This is a hard topic to communicate in depression treatment. It's easy to mistake substances that temporarily boost your mood or calm your nerves for effective treatments for an underlying condition.
There was a brief period of time before the opioid prescribing backlash when some fringe psychiatrists were proposing weaker opioids as adjunctive treatments for treatment resistant depression. It's hard to fathom now, but opioids were more casually prescribed a few decades ago. I recall some discussion where one of them said they were seeing good initial results but the effects faded, and then it was hard to get the patients off of the opioids when they were no longer helping. Not surprising to anyone now, but remember there was a period of time where many seemingly forgot about their addictive properties.
I feel like I've seen a weaker version of this in some friends who turned to THC to "treat" their depression: Initial mood boost, followed by dependency, then eventually into a protracted period where they know it's not helping but they don't want to stop because they feel worse when they discontinue. This wasn't helped by the decades of claims that claimed THC was basically free of dependency problems.
> but remember there was a period of time where many seemingly forgot about their addictive properties.
There was also quite alot of talk about how doctors, by being reticent to prescribe opioids, were inhumanely forcing patients to live in pain, and not being sufficiently deferential to patient autonomy. Moreover, the rhetoric was incorporated into discussions about racist disparities in treatment, given there was some evidence doctors were less likely to prescribe opioids to black patients, suggesting doctors were systematically being cruel. Naturally, the easiest way to dodge those accusations was to simply prescribe opioids as a matter of course. Even in the absence of Purdue Pharma pushing their claims about lack of significant addictive potential, there was already significant pressure to discount the risk of addiction.
As an aside, it is a well established fact that doctors, as a whole, take the the pain of black
people much less seriously than the pain of non-black people.
If you take it and you feel your anxiety is lessened, that's the greatest proof you can ask for. All the psychiatric studies are already based on self assessment.
Second, a lot of psychatric treatments are temporary, ending whenever the medication is stopped or wears off so I dont see how this would be any different
> If you take it and you feel your anxiety is lessened, that's the greatest proof you can ask for.
This mistake has been made many time throughout history. Cocaine was originally believed to be a viable treatment for depression. Opioids and amphetamines too. You take them and you feel good for a while, which was mistakenly equated with treating depression.
Many drugs will make you feel good temporarily by blocking certain feelings or tricking your brain into feeling good. This is not the same as treating a condition.
You can think of actual treatments as working closer to the source to reduce the problem, not temporarily overriding it with a powerful drug-induced sensation.
Psychiatry as its practiced has no idea as to what depression even is under the hood. The entire science is based on the patients self reported feelings or the psychatrists feeling of how someone else is feeling.
What you're saying is something else, that drugs can produce long term harm despite short term improvements
>> This study is showing that THC, CBD, blends, or cannabis do not improve self-reported feelings over the long term.
Just to clarify, the study is not saying that.
The study is saying "there isn't conclusive evidence at this point, but it leans more toward helping than hurting on many categories". Please read the paper if in doubt.
I did. I don’t know if you did, though, because the categories that they said there might be some signal were secondary topics like insomnia, not depression PTSD and anxiety.
I mean, it’s literally in the title. It’s covered again in the abstract.
I dont have a problem with the study or its conclusions, just the parent post I was replying to.
>Recreational drugs make you feel good temporarily. That's literally why people do them.
The point Im making is this is true for a ton of psychiatric or even non psychatric treatments. And to be perfectly clear Im not saying you should be treating your anxiety with weed, even if it does help you
> The point Im making is this is true for a ton of psychiatric or even non psychatric treatments
That point wasn't intended to be taken in isolation.
I was making statements about how long-term treatment of an underlying condition is not the same as taking a drug which temporarily masks a problem or induces altered mood states.
The fact that a drug has acute effects, good or bad, is separate from any conversation about chronic effects.
For depression, anxiety, and other conditions it's the chronic effects that matter. The acute effects almost become side effects at that point. For some drugs, getting to long-term treatment involves tolerating the acute effects while your body adapts
You keep ignoring the fact that what you just said applies to current medications used to treat depression and anxiety. They do not treat the underlying issue long-term, and if you stop them, you are worse off than before due to rebound effects, and even if those effects subdue, your depression and anxiety returns. And just to add to this for clarification, antidepressants may treat depression, but it does not cure it either.
Same with amphetamines for ADHD. And yes, if you take much more, you will experience side-effects ("cause harm when abused"). Opioids are not an outlier at all.
> Recreational drugs make you feel good temporarily
Drugs are only recreational if you take them recreationally, there is nothing that makes them inherently recreational.
And we have not discussed MDMA, which is considered a hard "recreational" drug, yet there are lots of benefits for treatment of PTSD, for one, similarly to psychedelics.
... or ketamine for depression, which is now approved by the FDA, even.
The difference between your positions is not about acute vs chronic, it's about tolerance. If a drug for a long term condition has short term effects the first few times and then they fade under regular use, it's less of a valid treatment. Especially if there is a withdrawal effect, and any negative side effects of regular use.
We absolutely overprescribe a lot of psychiatric meds that do not have significant beneficial long term effects. "Stabilizing" a patient in an inpatient hospital psych ward may as well involve a Magic 8-Ball picking the particular antipsychotic for its short term effects, while on the other hand doctors and nurses put people on Seroquel at the drop of a hat in reported sleep problems, and don't take them off until natural death or until the essential tremors get reported decades later.
This is a fair point but there’s also truth to the fact that “I feel better” does not automatically mean it’s an effective/good treatment.
Lots of depressed people turn to alcohol to provide a mood lift. But you can’t be drunk all the time and function, and when the alcohol wears off you feel even worse. So it’s a terrible treatment.
People talk a lot about cannabis like it’s a great treatment for all kinds of stuff. But is it closer to a drug you can take on a schedule that boosts your mood essentially all of the time with acceptable side effects? Or is it closer to a drug that lifts mood very short term and then makes it worse?
> “I feel better” does not automatically mean it’s an effective treatment.
Of course, I agree with that.
I also agree that you cannot be drunk to function, but there are many other "drugs" that people would oppose that do not make you dysfunctional.
Personally I would not use cannabis because I know that it makes me dysfunctional, but it may not be the case for some people for all I know.
FWIW I take opioids for my chronic condition, and it also helps with my emotional volatility, depression, and anxiety, too. I have not experienced any side-effects either.
Alcohol is so terrible, especially when severely abused, that "better than alcohol" absolutely cannot be a meaningful standard for being a proper treatment.
> there are many other "drugs" that people would oppose that do not make you dysfunctional.
People oppose these drugs because they do tend to make you dysfunctional, at least when abused. And when people are severely depressed, the depression itself makes it more likely that they will abuse their drugs.
> You keep ignoring the fact that what you just said applies to current medications used to treat depression and anxiety. They do not treat the underlying issue long-term
Those do cause improvement in self-reported feelings long term, i.e. they lower the baseline levels over a long period of time, rather than just for a short period right after you take the drug.
But you'd be right to say that they're not very good, i.e. that doesn't help your life very much. If there's an actual underlying cause, like sleep apnea, treating that will help a lot more.
Ketamine is a harder case, it really does cause improvement, but it lasts about two weeks. It also can cause psychosis, which is very dangerous. The s-ketamine the FDA approved for use in treatments is also via an inhaler, so it's both purer and via a different route than other a lot of other ketamine usage and it was approved because it actually showed a measurable effect in studies.
But it's really awful to use and if you find out that, say, sleep apnea was actually causing the issues, treating that will do a lot more good than inhaling s-ketamine ever did.
As you may have inferred, I write this based on personal experience.
The problem with your argument is it's whataboutism. Your argument's conclusion should be that even prescription drugs aren't necessarily good.
Really what is wrong is that most prescription drugs do show less tolerance. Yes, prescription drugs have tolerance, but not as fast as recreational drugs taken at recreational doses.
By giving a patient the ability & skills to establish a less dopamine-seeking lifestyle while temporarily relieving them of the deficit.
Its use is supposed to be coupled with therapy and/or coaching (e.g. https://www.thriveemerge.com) to ensure that the patient isn't just using it as a lifelong crutch.
That's how it's supposed to be done. This approach is more effective in children for obvious reasons. Persons diagnosed later in life are therefore more likely to require it permanently.
Why do you need amphetamines to do this? Why not a legal stimulant? Even something as trivial as coffee can be effective if you take it strategically, i.e. stay off of it completely until the rare times when you need the turbo boost.
There's also atomoxetine, but it's not very effective.
> Why not a legal stimulant?
Which ones? People absolutely do self-medicate with coffee, ephedrine, or even cocaine where it's available (coca tea). And these stimulants do work, but they have _more_ side effects than amphetamines when used in theurapeutic doses.
Would love to learn more about how this is the case (both assertions). Mind sharing?
Neuroscience seems to be coming through with more and more understanding using technologies like fMRI and others the past 5-10 years. There is definitely some understanding there.
The short version, as I understand is, is that brain scans show differences at the population level but not on the individual level. Amen claim to both diagnose ADHD through brain scans (which is already impossible) and also diagnose various "subtypes" of ADHD like "Limbic ADD" which have no scientific backing for their existence.
not clinical understanding, not in any useful way. its another tool for study, but my understanding is that aside from some very high level structural information, there's sadly not that much to be learned from watching the flashing lights.
> Cocaine was originally believed to be a viable treatment for depression.
Is it not??
Sure there's the addiction and harm from abuse that make it less than ideal for long term use, to put it mildly, but weed isn't coke so what's really the argument here?
As someone who has had depression literally as long as I can remember, being able to releve my symptoms when I really need it, even for just an hour, would be life changing.
Duration of effect matters when it comes to successful treatments.
If we take your position and apply reductio ad absurdum, we could say that cocaine is a highly effective treatment for anxiety, although of course we know that in the not-so-long run it has the opposite effect.
Shouldn't that be up to bodily autonomy? If someone feels that cocane relieves their symptoms then who is the doctor to say that they don't. Perhaps releaving those symptoms even for a short period of time is worth the consequences.
That's just arguing for drug legalization with extra pseudoscience.
I am all for people doing however much cocaine they feel they need. In broad daylight - let's just drag that into the light and let people go to the dispensary for cocaine hydrochloride, metered, measured and with warning labels.
Because the war on drugs is a stupid waste of time and lives, but no doctor or medical professional has to justify your own stupid actions.
But a lot of psychatric treatments are just that. Treatment for ADHD for example is giving ampethamines (which btw are chemically no different than a low dose of meth), which have a duration of 3-6 hours and its back to worse than baseline after the effect has worn off.
There are multiple treatments for ADHD, including alpha-2 receptor agonists and norepinephrine reuptake inhibitors. Some of them show patterns of increasing efficacy out to a year (the length of the study).
The reason amphetamines are used for ADHD but not depression is that they've been studied to show that the ADHD improving effect can remain for many months, while the mood-improving effect will taper off quickly if you take them every day. Almost everyone who takes ADHD stimulant, feels a mood and motivation boost ("so happy I could cry" is the common phrase) and then is disappointed when that mood boost stops happening after a few weeks or months will learn this. Attention enhancement is less prone to tolerance, though it still accumulates tolerance too. There are some studies showing that the effects of stimulants in ADHD diminish substantially on a multi-year time frame, and it's probably not a coincidence that many people (though not all) who take stimulants discontinue after several years.
No not just like it, because the only difference with methampathemines is that the added meth group makes it able to cross the blood barrier much quicker, hence why I said its equivalent to a lose dose of meth. The chemical/biological response on the body and brain are very similar, the difference is in potency
But onset of action is a very important distinction in medicine/pharmacology, as is dose.
