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Inhaled Cannabis Reduced OCD Symptoms In Recent Study

Study finds cannabis use is associated with immediate reductions in OCD symptoms

Obsessive-Compulsive Disorder, or OCD, is a challenging condition to live with. The chronic psychiatric disorder is characterized by persistent intrusive thoughts (often about things that might go wrong) along with urges and compulsions, such as the compulsion to repeatedly check locks or wash hands. And to add to these challenges, those with OCD tend to experience heightened levels of anxiety. While there are a variety of treatment options for OCD, including therapeutic and pharmaceutical options, many patients with the condition report that these treatments are unable to fully manage the condition.

Now, a new study published this month in the Journal of Affective Disorders is pointing towards cannabis as a potential treatment for OCD. The researchers from Washington State University found that acute cannabis use, and especially cannabis with higher levels of CBD, was able to quickly and temporarily reduce symptoms of OCD such as anxiety, compulsions, and intrusive thoughts. Still the symptom reductions for intrusive thoughts lessened over time, making it less clear whether cannabis could be a long term treatment for that particular symptom.

Previous research has already found that those with OCD have a higher likelihood to use cannabis, and researchers have hypothesized that this use is a coping mechanism to tell with the symptoms of OCD. But few studies have investigated whether cannabis is actually effective at reducing OCD symptoms. Those that have investigated the cannabis OCD connection have brought back mixed results.

Commercial cannabis growing in a greenhouse.

A recently published placebo-controlled study found that cannabis did offer symptom relief but not relief that was significantly larger than that found for the placebo group. Still, the potency of the cannabis used in this study was much lower than what is available in the legal cannabis market, and the sample size was small. So it may have been underpowered to find results.

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Case studies on cannabis, as well as synthetic forms of THC (one of the active chemicals in cannabis) have also found some evidence for symptom reduction. And several animal studies have found that CBD is able to reduce compulsive behaviors in rodents.

The researchers on this study sought to investigate this connection further in human subjects, so they utilized an app called Strainprint, which allows cannabis users in Canada to report their starting symptoms, the specific cannabis products and dose used, and the resulting impact those products had on their symptoms. The researchers tracked the responses of 87 individuals who self-identified as having OCD for over two years – looking specifically at inhaled cannabis use like vaping and smoking. Patients evaluated their starting symptoms prior to cannabis use, and the symptoms after cannabis use by responding to questions like “How intrusive are your thoughts?” or “How bad is your compulsive behaviour” on a 0-10 scale.

This study looked at patients who used vaporized or smoked cannabis only. Photographer: Cayce . [+] Clifford/Bloomberg

© 2018 Bloomberg Finance LP

Researchers then analyzed the data to see whether cannabis seemed to help or hurt when it came to managing OCD symptoms. The analysis revealed that cannabis use was tied to a reduction in OCD symptoms. In fact, most cannabis sessions recorded resulted in a reduction of symptoms. 95.4% of all sessions resulted in reduction of compulsions, 89.6% resulted in reduction of intrusive thoughts, and 93.8% of sessions resulted in reduction of anxiety.

On the other hand, only 1.9-3% of sessions resulted in a worsening of these symptoms (depending on the symptom).

Ultimately, these patients reported an average 60% reduction in compulsions, 49% reduction in intrusive thoughts and 52% reduction in anxiety.

Interestingly, researchers also had access to the CBD and THC levels in the products used. Calculating this into their analysis, they found that those who used high CBD products reported larger reductions in compulsion symptoms than those using higher THC options. This is consistent with previous animal studies suggesting CBD can aid in reducing compulsive behaviour. Those who used higher doses of cannabis also had larger reductions in compulsion symptoms.

Researchers also noted that cannabis seemed to help more with intrusive thoughts early on in cannabis use. But over time, the impact cannabis use had on intrusive thoughts lessened, suggesting that a tolerance to this benefit may develop over time. Still, cannabis remained effective for symptoms like anxiety and compulsive behavior.

While this study suggests that cannabis could be helpful for treating the symptoms of OCD, it does have some limitations. For one thing the sample was self-identified as having OCD, so it’s possible that some in the study may not actually have a diagnosis of OCD. There was also no placebo control group, so we can’t compare to see whether these impacts are attributable to a placebo effect, like they have been in smaller, earlier studies on lower potency cannabis. These limitations suggest that future rigorous clinical research needs to be conducted to truly answer these questions.

