Healthy Self Medication - Marijuana & Alcohol
November 14, 2017 6:32 AM   Subscribe

I suffer from severe anxiety and depression with OCD. I have been getting treatment for most of my adult life with little success. I am currently trying to manage it with exercise, therapy and marijuana/alcohol. Details inside

I suffer from severe anxiety and depression with OCD. I have been getting treatment for most of my adult life with little success. I am currently trying to manage it with exercise, CBT/ERP therapy and marijuana/alcohol.

I am up front with my PCP, therapists and psychiatrists about my use of alcohol and marijuana. They tell me not to worry, but that is kind of what I do. Meds never really worked, although I am exploring my options on that front. Most nights I have a glass of wine, and sometimes two. An actual glass, not a huge goblet. I also vape marijuana oil almost nightly. I have tried CBD, but it doesn't shut my brain off like the THC stuff does.

I am worried about my lungs and my liver and brain. I am a man and weigh about 170lbs. I eat healthy and exercise.

Summary - am I drinking too much? Is vaping marijuana super unhealthy? I feel like I have a hard time relaxing without one or both of these aids. I am also up front with my docs about that fact. I just want to make sure that I am not going to be doing harm - significant, I know that these things are not healthy, but it is all about managing my EXTREME mental stuff. That 2 hours of relative peace at night is very important to me.

Thank you
posted by kbbbo to Health & Fitness (12 answers total) 5 users marked this as a favorite
The NIH suggests no more than 14 drinks a week for men. I'd switch to edibles if you are concerned about your lungs. That said, while you may currently be in ok limits in terms of alcohol consumption, you should keep looking for more outlets, because dependency on substances is never great. The general progression is that you'll need more alcohol for the same effect. You might try using just the marijuana instead? Edibles do have a slightly different effect, but it would probably be better to do that long term.

I'm not a doctor, but I have been very close with alcoholics and also someone very close to me (a male) had heart issues after decades of daily marijuana use for managing anxiety. His doctor told him to switch to edibles.
posted by pazazygeek at 7:07 AM on November 14, 2017 [1 favorite]

If your doctors are ok with this, I'd be ok with this.
posted by Ms Vegetable at 7:14 AM on November 14, 2017 [1 favorite]

I have sent you a MeMail!
posted by terretu at 7:49 AM on November 14, 2017

Alcohol is going to eventually become a problem used in this way. You will develop a tolerance, drink more, and suffer the side effects. I would really reconsider using booze as a therapy. It is just so easy to ride it over a cliff. Also, if I told my doctor I was drinking a glass or two of wine a night for depression, and they said it was OK, I would change doctors. Also I’m very sorry you are going through this and I wish you the best.
posted by machinecraig at 9:40 AM on November 14, 2017 [5 favorites]

If you have exercise and therapy in the mix, rather than using alcohol/cannabis as a substitute for those, you should be just fine! This worry might be a manifestation of your anxiety, rather than a legit concern. Your doctors are right that it is perfectly safe.

People in the US get too worked up about alcohol because they can't moderate themselves. One glass of wine is healthy, it's not going to hurt you, and grandparents in Italy live into their hundreds all the time while drinking wine every night. Organic wine / no-additive wine is better, obviously, but one glass is better for your heart than no glasses, and won't damage your liver. UNLESS you are taking antidepressants or other medication that is contraindicated with alcohol.

Likewise with cannabis, the dangers are overblown and come from abuse rather than moderate usage. Vaping is gentler on the lungs than smoking, but be sure you are vaping herbal material, not extracts. The chemicals in the extracts (especially the flavours) CAN be harmful to your lungs. I believe CO2 is the safest extract but herb is still preferable (organic, because the pesticides they use on cannabis can be bad). The Volcano-style vapes are safest because you inhale room-temp vapour, but also they're very $$$.

That being said: alcohol is a depressant, and high-THC cannabis can increase anxiety. You may try 'going on vacation' from them both — for at least a month, to get the full experience — and see how you feel.

If you are finding all the things you're combining are not giving you ENOUGH relaxation, try these:
• Turn down all lights in your house very dim and yellow at night. Maybe switching out your bedside lamp for a small yellow nightlight/reading light. I like these.
• Doing breathing / meditation / stretching before bed, there are lots of youtube videos for this. Or, this meditation app has many free guided breathing meditations for relaxation/sleep
• Most important, NO screens at least 1 hour before bed, or if you have to, wear yellow/brown glasses or use an app like F.lux — staring into the blue light of tv/computer screens is VERY stimulating to the brain, and might be triggering some of your night-time anxiety.

Also, it seems counterintuitive but trouble getting to sleep can be an indicator of sleep issues. Sleep apnea is the big one, esp if you snore, have a thick neck, or enlarged tonsils. But even young, skinny people can have apnea, and it's more common in men. You may consider getting screened for it, they can do 'home studies' now where you don't have to go to a sleep lab.
posted by it's FuriOsa, not FurioSA at 10:01 AM on November 14, 2017 [3 favorites]

A glass of wine a day is not something you need to worry about. If you are concerned about it becoming a habit, take one a day a week off just so you know you can.

