As a budding writer, I was sent home by my fifth-grade teacher for writing the following on my brown lunch bag: “I have a few good reasons for drinking, and one has just entered my head. If a man can’t drink when he’s living, how the hell can he drink when he’s dead?”
My ode to alcohol was a harbinger of things to come, commencing in a bout of alcohol poisoning at 15. When denial and distraction from the world’s woes no longer work, many (e.g., your anxiety prone author) turn to substances for relief with varying effects.
Which Came First, the Mental Disorders or the Drugs?
The relationship between substance use and mental health has been a long and complex debate. Nearly half of people who have a serious psychiatric illness such as anxiety, depression, or PTSD also have a co-occurring substance use disorder.1 Because mood disorders increase vulnerability to drug abuse and addiction, the diagnosis and treatment of the mood disorder can reduce the risk of subsequent drug abuse.
And since the inverse may also be true, the diagnosis and treatment of drug use disorders may reduce the risk of developing other mental illnesses.2 The rank of one over the other is important only in recognizing that one can contribute to the other. Also, drugs whisper silly things like, “You should steal everything you can from Walmart today.”
“I only smoke when I drink.”
Interestingly, more than 40% of the cigarettes smoked in the United States are by individuals with a psychiatric disorder, such as major depressive disorder, alcoholism, posttraumatic stress disorder, schizophrenia, or bipolar disorder. Smoking by patients with mental illness contributes greatly to their increased morbidity and mortality.3
Amateur pharmacology is a risky endeavor. Long-term substance abuse changes brain chemistry and structure, which can cause or exacerbate mental health disorders inducing psychosis.4 Regardless of which came first, experts strongly recommend treating the addiction and the mental health disorder concurrently.
Can Weed Help with Mental Health Woes?
If I had a dime for every time some street pharmacist told me that weed is great for anxiety I’d have a dime bag. Cannabis products are increasingly popular alternative treatments for mental disorders. Cannabinoids such as THC and cannabidiol are potential therapeutic agents as they have been shown to modulate the receptors and neurotransmitters that play a role in mental disorders.5 And cannabinoid medicines are now authorized in the U.S. and other countries for the treatment of mental disorders.
But, let me be blunt about that jazz cabbage…
Today’s weed could kill a 1930s trumpet player, and there is a substantial gap between clinical use and available evidence. Recent studies found no evidence that any form of cannabis effectively treats anxiety, depression, or PTSD. While some studies show that low doses of cannabinoids might have temporary benefits, higher doses often increase anxiety and worsen depression. Moreover, frequent or high-THC cannabis use is associated with a higher risk of developing psychotic symptoms or accelerating the onset of mental health disorders, especially in young adults.5
In short, experts advise against using cannabis as a primary treatment for mental health disorders and emphasize the need for professional medical advice. And, the use of these treatments could also delay or replace the use of more effective therapies.
Don’t roll the messenger.