The internet is full of articles with titles like this!  Listicles, they say, get eyeballs.  Wouldn’t it be nice if all you needed was to find the right strain or strains that would magically cure you, or at least keep your anxiety at bay?  That’s the hype the cannabis industry is selling.  

But, you know me, I don’t play that game.  For whatever reason, I’m compelled to care for patients (and write blogs) based on human evidence aka Science.  So, where is this article going?  Let’s find out.  

The Problem with the Strain Name Game

There are over 7,000 different “strains” (not technically the right term, but the term that gets used).  You can go to sites that catalog these strains, like Leafly.com, and see all the names and types for yourself.  An interesting observation that I made years ago, and you can do this too, is that if you look up a couple of random strains and read the user comments, you’ll find someone saying that strain is good for X, and someone else will say Y, and pretty soon you’ll realize that the sum of the comments means it’s good for everything.  You’ll even find all sorts of contradictory statements.  At the end, if you’re scratching your head, good.  This is because it doesn’t make sense.

Similarly, you can look up some strain labeled as the most Sativa-y Sativa and another that is the most Indica-y of Indicas, and look at the comments.  You’ll find the sum of the comments shows they’re both good for all the same things.  

You could attribute these observations to the inarguable “everyone is different” mantra, but that’s neither true nor scientific.  Much more likely and provable, is that people get the reaction that they expect to get, for the most part.  This is called Expectation Bias and is a cousin of the Placebo Effect and Pavlovian conditioning.  In the modern dispensary system, no one ever buys a strain without being told what it is, and what to expect from it.  

As it turns out, most strains are nearly identical in chemical composition.  The differences are tiny and not enough to realistically cause the different reactions ascribed.  Furthermore, the chemical differences aren’t consistent with people’s reporting of their reactions.  

As an aside, there is some really interesting lab work showing differences in strain’s ability to kill cancer cells.  However, this does not mean that cannabis is an effective treatment for any tumor, but does suggest that it might someday be useful against tumors as a pharmaceutical drug that tailors the chemical make up of the drug to that specific type of tumor.  

The Problem with Human Beings

Well, there are many, but we’ll focus here on the fact that people generally want an easy answer and preferably one that supports what they’re already doing.  Sadly, in medicine the answers are rarely simple and in the cannabis arena often are very different from what people are doing.  

Anxiety treatment is a great example.  In the community (meaning in the real world, out there, where people use weed), the wisdom is that you should smoke cannabis each day when you wake up (called Wake and Bake) and then again throughout the day whenever you feel anxious.  Unfortunately, we have good human-based evidence that this is entirely wrong.  

Evidence shows that use of cannabis regularly during the day decreases work and school performance.  One famous study, called the Maastricht study, showed that cannabis users’ grades fell an entire letter grade compared to non-users.  

Further, numerous studies have shown that cannabis can backfire and make anxiety worse.  So the above Wake and Bake scenario is really a great Catch-22 that benefits the industry.  Just like Coca-Cola used to put cocaine in their formula, the Wake and Bake approach makes you feel better in the moment, but ultimately worsens your anxiety so you smoke up more, and repeat the cycle over and over again.  It’s certainly good to the seller in that scenario.  No so good to be the victim, however.  

Recently a patient asked me how I could help her anxiety if THC is the problem and CBD is not useful (or safe).  While I’m sympathetic to her confusion (which I immediately tried to straighten out), it’s that need for simplistic answers rearing its head again.  

THC is not the problem.  Too much THC is the problem!  Like any medication, more is not necessarily better.  Drugs have a range in which they work.  Below that range and you get nothing.  Above that range and you get more side effects and risk.  In the case of THC and cannabis, that risk is tolerance, dependence, and user-disorders.  Additionally, in the case of anxiety, there’s also the likelihood of worsening the anxiety.  

So, What’s the Right Answer?

The right answer is nuanced (and that’s hard for Humans).  It’s not about the strain, or even the delivery method.  It’s about dose and timing.  Small doses delivered at low-risk times, like bedtime, are effective and safer.  What that means for you, specifically, depends on your situation.  

If you have anxiety and have either not yet started cannabis treatment or have been self-medicating for a while, I would encourage you to connect with me for proper treatment.  There are so many pitfalls that I’d like you to avoid.  Yet, cannabis treatment for anxiety, when done well, can be a game-changer.

Consult with a Qualified Boston Medical Marijuana Expert Today

Those considering using THC, CBD, or any type of medicine found in cannabis to help manage their condition should consider speaking to a trained medical expert who is knowledgeable about using cannabis therapeutically. Massachusetts medical marijuana doctor Jordan Tishler, M.D. sits on the faculty of Harvard Medical School and has years of experience helping patients treat pain and other ailments using cannabis. He and the team at InhaleMD stand ready to assist patients in determining whether medical marijuana is right for them.

For more information, or to set up a virtual consultation with the team at InhaleMD, call us at (617) 477-8886 today.

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