Now I've been sober for 7 years and my depression has been treated, but I certainly remember those days
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.
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, most (EDITED FROM ALL) of the studies utilize isolates - and not necessarily in conjunction.
For 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 help 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.
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.
EDIT: I don't have time to read every single citation included, but the claim above that they were all THC or CBD isolates does not appear correct. One randomly selected citation:
> The short-term impact of 3 smoked cannabis preparations versus placebo on PTSD symptoms: a randomized cross-over clinical trial
So the claim above that they didn't investigate smoked cannabis or "entourage effect" is false.
You could study one combination that is broadly representative and is much much closer than the isolate.
The claim above about only looking at isolates was false.
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.
I 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?
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.
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.
There’s no evidence that what they tested with was pure THC isolates. If they’re using cannabis in plant form, even if it was bred for higher thc content, there is still cbd.
tldr; "If they're using cannabis in plant form" is a very, very high bar for the current state of cannabis (really cannabinoid) research.
It's a shame that first experiences with stress also coincide with that phase of life, so the debate never ends.
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.
There was also quite alot of talk about how doctors, by being reticent to prescribe opioids, were inhumanely forcing patients to live in pain, and not being sufficiently deferential to patient autonomy. Moreover, the rhetoric was incorporated into discussions about racist disparities in treatment, given there was some evidence doctors were less likely to prescribe opioids to black patients, suggesting doctors were systematically being cruel. Naturally, the easiest way to dodge those accusations was to simply prescribe opioids as a matter of course. Even in the absence of Purdue Pharma pushing their claims about lack of significant addictive potential, there was already significant pressure to discount the risk of addiction.
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
This mistake has been made many time throughout history. Cocaine was originally believed to be a viable treatment for depression. Opioids and amphetamines too. You take them and you feel good for a while, which was mistakenly equated with treating depression.
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.
It's not a cure. It's a high.
Is it not??
Sure there's the addiction and harm from abuse that make it less than ideal for long term use, to put it mildly, but weed isn't coke so what's really the argument here?
They may also have some other effects.
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
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 improvements
Recreational 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.
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.
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.
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.
Chasing a high is not a treatment, it merely defers the problem. As tolerance to the high builds, patients lose the therapeutic value but have gained crippling dependency and addiction.
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.
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.
Tangentially, The etymology nerd in me has been taunted by the current article thats been on the front page for the as of now last 19 hours[1] which conveniently has the origin of the term linked to in the first sentence! [2]… which @suprisetalk also links to in the article description!…
So now I’m wondering why mdma has got the street name molly… and if they're not perhaps related?
As in molly (aka mdma) has got the name as its used as a guard against these ailments specifically…
It's a highly regarded journal, but it doesn't mean 100% of the papers published are perfect.
If you're trying to dismiss a study because it was published in The Lancet then that's not a convincing line of reasoning to anyone who understands the scientific publishing landscape.
https://www.astralcodexten.com/p/practically-a-book-review-r...
https://medium.com/microbial-instincts/the-case-against-the-...
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.
- Not adjusted for strain, dose or delivery method across all studies.
- Not adjusted for receptor downregulation, for which rotation and/or drug holidays would be appropriate strategies.
- Not adjusted across all studies for time effect, e.g. 6 hours of relief, 1 hour, etc.
I can tell you from personal experience with a related disorder that disciplined rotation of 10mg edible cannabis provides 90% relief, 90% of the time, with far fewer side effects than alternative medications for the same disorder.
So, why do people use cannabis then?
Not because they're effective treatments for mental disorders
Okay, I've read the meta-study now and I think they are playing with the data or playing with the conclusion. In particular they found for anxiety there actually seems to be strong evidence in this exact data set that does help.
What they are doing is saying "there isn't 95% evidence it reduces anxiety" therefore "no evidence" even though they mean "some evidence, just not at the statistical significance level" -- it's one of the biggest confusions (and sometimes it feels deliberate) you'll see people do.
Also when you have a confidence interval that big it's a red flag. They themselves admit the data is all over the place.
In summary, don't assume much from the title of the summary article.
Plenty of people use cannabis to alleviate symptoms. I don't think they expect to be cured entirely.
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.
Wonder what is behind it, from my perspective it's quite remarkable.
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