Medical marijuana for anxiety and/or ADHD
April 23, 2018 10:11 PM   Subscribe

I have never considered medical marijuana as an option for me until several podcasts I listen to mentioned use of marijuana oil. I don't know where to start researching this.

I have had anxiety and ADHD for a long long time. I don't know if it's relevant but I am also diagnosed with BPD and I have been on lamotrigine for around 4 years.
I have been on adderall before and had real issues with it. It didn't do anything to ease my symptoms and if anything made me feel way worse. I also started to abuse it and ended up completely cutting it out. I have impulse control issues so it's a big no-no for me.
I really struggle with my anxiety and ADHD but after the adderall situation I've just kind of ignored it for a few years now. A guest on a podcast I listen to mentioned her use of marijuana oil for anxiety/ADHD. I do not smoke weed, I have no interest in smoking it. I didn't really know there was a way for me to consume it without smoking/eating it and I didn't really consider it as a treatment for my particular issues.
Does anyone have experience with using oil specifically? And for anxiety/ADHD? Any particular strains I should know about or is that something I ask at a dispensary? I don't really know where to start in researching. I've tried looking online but I don't really know what sources are reliable and what aren't.
I would be talking to my doctor about it but I want to have an idea what I'm talking about before I do. I live in a rural area and I want to be prepared for a conversation that is potentially judgmental. Not that it necessarily will be. I'm just a little concerned I will receive push back. I may just be being paranoid.

FWIW Medical marijuana is legal in my state and recreational use will be legal July 1st. I also work in HR and know my employer would be ok with it so no issues there.

I'm basically a total marijuana noob, please help me.
posted by anonymous to Health & Fitness (9 answers total) 9 users marked this as a favorite
I think you should start with CBD oil.
posted by bendy at 10:25 PM on April 23, 2018 [5 favorites]

I believe you want a tincture rather than an oil. For a tincture, you just place a drop or a few drops (depending on the strength) under your tongue. It will take effect somewhere between 10 minutes and 2 hours. (Yeah, I know. That variability is a bummer.)

Be very careful about what strains you pick. Marijuana can increase anxiety or it can alleviate anxiety, depending on the strain and on the person taking it.

I like bendy's suggestion of using a CBD-heavy tincture. CBD is the least psychoactive version. I would also focus on indica strains and keep away from sativa. Sativa is more mentally stimulating and thought-provoking, where indica strains tend to be more mellow and relaxing.

Start slow. Consider trying it first in the evening when you don't have to do anything, so you can see what the effect is.

You could also try a vaping pen. This is a version of smoking, but it has much less smoke and smell than smoking the actual plant substance does. When you vape, the drug takes effect within a few seconds and reaches full effect with 10 minutes or so. You can take single small puffs, so you're able to control the dosing better than you can with tincture.

It is good that you are going to coordinate this with your doctor. It's important for them to know what other inputs you're putting into your system, and to help you manage them.
posted by Winnie the Proust at 6:25 AM on April 24, 2018 [3 favorites]

Not a direct answer, but I have begun using vagal maneuvers for anxiety and inflammation. The research is thin for the effect on inflammation, pretty good for the effect in anxiety. There are no harmful side effects and it's legal everywhere.
posted by theora55 at 6:52 AM on April 24, 2018 [1 favorite]

there's nothing specifically amazing about oil vs vaping vs smoking. you're getting the same drug, just by a different route. the time to effect and duration will vary, but the end effect is the same.

so you find a strain or thc to cbd ratio that works for you, and then you take that by the route you like.
posted by zippy at 7:20 AM on April 24, 2018

for starting out i'd recommend a vaping pen by the way. it's convenient, the effect is immediate, and you have good dose control. with edibles and oil, the effect is delayed, so it's easy as a newbie to say "oh, this dose wasn't enough, let me take more" and then the first dose kicks in.
posted by zippy at 7:23 AM on April 24, 2018

please check with your doctor or a psychiatrist on this before you start. there's a decent amount of scientific literature that shows that cannabis can induce psychosis and other mental health episodes. my first panic attack happened maybe the third time I ever got high. I tried self-medicating on weed for a few years before realizing what my real issue was (I thought I had ADD until I was diagnosed) and my retrospective view is that it helped me open up initially but very quickly became an unhealthy coping mechanism that was making me more anxious than not

additionally, be mindful of mixing drugs - contraindications are complicated and myriad and best left to professional recommendations

if you're deadset though, I would say that you should see if you can start off buying trim (ie the parts of the plant that aren't typically sold because they're lower in concentration and are seen as detritus) and smoking it by way of traditional means (ie non-oil based; originally vaporizers were made for vaporizing solids, not oils - you might know them as Volcanoes but there are much cheaper options that work just as well)

vaping means less carcinogens and subjectively feels like an easier high. make sure you wait between intakes (ie tokes) for a good ten or twenty minutes and stay mindful of how you feel. if it's too much, stop. if it's too little, keep going but it's always better to be not high enough than stoned to a point of being incapable of taking care of yourself. and it's even better if you get high with someone you trust and who has experience - the less judgmental the better they will be at helping you regulate

