CAN CANNABIS REPLACE BENZODIAZEPINES AS AN ANTI ANXIETY DRUG?
Cannabis has been proven to be extremely safe and poses very little risk to those who consume it. Studies have shown that cannabis sustains anti anxiety effects and may work in similar ways to some prescribed drugs. On the other hand, benzodiazepines have a long list of negative side effects that make them a less beneficial option for the body.
As cannabis prohibition begins to relax in certain areas of the world, the herb is starting to re-enter the medical spheres it once populated before falling victim to political smear campaigns.
The ways in which cannabinoids interact with the human body is finally becoming more understood as research mounts in the area. Perhaps the most profound discovery thus far is the interaction between active constituents THC and CBD and how they are mediated by receptors in the human endogenous cannabinoid system or simply, the endocannabinoid system.
Cannabis is now available as a medicine in some regions and can be obtained with a medical card. Prescribed for a multitude of medical conditions including chronic pain, anxiety is also an area where cannabis shows profound ameliorative potential. Now the question is “Does cannabis really compare to prescription drugs as a treatment for anxiety disorders? Let’s see how cannabis fares in comparison to one of the most commonly prescribed classes of anti anxiety drugs, benzodiazepines.
A SUMMARY OF ANXIETY
Anxiety is an umbrella term encompassing several different disorders all resulting in feelings of fear, worry and nervousness. Anxiety can be a normal human experience at times, especially when an important life event is approaching, such as exams, meetings and interviews.
The seeming importance of these situations causes some of us to get lost in rumination, wondering what possible outcomes will arise or what could go wrong. However, other types of anxiety are more persistent and severe, inciting some individuals to visit their doctor in hopes of finding a medication to ease their symptoms. There are numerous manifestations of anxiety disorders, those listed below represent some of the most commonly treated.
GENERALISED ANXIETY DISORDER
Generalised Anxiety Disorder, or GAD, is a chronic type of anxiety that can catalyse a long-term and irrational state of worrying revolving around everyday events dealing with finance, health or work. Another type of anxiety is panic disorder. This disorder can cause the sudden onset of immense terror, resulting in confusion, dizziness and nausea.
SOCIAL ANXIETY DISORDER
Social anxiety disorder is characterized by the persistent fear of being judged by others. This usually involves one’s fear that their behaviour in social situations will lead to personal shame or embarrassment. Symptoms of social anxiety disorder include racing heart, dizziness or lightheadedness, muscle tension, confusion and even upset stomach or nausea.
Obsessive-Compulsive Disorder, or OCD, is an anxiety disorder accompanied by distressing and repetitive thoughts, leading to compulsive actions. Causes of the disorder are associated with family history, differences in the brain, traumatic life events and unique personality traits.
Benzodiazepines that are commonly prescribed to treat anxiety disorders include Xanax, Librium, Valium and Ativan. Benzodiazepines are a large class of drugs and maintain similarities to one another in regard to their mechanism of action in the central nervous system. However, they do differ in terms of potency and duration of effects. These drugs have a sedative effect and work by occupying GABA-A receptors within the brain. This culminates in a neuron becoming negatively charged and therefore resistant to excitation, which in turn brings about the anti-anxiety effects of the drug.
Interestingly, benzodiazepines are classified as Schedule 4 drug in the United States. Cannabis, however is deemed Schedule 1, describing it as potentially addictive and devoid of medical potential. This confounding decision makes it seem like “benzos” are safer than cannabis, when in actuality, the exact opposite is true.
In fact, benzodiazepines have been linked to a large amount of lethal overdose-related deaths. It is claimed by many that these drugs are overprescribed. According to the Center for disease Control and Prevention, over 22,000 people died from overdoses linked to prescription drugs in 2013. It is reported that a total of 31 percent of those deaths were associated with benzodiazepines prescribed for conditions including anxiety.
In 2008, approximately 5.2 percent of US adults used benzodiazepines. Despite widespread use, it is possible to develop both physical and psychological addictions to these drugs, which cause severe withdrawal symptoms such as seizures.
Side effects from high doses of benzodiazepines can manifest in drowsiness, confusion, dizziness, blurred vision, weakness, slurred speech, lack of coordination, difficulty breathing and even coma. Chronic abuse of these drugs leads to insomnia, anorexia, headaches, weakness and even anxiety, the very condition they are prescribed to treat.
