Discussion

Huge study finds no evidence cannabis helps anxiety, depression, or PTSD

int32_64: It's good to see science confirm what anybody who has accidentally taken too large of edibles dose understands.

embedding-shape: [delayed]

sublinear: If anything, I think most people discover anxiety with cannabis.It's a shame that first experiences with stress also coincide with that phase of life, so the debate never ends.

entropie: Ive overdosed edibles multiple times and I dont know what you talk about.

billfor: Well how do you know if you overdosed? What else happens besides anxiety and paranoia? Some of the reaction may be genetic, but I think many people have a negative reaction to taking mass quantities of cannabis.

bitxbitxbitcoin: The studies cited by this metastudy all suffer from the same issue: They aren't studying the same plants or chemical formulations that real consumers are actually consuming - due to cannabis sourcing issues stemming from cannabis's continued illegality.For randomized controlled trials, even in "legal" states, university scientists can't just walk into a dispensary and buy cannabis to then administer to test subjects.That's Post-Prohibition for you.As far as I can tell, all of the studies utilize isolates - and not necessarily in conjunctionFor instance, none of the 6 anxiety studies included in this metastudy used THC and CBD together.The headline could read instead: No evidence cannabinoid isolates helps anxiety, depression, or PTSD.Cannabis advocates are the first to mention the entourage effect. Cannabis prohibitionists on the other hand, love nothing more than to cite incomplete science.

MagicMoonlight: Obviously. It was always just a scam so that people could do drugs.Anyone who knows a weed addict knows that they end up anxious and stupid. It actually seems to reduce their IQ while they’re using it regularly.

mihaaly: But it can cause memory loss, impaired motor coordination, and food craving. Also memory loss.

cynicalsecurity: Soon they'll realise that it's actually harmful. The wonders of dismantling DEI. Glad to see people walking up.

Aurornis: This is a hard topic to communicate in depression treatment. It's easy to mistake substances that temporarily boost your mood or calm your nerves for effective treatments for an underlying condition.There was a brief period of time before the opioid prescribing backlash when some fringe psychiatrists were proposing weaker opioids as adjunctive treatments for treatment resistant depression. It's hard to fathom now, but opioids were more casually prescribed a few decades ago. I recall some discussion where one of them said they were seeing good initial results but the effects faded, and then it was hard to get the patients off of the opioids when they were no longer helping. Not surprising to anyone now, but remember there was a period of time where many seemingly forgot about their addictive properties.I feel like I've seen a weaker version of this in some friends who turned to THC to "treat" their depression: Initial mood boost, followed by dependency, then eventually into a protracted period where they know it's not helping but they don't want to stop because they feel worse when they discontinue. This wasn't helped by the decades of claims that claimed THC was basically free of dependency problems.

andoando: This point of view makes no sense to me.If you take it and you feel your anxiety is lessened, that's the greatest proof you can ask for. All the psychiatric studies are already based on self assessment.Second, a lot of psychatric treatments are temporary, ending whenever the medication is stopped or wears off so I dont see how this would be any different

Aurornis: > If you take it and you feel your anxiety is lessened, that's the greatest proof you can ask for.This mistake has been made many time throughout history. Cocaine was originally believed to be a viable treatment for depression. Opioids and amphetamines too.Many drugs will make you feel good temporarily by blocking certain feelings or tricking your brain into feeling good. This is not the same as treating a condition.You can think of actual treatments as working closer to the source to reduce the problem, not temporarily overriding it with a powerful drug-induced sensation.

odinthedog: Matthew Hill offers a great interview on Andrew Huberman's podcast - https://open.spotify.com/episode/26PR93gyNcs8YPlQ9dypW3?si=V...As someone who's used cannabis regularly for over a decade, I tried to start to explain in this body my experience but every sentence written ends with me deciding, "that's too circumstantial to my lifestyle-physiology to include."I think at the end of the day, empirical research's purpose is to get us closer to being able to just make our own decisions surrounding mind-altering drugs. Beyond that, cannabis affects a great deal of systems in our body concurrent to the rest of our environment's effects. Use your autonomy to determine if it's a positive or a negative for you. Don't drive fucked up, please.

haghding: me n my quarter brick beg to disagree

monster_truck: Isn't the lancet the same journal that has published the vax-autism and hydroxychloroquine studies?

zarathustreal: These dismissals based on the source rather than the material are getting really annoying. We’re supposed to be intellectuals here, we can do better than that.

erelong: Still ok with it being legal but yeah that doesn't mean it's beneficial

lokar: Yep. Of course alcohol is depressive.

