Medical Cannabis Treats Insomnia But Not Pain or Anxiety, Study Finds

Medical cannabis can help patients with insomnia but not those with anxiety, depression, or pain, according to a new study.

Published in JAMA Network Open, the study tracked the symptoms of 186 cannabis card holders in the Greater Boston area who suffered from either insomnia, anxiety, depression, or pain.

Only those with insomnia reported significant improvements in their symptoms.

But the researchers behind the study were more concerned with another finding: several of the participants developed mild cannabis use disorder (CUD) over the course of the trial.

This unwanted side-effect was predominantly present among the anxiety and depression patients; 28 percent of them qualified for the disorder by the end of the 12-week study.

Little effect

Some 22 million people around the world reportedly live with CUD, which is typified by cravings and withdrawal symptoms when marijuana isn’t taken.

This condition is usually associated with recreational cannabis, but the researchers from the Massachusetts General Hospital were curious to see how prevalent it is among medical cannabis patients in the area.

To find out more, they recruited 186 local participants who were seeking a medical cannabis card for depression, anxiety, insomnia, or pain.

The researchers asked 105 of the participants to obtain a card immediately and asked the remaining 81 to wait 12 weeks until doing so. As the trial only lasted 12 weeks, these latter participants effectively acted as a control group.

Perhaps unsurprisingly, then, the “immediate card” group reported significantly greater cannabis use at the end of the trial than the “delayed card” group.

But, for some in the immediate card group, consuming more cannabis seemed to come at a cost; around 28.3 percent of the those in the group with depression or anxiety began displaying CUD symptoms by the end of the trial. CUD was much less prevalent, though, among those living with insomnia and pain in the same “immediate” group.

In total, 18 participants (17.1 percent) in the immediate card group had a CUD diagnosis during the trial, compared with 7 participants (8.6 percent) in the delayed card group. While most of these cases were mild, those in the immediate card group were still more likely to display severe CUD.

And these CUD cases didn’t exactly come as a toll for improved symptoms. Instead, the researchers observed no significant change in the participants’ anxiety, depression, and pain by the end of the trial. Only the insomnia patients reported significantly improved symptoms.

Despite these results, the whole immediate card group, on average, reported greater improvements in mental well-being than the delayed card group at the end of the trial.

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While the trial had its limitations – there were no data on the amount or type of cannabis consumed, for instance – the researchers were confident in its robustness and, in the end, concluded that obtaining a medical cannabis card to treat anxiety, depression, or pain will only increase “the risk for developing CUD without significantly improving symptoms.”

Yet, medical cannabis did seem to help the patients living with insomnia, and this benefit didn’t come with a significantly elevated risk of developing CUD. As such, the researchers say this avenue of insomnia treatment deserves more clinical attention.

“Those with a primary insomnia concern were unlikely to develop CUD, suggesting a potential clinical utility of cannabinoids for insomnia,” they wrote in their paper.

“Thus, further study of the effect of cannabinoids on people with primary insomnia is warranted, using objective measures and self-assessments of sleep, along with analysis of CUD symptoms over a period longer than this 12-week trial.”

The study isn’t the first to find concerning rates of CUD among medical cannabis patients.

Only last month, a study was published in Drug and Alcohol Review that found that about a third of people using cannabis to treat a medical condition could have CUD. The researchers from the University of Sydney surveyed 905 people in Australia who used illicit cannabis to treat a medical condition and found that 32 percent met the criteria for CUD.

As estimates of CUD among recreational consumers have put the proportion between 22 and 32 percent, the researchers concluded that medical cannabis consumers seemed just as likely to exhibit CUD as their recreational counterparts.

“Our study highlights that CUD is not an uncommon condition amongst people using cannabis to treat medical conditions, with rates comparable to populations of people who use cannabis for recreational purposes,” the researchers wrote in their conclusion.