What cannabis products are good for anxiety? Cannabis has been promoted for its ability to reduce stress and help with anxiety. Many patients self-report that cannabis helps them with their anxiety and symptom. In a survey amongst 1429 medical cannabis patients, 58.1% reported they used cannabis for anxiety. But what did they use? What dose? What route of administration? High/low THC?

What Does the Evidence Say? Surprisingly there is very few studies randomized controlled trials on cannabis for treating anxiety as a primary diagnosis, such as Generalize Anxiety Disorder. Most of the studies are either very small trials, with different products, routes of administration and usually studying other primary endpoints, while at the same time using retrospective, self-report data. There are numerous studies showing both association and no association of anxiety and cannabis use. For example:

  • In a cannabis and cancer patient study, they did report the side effect of increased anxiety with high dose THC. Several studies show an increase in anxiety with cannabis use. PMID: 38430618.
  • In 2022, the authors compared vaporized THC, THC+CBD, CBD, and placebo, in 26 patients. THC alone did induce the most anxiety, while the 1:1 THC:CBD caused anxiety, but less than THC alone. The CBD did not impact the anxiety score versus placebo. PMID: 36227352
  • In 2007, an Australian study of 3239 young adults was followed from age 14 to 21, and they reported an odds ratio of 3.4 that frequent cannabis use would be more likely to report anxiety symptoms as an adult. PMID: 17314727.
  • In 2016, 8598 Swedish adults aged 20 to 64 were followed in a 3-year longitudinal cohort, they found no statistically significant increase in anxiety at follow-up. The frequency or type of cannabis was not reported. PMID: 26773900
  • In 2024, Beletsky et al. did a literature review on cannabis use and its relationship to anxiety and cannabis use disorder. They have a great summary of numerous trials showing positive and negative associations of cannabis use and anxiety. Overall, they report a higher association of cannabis use in patients with anxiety via mostly self-reporting studies. They did interpret that there is no data to suggest that cannabis is the cause of the anxiety, versus patients with anxiety may self-medicate with cannabis. PMID: Not provided.
  • In Jan 2024, a non-equivalent, controlled study did compare anxiety symptoms of non-cannabis and regular cannabis users. They compared 24% THC, 24% CBD, and 12%:12% THC:CBD. Over 4 weeks, they found no significant increase in anxiety score with THC dominant flowers, and all products showed some improvement in scores, but they found the largest improvement was associated with the CBD dominant products. PMID: 38252547

Key Points

  • There are no studies showing cannabis treating Generalized Anxiety Disorder in humans.
  • CBD and THC have been reported in lab models to have some association with different receptors and neurotransmitters that affect mood.
  • In general, CBD is thought to have more anxiolytic (reducing) effects, while THC tends to have more anxiogenic (increasing) effects.
  • Small studies show that high THC may cause more anxiety, while THC with at least equivalent CBD did cause less anxiety than THC alone.
  • It is unknown if anxiety patients tend to self-medicate with cannabis or if there is a causal effect of frequent cannabis use and anxiety.
  • Frequent cannabis use in youth has an association with anxiety symptoms in adulthood.
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