Most abusers of methamphetamine are not taking it orally (slow route of administration) and are generally using much higher relative dosing than ADHD patients are using amphetamines. Potential for addiction and other physical harms are greatly affected by both of those things, so the comparison has some truth, but is obviously sensationalized.
That's a terrible oversimplification. Stimulant treatments for ADHD are not supposed to produce pronounced mood-enhancing effects. Stimulant treatment has been shown to be effective indefinitely in majority of people without increasing the dosage over time.
These days formulations like lisdexamfetamine and extended release methylphenidate are preferred because they have all-day efficacy with typical duration of action of around 8-12h which carries lower abuse potential.
extended release are just two doses of the drug where half the beads are delayed by ~4 hours. How is that different from taking two edibles a day and claiming full day efficacy?
I mean the difference is that you just take one in the morning? Which makes adherence easier, makes sure that the delay is constant rather than variable, and reduces abuse liability.
(As an aside, there are more complex extended release mechanisms than just delayed bead release - like lisfexamfetamine is a inactive prodrug, so cleaving the lysine off the amphetamine is rate limited. This has the effect of extended the duration of effect, and reduces the potential to abuse by snorting/iv/etc).
That's not the case for lisdex nor Concerta methylphenidate. Some generics work that way and they're generally regarded as being worse than Concerta.
The benefit is that the medication automatically produces a smooth effects profile allowing you to live your life without timing medication to perfection.
A pronounced come-up and crash is a risk factor for abuse and addiction, so smoothing or removing the peaks and valleys is important.
Well, it's not that simple. It's reasonable to expect that you could see some increased level of oxidative and excitotoxicity. It's harder to draw a bright line around the dopaminergic system specifically because some level of neuronal death is expected over the course of a lifetime. We lose 5-10% starting with middle age yet don't tend to show parkinsonian symptoms until 60-80% are gone.
It's pretty reasonable to expect reversing DAT and inhibiting VMAT2 increases oxidative flux, the question is really how much not if. Methheads certainly get "brain damage", but is nudging the average loss from 5-10% to 7-12% "damage"? Is it meaningful? Over 30, 40 years that could very well add up.
Meth is also used as an ADHD treatment. I think the reason is just the dosages that are used by addicts compared to people who just need the ADHD treatment.
A typical legitimate therapeutic methamphetamine dose is around ~20mg (up to maybe 60mg a day). A typical dose used by addicts is around 1 gram. And it's usually smoked, resulting in immediate bioavailability.
There’s a difference between intoxication and treating the chemical imbalance behind depression or anxiety. For one thing, treatments for anxiety only target the anxiety: they don’t impair the person the way that weed or alcohol does. (They can have other side effects, of course.)
Drugs for anxiety treatment do wear off, but not the same way that weed or alcohol does: something like Celexa takes a few weeks to build up in the system, and don’t lose effect 12-24 hours later if you miss a dose. I’m not sure how long you’d have to stop before it loses efficacy entirely.
I’m not Nancy Reagan, though: I would not advise people to self-medicate with booze or pot if they’re suffering from depression or anxiety, but I’m not going to preach at anybody who is doing so and thinks it’s working for them. I will say that I’ve seen that end badly, though. I can think of three people I’m close to who’ve tried it and have had problems with addiction: all of them are now sober and (I believe) on regular antidepressants.
Im prescribed adderall for ADHD. It is a high. You feel more positive, more productive, more forward looking for a few hours and its back to baseline or worse when you crash.
As for impairment, it really depends. If weed removes your anxiety and lets you relax, its benefit could be greater for what youre doing than the impairment it causes. And adderall, SSRIs can cause impairment of sorts too.
I won't call you an idiot, but assuming that all cases are simply people being sad is a bit simplistic.
Some people are going to be more susceptible to depression, for whatever reasons, and improving someone's surroundings is probably going to prevent or alleviate depression to an extent, but to people who are depressed now it's somewhat pointless advice.
I think the problem is that, at least in my experience, you end up with more anxiety once the initial high wears off. Paranoia is an extremely common side effect of Marijuana, and so are nightmares with prolonged use. And once you kinda get into a routine with it, you have a hard time quitting, because your overall anxiety is raised, and you need it just to get back to a normal functioning level. My guess is that this is due to the effects that THC has on blocking your REM sleep. Without the proper REM sleep, it seems pretty common to be anxious and foggy-brained.
THC cannot both ”cause nightmares” and ”block REM sleep”, because nightmares happen during REM sleep.
People who suffer from nightmares may benefit from less REM sleep. It’s much more refreshing to sleep in a non-REM state and wake up normally than it is to repeatedly wake up in cold sweat and be afraid to go to sleep again.
Psychiatric treatments return a person to a baseline that can be managed with therapy or healthy coping mechanisms.
Chasing a high is not a treatment, it merely defers the problem. As tolerance to the high builds, patients lose the therapeutic value but have gained crippling dependency and addiction.
Doing ten shots of tequila is a 100% scientifically proven cure for social anxiety then. If you take it and your anxiety lessens, that's the greatest proof you can ask for! Let's just completely ignore the crippling morning hangover and liver damage
Sure but my point was that you cannot have an argument where you go "yeah this happens so it's good" while you disregard everything else (it's a different question on how bad it is compared to alcohol etc). But if we follow the logic of the original comment, then it's valid logic since "hey it works so its scientifically proven!" You can replace alcohol with something else to highlight that as well, like how putting out a kitchen fire with a bucket of gasoline is a good idea. It completely covers the flames for a split second! Why worry about the explosion that happens immediately after?
So my comment wasn't about alcohol vrs cannabis but rather how that kind of logic is short-sighted and faulty.
I mean... Yeah. Alcohol is very well documented and even more widely used for exactly this purpose BECAUSE it works.
The side-effects are often terrible. This is also true for many widely-prescribed drugs, and has been even more true in the past. The folks I've known on MAOIs were pretty wrecked.
Yes. Rather it is the reverse that helps. Exercise is the biggest one, but essentially “pain that will stop” seems to help in general. Ice showers, fasting, new challenging activity, giving up caffeine/alcohol.
All these things suck in the short term, and make you feel more good in the medium term. Maybe because your default becomes “not in so much pain”, rather than “feeling worse than when briefly enhanced by substance X”
Edit: I’m referring more to the “self medication” approach. Please don’t take any of this as medical advice.
Sadly, I have witnessed three of my friends who started THC product to deal with anxiety, developed paranoia. Two of them quit THC and got better but one got way worse and now is in process of divorce. His personality is completely different, he was pretty chill guy but now he is talking way too much, easily distracted, and always worried about macro events.
Isn't the problem with psychological dependency that drugs generate basically a artifical depression, so more drugs are needed to basically feel normal again? Thus saddling a already existing problem with the same on top?
Yeah this has been my experience with THC. I never took it for depression, but it was always a temporary thing. I doesn't treat anything IMHO. its a symptom relief at best.
it works pretty good as a temporary relief from anxiety.
Title says "helps" but the summary says "it doesn’t effectively treat anxiety, depression, or PTSD". Big difference between the two IMO.
Plenty of people use cannabis to alleviate symptoms. I don't think they expect to be cured entirely. Getting a good night's sleep or being without chronic pain for a few hours is often enough.
It's a meta-study and came to the conclusion that there isn't reliable evidence that it alleviates symptoms of a bunch of stuff:
> There were no significant effects on outcomes associated with anxiety, anorexia nervosa, psychotic disorders, post-traumatic stress disorder, and opioid use disorder. There were insufficient data to meta-analyse studies of ADHD, bipolar disorder, obsessive-compulsive disorder, and tobacco use disorder. There was an absence of RCT evidence for the treatment of depression.
They have some more useful figures in the paper, but for a lot of things they're essentially saying there is not enough evidence to support using cannabis yet.
The strongest claim is the lack of significant effects for anxiety, ptsd etc. but it varies a bit whether that's because the effect is too small or because it is not studied enough.
For anxiety for instance the effect they list in the paper is quite big but the error bars are even bigger so the net result is inconclusive. This is quite different from PTSD where they note little to no effect with small error bars.
Beyond the semantics, this is what the meta analysis(1) actually says in the abstract
> There were insufficient data to meta-analyse studies of ADHD, bipolar disorder, obsessive-compulsive disorder, and tobacco use disorder. There was an absence of RCT evidence for the treatment of depression. Meta-analysis revealed higher odds of all-cause adverse events (OR 1·75, 95% CI 1·25 to 2·46) among those using cannabis versus control group
The paper says there's no evidence of effectiveness in treatment, and evidence of harm.
It sounds to me like you didn't understand the paper at all, or are worse willfully misrepresenting.
The paper says "insufficient data" for helpfulness for most positive categories (but leans more positive than negative just doesn't reach 95% confidence), but also insufficient data on most negative categories. It finds 5 conditions it's helpful for, and 3 it hurts for.
> Plenty of people use cannabis to alleviate symptoms. I don't think they expect to be cured entirely.
Obviously can't speak for everyone, but I know people who do think literally that. They think that weed will actually cure their depression, and they'll allude to some studies about it that I'm pretty sure don't exist and that they just made up.
From the paper itself: "54 trials were identified for inclusion (2477 participants...) ....24 (44%) of these trials had a high risk of bias, and the certainty of evidence for most outcomes was low."
American media has really been shockingly pro weed/cannabis for the past 20 or so years. Really astounding to witness considering the well known downsides to human health and cognitive function. Main characters smoke weed as a cool disobedience, in sitcoms even.
Wonder what is behind it, from my perspective it's quite remarkable.
I think there’s probably some adjacency to other things which make people feel good, but are ultimately bad for them. Gambling, alcohol, porn, infinite scroll social media. There are a few people making a ton of money on this stuff and the social costs aren’t something they care about.
I think it became socially acceptable because there’s not a huge reason to hate on it.
The risks to cognition and health exist, but they’re no where near as bad as alcohol or cigarettes (and the negative effects basically don’t exist at low, even moderate doses)
The biggest negative effect of using weed regularly is it seems to slowly kill people’s motivation to do stuff over time. It will turn just about anyone into a couch potato. That’s more dangerous than any other effect IMO.
I am not sure I'd say I'm "against" it since broadly speaking I don't think it should be illegal, but I am against it in the sense that I really think that absolutely no one should be smoking weed. It's kind of an unearned opinion; I don't know anything about medicine or health or anything like that, but I hated what it would seemingly do to my friends in high school.
I'd have friends that would be more or less down to earth, start smoking weed, then start finding and watching videos of Alan Watts and Carl Sagan and convince themselves that they knew everything in the world about physics and philosophy, and they became utterly insufferable in the process, and whenever anything negative about weed was ever said, they would provide me a lecture about how weed is a cure to pretty much everything and how no one has ever had a negative effect from it ever in history.
I think there's been a huge over correction; there was so much bullshit about the dangers of weed that people started acting like it's some miraculous cure-all and ignoring actual issues.
This was such a visceral turn-off for me that I to this day have never used weed, and the idea of using it still kind of makes me viscerally annoyed. It's entirely possible that my friends were insufferable teenagers purely because teenagers can be insufferable, and that's not even unlikely, but the way I remember it is the weed making them annoying it. Not saying it's rational, just that memory and human brains are weird.
