Summary
Cannabis and psychedelics can affect your mental health. Research is being conducted exploring the benefits and side effects of using cannabis and psychedelics. Cannabis products are FDA approved for very few conditions. Psychedelics may change the way certain mental health conditions are treated, particularly depression, anxiety, and trauma disorders. Cannabis and some psychedelics are derived from natural sources but this does not mean they are safe or right for every person. Cannabis and psychedelic research will increase the evidence we have for or against the use of cannabis and psychedelics in mental health treatment. To prevent drug-drug interactions, always tell the people prescribing any medication to you if you are using psychedelics or cannabis.
Cannabis, Psychedelics, and Mental Health
Why Discuss Cannabis, Psychedelics, and Mental Health
One reason for this post is that the neuroscience of psychedelics and cannabis lures neuroscience geeks like me. I realize I need a better rationale for creating a blog post than simply my own interest in the topic.
So, let’s explore further.
The Intersection of Cannabis and Psychedelics with Mental Health
A discussion of cannabis, psychedelics, and mental health is relevant given the burgeoning field of research in psychedelics, the ubiquity of cannabis products in the USA, and the popular belief in the benefits of cannabis and psychedelics.
The Pew Research Center reported on February 29, 2024, that most of us reside in areas where a cannabis dispensary exists. Many states have legalized recreational cannabis while others have only authorized medicinal cannabis, despite federal law which, as of this date, still deems cannabis as an illegal substance.
Take a look at the Pew Research article:
Cannabis is perceived as ‘natural’ and, to some people, that equates to cannabis being ‘safe’.
Cannabis and psychedelics are increasingly lumped together because some of the publicly recognized psychedelics (mescaline, ayahuasca, psylocibin) are deemed ‘natural’ like cannabis.
Lobby groups are requesting further access to psychedelic agents, increasingly touted as being able to revolutionize mental health treatment.
Potential Risks and Benefits of Cannabis and Psychedelics
Caveat: A predisposition to psychosis increases the risk for psychotic disorders emerging as a result of using either cannabis or psychedelics.
Cannabis
Using cannabis and psychedelics is accompanied by risks. Just because something is derived from something found in nature, does not mean a person ought to ingest it. Cat feces is natural and it is not a food staple for human beings, with good reason. Arsenic is natural but we do not flavour our meals with it, for good reason. Claviceps purpurea is a naturally occurring fungus which infects grains, particularly rye, and its contamination of rye has been associated with outbreaks of ergotism (convulsions, headaches, hallucinations or gangrene). This is why we have regulations for the production of grains for human and animal consumption. Poison hemlock is a member of the carrot family and, if consumed in small quantities by humans and animals, results in death. Thus, we do not keep poison hemlock in our vegetable drawers at home.
Cannabis is a plant which contains over 300 chemicals, including over 100 cannabinoid compounds, that can elicit psychoactive effects (effects on the human brain), via endocannabinoid receptors or via other means. It is estimated that cannabis has been consumed by people in various cultures since as far back as 12 000 years ago.
Approved Uses of Cannabis
Cannabis is a Schedule I substance under the Controlled Substances Act and is deemed illegal at the federal level in the USA. A few cannabinoid formulations are approved by the FDA (federal approval) for the treatments of the following disorders: chemotherapy induced nausea; AIDS related anorexia with weight loss; and a very specific seizure disorder which does not respond well to other medications. There is a lack of evidence for the use of cannabis for other disorders/symptoms.
Risks of Cannabis Use
- The potency of THC in cannabis has exponentially increased since the 1970s. THC levels is contemporary cannabis have been detected as high as 30%. This level is 10 times the average THC level found in cannabis in the 1970s. Yale School of Medicine published an article in 2023 addressing the THC content of cannabis. Not Your Grandmother’s Marijuana: Rising THC Concentrations in Cannabis Can Pose Devastating Health Risks. Isabella Backman. August 30, 2023. Yale School of Medicine. https://medicine.yale.edu/news-article/not-your-grandmothers-marijuana-rising-thc-concentrations-in-cannabis-can-pose-devastating-health-risks/
- Driving under the influence of cannabis impairs reflexes. In March of 2024, a woman in New York State was convicted of vehicular homicide under the influence of cannabis. She will be serving a sentence in state prison. Driving and cannabis are not good companions. Poughkeepsie woman high on cannabis sentenced in crash that killed beloved veteran. https://newjersey.news12.com/poughkeepsie-woman-high-on-cannabis-sentenced-in-crash-that-killed-beloved-veteran
- Cannabis has been linked to cardiovascular conditions.
- Cannabis can interact with anesthetic agents used during surgery.
- The constituents of cannabis products can impact the metabolism of prescribed medications which may affect the level of the medications in blood and may affect the efficacy or toxicity of the medication.
- Cannabis use is linked to emergency room consultations for anxiety.
Common Psychedelics
Psychedelics familiar to the public include ketamine, LSD, psylocibin, ayahuasca, mescaline, DMT, MDMA. MDMA is not considered a typical psychedelic due to its mechanism of action. By definition, psychedelics elicit hallucinations and may elicit life altering experiences which can be but are not always beneficial.
Typical psychedelics, psylocibin, ayahuasca, mescaline, LSD, and DMT, stimulate 5HT2A receptor, one of the most common serotonergic receptors. 5HT2A receptors are more prominent in more advanced brain centers, such as the association cortex, the visual cortex, and higher processing centers (like the default mode network).
