These statistics vary drastically around the world, for many reasons. But in the US, at least, widespread and growing use points to a reality in which cannabis products ought to be part of any discussion about mental health. It also points to a need for these discussions to be based in evidence, not alarmism or anecdote.
Another substance to worry about?
Subject to claims of effectiveness for all kinds of conditions, CBD is being marketed far more quickly than it can be researched. Due to its trendiness and a shaky but largely unenforced legal status, US sales grew from $108.1 million in 2014 to an estimated $813.2 million in 2019. By 2022 CBD sales are projected to approach $2 billion. Walgreens sells CBD products in nine states, CVS in eight. A staggering 14% of American adults say they use CBD, primarily for pain, anxiety, and insomnia.
Cannabis products and OCD
Researchers have conducted a few animal studies with cannabinoids, yielding mixed results. Two studies, from 2010 and 2013, linked CBD with a reduction in compulsive-like marble-burying behavior among mice. However, as Dr. Feusner notes, the observed mouse behaviors like marble-burying or pathological grooming aren’t necessarily complete models for OCD in humans.
Background: Preclinical data implicate the endocannabinoid system in the pathology underlying obsessive-compulsive disorder (OCD), while survey data have linked OCD symptoms to increased cannabis use. Cannabis products are increasingly marketed as treatments for anxiety and other OCD-related symptoms. Yet, few studies have tested the acute effects of cannabis on psychiatric symptoms in humans.
Methods: We recruited 14 adults with OCD and prior experience using cannabis to enter a randomized, placebo-controlled, human laboratory study to compare the effects on OCD symptoms of cannabis containing varying concentrations of Δ-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) on OCD symptoms to placebo. We used a within-subjects design to increase statistical power. Across three laboratory sessions, participants smoked three cannabis varietals in random order: placebo (0% THC/0% CBD); THC (7.0% THC/0.18% CBD); and CBD (0.4% THC/10.4% CBD). We analyzed acute changes in OCD symptoms, state anxiety, cardiovascular measures, and drug-related effects (e.g., euphoria) as a function of varietal.
Conclusions: This is the first placebo-controlled investigation of cannabis in adults with OCD. The data suggest that smoked cannabis, whether containing primarily THC or CBD, has little acute impact on OCD symptoms and yields smaller reductions in anxiety compared to placebo.