It is a fair assessment to state that this class of drugs is very dangerous with a high potential for abuse. Let’s explore how cannabis can serve as a much safer and natural replacement for these medications.
CANNABIS IS MUCH SAFER
Cannabis is an extremely safe substance, one that does not account for any overdose-related deaths when used on its own. Cannabis’ Schedule 1 denomination as decided by the American Drug Enforcement Agency (DEA) lists it among the world’s most dangerous drugs, citing a high potential for abuse and no proven medicinal value.
Placing cannabis into this group is based on corporate manipulation, ignorance and scientific illiteracy. A scientific papertitled “Comparative risk assessment of alcohol, tobacco, cannabis and other illicit drugs using the margin exposure approach” displayed just how safe cannabis really is.
The study examined the toxicity of drugs such as alcohol, cannabis, heroin, ecstasy, cocaine, nicotine and amphetamines. Among all of these substances, cannabis was deemed the only low risk substance. On top of that, the study proved that cannabis is a mind blowing 114 times less deadly than alcohol.
ANTI ANXIETY EFFECTS OF CANNABIS
One reason cannabis is prescribed in the US is to treat conditions of anxiety such as the aforementioned and Post Traumatic Stress Disorder (PTSD). It is easy to see how cannabis can reduce the symptoms of anxiety considering its famed potential for inducing relaxation.
A paper published in the journal Biological Psychiatry documents a study observing the anti anxiety effects of cannabis. 50 male subjects who smoked weed on a regular basis were observed and compared to 50 other subjects who did not smoke and served as a control group. It was observed that participants who regularly smoked cannabis showed lower anxiety scores when compared to those from the control group.
Researchers set out with the intention of exploring possible interactions between cannabis and benzodiazepine receptors in mice. They found that cannabis had significant anti anxiety effects and did indeed bind to the same receptor sites. The authors of the paper concluded that, “It is therefore our contention that the anti anxiety effect of cannabis is mediated through central benzodiazepine receptors.”
CBD AND ANXIETY
The Cannabis sativa species produces a vast phytocomplex of chemicals, including one special class known as cannabinoids. These substances are found in resin that is produced by small glands on the surface of cannabis leaves and flowers known as trichomes. One of the most prevalent cannabinoids is CBD, which has become increasingly well known for its many potential medical applications. One such application centers on the subject of anxiety.
A paper titled “Cannabidiol, a Cannabis sativa constituent, as an anxiolytic drug” reviewed studies based on CBD’s role as an anti anxiety drug. It was found that CBD does display anti-anxiety effects in several studies using both human and animal subjects. The authors of the paper state that, “Future clinical trials involving patients with different anxiety disorders are warranted, especially of panic disorder, obsessive-compulsive disorder, social anxiety disorder, and post-traumatic stress disorders. The adequate therapeutic window of CBD and the precise mechanisms involved in its anxiolytic action remain to be determined.”
CBD FOR SOCIAL ANXIETY
CBD may play a role in treating specific forms of anxiety. A paper published within the journal of Neuropsychopharmacology tested to see if CBD impacted social anxiety. Subjects with social anxiety disorder who had never received treatment were given either 600mg of CBD or a placebo before taking part in a simulated public speaking test. Results showed that CBD significantly reduced anxiety, cognitive impairment and discomfort in speech performance. CBD also significantly decreased alert in their anticipatory speech.
NEW STUDY ON BENZODIAZEPINES CONFLICTS WITH PAST RESEARCH
A recent study on 146 patients with an average age of 47 years is the first document reporting decreased benzodiazepine use among patients who started medical cannabis therapy. Results show more than 45% of patients discontinuing their benzodiazepine regime within six months. The study is entitled “Reduction of Benzodiazepine Use in Patients Prescribed Medical Cannabis”.
Patients also reported a sense of general well-being and decreased suffering from their conditions for a short time after they started the medical cannabis programme. The association between medical cannabis therapy and reduction in benzodiazepine use seems to be evident in this research, although large-scale studies should expand our understanding of the brain mechanisms involved in these kind of results.
After completing a 2-month course of medical cannabis, 30.1% of patients quit benzodiazepines. After 4 months, 44.5% had discontinued benzodiazepine use, and the final stage saw 66 patients (45.2%) breaking off their benzodiazepine use.