Since the 1960s and the emergence of the New Left, and the introduction of the Frankfurt School and 60s post modernism into academia, there has been a widespread belief amongst a large segment of the population that everything traditional is wrong. A social stigma is merely ignorance, that which is seen as bad is actually good, traditions are wrong. All of these things need to be overturned for the enlightenment. Since society deemed marijuana bad, it is therefore good. As those people who were went through that indoctrination in the 60s as students got older, they got into power. They took power in universities. By the 90s they were pushing all of the ideas as the status quo. Students in the 90s then took those ideas, and when they got into power in Media, they pushed those ideas into all movies and tv.
Alternate theory: there's a shit load of money to be made with legal marijuana so it will be mainstream just to ensure those paychecks keep coming. And for media, it's a low hanging trope that if you want your character to seen edgy but not dangerous, you have them do safe drugs like marijuana. It's easier than the weeks of story it would take to let the audience know they're just slightly anti establishment.
I'm not sure I buy your theory even a little, to be honest. The children of the 60's have, by and large, gotten FAR more conservative as they've gotten older.
Students in the 90s had also lived their entire lives under the counter-productive and utterly racist War on Drugs. That might have colored their attitude more than the leftist indoctrination bogeyman.
The college indoctrination boogieman exists because it is coincidentally the first time in their lives a lot of people live away from their parents fulltime.
How much your opinions change once you're not in that environment can be amazing to both yourself and to the people who think they understand you because you were financially dependent on them.
New ideas or diversity or whatever: living by yourself 24/7 is a huge liberator of thought.
People were smoking weed even when it was socially unacceptable and illegal. Then they were going to jail for a decade or more because of it. This simply did not make any sense. I believe most of this is a backlash effect.
Weed was the worst thing ever. Weed is the best thing ever. Eventually weed will be in the same category as coffee.
I've always been suspicious of the claims THC helps anxiety. CBD may, but my experience is that high doses of THC without corresponding CBD tends to induce anxiety in many people. I also found the brief notes in the article about MMJ and autism intriguing. I'm diagnosed ASD. I would think the use of THC to manage overstimulation could be problematic, as it tends to make colors and sounds and flavours _more_ intense. Conversely, indica strains tend to slow you down.
DISCLOSURE: I use large amounts of high potency cannabis flower with CBD/CBG edibles for intractable neuropathic pain. I also smoked a hell of a lot of weed in my 20s and 30s. I've more experience of Pot than most. MMJ lowers my pain a bit, and reduces suffering a lot. Its the suffering that makes life difficult.
As a middle aged guy who has used pot on and off for decades and no longer really enjoys the high, I'll say weed is good for two things:
Old man joint pains. Not headaches, broken bones, etc. But it nearly erases achy joint pain for me.
Being angry. I am much less angry in general when I'm smoking a bit every couple of days. That said, when I take a break I feel like my testosterone goes through the roof. I get more irritable and, TMI, I get a lot more spontaneous boners.
Weed is great for my anger and sleep. I’ve never found as good of a sleep medicine for someone who wakes up too early.
I also had debilitating anger in my teens and weed really helped calm that down. I’ve been off it for years at a time and I still can’t get past my anger without it.
Tell that to my depression. Back before I got sober days after alcohol were certainly some of my lowest mood days. Its well known that alcohol impares next day production of neurotransmitters responsible for balancing moods.
Now I've been sober for 7 years and my depression has been treated, but I certainly remember those days
Not entirely on topic: If pot is illegal people will grow extremely potent variaties. If it's normal you get very tasty variaties that give a mild buzz even if you smoke pure joints all day.
It's like comparing a casual light beer with the 90% moonshine or 45% bathtub gin sold during prohibition.
I have found the exact opposite of that. Illegal weed was mild buzz and fun. Legal weed is EXTREMELY potent. They want to pack as much THC into the legal limit as they can.
We can acknowledge that weed might be bad for people while also acknowledging that it probably shouldn't be illegal. There's no contradiction.
I think alcohol is bad for people but I don't think it should be illegal. I also think weed is probably bad for people but probably shouldn't be illegal.
Idk, you can still find outrageously potent weed in states where it's recreationally legal. But maybe it's just a residual from the fact that it was illegal not that long ago and binge consuming it is still quite normalized?
This is not entirely surprising, as the evidence was always weakly correlated. I say this as a proponent of legalization, mind you.
Cannabis, like alcohol and tobacco, is a vice. It definitely helps with some physical ailments (like helping stimulate hunger in cancer patients), just like alcohol and tobacco can with other ailments, but it’s not a panacea for mental health disorders.
We need to stop marketing these things as curatives when they’re mostly just coping mechanisms or social lubricants. We’re doing more harm than good by leaning into the “legitimate pharmaceutical” angle.
”The findings are based on a systematic review and meta-analysis of 54 randomized controlled trials (RCTs) conducted worldwide over a 45 year period (1980-2025).”
This review seems dubious considering the huge gap in motivations and scientific rigor between 1980 and 2025.
Okay, I've read the meta-study now and I think the summary article isn't representing the picture very well. In particular they found for anxiety there actually seems to be evidence in this exact data set that does help.
What they are doing is saying "there isn't 95% evidence it reduces anxiety" therefore "no evidence" even though they mean "some evidence, just not at the statistical significance level" -- it's one of the biggest confusions (and sometimes it feels deliberate) you'll see people do.
Also when you have a confidence interval that big it's a red flag. They themselves admit the data is all over the place.
In summary, don't assume much from the title of the summary article.
The data being all over the place on benefits, but pretty clear on harms, is about as good a reason you could want for experts not to recommend something as treatment. That's what it often looks like when something doesn't work, or doesn't work very well. "The error bars are too big to say it works, so we shouldn't tell people it works" is a pretty good thing to inform people about if that's the case.
It's really easy to convince yourself that something works when it doesn't, that's the whole reason why people have to take statistical significance seriously. Maybe it really does work and a really good study could shrink the error bars but that's more hope than anything.
> The data being all over the place on benefits, but pretty clear on harms
Uhhh... no? Did you even read it? This research actually found more benefits than harms. I see it only identified two harms both graded very low.
Let's just quote here the researcher's own conclusions:
"Interpretation There was some evidence that cannabinoids can reduce symptoms of cannabis use disorder, insomnia,
tic or Tourette’s syndrome, and autism spectrum disorder, but the quality of this evidence was generally low.
Cannabinoids were associated with a greater risk of any adverse events but not of serious adverse events. Overall,
there is a crucial need for more high-quality research. Given the scarcity of evidence, the routine use of cannabinoids
for the treatment of mental disorders and SUDs is currently rarely justified"
>>> "The error bars are too big to say it works, so we shouldn't tell people it works"
I can see you didn't really understand my comment. There's a huge difference between not saying something is proven to work, and saying it's proven not to work. This study falls in the former category, by the authors own words.
I guess if you weren't around for the 30 years when every marijuana advocate on the planet wouldn't shut up about it being a cure for anxiety, evidence that it is not wouldn't be particularly interesting to you.
That seems biased: if you only notice the people who act out due to their mental health issues, you will not notice the people who use cannabis but don’t have any issues with mental health.
Furthermore, people with mental health issues are known to self-medicate, which will introduce a bias if the correlation is seen as causation.
The studies cited by this metastudy all suffer from the same issue: They aren't studying the cannabis plant at all and even if they are, it's not in the chemovars (chemical makeups) that real consumers are actually consuming - due to cannabis sourcing issues stemming from cannabis's continued illegality.
For randomized controlled trials, even in "legal" states, university scientists can't just walk into a dispensary and buy cannabis to then administer to test subjects.
That's Post-Prohibition for you.
As far as I can tell, most (EDITED FROM ALL) of the studies utilize isolates - and not necessarily in conjunction.
For instance, none of the 6 anxiety studies included in this metastudy used THC and CBD together.
The headline could read instead: No evidence cannabinoid isolates help anxiety, depression, or PTSD.
Cannabis advocates are the first to mention the entourage effect. Cannabis prohibitionists on the other hand, love nothing more than to cite incomplete science.
Using quantified isolates is the correct way to do a controlled study. Dosing is important.
Claims that you need a special combination of exactly the right strains are just a way to move the goalposts forever. They could study 10 different strains in controlled trials and the same people would show up to dismiss this study because they weren't using some random strain that has some perfect combination of entourage effect.
Using actual plants and smoking would also introduce another major variable, with further claims that the strains they were giving patients were too weak or they were smoking it wrong.
EDIT: I don't have time to read every single citation included, but the claim above that they were all THC or CBD isolates does not appear correct. One randomly selected citation:
> The short-term impact of 3 smoked cannabis preparations versus placebo on PTSD symptoms: a randomized cross-over clinical trial
So the claim above that they didn't investigate smoked cannabis or "entourage effect" is false.
Way to completely misunderstand and try in an underhanded way to the dismiss entourage effect.
It’s not smoking 10 strains in a row it’s the fact that you need CBD THC and all the terpenes to get the effects. So the current growing trend of just getting the THC number higher tends to result in plants that don’t actually give people the full spectrum of effects, beneficial or not.
So the correct way to do this would be a full spectrum isolate, which again you coincidently forgot to mention I’m sure.
I never said it was. I was saying you could run 10 different studies on 10 different strains with 10 different "entourage effect" profiles and even if all of them were negative, they would be dismissed as not having precisely the right entourage effect.
If there are anti-depressant compounds in cannabis plants then they can be extracted and isolated, too.
> So the correct way to do this would be a full spectrum isolate, which again you coincidently forgot to mention I’m sure.
Of course, the correct formulation is something other than what was tested, right? And if they tested a full spectrum isolate with negative results, we should assume that it just wasn't the right blend of terpenes and therefore that study should be dismissed too? Repeat ad nauseum?
Why would you not have to try each and every combination of features known to create a different effect on the outcome?
There are what, 500 different psycho-active chemicals in cannabis? And how many different kinds of neuro-chemicals can our brains create in synapses? And how do we even begin to organize the ways that that information is transmitted to the structure (topology) of the neural systems? And their firing action logic? And the behavior of the whole organism in question?
Seems like like multiple, multi-linear variable spaces composed within each other. None of which are understandable independently of the other. None of which are perfectly mapped or traverscible landscapes. Why wouldn’t you have to try each and every possible configuration of the system in order to understand how it works?
We are not even working with a strong philosophical foundation or definition of consciousness. We must explore every possibility, leave no stone unturned.
> There are what, 500 different psycho-active chemicals in cannabis?
I think you're extrapolating from exaggerated factoids. There are only a small number of compounds in cannabis that exist at the intersection of:
- Present in high enough quantities to matter
- Not destroyed during smoking/vaping/processing
- Bioavailable enough to enter the bloodstream
- With the correct chemical structure to penetrate the blood-brain barrier
- Potent enough to elicit effects at the concentrations achieved in human consumption
There are not 500 compounds in cannabis that fit this criteria. The number is much smaller.
If there was some combination that achieved dramatic antidepressant effects where typical cannabis failed, don't you think someone would have noticed by now?
There's no reason to assume that some combination of 500 different variables exists to do something that we haven't observed yet. There are much more fruitful paths to research than endlessly researching every variation of cannabis for the sake of researching cannabis.
That's a great example study to highlight what I really mean by entourage effect. I've edited my post to emphasize most not all - i only looked at the 6 anxiety studies as that's what I have the most experience with - as well as the included table which highlighted that the vast majority of studies included in this metastudy only looked at THC.
