Marijuana for Anxiety

(This article was reprinted in the online magazine of Institute for Ethics & Emerging Technologies, March 13, 2015. )

A few days ago there was an interesting article in the New York Times, “The Feel-Good Gene,” by a professor of clinical psychiatry at Weill Cornell Medical College. The author wonders why some people are predisposed to anxiety which doesn’t have obvious environmental causes, and which is thus not helped by psychotherapy; while others are immune to such anxiety.

Not surprisingly, the answer is that “a genetic variation in the brain makes some people inherently less anxious, and more able to forget fearful and unpleasant experiences. This lucky genetic mutation produces higher levels of anandamide — the so-called bliss molecule and our own natural marijuana — in our brains.” Those who have this mutation are also “less likely to become addicted to marijuana and, possibly, other drugs — presumably because they don’t need the calming effects that marijuana provides.” Unfortunately only about 20% people have the mutation.

For those without the lucky genetic variation, the author has found that marijuana is generally effective for anxiety, and the reasons for this are physiological.  It turns out that marijuana targets “the endocannabinoid system [which] is closely related to the brain’s own anandamide.” And when anandamide “binds to the cannabinoid receptor, it has a calming effect … We all have anandamide, but those who have won the lucky gene have more of it because they have less of an enzyme called FAAH, which deactivates anandamide. It is a mutation in the FAAH gene that leads to more of the bliss molecule anandamide bathing the brain.”

So the evidence strongly supports that the mutation doesn’t just correlate with less anxiety, it causes people to have less anxiety. The author’s moral conclusion is that “there is more to abstinence than grit and moral fiber: Having a double dose of a gene mutation gives you a big advantage in being able to “just say no.” Of course the author notes that “… these studies should not be taken to mean that biology calls all the shots … The environment plays a critical role and can sometimes even trump genetics.”

As for the use of marijuana to treat anxiety the author is skeptical.

The problem is that cannabis swamps and overpowers the brain’s cannabinoid system, and there is evidence that chronic use may not just relieve anxiety but interfere with learning and memory. What we really need is a drug that can boost anandamide — our bliss molecule — for those who are genetically disadvantaged.

Reflections – I have written recently about issues of freedom and responsibility regarding anxiety and depression. I think we should accept that many things are out of control, especially the past, while accepting that we have influence on the present and future. So I agree with the author’s claim that such diseases have a strong genetic influence.

As for marijuana, while I have never been a user myself, I disagree with the author’s conclusion. However, before I continue let me issue two disclaimers: (Disclaimer #1 – I am not a medical doctor. Disclaimer #2 – I do not advocate using marijuana if it is against state law.)

Alcohol, cigarettes,  tylenol, antidepressants, antipsychotics and benzodiazepines have more bad side-effects and are more dangerous than marijuana by  a considerable amount. This is a fact. So in a cost-benefit analysis between marijuana and persistent anxiety, or marijuana and these other drugs, marijuana win easily. Ask yourself this. Do you want cortisol coursing through your veins? Do you want the awful side-effects that accompany so many of the mainstream anxiety medications? Do you want to drink alcohol or smoke cigarettes? Do you want to experience life-effecting and possibly life-destroying anxiety? Or do you want to feel better with some possible minor cost?

I think the rational choice is clear. If marijuana is legal where you live, as it is today in Washington and Colorado, then there is little cost and much benefit in trying it for anxiety. (I include the legality constraint because people are still incarcerated for marijuana use, although that is patently unjust.) Yes what your psychiatrist and psychotherapist say is true; there is no demonstrable scientific evidence for marijuana helping with major anxiety. But this is because the government classifies marijuana and a Stage I drug, and it is thus not available for normal research.

And while I’m at it I think nicotine gum would be a better, safer alternative than most of the psychopharmaceutical  drugs currently in use.

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