New clinical research finds CBD addresses anxiety better than THC products

29 Feb 2024 --- A “first-ever” randomized trial of commercially available cannabis products indicates that products high in cannabidiol (CBD) can address anxiety better than those containing Δ9-tetrahydrocannabinol (THC), without the potential side effects. CBD products were linked to acute tension reduction, which may translate to longer-term decreases in anxiety symptoms.

“We need more data before we can say conclusively that there are long-term, beneficial effects, but the short-term effects were very clear — CBD was associated with tension and anxiety relief with limited harm,” says senior author Cinnamon Bidwell, associate professor in the department of psychology and neuroscience and the Institute of Cognitive Science at the University of Colorado Boulder, US.

According to the study’s authors, the top three reasons to use cannabis include anxiety, sleep and pain. However, research outcomes on its effectiveness are mixed, with some studies suggesting frequent cannabis use or products high in THC may worsen anxiety long-term. 

Others suggest that adding CBD may counteract some of the adverse effects of THC, such as impairment and paranoia. 

CBD vs. THC 
The study published in Cannabis and Cannabinoid Research included 300 participants with anxiety symptoms, of which 42 did not use cannabis. The group of 258 participants who had used cannabis before was randomly assigned to use one of three products on the market — THC-dominant, THC plus CBD or CBD-dominant. 

During the four-week study period, participants could use the cannabis products as much and frequently as they wanted. On average, people used the products three times weekly. 

The research team measured changes in anxiety symptoms over four weeks through the Patient Global Impression of Change (PGIC) scale and the Depression, Anxiety, and Stress Scale (DASS). Acute changes in subjective mood were measured immediately after cannabis use on the Profile of Mood States (POMS) Elation, Tension and Paranoia subscales and the Addiction Research Center Inventory intoxication scale.

All participants reported anxiety reductions in PGIC and DASS anxiety measures and experienced acute changes in positive mood and subjective drug effects. 

However, CBD-dominant cannabis use was associated with lower DASS anxiety subscale scores than THC-dominant use when looking at frequency of use. Moreover, acute CBD-dominant cannabis use was linked to lower POMS tension and paranoia subscales. 

As CBD has greater anti-inflammatory properties than THC, this could explain the effect on relieving anxiety.Reducing anxiety 
Bidwell suggests that CBD-dominant products could reduce anxiety through their anti-inflammatory properties, which are greater than THC. However, she notes that even 1% of THC — the maximum level in the used CBD-dominant products — can have a swift impact on mood. 

She adds that both early and frequent use of THC can increase the risk for cannabis-related harms, such as problem use and cognitive difficulties. 

“Our study suggests that CBD products may be able to relieve anxiety at the moment for adults who use them, and possibly longer-term, in a way that is meaningful and doesn’t necessarily produce the same risks or harms of THC or prescription medications,” Bidwell comments. “We need more data before we can make conclusive recommendations, but this is promising news.”

Regulatory updates  
Last year, US industry stakeholders urged Congress to demand that the US Food and Drug Administration (FDA) regulate CBD as a supplement instead of creating a new regulatory pathway as the agency suggested. They note that the CBD market has stagnated due to a lack of national standards. 

To strengthen their case, several US cannabidiol companies formed the One Hemp alliance, which advised Congress and the FDA on a policy solution to create a regulatory framework for CBD products as supplements. The coalition is hopeful it can reach an agreement, leading to the formulation of a regulatory framework for CBD production and sales. 

Meanwhile, unclear legal frameworks in the EU and UK are stifling innovation for CBD. The European Commission has determined that CBD is a Novel Food ingredient, though knowledge gaps must be addressed before concluding its safety. 

In the UK, the Association for the Cannabinoid Industry has called on the country’s Food Standards Agency and the UK Home Office to speed up CBD’s authorization process. The organization has published a white paper to establish a clear legal framework as the CBD food and beverages market hangs in the balance. 

By Jolanda van Hal