I don't recommend CBD / hemp oil starting off - leave that stuff off until you're used to being high because it is potent stuff. I'm saying that as someone who used to go through an eighth of high-grade stuff every week or so. for someone new to this, you want to approach it slowly and gradually. getting blasted your first is risky and I would really suggest that you approach your mental health with intention and due diligence rather than following some popular, zeitgeisty whim
posted by runt at 8:05 AM on April 24, 2018

I think runt's recommendation against CBD/hemp oil may be based on a misunderstanding, so I just want to clarify (they can chime in again if I'm wrong): CBD tincture is different than what runt mentions above, which is sometimes colloquially called wax. Wax is super-strong, and it sounds like you should definitely avoid it. CBD oil/tincture, on the other hand, contains cannibidiol isolated from THC (it does contain a tiny amount of THC, which is the compound that makes you high, but such a small amount that it shouldn't affect you).

I take a drop or two of sativa-derived CBD tincture sublingually before bed and it helps me relax and fall asleep. (I avoid indicas because they tend to make me physically sluggish the next day.) For lack of a better description, CBD tincture makes me feel snuggly and drowsy, and helps my mind calm down. If I take it during the day--as a confirmed lightweight who can get stoned by mistake for the entire day off a single hit from a joint--it makes me relaxed. It also makes me intellectually slower; I can clean all day, organize my house, and do other physical chores, but writing a simple email is kinda hard, and doing complex intellectual work of any sort is ultimately beyond me. Similarly, if I smoke THC (and get stoned, which is not what people taking CBD are aiming for or getting out of it), I have a lovely time but it kills my short-term memory for the next 24hrs, long after the high itself has receded. FYI. Most people are not as sensitive as I am, but if you've never (or extremely rarely) gotten high, you may also be similarly sensitive.

FYI as a newbie, you should be able to walk into any dispensary (once weed is recreationally legal), or with your medical card now, and tell them exactly what you've said here: you're a total newbie and have heard that CBD can help with ADHD and anxiety, and you'd like a recommendation or two. They'll probably ask you a few different questions--and if they're surly or make you feel awkward about being clueless, just go to a different dispensary or ask to talk to a different staff member--to help you narrow down the available options. As with any drug--prescription or otherwise--it can take a little while to figure out the right dosages, and to get a sense of how it'll affect you, so be aware that your very first experience, or product, may not be representative.

Finally, you should absolutely do a bit of research on how weed will interact with Lamotrigine and other drugs of that class.
posted by tapir-whorf at 11:27 AM on April 24, 2018 [5 favorites]

For a person who wasn't taking meds and had plain anxiety, I'd say just buy some CBD tincture online (Green Mountain, Charlotte's Web, Flower Child, Dutch Naturals and Entangled Biome are all trustworthy brands that you can buy online) and take under your tongue, starting with low doses (i.e. 2 mg) and working up to bigger doses (i.e. 20 mg) as applicable. It is pleasant, calming and gentle. Seconding tapir-whorf that "CBD oil" is not "potent" in the sense of getting you high. It's a non-psychoactive part of marijuana and is actually being trialled as an anti-psychotic drug. If you took way too much it would sedate you, but that's about it.

For ADHD, it's a little murkier than with anxiety. As you probably know ADHD is a risk factor for addiction in general, plus ADHD been associated with overuse/dependence with high-THC pot. With that in mind I would definitely be wary of THC for you. But I have a book about the medical use of CBD and Dr. David Bearman is quoted in there saying "Cannabis appears to treat ADD and ADHD by increasing the availability of dopamine. This then has the same effect but is a different mechanism of action than stimulants like Ritalin and Dexedrine, which act by binding to the dopamine and interfering with the metabolic breakdown of dopamine." So maybe CBD could be helpful for ADHD.

ALSO VERY IMPORTANT FOR YOU IN PARTICULAR: there's evidence that CBD lowers Lamotrigine in the blood. (CBD causes cyctochrome P450 effects, the same way grapefruit does, and can increase the effects of some medicines and reduce others). So if you're going to take CBD and Lamotrigine at the same time you'd definitely want your doctor to be on board and helping you figure out the new Lamotrigine dose.
posted by hungrytiger at 3:17 PM on April 29, 2018 [2 favorites]

If I were talking to my doctor, I'd say "I've heard that there is a non-psychoactive part of marijuana that has some successful preliminary results helping with anxiety and ADHD. It's called CBD and I'm interested in trying it." I might print out some relevant papers from Project CBD. And I would definitely bring up the Lamotrigine interaction.**

(If they pushed back saying there isn't enough evidence, the thing is that US scientists can't freely study cannabis because it's a Schedule 1 drug and so historically you can only get it from a special DEA farm at the University of Mississippi, and the DEA/National Institute on Drug Abuse have historically only been wiling to give it to scientists who are studying the health HAZARDS of pot, not its therapeutic qualities. So they're right, there isn't very complete evidence, but there are lots of intriguing preliminary studies, and a ton of anecdata.)

**Lamotrigine and CBD are also both anti-epilepsy drugs. I don't know what to make of that but it seems worth noting.
posted by hungrytiger at 3:24 PM on April 29, 2018 [2 favorites]

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