Anxiety, Inflammation, and Stress
Condition: Anxiety; Anxiety Disorders; Anxiety Generalized; Anxiety Chronic; Inflammation; Inflammatory Response
MeSH terms: Inflammation; Anxiety Disorders
Study type: Observational

Summary: 
      This study investigates whether the anxiolytic effects and anti-inflammatory properties of
      cannabis vary as a function of the ratio of CBD to THC, with the goal that these effects may
      shed light on the mixed data linking cannabis use and anxiety. Individuals with mild to
      moderate anxiety who elect to use cannabis (smoked flower or edible) will complete four weeks
      of observation. Participants complete cognitive tasks, a substance use history, health
      questionnaires concerning sleep and physical activity, and a blood draw at four different
      time points (Baseline, after 2 weeks of cannabis use, and immediately before and after
      self-administration after 4 weeks of use) with the use of a mobile pharmacology laboratory,
      which goes to a convenient location for each participant to self-administer their cannabis.
      Participants are then followed for five months to self-report on cannabis use, anxiety,
      subjective cognitive functioning, sleep quality, and other mental health symptoms.
    

Detailed description: 
      Marijuana use is on the rise with the number of adults reporting medical and recreational use
      doubling in the past decade. Among adult medical marijuana users, 39% report using marijuana
      for the purposes of self-treating or coping with anxiety. Marijuana is approved for medical
      use in over half the states and is gaining traction for use as an "off-label" add-on therapy
      for treatment-resistant anxiety and stress-related disorders. Paradoxically, however, while
      data suggest that marijuana, in particular ∆9-tetrahydrocannabinol (THC), increases anxiety
      acutely, cross sectional and longitudinal data suggest associations between marijuana use and
      lower risk for anxiety disorders.

      There is some evidence demonstrating that marijuana use is associated with increases in acute
      anxiety and anxiety disorders. However, other data suggests that marijuana use may be
      protective for adolescents at-risk for anxiety and decrease the chances of developing an
      anxiety disorder during college. This finding is consistent with a growing body of evidence
      from animal models suggesting that marijuana has anxiolytic and anti-inflammatory properties.
      Clarifying the anxiolytic effects of specific strains that differ in their cannabinoid
      composition may explain these discrepant findings. Thus, regardless of whether results
      support or refute the anxiolytic properties of marijuana, findings from this study fill a
      critical void and can inform public perception.

      The study goal is to understand the anxiolytic effects of cannabinoids, in particular the
      effects of THC-based strains vs. CBD-based strains vs strains containing both THC and CBD in
      different ratios (1:0, 1:1, or 0:1) on inflammation, cognitive functioning, and
      anxiety/negative affect. This design will capitalize on the novel opportunity to examine the
      effects of real world marijuana strains on key outcomes.
    

Intervention name(s): Cannabis (smoked flower, ingested edible)
Intervention type(s): Drug
Intervention description(s): Self-Directed Use (ad-libitum)
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Community Sample
      
Biospecimen description: 
      Blood samples (including DNA analysis) gut microbiome samples (including microbial DNA
      analysis)
    
Keywords: anxiety; inflammation; cannabis; marijuana; stress