Ingesting psychedelics can allow the human brain to be receptive to neuroplasticity (making new connections). Psychedelics, by disrupting neural processes, can lead us to perceive memories differently, to distance ourselves from rigid perceptual tendencies, allowing for flow and receptive thinking processes with less filtering.
Psychedelics also target other receptors.
Listen to The Social Brain guys talking about the hypothesis on how psychedelics impact the human brain and elicit effects in human beings.
Cellular Republic. The Social Brain, Episode 36. Revealing the Brain: The Neuroscience of Psychedelics. https://www.youtube.com/watch?v=bEp2a38EE6g
Risks of Psychedelic Use
- Use of psychedelics can lead to psychotic symptoms which are not always pleasant experiences.
- As a result of psychedelics interacting with serotonergic receptors (and other receptors) and due to the potential impact of psychedelics on the metabolic enzymes, use of psychedelics can lead to drug-drug interactions.
- MDMA and ketamine can lead to dependence as they have addictive qualities.
Potential of Psychedelics to Benefit Our Mental Health
Studies of the use of psychedelics for mental health symptom relief are often therapy facilitated experiences due to the difficulty in conducting Randomized Controlled Trials (RCT) secondary to the dramatic differences elicited by placebo and psychedelic administration.
Studies are being conducted to explore how using psychedelics can treat depression, addiction conditions, and end-of-life issues. Psychedelics facilitate biological changes leading to the ability to derive benefit from psychotherapeutic interventions or simply benefit from physiological effect of the psychedelics. Of note, the individual studies do not necessarily meet gold standard criteria for research due to the individual studies comprising a very small number of participants. There may be selection bias in the participants involved in the studies.
Profound experiences have been reported by participants for the alleviation of anxiety, depression, and trauma symptoms. Even a single experience of psychedelic use can relieve symptoms as compared to years of antidepressant and other psychotropic medication use or participation in long-term psychotherapy.
In episode 36 of the Social Brain with Taylor Guthrie and Andrew Cooper-Sansone, the presenters speak of other limitations, aside from those mentioned above, including cost and accessibility for coverage by health insurance.
Sleep and Cannabis
Some people believe cannabis improves their sleep. We do not have adequate data to substantiate the use of cannabis for sleep conditions. Take a listen to a researcher in the field discussing the evidence.
Can cannabis help you sleep? Here’s the science. TEDxKingsParkSalon, September 2022, Jen Walsh
https://www.ted.com/talks/jen_walsh_can_cannabis_help_you_sleep_here_s_the_science
Takeaways: Cannabis, Psychedelics, and Mental Health
Cannabis, psychedelics, and mental health are associated. Cannabis and psychedelics can impact your mental health.
Psychedelic treatment may change the delivery of interventions in the treatment of depression, anxiety, and trauma-related symptoms. Research studies will continue to produce results to inform our practice as clinicians and the experience of clients in receiving treatment.
Cannabis, cannabis products, and psychedelics can interact with prescribed medications. Tell your healthcare provider if you are consuming cannabis, cannabis products, or psychedelics.
Cannabis use in the treatment of mental health symptoms lacks adequate evidence to substantiate it as an intervention. Cannabis comprises hundreds of chemicals which can affect our brain, directly or indirectly. The legalization of recreational cannabis and the legalization of medicinal cannabis at the state level are economically based and are not based on the science.
Psychedelics may revolutionize mental health treatment, for some people and for some mental health symptoms. I am optimistic. The data will inform my practice.
Disclaimer: The information in this post does not substitute for a consultation with a mental health professional.
Consult with a mental health professional for additional information and for the best options for you to address any mental health symptoms you are experiencing.
Additional Resources:
About Cannabis. Government of Canada. Gouvernement du Canada. https://www.canada.ca/en/health-canada/services/drugs-medication/cannabis/about.html
Cannabis Use Tied to Increased Cardiovascular Risk. Medscape Medical News. https://www.medscape.com/viewarticle/cannabis-use-tied-increased-cardiovascular-risk-2024a10003yr#:~:text=The%20association%20between%20cannabis%20use,stroke%20(OR%2C%201.77)
Contemplating cannabis? The complex relationship between cannabinoids and hepatic metabolism resulting in the potential for drug-drug interactions. Rosemary T. Smith and Traci A. Gruber. 09 January 2023. Front Psychiatry. Vol 13. https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2022.1055481/full
Drug-drug interactions involving classic psychedelics: A Systematic Review. Andreas Halman, Geraldine Kong, Jerome Sarris, and Daniel Perkins. 2024 Jan. J. Psychopharmacol, 38 (1), 3-18. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851641/
ED (Emergency Department) Visits for Cannabis a Harbinger of Anxiety Disorder. Medscape Nurses. https://www.medscape.com/viewarticle/ed-visits-cannabis-use-harbinger-anxiety-disorder-2024a10003a0?ecd=wnl_tp10_daily_240219_MSCPEDIT_etid6316190&uac=5131MN&impID=6316190
Falling for Psychedelics. Tracie White. March 2023. Stanford Magazine. https://stanfordmag.org/contents/falling-for-psychedelics
Why Patients Need to Come Clean About Cannabis to Their Anesthesiologist. Medpage Today. https://www.medpagetoday.com/popmedicine/popmedicine/108856?xid=nl_popmed_2024-02-23&eun=g149490d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=PopMedicine_022324&utm_term=NL_Gen_Int_PopMedicine_Active
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