Still, this study points the way, with some evidence that cannabis, and perhaps especially high CBD cannabis, could be a beneficial treatment for those suffering from OCD.

A new study published this month is pointing towards cannabis as a potential treatment for OCD. The researchers from Washington State University found that cannabis use was able to quickly and temporarily reduce symptoms of OCD such as anxiety, compulsions, and intrusive thoughts.

Marijuana and OCD: Will it help or hurt? Ask Dr Reilly Kayser

September 24, 2019

This August, we published a blog post about the effects of marijuana and CBD on OCD symptoms. We receive a lot of questions on this topic, and to address them thoroughly we’re bringing a number of perspectives to this blog.

Today’s post comes from Dr. Reilly Kayser, MD. Dr. Kayser is a psychiatrist and clinical research fellow in the Anxiety Disorders Clinic at the New York State Psychiatric Institute, which is affiliated with Columbia University Medical Center. His research focuses on the use of new treatments for OCD, and he’s currently focusing on the role of the endocannabinoid system in OCD and anxiety disorders.

Now we’ll leave things to Dr. Kayser.

Q: How do you feel about substances / cannabis?

Dr. Kayser: Marijuana, or cannabis, is illegal in most of the United States but is nonetheless one of the most commonly used substances. As our political and cultural landscape has changed, cannabis use appears to be on the rise. For example, a 2019 Gallup poll found that 12% of adults in the US reported having used cannabis in the past week—a rate nearly matching the 15% who say they’d smoked cigarettes. Similarly, a survey by the Substance Abuse and Mental Health Services Administration (SAMHSA) found that, between 2008 and 2018, the number of adults who reported using cannabis on a daily basis increased by 4.8 million.

These trends suggest that cannabis’ presence in our society is growing. Americans increasingly appear to find cannabis use socially acceptable, with the General Social Survey finding that a record 61% support cannabis legalization. An expanding number of states are introducing legislation to increase access to medical and recreational cannabis.

Shifting attitudes toward cannabis among American consumers have also been reflected in an explosion in the marketing of cannabis products as potential treatments for all sorts of different conditions, including mental health problems like anxiety and OCD. The bottom line: with so much information about cannabis out there, and so many different claims about what it can do, it can be difficult to figure out what to believe.

Q: How does cannabis interact with OCD or other mental illnesses? Does smoking weed make OCD worse and make obsessions more real?

Dr. Kayser: Given that cannabis use is more and more common among Americans in general, it’s probably no surprise that many people with OCD symptoms have tried it as well. In fact, a large residential treatment facility for OCD recently reported that around 30% of adults with OCD who sought treatment in their program said they had used cannabis at least once. But although we know that many people do use cannabis, how it interacts with symptoms of OCD and other mental illnesses is less clear.

One thing that most researchers agree on is that cannabis is not without risks. For example, cannabis is known to affect the developing brain, and may cause problems later in life for those who are exposed to it at an early age. Similarly, using cannabis has been associated with increased rates of psychotic symptoms. While in this case no causal link has been found— meaning that it hasn’t been proven that cannabis use causes psychosis directly—it also hasn’t been established that cannabis is not capable of causing psychosis in some individuals. So, in general, it is safest for those who fall into high-risk groups (such as children, adolescents, and anyone with a personal or family history of psychosis) to abstain from using cannabis.

Far less is known about how cannabis interacts with anxiety and OCD symptoms. Most of what we do know comes from studies in animals—aside from a few very small studies looking at social anxiety, almost no human trials have looked into this question. We do know that the effects of cannabis (and products derived from cannabis) depend on a variety of factors, including a person’s genetic background, gender, frequency of use, amount used, and expectations about what they will experience.

Someone who has never used cannabis might be more likely to experience anxiety after using, compared to someone who has tried it many times in the past. Similarly, using cannabis with very high concentrations of THC (the main psychoactive ingredient in the marijuana plant) probably increases the chance that a person will experience anxiety and other adverse effects. There is some evidence that those with certain OCD symptoms, particularly obsessions, may be more likely to use cannabis, possibly as a means of coping with their symptoms. However, there are still more questions than answers regarding how exactly cannabis use affects OCD and anxiety symptoms.

This is an active area of research for us at the Center for OCD Research at Columbia University/New York State Psychiatric Institute. We became interested in this question in part because we were hearing vastly different stories from our patients: some told us that cannabis helped to control obsessions, compulsions, or anxiety; others told us that it did nothing; and still others described the ways it worsened their symptoms.