That particular study did look at High THC low CBD, mid THC mid CBD, and high CBD low THC. There's no information on the terpene profile of the smoked cannabis preparations, though, and that is a confounding variable in the entourage effect that potentially defeats the part of the entourage effect they did test. Additionally, a quick look at the cannabinoid %s in those smoked preparations rehighlights my point that these are not inclusive of all the chemical compositions that the cannabis plant could present itself in.
I still stand by my point and hope the clarifications bring the conversation back on track to the fact I was highlighting which is simply that this is a metastudy built off of studies that were conducted with restrictions on experimental design that few observers fully understand the research implications of.
Yeah, I noticed this too. Canadian universities have been studying cannabis use using actual cannabis, so I'm not sure why this metastudy considered anything else. "We need to publish something" perhaps.
>The headline could read instead: No evidence cannabinoid isolates help anxiety, depression, or PTSD.
There’s no evidence that what they tested with was pure THC isolates. If they’re using cannabis in plant form, even if it was bred for higher thc content, there is still cbd.
Those that are interested to click through should and see the studies cited by this metastudy and whether they used whole plant cannabis extracts, cannabis isolates, or even non cannabis derived isolates.
tldr; "If they're using cannabis in plant form" is a very, very high bar for the current state of cannabis (really cannabinoid) research.
As someone who's used cannabis regularly for over a decade, I tried to start to explain in this body my experience but every sentence written ends with me deciding, "that's too circumstantial to my lifestyle-physiology to include."
I think at the end of the day, empirical research's purpose is to get us closer to being able to just make our own decisions surrounding mind-altering drugs. Beyond that, cannabis affects a great deal of systems in our body concurrent to the rest of our environment's effects. Use your autonomy to determine if it's a positive or a negative for you. Don't drive fucked up, please.
This is the most reasonable take I’ve seen in this whole thread. Alcohol doesn’t reduce anxiety either yet tons of people take it as a social lubricant and it probably does more damage to those consuming it than those who consume weed. So shrug? Just be responsible folks and let people blow off steam how they like without judging it like weed is an 8 ball.
The Lancet has been around for 200 years. It publishes weekly.
It's a highly regarded journal, but it doesn't mean 100% of the papers published are perfect.
If you're trying to dismiss a study because it was published in The Lancet then that's not a convincing line of reasoning to anyone who understands the scientific publishing landscape.
> anyone who understands the scientific publishing landscape.
Anyone genuinely familiar with the scientific publishing process probably holds the most skepticism around publications. I could probably get ANYTHING published if I wrote it well enough.
IMO, publications are mostly useful if you're already a bit of an SME in the field so that you can parse snake oil from gold. Certain publishers and institutions also hold more credibility, depending on the topic. Broadly speaking, there's a ton of crap in the journal space and the ratio of crap/good grows by the year.
The above view is independent of the current article. But it's embarrassing to see people praise the heck out of publications in 2026 in a vacuum. Reeks of young PhD student vibes. Even nature is not what it was even 10 years prior.
> Anyone genuinely familiar with the scientific publishing process probably holds the most skepticism around publications
Healthy skepticism is a good idea
The silly notion that being published means it should be dismissed or that we should assume the opposite is true is not healthy though.
> The above view is independent of the current article. But it's embarrassing to see people praise the heck out of publications in 2026 in a vacuum. Reeks of young PhD student vibes.
I was responding to a comment above mine that said this journal was untrustworthy because of a single news bite they recalled.
I specifically said that not everything published in a journal is true!
Your condescending “young PhD student vibes” attempt at an insult is rich considering you didn’t even try to acknowledge what I actually said or the context in which I was delivering it.
Discussing anything science and research related on HN is such a slog because so many commenters are in such a rush to deliver some contrarian smug take that they’re not even reading what’s written.
> I specifically said that not everything published in a journal is true!
Yes, but the undertone of your message was towards them being generally good and useful. Which my post disagrees with. This view hardens with every new year.
The entirety of your comment just now is predicated on this one point, which is treating your words at face value, rather than their implication. To act like I didn't understand your words, let alone read them, is an insult to the both of us - notably you. Because if you believed what you had typed, you would not expect a real response from you typing it, which would make you typing it pointless in the first place.
> Yes, but the undertone of your message was towards them being generally good and useful. Which my post disagrees with.
Research published in journals like The Lancet is generally useful. I don't agree that it's reasonable to dismiss everything published like that. What are you even left with at that point, other than knee-jerk contrarian takes?
These dismissals based on the source rather than the material are getting really annoying. We’re supposed to be intellectuals here, we can do better than that.
- Not adjusted for strain, dose or delivery method across all studies.
- Not adjusted for receptor downregulation, for which rotation and/or drug holidays would be appropriate strategies.
- Not adjusted across all studies for time effect, e.g. 6 hours of relief, 1 hour, etc.
I can tell you from personal experience with a related disorder that disciplined rotation of 10mg edible cannabis provides 90% relief, 90% of the time, with far fewer side effects than alternative medications for the same disorder.
Working with ayahuasca for several years in a traditional (Shipibo) context has showed me just how bad cannabis can be- it is more difficult to clean out of the body (energetically/spiritually) than any other drug. It creates so many associations in our mind- memories, relationships, pains, emotions, etc.. When "on the path" (meaning, apprenticing and learning how to work with ayahuasca), it really needs to be cleaned out for useful visions to open up (to work on other people) and to be able to cleanly connect to and call in the medicinal spirits/doctors (through the icaros/songs). It can really blunt dreams, intuition and senses.
(Yah this probably sounded woo-woo, but I am speaking from a different, non-western context/lens that views this as a spiritual malady. So take that as you will)
Studying the effects of recreational drugs is similar to studying diet in terms of the level of complication. The headline "No evidence" is a good example of the discourse about this subject. There absolutely is such evidence, but this new analysis comes to different, potentially more robust, conclusions from the same data. As long as results are presented in this way a meaningful shared comprehension of the situation is likely to remain out of reach.
My initial take from reading the headline was: no shit this is what mdma is for…
Tangentially,
The etymology nerd in me has been taunted by the current article thats been on the front page for the as of now last 19 hours[1] which conveniently has the origin of the term linked to in the first sentence! [2]… which @suprisetalk also links to in the article description!…
So now I’m wondering why mdma has got the street name molly… and if they're not perhaps related?
As in molly (aka mdma) has got the name as its used as a guard against these ailments specifically…
Millions of people use it because it helps them, but trust some edgy scientists who say nope it doesn't.
These gaslighting studies are unhelpful. For me cannabis has been life changing, no more pain killers and I live very much pain free. But I read studies claiming cannabis doesn't help with pain.
Then you'll have anti-drug crusaders taking these headlines and abuse people for whom cannabis made massive positive difference.
The entire point of the drug research is to make them palatable to authorities through plausible lies. American culture does not permit enjoyment for the sake of it. So you have to make up some stories and say “there is some evidence that psilocybin helps depression” or whatever and then slowly leak it towards legality.
I mean if I told you I wanted to have fun you’d lose your mind. But if I told you I needed to heal you’re fine with it. So I make it so I’m always ill and needing pharmacological therapy.
Well how do you know if you overdosed? What else happens besides anxiety and paranoia? Some of the reaction may be genetic, but I think many people have a negative reaction to taking mass quantities of cannabis. I don't know if you want to take a poll here but it's pretty common...
The fact that someone had a negative reaction to an overdose has nothing to do with how (properly dosed) THC/CBD affects unhealthy (and healthy) people.
Many substances can be overdosed on, even though they may not be harmful - or may even be beneficial - in appropriate amounts.
This is a hard topic to communicate in depression treatment. It's easy to mistake substances that temporarily boost your mood or calm your nerves for effective treatments for an underlying condition.
There was a brief period of time before the opioid prescribing backlash when some fringe psychiatrists were proposing weaker opioids as adjunctive treatments for treatment resistant depression. It's hard to fathom now, but opioids were more casually prescribed a few decades ago. I recall some discussion where one of them said they were seeing good initial results but the effects faded, and then it was hard to get the patients off of the opioids when they were no longer helping. Not surprising to anyone now, but remember there was a period of time where many seemingly forgot about their addictive properties.
I feel like I've seen a weaker version of this in some friends who turned to THC to "treat" their depression: Initial mood boost, followed by dependency, then eventually into a protracted period where they know it's not helping but they don't want to stop because they feel worse when they discontinue. This wasn't helped by the decades of claims that claimed THC was basically free of dependency problems.
> but remember there was a period of time where many seemingly forgot about their addictive properties.
There was also quite alot of talk about how doctors, by being reticent to prescribe opioids, were inhumanely forcing patients to live in pain, and not being sufficiently deferential to patient autonomy. Moreover, the rhetoric was incorporated into discussions about racist disparities in treatment, given there was some evidence doctors were less likely to prescribe opioids to black patients, suggesting doctors were systematically being cruel. Naturally, the easiest way to dodge those accusations was to simply prescribe opioids as a matter of course. Even in the absence of Purdue Pharma pushing their claims about lack of significant addictive potential, there was already significant pressure to discount the risk of addiction.
As an aside, it is a well established fact that doctors, as a whole, take the the pain of black people much less seriously than the pain of non-black people.
Even black doctors?
Does this finding hold across different nations?
> it is a well established fact
[Citation Needed]
This point of view makes no sense to me.
If you take it and you feel your anxiety is lessened, that's the greatest proof you can ask for. All the psychiatric studies are already based on self assessment.
Second, a lot of psychatric treatments are temporary, ending whenever the medication is stopped or wears off so I dont see how this would be any different
> If you take it and you feel your anxiety is lessened, that's the greatest proof you can ask for.
This mistake has been made many time throughout history. Cocaine was originally believed to be a viable treatment for depression. Opioids and amphetamines too. You take them and you feel good for a while, which was mistakenly equated with treating depression.
Many drugs will make you feel good temporarily by blocking certain feelings or tricking your brain into feeling good. This is not the same as treating a condition.
You can think of actual treatments as working closer to the source to reduce the problem, not temporarily overriding it with a powerful drug-induced sensation.
How do amphetamines treat the source of ADHD?
Psychiatry as its practiced has no idea as to what depression even is under the hood. The entire science is based on the patients self reported feelings or the psychatrists feeling of how someone else is feeling.
What you're saying is something else, that drugs can produce long term harm despite short term improvements
> The entire science is based on the patients self reported feelings or the psychatrists feeling of how someone else is feeling.
This study is showing that THC, CBD, blends, or cannabis do not improve self-reported feelings over the long term.
You can use pedantry and wordplay all you want, but no matter how we look at this study it does not show positive effects.
> What you're saying is something else, that drugs can produce long term harm despite short term improvements
Recreational drugs make you feel good temporarily. That's literally why people do them.
They also cause harm when abused.
These are all obvious and well known facts.
>> This study is showing that THC, CBD, blends, or cannabis do not improve self-reported feelings over the long term.
Just to clarify, the study is not saying that.
The study is saying "there isn't conclusive evidence at this point, but it leans more toward helping than hurting on many categories". Please read the paper if in doubt.
> Please read the paper if in doubt.
I did. I don’t know if you did, though, because the categories that they said there might be some signal were secondary topics like insomnia, not depression PTSD and anxiety.
I mean, it’s literally in the title. It’s covered again in the abstract.
I dont have a problem with the study or its conclusions, just the parent post I was replying to.
>Recreational drugs make you feel good temporarily. That's literally why people do them.
The point Im making is this is true for a ton of psychiatric or even non psychatric treatments. And to be perfectly clear Im not saying you should be treating your anxiety with weed, even if it does help you
> The point Im making is this is true for a ton of psychiatric or even non psychatric treatments
That point wasn't intended to be taken in isolation.