LPisGood: “Depressant” refers to its impacts on nervous system activity, not that it causes feelings of depression.

olyjohn: [delayed]

Aurornis: Using quantified isolates is the correct way to do a controlled study. Dosing is important.Claims that you need a special combination of exactly the right strains are just a way to move the goalposts forever. They could study 10 different strains in controlled trials and the same people would show up to dismiss this study because they weren't using some random strain that has some perfect combination of entourage effect.Using actual plants and smoking would also introduce another major variable, with further claims that the strains they were giving patients were too weak or they were smoking it wrong.

tannedNerd: Way to completely misunderstand and try in an underhanded way to the dismiss entourage effect.It’s not smoking 10 strains in a row it’s the fact that you need CBD THC and all the terpenes to get the effects. So the current growing trend of just getting the THC number higher tends to result in plants that don’t actually give people the full spectrum of effects, beneficial or not.So the correct way to do this would be a full spectrum isolate, which again you coincidently forgot to mention I’m sure.

Aurornis: > It’s not smoking 10 strains in a rowI never said it was. I was saying you could run 10 different studies on 10 different strains with 10 different "entourage effect" profiles and even if all of them were negative, they would be dismissed as not having precisely the right entourage effect.If there are anti-depressant compounds in cannabis plants then they can be extracted and isolated, too.> So the correct way to do this would be a full spectrum isolate, which again you coincidently forgot to mention I’m sure.Of course, the correct formulation is something other than what was tested, right? And if they tested a full spectrum isolate with negative results, we should assume that it just wasn't the right blend of terpenes and therefore that study should be dismissed too? Repeat ad nauseum?

lioeters: > despite millions using it for those reasons> calls for stronger regulationFindings based on a review of 54 randomized controlled trials with a total of 2477 participants. "24 (44%) of these trials had a high risk of bias, and the certainty of evidence for most outcomes was low."No evidence found this study helps all the people choosing to use herbal remedies you can grow at home for subjective relief.

noosphr: Alcohol too.It's not a cure. It's a high.

foolfoolz: same lancet that tried to bury covid lab leak theories in february 2020

object-a: Evidence for lab leak is extremely weak, zoonosis is the most likely origin:https://www.astralcodexten.com/p/practically-a-book-review-r...https://medium.com/microbial-instincts/the-case-against-the-...

jalla: So, a meta study. While important, it assumes that the underlying studies are based on solid science.So, why do people use cannabis then?

bitxbitxbitcoin: That's a great example study to highlight what I really mean by entourage effect. I've edited my post to emphasize most not all - i only looked at the 6 anxiety studies as that's what I have the most experience with - as well as the included table which highlighted that the vast majority of studies included in this metastudy only looked at THC.That particular study did look at High THC low CBD, mid THC mid CBD, and high CBD low THC. There's no information on the terpene profile of the smoked cannabis preparations, though, and that is a confounding variable in the entourage effect that potentially defeats the part of the entourage effect they did test. Additionally, a quick look at the cannabinoid %s in those smoked preparations rehighlights my point that these are not inclusive of all the chemical compositions that the cannabis plant could present itself in.I still stand by my point and hope the clarifications bring the conversation back on track to the fact I was highlighting which is simply that this is a metastudy built off of studies that were conducted with restrictions on experimental design that few observers fully understand the research implications of.

phainopepla2: Duration of effect matters when it comes to successful treatments.If we take your position and apply reductio ad absurdum, we could say that cocaine is a highly effective treatment for anxiety, although of course we know that in the not-so-long run it has the opposite effect.

andoando: [delayed]

malfist: Why do people use cigarettes? Cocaine? LSD?Not because they're effective treatments for mental disorders

paxys: Title says "helps" but the summary says "it doesn’t effectively treat anxiety, depression, or PTSD". Big difference between the two IMO.Plenty of people relying on cannabis are using it to alleviate symptoms. I don't think they expect to be cured entirely.

