms after consuming cannabis.
There is some evidence that cannabidiol, or CBD, which is a nonintoxicating substance derived from cannabis, may relieve anxiety symptoms. But the science is limited. Companies and scientists say federal restrictions, which may soon lift, have hampered research on cannabis.
The complexity of the cannabis plant—and the many cannabis products available—make it difficult to study and determine how best to use it therapeutically, said Ziva Cooper, director of the Center for Cannabis and Cannabinoids at the University of California, Los Angeles.
The composition of products can also vary from batch to batch, said Cooper. Products have different effects on people depending on their age, usage and other factors too.
“When you go to the pharmacy, the Prozac you get is going to be just like the Prozac that you got last month. There’s a great deal of very controlled research to provide a road map of how to use it. With cannabis, we don’t have that,” Cooper said.
Anne Marie Albano, director of the Columbia University Clinic for Anxiety and Related Disorders, said that marijuana can interfere with treatment for anxiety.
The most evidence-based non-drug treatment for anxiety disorders, cognitive behavioral therapy, involves approaching the situations that make you anxious and learning how to tolerate the uncomfortable feelings. Being high can get in the way of that, she said.
The risks
Using cannabis regularly comes with a significant risk of addiction. Among people who reported using marijuana in the past year, about 30% have cannabis use disorder, according to an analysis of federal data. Marijuana use can become a disorder when people need to use an increasing amount to get the same effect and when the use interferes with work and relationships, among other symptoms.
Marijuana users also run a higher risk of delusions and psychosis, research has found.
Jordan Davidson, 22, was diagnosed with generalized anxiety disorder as a kid growing up in Connecticut. In high school, he started using high-potency THC products, which at first, he said, made him have fewer anxious thoughts. But soon, when he didn’t have marijuana, he felt like his skin was crawling; he couldn’t sleep.
‘I feel like I was duped [into believing] it’s not addictive, it’s just a plant, it will cure your anxiety,’ said Jordan Davidson. PHOTO: JORDAN DAVIDSON
Ultimately, he decided to get help and hasn’t used cannabis since 2018, he said. He joined a group dedicated to convincing lawmakers in Washington that the substance is dangerous.
“I feel like I was duped [into believing] it’s not addictive, it’s just a plant, it will cure your anxiety,” he said. “We were played.”