I was making statements about how long-term treatment of an underlying condition is not the same as taking a drug which temporarily masks a problem or induces altered mood states.
The fact that a drug has acute effects, good or bad, is separate from any conversation about chronic effects.
For depression, anxiety, and other conditions it's the chronic effects that matter. The acute effects almost become side effects at that point. For some drugs, getting to long-term treatment involves tolerating the acute effects while your body adapts
You keep ignoring the fact that what you just said applies to current medications used to treat depression and anxiety. They do not treat the underlying issue long-term, and if you stop them, you are worse off than before due to rebound effects, and even if those effects subdue, your depression and anxiety returns. And just to add to this for clarification, antidepressants may treat depression, but it does not cure it either.
Same with amphetamines for ADHD. And yes, if you take much more, you will experience side-effects ("cause harm when abused"). Opioids are not an outlier at all.
> Recreational drugs make you feel good temporarily
Drugs are only recreational if you take them recreationally, there is nothing that makes them inherently recreational.
And we have not discussed MDMA, which is considered a hard "recreational" drug, yet there are lots of benefits for treatment of PTSD, for one, similarly to psychedelics.
... or ketamine for depression, which is now approved by the FDA, even.
The difference between your positions is not about acute vs chronic, it's about tolerance. If a drug for a long term condition has short term effects the first few times and then they fade under regular use, it's less of a valid treatment. Especially if there is a withdrawal effect, and any negative side effects of regular use.
We absolutely overprescribe a lot of psychiatric meds that do not have significant beneficial long term effects. "Stabilizing" a patient in an inpatient hospital psych ward may as well involve a Magic 8-Ball picking the particular antipsychotic for its short term effects, while on the other hand doctors and nurses put people on Seroquel at the drop of a hat in reported sleep problems, and don't take them off until natural death or until the essential tremors get reported decades later.
This is a fair point but there’s also truth to the fact that “I feel better” does not automatically mean it’s an effective/good treatment.
Lots of depressed people turn to alcohol to provide a mood lift. But you can’t be drunk all the time and function, and when the alcohol wears off you feel even worse. So it’s a terrible treatment.
People talk a lot about cannabis like it’s a great treatment for all kinds of stuff. But is it closer to a drug you can take on a schedule that boosts your mood essentially all of the time with acceptable side effects? Or is it closer to a drug that lifts mood very short term and then makes it worse?
> “I feel better” does not automatically mean it’s an effective treatment.
Of course, I agree with that.
I also agree that you cannot be drunk to function, but there are many other "drugs" that people would oppose that do not make you dysfunctional.
Personally I would not use cannabis because I know that it makes me dysfunctional, but it may not be the case for some people for all I know.
FWIW I take opioids for my chronic condition, and it also helps with my emotional volatility, depression, and anxiety, too. I have not experienced any side-effects either.
Alcohol is so terrible, especially when severely abused, that "better than alcohol" absolutely cannot be a meaningful standard for being a proper treatment.
> there are many other "drugs" that people would oppose that do not make you dysfunctional.
People oppose these drugs because they do tend to make you dysfunctional, at least when abused. And when people are severely depressed, the depression itself makes it more likely that they will abuse their drugs.
> You keep ignoring the fact that what you just said applies to current medications used to treat depression and anxiety. They do not treat the underlying issue long-term
Those do cause improvement in self-reported feelings long term, i.e. they lower the baseline levels over a long period of time, rather than just for a short period right after you take the drug.
But you'd be right to say that they're not very good, i.e. that doesn't help your life very much. If there's an actual underlying cause, like sleep apnea, treating that will help a lot more.
Ketamine is a harder case, it really does cause improvement, but it lasts about two weeks. It also can cause psychosis, which is very dangerous. The s-ketamine the FDA approved for use in treatments is also via an inhaler, so it's both purer and via a different route than other a lot of other ketamine usage and it was approved because it actually showed a measurable effect in studies.
But it's really awful to use and if you find out that, say, sleep apnea was actually causing the issues, treating that will do a lot more good than inhaling s-ketamine ever did.
As you may have inferred, I write this based on personal experience.
The problem with your argument is it's whataboutism. Your argument's conclusion should be that even prescription drugs aren't necessarily good.
Really what is wrong is that most prescription drugs do show less tolerance. Yes, prescription drugs have tolerance, but not as fast as recreational drugs taken at recreational doses.
> How do amphetamines treat the source of ADHD?
By giving a patient the ability & skills to establish a less dopamine-seeking lifestyle while temporarily relieving them of the deficit.
Its use is supposed to be coupled with therapy and/or coaching (e.g. https://www.thriveemerge.com) to ensure that the patient isn't just using it as a lifelong crutch.
That's how it's supposed to be done. This approach is more effective in children for obvious reasons. Persons diagnosed later in life are therefore more likely to require it permanently.
Why do you need amphetamines to do this? Why not a legal stimulant? Even something as trivial as coffee can be effective if you take it strategically, i.e. stay off of it completely until the rare times when you need the turbo boost.
> Why do you need amphetamines to do this?
That's a question for a specialist and/or a medical researcher in the field. It's well above our "pay grade" here.
Anecdotally, I have tried the majority of legal stimulants at therapeutic doses. Nothing works quite like Amphetamines do for me.
> Why not a legal stimulant?
My prescription for it IS legal.
> Why do you need amphetamines to do this?
There's also atomoxetine, but it's not very effective.
> Why not a legal stimulant?
Which ones? People absolutely do self-medicate with coffee, ephedrine, or even cocaine where it's available (coca tea). And these stimulants do work, but they have _more_ side effects than amphetamines when used in theurapeutic doses.
> How do amphetamines treat the source of ADHD?
By increasing the baseline dopamine? I think the biological mechanisms for the ADHD treatment are more-or-less clear at this point.
Not so much with depression, though.
As doctors Psychiatry should definitely look at imaging of the brain.
One place I'm aware of that works from imaging as well is Amen Clinics in the US.
we don't understand the brain well enough for images to be of any use. amen is a fraud.
Would love to learn more about how this is the case (both assertions). Mind sharing?
Neuroscience seems to be coming through with more and more understanding using technologies like fMRI and others the past 5-10 years. There is definitely some understanding there.
Amen are definitely fraudsters. Russell Barkley talks about this topic in this video: https://youtu.be/R_HCw-QePaA?t=900
The short version, as I understand is, is that brain scans show differences at the population level but not on the individual level. Amen claim to both diagnose ADHD through brain scans (which is already impossible) and also diagnose various "subtypes" of ADHD like "Limbic ADD" which have no scientific backing for their existence.
Thanks I’ll check out the video.
I didn’t think their clinics only worked on ADHD.
Other types of imaging like fMRI are being used successfully by others as well for things like TBI, so I won’t jump to ruling out all types imaging.
Is it true that psychiatry doesn’t prescribe off imaging but symptom clusters?
not clinical understanding, not in any useful way. its another tool for study, but my understanding is that aside from some very high level structural information, there's sadly not that much to be learned from watching the flashing lights.
Alcohol too.
It's not a cure. It's a high.
Im unaware of any frequently medicated psychiatric disorder for which there is a cure.
Are all psych meds just "a high"?
> Cocaine was originally believed to be a viable treatment for depression.
Is it not??
Sure there's the addiction and harm from abuse that make it less than ideal for long term use, to put it mildly, but weed isn't coke so what's really the argument here?
Acetaminophen blunts the parasympathetic nervous system…what do you think cocaine could be capable of?
I mean, aren't they effective treatments?
As someone who has had depression literally as long as I can remember, being able to releve my symptoms when I really need it, even for just an hour, would be life changing.
Acetaminophen also does not provide long term benefit. I am still glad its available when I need it.
It reduces suffering in the moment, which is sometimes the entire goal.
Duration of effect matters when it comes to successful treatments.
If we take your position and apply reductio ad absurdum, we could say that cocaine is a highly effective treatment for anxiety, although of course we know that in the not-so-long run it has the opposite effect.
Shouldn't that be up to bodily autonomy? If someone feels that cocane relieves their symptoms then who is the doctor to say that they don't. Perhaps releaving those symptoms even for a short period of time is worth the consequences.
That's just arguing for drug legalization with extra pseudoscience.
I am all for people doing however much cocaine they feel they need. In broad daylight - let's just drag that into the light and let people go to the dispensary for cocaine hydrochloride, metered, measured and with warning labels.
Because the war on drugs is a stupid waste of time and lives, but no doctor or medical professional has to justify your own stupid actions.
But a lot of psychatric treatments are just that. Treatment for ADHD for example is giving ampethamines (which btw are chemically no different than a low dose of meth), which have a duration of 3-6 hours and its back to worse than baseline after the effect has worn off.
There are multiple treatments for ADHD, including alpha-2 receptor agonists and norepinephrine reuptake inhibitors. Some of them show patterns of increasing efficacy out to a year (the length of the study).
The reason amphetamines are used for ADHD but not depression is that they've been studied to show that the ADHD improving effect can remain for many months, while the mood-improving effect will taper off quickly if you take them every day. Almost everyone who takes ADHD stimulant, feels a mood and motivation boost ("so happy I could cry" is the common phrase) and then is disappointed when that mood boost stops happening after a few weeks or months will learn this. Attention enhancement is less prone to tolerance, though it still accumulates tolerance too. There are some studies showing that the effects of stimulants in ADHD diminish substantially on a multi-year time frame, and it's probably not a coincidence that many people (though not all) who take stimulants discontinue after several years.
Just like how Hydrogen peroxide is chemically no different than a low dose of dihydrogen monoxide?
No not just like it, because the only difference with methampathemines is that the added meth group makes it able to cross the blood barrier much quicker, hence why I said its equivalent to a lose dose of meth. The chemical/biological response on the body and brain are very similar, the difference is in potency
But onset of action is a very important distinction in medicine/pharmacology, as is dose.
Most abusers of methamphetamine are not taking it orally (slow route of administration) and are generally using much higher relative dosing than ADHD patients are using amphetamines. Potential for addiction and other physical harms are greatly affected by both of those things, so the comparison has some truth, but is obviously sensationalized.
That's a terrible oversimplification. Stimulant treatments for ADHD are not supposed to produce pronounced mood-enhancing effects. Stimulant treatment has been shown to be effective indefinitely in majority of people without increasing the dosage over time.
These days formulations like lisdexamfetamine and extended release methylphenidate are preferred because they have all-day efficacy with typical duration of action of around 8-12h which carries lower abuse potential.
extended release are just two doses of the drug where half the beads are delayed by ~4 hours. How is that different from taking two edibles a day and claiming full day efficacy?
I mean the difference is that you just take one in the morning? Which makes adherence easier, makes sure that the delay is constant rather than variable, and reduces abuse liability.
(As an aside, there are more complex extended release mechanisms than just delayed bead release - like lisfexamfetamine is a inactive prodrug, so cleaving the lysine off the amphetamine is rate limited. This has the effect of extended the duration of effect, and reduces the potential to abuse by snorting/iv/etc).
That's not the case for lisdex nor Concerta methylphenidate. Some generics work that way and they're generally regarded as being worse than Concerta.
The benefit is that the medication automatically produces a smooth effects profile allowing you to live your life without timing medication to perfection.
A pronounced come-up and crash is a risk factor for abuse and addiction, so smoothing or removing the peaks and valleys is important.
Meth causes brain damage. Dex doesn't.