malfist: Tell that to my depression. Back before I got sober days after alcohol were certainly some of my lowest mood days. Its well known that alcohol impares next day production of neurotransmitters responsible for balancing moods.Now I've been sober for 7 years and my depression has been treated, but I certainly remember those days

bitxbitxbitcoin: > Using quantified isolates is the correct way to do a controlled study. Dosing is important.That's the correct way to do a controlled study on the isolate - not the plant that it comes from.It's clear to me at least that the authors of the metastudy conflate the two and many shades between them for purposes of this study.

jzb: There’s a difference between intoxication and treating the chemical imbalance behind depression or anxiety. For one thing, treatments for anxiety only target the anxiety: they don’t impair the person the way that weed or alcohol does. (They can have other side effects, of course.)Drugs for anxiety treatment do wear off, but not the same way that weed or alcohol does: something like Celexa takes a few weeks to build up in the system, and don’t lose effect 12-24 hours later if you miss a dose. I’m not sure how long you’d have to stop before it loses efficacy entirely.I’m not Nancy Reagan, though: I would not advise people to self-medicate with booze or pot if they’re suffering from depression or anxiety, but I’m not going to preach at anybody who is doing so and thinks it’s working for them. I will say that I’ve seen that end badly, though. I can think of three people I’m close to who’ve tried it and have had problems with addiction: all of them are now sober and (I believe) on regular antidepressants.

andoando: How do amphetamines treat the source of ADHD?Psychiatry as its practiced has no idea as to what depression even is under the hood. The entire science is based on the patients self reported feelings or the psychatrists feeling of how someone else is feeling.What you're saying is something else, that drugs can produce long term harm despite short term improvements

adi_kurian: Worth noting that it very much can cause feelings of depression, also.

zug_zug: I guess my reaction to this is:- The title is just saying that this recreational drug isn't a long-term medicine for these 3 conditions (but then it helps with some others). I guess we don't expect this of alcohol or anything else, so that is what it is.- Personally I'm a bit skeptical of this finding, but again like alcohol, I think weed is best enjoyed a few times a week, so I guess I don't see it as a everyday treatment for depression and such. But certainly while enjoying it one is less anxious and depressed.- And I guess it should be pointed out that treating depression is very hard. Lots of people find SSRIs don't work long term, therapy has a very low R^2, etc.

illusive4080: In alcohol’s case I think you’re masking the depression by drinking which makes you even more depressed when you aren’t drinking.

Aurornis: There are multiple treatments for ADHD, including alpha-2 receptor agonists and norepinephrine reuptake inhibitors. Some of them show patterns of increasing efficacy out to a year (the length of the study).The reason amphetamines are used for ADHD but not depression is that they've been studied to show that the ADHD improving effect can remain for many months, while the mood-improving effect will taper off quickly if you take them every day. Almost everyone who takes ADHD stimulant, feels a mood and motivation boost ("so happy I could cry" is the common phrase) and then is disappointed when that mood boost stops happening after a few weeks or months will learn this. Attention enhancement is less prone to tolerance, though it still accumulates tolerance too. There are some studies showing that the effects of stimulants in ADHD diminish substantially on a multi-year time frame, and it's probably not a coincidence that many people (though not all) who take stimulants discontinue after several years.

andoando: Im prescribed adderall for ADHD. It is a high. You feel more positive, more productive, more forward looking for a few hours and its back to baseline or worse when you crash.As for impairment, it really depends. If weed removes your anxiety and lets you relax, its benefit could be greater for what youre doing than the impairment it causes. And adderall, SSRIs can cause impairment of sorts too.

Aurornis: > The entire science is based on the patients self reported feelings or the psychatrists feeling of how someone else is feeling.This study is showing that THC, CBD, blends, or cannabis do not improve self-reported feelings over the long term.You can use pedantry and wordplay all you want, but no matter how we look at this study it does not show positive effects.> What you're saying is something else, that drugs can produce long term harm despite short term improvementsRecreational drugs make you feel good temporarily. That's literally why people do them.They also cause harm when abused.These are all obvious and well known facts.

altmanaltman: Doing ten shots of tequila is a 100% scientifically proven cure for social anxiety then. If you take it and your anxiety lessens, that's the greatest proof you can ask for! Let's just completely ignore the crippling morning hangover and liver damage

Shog9: I mean... Yeah. Alcohol is very well documented and even more widely used for exactly this purpose BECAUSE it works.The side-effects are often terrible. This is also true for many widely-prescribed drugs, and has been even more true in the past. The folks I've known on MAOIs were pretty wrecked.