Vaping THC is not super unhealthy; in fact, it's probably not even a little bit unhealthy, though this depends on a couple of factors, like how you are vaping it. I have no idea what the previous suggestion of "be sure you are vaping herbal material, not extracts" means, since THC oil is necessarily an extract.
posted by DarlingBri at 10:21 AM on November 14, 2017 [1 favorite]

Oh, other things you might try to reduce nighttime / general anxiety. Maybe you do some or all of these things, but you didn't mention, so I thought I'd throw them in the mix:
• Bright lights, fresh air, and exercise FIRST THING in the morning. If you've been going to the gym after work, try switching to going for a run outside in the morning instead, especially if you're extra-sleepy. Get one of the SAD lamps if you live at a higher latitude and can't see the sun before you go to work. Your body has several different systems (hormonal, brain-based, etc) to track time of day, and it's very common for the weirdness of modern life to cause them to get out of sync, which can lead to sleep issues and anxiety at night.
• Switch to a higher protein & higher fat diet, especially for dinner. Focus on healthy fats like olive oil, coconut oil, oily fish; with protein from some red meat but mostly legumes, chicken and seafood (salmon, sardines/herring, mussels/clams/oysters). Like seriously eat JUST a huge salad doused in olive oil and a big hunk of salmon (bigger than '1 serving' because it's subbing for the carbs too), or half a roast chicken with lentil stew. If you're 170lbs you should be able to eat half a chicken no problem. If you can't, you're not exercising hard enough!
• Cut out sugar, or reduce it to a minimum, and limit caffeine to one or two cups only before noon. If you want something sweet after dinner, try mango or pineapple, or herbal tea with honey, which will give you that sweetness without getting your blood sugar up too much. If you're using sugar/caffeine a lot because you feel sleepy all day, that can be an indication of sleep problems. Get checked out for apnea in that case.
• Melatonin before bed, if absolutely necessary.
• Bathing in epsom salts 1-3 times per week. Something to do with absorbing magnesium helps people sleep, I find it very effective.
posted by it's FuriOsa, not FurioSA at 10:25 AM on November 14, 2017 [2 favorites]

Vaping THC is not super unhealthy; in fact, it's probably not even a little bit unhealthy, though this depends on a couple of factors, like how you are vaping it. I have no idea what the previous suggestion of "be sure you are vaping herbal material, not extracts" means, since THC oil is necessarily an extract.

'Herbal material' is what the medical cannabis community calls 'dried bud' aka the basic form of the cured cannabis flower.

I meant that exactly: oil/extract vaping can be dangerous, herb vaping is preferable (link 1, link 2, link 3) — whether it's THC oil, CBD oil, etc. A lot of the danger comes from propylene glycol, but solvents and pesticides are also an issue.

You can get herbal cannabis that is high THC (almost all of it, these days) or low THC, high or low CBD. The other cannabinoids (CBG, CBN, THCa, CBDa, etc) and the many terpenes are also important to cannabis's healthier properties, and oil extractions won't preserve them unless the company specifically cares about that. Which most don't, because THC extracts are marketed to people who want to 'get high' and party. They don't particularly care about those using cannabis for theraputic properties like anti-anxiety / sleep, or people who care about the health of their lungs.
posted by it's FuriOsa, not FurioSA at 10:41 AM on November 14, 2017 [1 favorite]

As someone who manages their anxiety with marijuana, this all sounds ok. Furiosa makes an excellent point however, and if you can you should switch to vaping dried bud(I use the highest percentage Indica strain available when I go). Edibles are certainly an option but I find the effects to be quite different and extremely strong. Which might be for you! But I had a very difficult time trying to dial in an appropriate edible 'dose' especially when even the best of shops don't always have the same item week to week.

I will also offer a very strong recommendation for adding exercise to your morning routine, this helps me more than the MJ when I am consistent about it (and its much cheaper!) and lets me reduce my MJ use to more 'emergency' situations or especially bad days.
posted by deadwater at 11:01 AM on November 14, 2017

I cut out my (moderate, 3-5 drinks a week) alcohol consumption to address seasonal depression symptoms a couple months ago, and it's been shockingly helpful. It took several weeks to see a difference. YMWV, I'm significantly smaller than you. I was also consciously substituting other ways to relax to replace alcohol (Netflix, dance classes, texting friends, etc.).

While you're not drinking so much it's an obvious health concern, you're concerned, it's your body, you can try something different. This doesn't sound to me like a worry fabricated by your anxiety, but IANYD.
posted by momus_window at 1:03 PM on November 14, 2017

Since tolerance is A Thing, regular use can slowly creep up to acheive the same effects. This is harder to gauge with cannabis than with alcohol, but it's doable.

If you are serious about medicating with cannabis, treat it like medicine. Get a mg scale and keep track of how much you're using. If it's creeping up, time to examine whats going on.

And yeah, edibles are probably long term 'safest' with vaporized flower behind that, but really since cannabis is schedule I, there's been a complete lack of good hard data around this. Most of the information around cannabis intake, and the dangers or benefits therein, are unfortunately anecdotal at best.
posted by furnace.heart at 1:55 PM on November 14, 2017

I find that while alcohol can calm my depression/anxiety in the moment, even an occasional drink increases my depressive symptoms for the next few days, up to a week. This might be something it’s worth trying to chart—rate your mood during the day and at night for a few weeks, then stop alcohol (but not marijuana) for a couple weeks and chart that. I’m anecdotally aware of many more people using marijuana to manage anxiety with some success.
posted by epj at 2:16 PM on November 14, 2017 [1 favorite]

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