Well, it's not that simple. It's reasonable to expect that you could see some increased level of oxidative and excitotoxicity. It's harder to draw a bright line around the dopaminergic system specifically because some level of neuronal death is expected over the course of a lifetime. We lose 5-10% starting with middle age yet don't tend to show parkinsonian symptoms until 60-80% are gone.
It's pretty reasonable to expect reversing DAT and inhibiting VMAT2 increases oxidative flux, the question is really how much not if. Methheads certainly get "brain damage", but is nudging the average loss from 5-10% to 7-12% "damage"? Is it meaningful? Over 30, 40 years that could very well add up.
Could you point me to your research?
You made the first unsubstantiated claim
Meth is also used as an ADHD treatment. I think the reason is just the dosages that are used by addicts compared to people who just need the ADHD treatment.
A typical legitimate therapeutic methamphetamine dose is around ~20mg (up to maybe 60mg a day). A typical dose used by addicts is around 1 gram. And it's usually smoked, resulting in immediate bioavailability.
There’s a difference between intoxication and treating the chemical imbalance behind depression or anxiety. For one thing, treatments for anxiety only target the anxiety: they don’t impair the person the way that weed or alcohol does. (They can have other side effects, of course.)
Drugs for anxiety treatment do wear off, but not the same way that weed or alcohol does: something like Celexa takes a few weeks to build up in the system, and don’t lose effect 12-24 hours later if you miss a dose. I’m not sure how long you’d have to stop before it loses efficacy entirely.
I’m not Nancy Reagan, though: I would not advise people to self-medicate with booze or pot if they’re suffering from depression or anxiety, but I’m not going to preach at anybody who is doing so and thinks it’s working for them. I will say that I’ve seen that end badly, though. I can think of three people I’m close to who’ve tried it and have had problems with addiction: all of them are now sober and (I believe) on regular antidepressants.
Im prescribed adderall for ADHD. It is a high. You feel more positive, more productive, more forward looking for a few hours and its back to baseline or worse when you crash.
As for impairment, it really depends. If weed removes your anxiety and lets you relax, its benefit could be greater for what youre doing than the impairment it causes. And adderall, SSRIs can cause impairment of sorts too.
”There’s a difference between intoxication and treating the chemical imbalance behind depression or anxiety.”
There is no significant, rigorous evidence that depression or anxiety are caused by an inherent ”chemical imbalance”.
Am I an idiot or is it not glaringly obvious to everyone that the cause is our individualistic hyper competitive culture?
I won't call you an idiot, but assuming that all cases are simply people being sad is a bit simplistic.
Some people are going to be more susceptible to depression, for whatever reasons, and improving someone's surroundings is probably going to prevent or alleviate depression to an extent, but to people who are depressed now it's somewhat pointless advice.
There are plenty of historical records of people having anxiety or depression.
There's almost certainly a link between the prevalence and modern, always-on culture, but to suggest that it alone is the cause is blatantly wrong.
I think the problem is that, at least in my experience, you end up with more anxiety once the initial high wears off. Paranoia is an extremely common side effect of Marijuana, and so are nightmares with prolonged use. And once you kinda get into a routine with it, you have a hard time quitting, because your overall anxiety is raised, and you need it just to get back to a normal functioning level. My guess is that this is due to the effects that THC has on blocking your REM sleep. Without the proper REM sleep, it seems pretty common to be anxious and foggy-brained.
THC cannot both ”cause nightmares” and ”block REM sleep”, because nightmares happen during REM sleep.
People who suffer from nightmares may benefit from less REM sleep. It’s much more refreshing to sleep in a non-REM state and wake up normally than it is to repeatedly wake up in cold sweat and be afraid to go to sleep again.
Psychiatric treatments return a person to a baseline that can be managed with therapy or healthy coping mechanisms.
Chasing a high is not a treatment, it merely defers the problem. As tolerance to the high builds, patients lose the therapeutic value but have gained crippling dependency and addiction.
Doing ten shots of tequila is a 100% scientifically proven cure for social anxiety then. If you take it and your anxiety lessens, that's the greatest proof you can ask for! Let's just completely ignore the crippling morning hangover and liver damage
But I don't think we've seen cannabis, especially when not smoked, have anywhere near the health risk of alcohol.
Sure but my point was that you cannot have an argument where you go "yeah this happens so it's good" while you disregard everything else (it's a different question on how bad it is compared to alcohol etc). But if we follow the logic of the original comment, then it's valid logic since "hey it works so its scientifically proven!" You can replace alcohol with something else to highlight that as well, like how putting out a kitchen fire with a bucket of gasoline is a good idea. It completely covers the flames for a split second! Why worry about the explosion that happens immediately after?
So my comment wasn't about alcohol vrs cannabis but rather how that kind of logic is short-sighted and faulty.
I mean... Yeah. Alcohol is very well documented and even more widely used for exactly this purpose BECAUSE it works.
The side-effects are often terrible. This is also true for many widely-prescribed drugs, and has been even more true in the past. The folks I've known on MAOIs were pretty wrecked.
”The folks I've known on MAOIs were pretty wrecked.”
And then one must consider that tobacco smoke and coffee both contain high levels of MAOIs.
Yes. Rather it is the reverse that helps. Exercise is the biggest one, but essentially “pain that will stop” seems to help in general. Ice showers, fasting, new challenging activity, giving up caffeine/alcohol.
All these things suck in the short term, and make you feel more good in the medium term. Maybe because your default becomes “not in so much pain”, rather than “feeling worse than when briefly enhanced by substance X”
Edit: I’m referring more to the “self medication” approach. Please don’t take any of this as medical advice.
"This wasn't helped by the decades of claims that claimed THC was basically free of dependency problems."
But did anyone professional made these claims?
I was pretty much told since a child, no physical dependency (unlike alcohol and nicotin) but potentially strong psychological withdraw symptoms.
Sadly, I have witnessed three of my friends who started THC product to deal with anxiety, developed paranoia. Two of them quit THC and got better but one got way worse and now is in process of divorce. His personality is completely different, he was pretty chill guy but now he is talking way too much, easily distracted, and always worried about macro events.
Isn't the problem with psychological dependency that drugs generate basically a artifical depression, so more drugs are needed to basically feel normal again? Thus saddling a already existing problem with the same on top?
Yeah this has been my experience with THC. I never took it for depression, but it was always a temporary thing. I doesn't treat anything IMHO. its a symptom relief at best.
it works pretty good as a temporary relief from anxiety.
Title says "helps" but the summary says "it doesn’t effectively treat anxiety, depression, or PTSD". Big difference between the two IMO.
Plenty of people use cannabis to alleviate symptoms. I don't think they expect to be cured entirely. Getting a good night's sleep or being without chronic pain for a few hours is often enough.
It's a meta-study and came to the conclusion that there isn't reliable evidence that it alleviates symptoms of a bunch of stuff:
> There were no significant effects on outcomes associated with anxiety, anorexia nervosa, psychotic disorders, post-traumatic stress disorder, and opioid use disorder. There were insufficient data to meta-analyse studies of ADHD, bipolar disorder, obsessive-compulsive disorder, and tobacco use disorder. There was an absence of RCT evidence for the treatment of depression.
They have some more useful figures in the paper, but for a lot of things they're essentially saying there is not enough evidence to support using cannabis yet.
The strongest claim is the lack of significant effects for anxiety, ptsd etc. but it varies a bit whether that's because the effect is too small or because it is not studied enough.
For anxiety for instance the effect they list in the paper is quite big but the error bars are even bigger so the net result is inconclusive. This is quite different from PTSD where they note little to no effect with small error bars.
Beyond the semantics, this is what the meta analysis(1) actually says in the abstract
> There were insufficient data to meta-analyse studies of ADHD, bipolar disorder, obsessive-compulsive disorder, and tobacco use disorder. There was an absence of RCT evidence for the treatment of depression. Meta-analysis revealed higher odds of all-cause adverse events (OR 1·75, 95% CI 1·25 to 2·46) among those using cannabis versus control group
The paper says there's no evidence of effectiveness in treatment, and evidence of harm.
1: https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0...
It sounds to me like you didn't understand the paper at all, or are worse willfully misrepresenting.
The paper says "insufficient data" for helpfulness for most positive categories (but leans more positive than negative just doesn't reach 95% confidence), but also insufficient data on most negative categories. It finds 5 conditions it's helpful for, and 3 it hurts for.
I'm directly quoting the portion of the abstract related to anxiety and depression, tell me how that's misrepresenting?
> There was an absence of RCT evidence for the treatment of depression.
> Meta-analysis revealed higher odds of all-cause adverse events (OR 1·75, 95% CI 1·25 to 2·46) among those using cannabis versus control group
And my point was that the paper talks about absence of data about efficacy on treatment so arguing on helping vs. curing in interpreting it is moot.
> Plenty of people use cannabis to alleviate symptoms. I don't think they expect to be cured entirely.
Obviously can't speak for everyone, but I know people who do think literally that. They think that weed will actually cure their depression, and they'll allude to some studies about it that I'm pretty sure don't exist and that they just made up.
"Treat" != "cure"
From the paper itself: "54 trials were identified for inclusion (2477 participants...) ....24 (44%) of these trials had a high risk of bias, and the certainty of evidence for most outcomes was low."
American media has really been shockingly pro weed/cannabis for the past 20 or so years. Really astounding to witness considering the well known downsides to human health and cognitive function. Main characters smoke weed as a cool disobedience, in sitcoms even.
Wonder what is behind it, from my perspective it's quite remarkable.
I think there’s probably some adjacency to other things which make people feel good, but are ultimately bad for them. Gambling, alcohol, porn, infinite scroll social media. There are a few people making a ton of money on this stuff and the social costs aren’t something they care about.
I think it became socially acceptable because there’s not a huge reason to hate on it.
The risks to cognition and health exist, but they’re no where near as bad as alcohol or cigarettes (and the negative effects basically don’t exist at low, even moderate doses)
The biggest negative effect of using weed regularly is it seems to slowly kill people’s motivation to do stuff over time. It will turn just about anyone into a couch potato. That’s more dangerous than any other effect IMO.
>I think it became socially acceptable because there’s not a huge reason to hate on it.
That may be but I see no reason to encourage it either, which is what I feel is happening.
Maybe because like 65% of the nation is in favor of legalization and a huge chunk of the nation has been smoking weed for 70+ years without crisis?
Because the Schedule 1 prohibition was ridiculous. This is the cultural pendulum swing to normalize it and push legalization.
The DARE program just had to tell the truth, but they didn’t and it made everyone question how bad everything really was, if pot wasn’t a problem.
Full agree here. Unfortunately, history is what clarifies why pot is SO HUGE now rather than being something indifferent about, like it should be.
I am not sure I'd say I'm "against" it since broadly speaking I don't think it should be illegal, but I am against it in the sense that I really think that absolutely no one should be smoking weed. It's kind of an unearned opinion; I don't know anything about medicine or health or anything like that, but I hated what it would seemingly do to my friends in high school.
I'd have friends that would be more or less down to earth, start smoking weed, then start finding and watching videos of Alan Watts and Carl Sagan and convince themselves that they knew everything in the world about physics and philosophy, and they became utterly insufferable in the process, and whenever anything negative about weed was ever said, they would provide me a lecture about how weed is a cure to pretty much everything and how no one has ever had a negative effect from it ever in history.
I think there's been a huge over correction; there was so much bullshit about the dangers of weed that people started acting like it's some miraculous cure-all and ignoring actual issues.