In addition to studying how cannabis affects OCD symptoms in the clinic, we’re currently recruiting people who have experienced OCD symptoms and have also used cannabis in the past to complete a survey about their experiences. If you think you might meet these criteria, please consider filling out the survey—it will help us answer important questions. We would love to hear from people with a range of experiences, whether they’ve had an OCD diagnosis for years or still aren’t sure if they have OCD, whether they’re regular cannabis users or have only tried it once or twice.

Q: How does CBD oil even work? I don’t like smoking weed because it has always made my anxiety worse, so what’s the difference? Could CBD help my OCD?

Dr. Kayser: The short answer to this question is that nobody knows! Interest in CBD has surged over the past few years, which has been accompanied by a great deal of marketing of CBD products for various medical conditions, including anxiety and OCD. However, even though researchers think that CBD has several different effects on the brain, very little is known about its effects on individuals with anxiety and OCD.

Unfortunately, there are many exaggerated or misleading claims about CBD that do not reflect what is actually known scientifically. In reality, there have only been a few small studies in humans. Though these have given us some hints that CBD may help with certain anxiety symptoms, the results are far from conclusive. We are even more in the dark in terms of how CBD affects obsessions and compulsions, as there have been no studies at all in patients with OCD.

So, at this point, we still cannot say whether CBD would help, harm, or have a neutral effect on OCD symptoms. It’s not all bad news, though: in addition to the survey listed above, our team is currently pursuing a study on CBD’s effects in patients with OCD. So we hope to be able to answer this question in more detail soon.

Q: What can I do for my OCD instead of smoking weed?

Dr. Kayser: Fortunately, there’s a variety of treatment options for those with OCD, including medications, psychotherapy, and device-based treatments. The main medications shown to be effective in OCD are those that work on the brain’s serotonin system—this includes SSRIs and clomipramine. These are often effective on their own, but other classes of medications can also be added, depending on a person’s symptoms.

The main form of psychotherapy for OCD is a specific form of cognitive behavioral therapy (CBT) which includes exposure and response/ritual prevention. This type of therapy, known as ERP or EX/RP, can be just as effective as medication for treating OCD symptoms. Some people may benefit even further from combining medication(s) and ERP.

Though medication and ERP are the first-line treatment options, there are a number of alternatives. These include different forms of psychotherapy like acceptance and commitment therapy (ACT), mindfulness, residential treatment programs, and device-based treatments such as transcranial magnetic stimulation (TMS). TMS, which was recently approved by the FDA for treating OCD, is a non-invasive method that uses magnetic fields to stimulate specific brain circuits known to be involved in OCD symptoms.

Overall, the good news is that many options besides cannabis may be helpful. If you’re experiencing OCD symptoms, we recommend consulting a mental health professional who can help you determine whether any of these treatments might be right for you.

Q: So how can I get the most effective therapy for OCD?

Please note that the following is written by the NOCD team. Dr. Kayser has not endorsed the NOCD Therapy treatment service.

As Dr. Kayser mentioned, the verdict is still out on the effects of marijuana and CBD on people with OCD. But, either way, the most effective treatment we currently have is ERP. Conducted by a licensed OCD therapist, it significantly decreases distress in most people. Trying to “fight” our thoughts directly is a losing battle, so ERP works by helping people recognize and resist their compulsions. And it does so without any substances.

Although this might sound simple, it involves careful planning and constant adjustment; so ERP is most effective when practiced with a therapist who has received specialized training. An OCD-trained therapist knows how to spot compulsions and tease them apart from obsessions. These observations are the building blocks of the personalized treatment programs they create. Their expertise is in teaching you how to manage your OCD and make positive changes in all areas of your life, redirecting all the energy you might otherwise have spent on OCD or trying to eliminate anxiety with drugs like marijuana.

This is the same training all of our NOCD Therapists receive. The goal of NOCD is to reduce your OCD symptoms within just a few weeks of live one-on-one video therapy. You’ll be welcomed into our supportive peer community, with 24/7 access to personalized self-management tools built by people who have been through severe OCD and successfully recovered using ERP.

Schedule a phone call with a member of the NOCD clinical team to learn more about how a licensed OCD therapist can help you get better. This consultation is free and doesn’t take very long—and it could be one of the most important calls you ever make.

We receive a lot of questions on marijuana & OCD, and to address it thoroughly Dr. Reilly Kayser, MD and a psychiatrist will answer the questions on it.