Kon5ole: American media has really been shockingly pro weed/cannabis for the past 20 or so years. Really astounding to witness considering the well known downsides to human health and cognitive function. Main characters smoke weed as a cool disobedience, in sitcoms even.Wonder what is behind it, from my perspective it's quite remarkable.

Perenti: I've always been suspicious of the claims THC helps anxiety. CBD may, but my experience is that high doses of THC without corresponding CBD tends to induce anxiety in many people. I also found the brief notes in the article about MMJ and autism intriguing. I'm diagnosed ASD. I would think the use of THC to manage overstimulation could be problematic, as it tends to make colors and sounds and flavours _more_ intense. Conversely, indica strains tend to slow you down.DISCLOSURE: I use large amounts of high potency cannabis flower with CBD/CBG edibles for intractable neuropathic pain. I also smoked a hell of a lot of weed in my 20s and 30s. I've more experience of Pot than most. MMJ lowers my pain a bit, and reduces suffering a lot. Its the suffering that makes life difficult.

anon84873628: Because the Schedule 1 prohibition was ridiculous. This is the cultural pendulum swing to normalize it and push legalization.

themafia: People were smoking weed even when it was socially unacceptable and illegal. Then they were going to jail for a decade or more because of it. This simply did not make any sense. I believe most of this is a backlash effect.Weed was the worst thing ever. Weed is the best thing ever. Eventually weed will be in the same category as coffee.

andoando: I dont have a problem with the study or its conclusions, just the parent post I was replying to.>Recreational drugs make you feel good temporarily. That's literally why people do them.The point Im making is this is true for a ton of psychiatric or even non psychatric treatments. And to be perfectly clear Im not saying you should be treating your anxiety with weed, even if it does help you

Aurornis: > The point Im making is this is true for a ton of psychiatric or even non psychatric treatmentsThat point wasn't intended to be taken in isolation.I was making statements about how long-term treatment of an underlying condition is not the same as taking a drug which temporarily masks a problem or induces altered mood states.The fact that a drug has acute effects, good or bad, is separate from any conversation about chronic effects.For depression, anxiety, and other conditions it's the chronic effects that matter. The acute effects almost become side effects at that point. For some drugs, getting to long-term treatment involves tolerating the acute effects while your body adapts

sillywabbit: Meth causes brain damage. Dex doesn't.

trinsic2: Yeah this has been my experience with THC. I never took it for depression, but it was always a temporary thing. I doesn't treat anything IMHO. its a symptom relief at best.it works pretty good as a temporary relief from anxiety.

smt88: "Treat" != "cure"

cj: I think it became socially acceptable because there’s not a huge reason to hate on it.The risks to cognition and health exist, but they’re no where near as bad as alcohol or cigarettes (and the negative effects basically don’t exist at low, even moderate doses)The biggest negative effect of using weed regularly is it seems to slowly kill people’s motivation to do stuff over time. It will turn just about anyone into a couch potato. That’s more dangerous than any other effect IMO.

Ylpertnodi: Evidence?

Bratmon: I guess if you weren't around for the 30 years when every marijuana advocate on the planet wouldn't shut up about it being a cure for anxiety, evidence that it is not wouldn't be particularly interesting to you.

Ylpertnodi: > ...evidence that it is not wouldn't be particularly interesting to you.Were you stoned when you wrote that?

m0llusk: Studying the effects of recreational drugs is similar to studying diet in terms of the level of complication. The headline "No evidence" is a good example of the discourse about this subject. There absolutely is such evidence, but this new analysis comes to different, potentially more robust, conclusions from the same data. As long as results are presented in this way a meaningful shared comprehension of the situation is likely to remain out of reach.

ecshafer: Since the 1960s and the emergence of the New Left, and the introduction of the Frankfurt School and 60s post modernism into academia, there has been a widespread belief amongst a large segment of the population that everything traditional is wrong. A social stigma is merely ignorance, that which is seen as bad is actually good, traditions are wrong. All of these things need to be overturned for the enlightenment. Since society deemed marijuana bad, it is therefore good. As those people who were went through that indoctrination in the 60s as students got older, they got into power. They took power in universities. By the 90s they were pushing all of the ideas as the status quo. Students in the 90s then took those ideas, and when they got into power in Media, they pushed those ideas into all movies and tv.