This was such a visceral turn-off for me that I to this day have never used weed, and the idea of using it still kind of makes me viscerally annoyed. It's entirely possible that my friends were insufferable teenagers purely because teenagers can be insufferable, and that's not even unlikely, but the way I remember it is the weed making them annoying it. Not saying it's rational, just that memory and human brains are weird.
Probably because almost everyone has done it and it's fun.
Since the 1960s and the emergence of the New Left, and the introduction of the Frankfurt School and 60s post modernism into academia, there has been a widespread belief amongst a large segment of the population that everything traditional is wrong. A social stigma is merely ignorance, that which is seen as bad is actually good, traditions are wrong. All of these things need to be overturned for the enlightenment. Since society deemed marijuana bad, it is therefore good. As those people who were went through that indoctrination in the 60s as students got older, they got into power. They took power in universities. By the 90s they were pushing all of the ideas as the status quo. Students in the 90s then took those ideas, and when they got into power in Media, they pushed those ideas into all movies and tv.
Alternate theory: there's a shit load of money to be made with legal marijuana so it will be mainstream just to ensure those paychecks keep coming. And for media, it's a low hanging trope that if you want your character to seen edgy but not dangerous, you have them do safe drugs like marijuana. It's easier than the weeks of story it would take to let the audience know they're just slightly anti establishment.
I'm not sure I buy your theory even a little, to be honest. The children of the 60's have, by and large, gotten FAR more conservative as they've gotten older.
Students in the 90s had also lived their entire lives under the counter-productive and utterly racist War on Drugs. That might have colored their attitude more than the leftist indoctrination bogeyman.
The college indoctrination boogieman exists because it is coincidentally the first time in their lives a lot of people live away from their parents fulltime.
How much your opinions change once you're not in that environment can be amazing to both yourself and to the people who think they understand you because you were financially dependent on them.
New ideas or diversity or whatever: living by yourself 24/7 is a huge liberator of thought.
This assumes that culture and academia work hand in hand, which is just in line with many right-wing conspiracies and plain wrong.
People were smoking weed even when it was socially unacceptable and illegal. Then they were going to jail for a decade or more because of it. This simply did not make any sense. I believe most of this is a backlash effect.
Weed was the worst thing ever. Weed is the best thing ever. Eventually weed will be in the same category as coffee.
I'd be real happy if we landed on "edibles" and not smoking though.
Just about all drugs would benefit from people doing the unobtrusively.
I've always been suspicious of the claims THC helps anxiety. CBD may, but my experience is that high doses of THC without corresponding CBD tends to induce anxiety in many people. I also found the brief notes in the article about MMJ and autism intriguing. I'm diagnosed ASD. I would think the use of THC to manage overstimulation could be problematic, as it tends to make colors and sounds and flavours _more_ intense. Conversely, indica strains tend to slow you down.
DISCLOSURE: I use large amounts of high potency cannabis flower with CBD/CBG edibles for intractable neuropathic pain. I also smoked a hell of a lot of weed in my 20s and 30s. I've more experience of Pot than most. MMJ lowers my pain a bit, and reduces suffering a lot. Its the suffering that makes life difficult.
As a middle aged guy who has used pot on and off for decades and no longer really enjoys the high, I'll say weed is good for two things:
Old man joint pains. Not headaches, broken bones, etc. But it nearly erases achy joint pain for me.
Being angry. I am much less angry in general when I'm smoking a bit every couple of days. That said, when I take a break I feel like my testosterone goes through the roof. I get more irritable and, TMI, I get a lot more spontaneous boners.
Weed is great for my anger and sleep. I’ve never found as good of a sleep medicine for someone who wakes up too early.
I also had debilitating anger in my teens and weed really helped calm that down. I’ve been off it for years at a time and I still can’t get past my anger without it.
That said my memory is shit
Reading that study sure didn't help with my anxiety, depression or PTSD either.
Still ok with it being legal but yeah that doesn't mean it's beneficial
Yep. Of course alcohol is depressive.
“Depressant” refers to its impacts on nervous system activity, not that it causes feelings of depression.
Tell that to my depression. Back before I got sober days after alcohol were certainly some of my lowest mood days. Its well known that alcohol impares next day production of neurotransmitters responsible for balancing moods.
Now I've been sober for 7 years and my depression has been treated, but I certainly remember those days
In alcohol’s case I think you’re masking the depression by drinking which makes you even more depressed when you aren’t drinking.
Worth noting that it very much can cause feelings of depression, also.
Which makes it all the more weird we see so much negative press about weed on Hacker News but I never see an article about alcohol.
Not entirely on topic: If pot is illegal people will grow extremely potent variaties. If it's normal you get very tasty variaties that give a mild buzz even if you smoke pure joints all day.
It's like comparing a casual light beer with the 90% moonshine or 45% bathtub gin sold during prohibition.
I have found the exact opposite of that. Illegal weed was mild buzz and fun. Legal weed is EXTREMELY potent. They want to pack as much THC into the legal limit as they can.
We can acknowledge that weed might be bad for people while also acknowledging that it probably shouldn't be illegal. There's no contradiction.
I think alcohol is bad for people but I don't think it should be illegal. I also think weed is probably bad for people but probably shouldn't be illegal.
https://en.wikipedia.org/wiki/Iron_law_of_prohibition
Idk, you can still find outrageously potent weed in states where it's recreationally legal. But maybe it's just a residual from the fact that it was illegal not that long ago and binge consuming it is still quite normalized?
This is not entirely surprising, as the evidence was always weakly correlated. I say this as a proponent of legalization, mind you.
Cannabis, like alcohol and tobacco, is a vice. It definitely helps with some physical ailments (like helping stimulate hunger in cancer patients), just like alcohol and tobacco can with other ailments, but it’s not a panacea for mental health disorders.
We need to stop marketing these things as curatives when they’re mostly just coping mechanisms or social lubricants. We’re doing more harm than good by leaning into the “legitimate pharmaceutical” angle.
”The findings are based on a systematic review and meta-analysis of 54 randomized controlled trials (RCTs) conducted worldwide over a 45 year period (1980-2025).”
This review seems dubious considering the huge gap in motivations and scientific rigor between 1980 and 2025.
That's classic with most cannabis studies. They sound like they started with a conclusion and then worked their way back fitting the data.
Edit:
Okay, I've read the meta-study now and I think the summary article isn't representing the picture very well. In particular they found for anxiety there actually seems to be evidence in this exact data set that does help.
What they are doing is saying "there isn't 95% evidence it reduces anxiety" therefore "no evidence" even though they mean "some evidence, just not at the statistical significance level" -- it's one of the biggest confusions (and sometimes it feels deliberate) you'll see people do.
Also when you have a confidence interval that big it's a red flag. They themselves admit the data is all over the place.
In summary, don't assume much from the title of the summary article.
The data being all over the place on benefits, but pretty clear on harms, is about as good a reason you could want for experts not to recommend something as treatment. That's what it often looks like when something doesn't work, or doesn't work very well. "The error bars are too big to say it works, so we shouldn't tell people it works" is a pretty good thing to inform people about if that's the case.
It's really easy to convince yourself that something works when it doesn't, that's the whole reason why people have to take statistical significance seriously. Maybe it really does work and a really good study could shrink the error bars but that's more hope than anything.
> The data being all over the place on benefits, but pretty clear on harms
Uhhh... no? Did you even read it? This research actually found more benefits than harms. I see it only identified two harms both graded very low.
Let's just quote here the researcher's own conclusions:
"Interpretation There was some evidence that cannabinoids can reduce symptoms of cannabis use disorder, insomnia, tic or Tourette’s syndrome, and autism spectrum disorder, but the quality of this evidence was generally low. Cannabinoids were associated with a greater risk of any adverse events but not of serious adverse events. Overall, there is a crucial need for more high-quality research. Given the scarcity of evidence, the routine use of cannabinoids for the treatment of mental disorders and SUDs is currently rarely justified"
>>> "The error bars are too big to say it works, so we shouldn't tell people it works"
I can see you didn't really understand my comment. There's a huge difference between not saying something is proven to work, and saying it's proven not to work. This study falls in the former category, by the authors own words.
I guess if you weren't around for the 30 years when every marijuana advocate on the planet wouldn't shut up about it being a cure for anxiety, evidence that it is not wouldn't be particularly interesting to you.
> ...evidence that it is not wouldn't be particularly interesting to you.
Were you stoned when you wrote that?
I have been a smoker for more than a decade and I don't think it has any good impact on any of those.
In fact, it's quite the contrary.
The only times when it's really enjoyable is when you're with someone and you chill out and lightens the mood.
But overall it's a drug which I haven't seen bringing any good effect on people's mental health.
That seems biased: if you only notice the people who act out due to their mental health issues, you will not notice the people who use cannabis but don’t have any issues with mental health.
Furthermore, people with mental health issues are known to self-medicate, which will introduce a bias if the correlation is seen as causation.
It certainly helps with boredom but quickly losses it's effect after repeated use.
I am calling it quits for now it's been making m a little crazy and I want to see what life is like without it for a while.
It's way better trust me.
Only smoke when at parties and in company.
Alone smoking is terrible. You enjoy the first, then you know very well how you feel the following ones.
Only the bad effects of being lazy, tired, sleepy, none of the pros.
So, a meta study. While important, it assumes that the underlying studies are based on solid science.
So, why do people use cannabis then?
Why do people use cigarettes? Cocaine? LSD?
Not because they're effective treatments for mental disorders
Evidence?
The studies cited by this metastudy all suffer from the same issue: They aren't studying the cannabis plant at all and even if they are, it's not in the chemovars (chemical makeups) that real consumers are actually consuming - due to cannabis sourcing issues stemming from cannabis's continued illegality.
For randomized controlled trials, even in "legal" states, university scientists can't just walk into a dispensary and buy cannabis to then administer to test subjects.
That's Post-Prohibition for you.
As far as I can tell, most (EDITED FROM ALL) of the studies utilize isolates - and not necessarily in conjunction.
For instance, none of the 6 anxiety studies included in this metastudy used THC and CBD together.
The headline could read instead: No evidence cannabinoid isolates help anxiety, depression, or PTSD.
Cannabis advocates are the first to mention the entourage effect. Cannabis prohibitionists on the other hand, love nothing more than to cite incomplete science.
Using quantified isolates is the correct way to do a controlled study. Dosing is important.
Claims that you need a special combination of exactly the right strains are just a way to move the goalposts forever. They could study 10 different strains in controlled trials and the same people would show up to dismiss this study because they weren't using some random strain that has some perfect combination of entourage effect.
Using actual plants and smoking would also introduce another major variable, with further claims that the strains they were giving patients were too weak or they were smoking it wrong.
EDIT: I don't have time to read every single citation included, but the claim above that they were all THC or CBD isolates does not appear correct. One randomly selected citation:
> The short-term impact of 3 smoked cannabis preparations versus placebo on PTSD symptoms: a randomized cross-over clinical trial
So the claim above that they didn't investigate smoked cannabis or "entourage effect" is false.
Way to completely misunderstand and try in an underhanded way to the dismiss entourage effect.
It’s not smoking 10 strains in a row it’s the fact that you need CBD THC and all the terpenes to get the effects. So the current growing trend of just getting the THC number higher tends to result in plants that don’t actually give people the full spectrum of effects, beneficial or not.
So the correct way to do this would be a full spectrum isolate, which again you coincidently forgot to mention I’m sure.
> It’s not smoking 10 strains in a row
I never said it was. I was saying you could run 10 different studies on 10 different strains with 10 different "entourage effect" profiles and even if all of them were negative, they would be dismissed as not having precisely the right entourage effect.
If there are anti-depressant compounds in cannabis plants then they can be extracted and isolated, too.
> So the correct way to do this would be a full spectrum isolate, which again you coincidently forgot to mention I’m sure.
Of course, the correct formulation is something other than what was tested, right? And if they tested a full spectrum isolate with negative results, we should assume that it just wasn't the right blend of terpenes and therefore that study should be dismissed too? Repeat ad nauseum?
Why would you not have to try each and every combination of features known to create a different effect on the outcome?
There are what, 500 different psycho-active chemicals in cannabis? And how many different kinds of neuro-chemicals can our brains create in synapses? And how do we even begin to organize the ways that that information is transmitted to the structure (topology) of the neural systems? And their firing action logic? And the behavior of the whole organism in question?
Seems like like multiple, multi-linear variable spaces composed within each other. None of which are understandable independently of the other. None of which are perfectly mapped or traverscible landscapes. Why wouldn’t you have to try each and every possible configuration of the system in order to understand how it works?
We are not even working with a strong philosophical foundation or definition of consciousness. We must explore every possibility, leave no stone unturned.
> There are what, 500 different psycho-active chemicals in cannabis?
I think you're extrapolating from exaggerated factoids. There are only a small number of compounds in cannabis that exist at the intersection of:
- Present in high enough quantities to matter
- Not destroyed during smoking/vaping/processing
- Bioavailable enough to enter the bloodstream
- With the correct chemical structure to penetrate the blood-brain barrier
- Potent enough to elicit effects at the concentrations achieved in human consumption
There are not 500 compounds in cannabis that fit this criteria. The number is much smaller.
If there was some combination that achieved dramatic antidepressant effects where typical cannabis failed, don't you think someone would have noticed by now?
There's no reason to assume that some combination of 500 different variables exists to do something that we haven't observed yet. There are much more fruitful paths to research than endlessly researching every variation of cannabis for the sake of researching cannabis.
> Using quantified isolates is the correct way to do a controlled study. Dosing is important.
That's the correct way to do a controlled study on the isolate - not the plant that it comes from.
It's clear to me at least that the authors of the metastudy conflate the two and many shades between them for purposes of this study.
I think that's a bit of a straw man.
You could study one combination that is broadly representative and is much much closer than the isolate.
They included studies which looked at multiple different smoked cannabis varieties.
The claim above about only looking at isolates was false.
That's a great example study to highlight what I really mean by entourage effect. I've edited my post to emphasize most not all - i only looked at the 6 anxiety studies as that's what I have the most experience with - as well as the included table which highlighted that the vast majority of studies included in this metastudy only looked at THC.
That particular study did look at High THC low CBD, mid THC mid CBD, and high CBD low THC. There's no information on the terpene profile of the smoked cannabis preparations, though, and that is a confounding variable in the entourage effect that potentially defeats the part of the entourage effect they did test. Additionally, a quick look at the cannabinoid %s in those smoked preparations rehighlights my point that these are not inclusive of all the chemical compositions that the cannabis plant could present itself in.
I still stand by my point and hope the clarifications bring the conversation back on track to the fact I was highlighting which is simply that this is a metastudy built off of studies that were conducted with restrictions on experimental design that few observers fully understand the research implications of.
Yeah, I noticed this too. Canadian universities have been studying cannabis use using actual cannabis, so I'm not sure why this metastudy considered anything else. "We need to publish something" perhaps.
>The headline could read instead: No evidence cannabinoid isolates help anxiety, depression, or PTSD.
There’s no evidence that what they tested with was pure THC isolates. If they’re using cannabis in plant form, even if it was bred for higher thc content, there is still cbd.
Those that are interested to click through should and see the studies cited by this metastudy and whether they used whole plant cannabis extracts, cannabis isolates, or even non cannabis derived isolates.
tldr; "If they're using cannabis in plant form" is a very, very high bar for the current state of cannabis (really cannabinoid) research.
Matthew Hill offers a great interview on Andrew Huberman's podcast - https://open.spotify.com/episode/26PR93gyNcs8YPlQ9dypW3?si=V...
As someone who's used cannabis regularly for over a decade, I tried to start to explain in this body my experience but every sentence written ends with me deciding, "that's too circumstantial to my lifestyle-physiology to include."
I think at the end of the day, empirical research's purpose is to get us closer to being able to just make our own decisions surrounding mind-altering drugs. Beyond that, cannabis affects a great deal of systems in our body concurrent to the rest of our environment's effects. Use your autonomy to determine if it's a positive or a negative for you. Don't drive fucked up, please.
This is the most reasonable take I’ve seen in this whole thread. Alcohol doesn’t reduce anxiety either yet tons of people take it as a social lubricant and it probably does more damage to those consuming it than those who consume weed. So shrug? Just be responsible folks and let people blow off steam how they like without judging it like weed is an 8 ball.
Isn't the lancet the same journal that has published the vax-autism and hydroxychloroquine studies?
The Lancet has been around for 200 years. It publishes weekly.
It's a highly regarded journal, but it doesn't mean 100% of the papers published are perfect.
If you're trying to dismiss a study because it was published in The Lancet then that's not a convincing line of reasoning to anyone who understands the scientific publishing landscape.
> anyone who understands the scientific publishing landscape.
Anyone genuinely familiar with the scientific publishing process probably holds the most skepticism around publications. I could probably get ANYTHING published if I wrote it well enough.
IMO, publications are mostly useful if you're already a bit of an SME in the field so that you can parse snake oil from gold. Certain publishers and institutions also hold more credibility, depending on the topic. Broadly speaking, there's a ton of crap in the journal space and the ratio of crap/good grows by the year.
The above view is independent of the current article. But it's embarrassing to see people praise the heck out of publications in 2026 in a vacuum. Reeks of young PhD student vibes. Even nature is not what it was even 10 years prior.
> Anyone genuinely familiar with the scientific publishing process probably holds the most skepticism around publications
Healthy skepticism is a good idea
The silly notion that being published means it should be dismissed or that we should assume the opposite is true is not healthy though.
> The above view is independent of the current article. But it's embarrassing to see people praise the heck out of publications in 2026 in a vacuum. Reeks of young PhD student vibes.
I was responding to a comment above mine that said this journal was untrustworthy because of a single news bite they recalled.
I specifically said that not everything published in a journal is true!
Your condescending “young PhD student vibes” attempt at an insult is rich considering you didn’t even try to acknowledge what I actually said or the context in which I was delivering it.
Discussing anything science and research related on HN is such a slog because so many commenters are in such a rush to deliver some contrarian smug take that they’re not even reading what’s written.
> I specifically said that not everything published in a journal is true!
Yes, but the undertone of your message was towards them being generally good and useful. Which my post disagrees with. This view hardens with every new year.
The entirety of your comment just now is predicated on this one point, which is treating your words at face value, rather than their implication. To act like I didn't understand your words, let alone read them, is an insult to the both of us - notably you. Because if you believed what you had typed, you would not expect a real response from you typing it, which would make you typing it pointless in the first place.
> Yes, but the undertone of your message was towards them being generally good and useful. Which my post disagrees with.
Research published in journals like The Lancet is generally useful. I don't agree that it's reasonable to dismiss everything published like that. What are you even left with at that point, other than knee-jerk contrarian takes?
same lancet that tried to bury covid lab leak theories in february 2020
Evidence for lab leak is extremely weak, zoonosis is the most likely origin:
https://www.astralcodexten.com/p/practically-a-book-review-r...
https://medium.com/microbial-instincts/the-case-against-the-...
These dismissals based on the source rather than the material are getting really annoying. We’re supposed to be intellectuals here, we can do better than that.
I see problems with this meta-analysis.
- Not adjusted for strain, dose or delivery method across all studies.
- Not adjusted for receptor downregulation, for which rotation and/or drug holidays would be appropriate strategies.
- Not adjusted across all studies for time effect, e.g. 6 hours of relief, 1 hour, etc.
I can tell you from personal experience with a related disorder that disciplined rotation of 10mg edible cannabis provides 90% relief, 90% of the time, with far fewer side effects than alternative medications for the same disorder.
Working with ayahuasca for several years in a traditional (Shipibo) context has showed me just how bad cannabis can be- it is more difficult to clean out of the body (energetically/spiritually) than any other drug. It creates so many associations in our mind- memories, relationships, pains, emotions, etc.. When "on the path" (meaning, apprenticing and learning how to work with ayahuasca), it really needs to be cleaned out for useful visions to open up (to work on other people) and to be able to cleanly connect to and call in the medicinal spirits/doctors (through the icaros/songs). It can really blunt dreams, intuition and senses.
(Yah this probably sounded woo-woo, but I am speaking from a different, non-western context/lens that views this as a spiritual malady. So take that as you will)
There seems to be more information out there about the effect on the brain with cannabis and it doesn't always seem great long term.
Might be different for THC/CBD in different ways.
But it can cause memory loss, impaired motor coordination, and food craving. Also memory loss.
Studying the effects of recreational drugs is similar to studying diet in terms of the level of complication. The headline "No evidence" is a good example of the discourse about this subject. There absolutely is such evidence, but this new analysis comes to different, potentially more robust, conclusions from the same data. As long as results are presented in this way a meaningful shared comprehension of the situation is likely to remain out of reach.
me n my quarter brick beg to disagree
My initial take from reading the headline was: no shit this is what mdma is for…
Tangentially, The etymology nerd in me has been taunted by the current article thats been on the front page for the as of now last 19 hours[1] which conveniently has the origin of the term linked to in the first sentence! [2]… which @suprisetalk also links to in the article description!…
So now I’m wondering why mdma has got the street name molly… and if they're not perhaps related?
As in molly (aka mdma) has got the name as its used as a guard against these ailments specifically…
[1] https://unsung.aresluna.org/molly-guard-in-reverse/
[2] https://en.wiktionary.org/wiki/molly-guard
Millions of people use it because it helps them, but trust some edgy scientists who say nope it doesn't.
These gaslighting studies are unhelpful. For me cannabis has been life changing, no more pain killers and I live very much pain free. But I read studies claiming cannabis doesn't help with pain.
Then you'll have anti-drug crusaders taking these headlines and abuse people for whom cannabis made massive positive difference.
To those scientists: Go fuck yourself.
The entire point of the drug research is to make them palatable to authorities through plausible lies. American culture does not permit enjoyment for the sake of it. So you have to make up some stories and say “there is some evidence that psilocybin helps depression” or whatever and then slowly leak it towards legality.
I mean if I told you I wanted to have fun you’d lose your mind. But if I told you I needed to heal you’re fine with it. So I make it so I’m always ill and needing pharmacological therapy.
If anything, I think most people discover anxiety with cannabis.
It's a shame that first experiences with stress also coincide with that phase of life, so the debate never ends.
It's good to see science confirm what anybody who has accidentally taken too large of edibles dose understands.
Huh? Like Paracetamol doesn't work because if you take too much you die? Are you confusing "overdosing" with something else here maybe?
Ive overdosed edibles multiple times and I dont know what you talk about.
Well how do you know if you overdosed? What else happens besides anxiety and paranoia? Some of the reaction may be genetic, but I think many people have a negative reaction to taking mass quantities of cannabis. I don't know if you want to take a poll here but it's pretty common...
The fact that someone had a negative reaction to an overdose has nothing to do with how (properly dosed) THC/CBD affects unhealthy (and healthy) people.
Many substances can be overdosed on, even though they may not be harmful - or may even be beneficial - in appropriate amounts.