Cannabis as a legitimate replacement for conventional and prescribed medications is becoming more common among medical patients and recreational users than ever before.
In Canada, one study showed 63% of patients swapped out prescription meds and replaced them with cannabis, vastly improving their physical, mental, and emotional quality of life.
Likewise, a cross-section study reported 46% out of 1,248 medical cannabis participants used cannabis for opioids (for pain), anxiolytics (benzodiazepines), and antidepressants.
But, the question is, how effective is cannabis as a replacement for prescription and non-prescription medications? Is it all too good to be true? Which specific cannabinoids actually help?
- Multiple studies show cannabis could potentially replace a number of prescription and non-prescription medications e.g. antiepileptics, opioids, and antidepressants.
- Epiodiolex, a cannabis-based antiepileptic, reduced average seizure frequency in patients with rare forms of epilepsy by 40-41%.
- Opioid abuse is one of the US’s biggest killers (50,000 in 2019), cannabis could provide a safer alternative — one study showed cannabis reduced daily opioid use from 28% down to 11% among 1,145 patients.
- Cannabis for depression is promising — high-CBD, low-THC strains are good for stress, while low-CBD, high-THC strains are better for depression.
- Out of 973 study participants, 44% reduced their alcohol intake significantly, replacing it with moderate cannabis usage.
- Some concerns about cannabis subsituting alcohol include negative medication interactions, exacerbation of pre-existing psychosis, and cognitive decline in adolescents.
Replacing antiepileptic medications with cannabis
Cannabis and its compounds—namely cannabidiol (CBD)—is a well-documented treatment for certain types of epilepsy and could be a viable replacement for antiepileptic medications.
Epidiolex, one of the first cannabis-based CBD medications to be approved by the FDA, successfully treats seizures related to rare forms of epilepsy such as Lennox-Gastaut syndrome (LGS), Dravet syndrome, and tuberous sclerosis complex (TSC).
In clinical studies, patients with LGS took 20 milligrams per kg of Epidiolex per day, causing up to a 44% reduction in seizures. Similarly, patients with Dravet syndrome took the same dose per day and experienced a 39% decrease in seizure frequency.
How does CBD work for rare forms of epilepsy?
The exact mechanics behind CBD’s ability to reduce seizure frequency and intensity in patients with rare forms of epilepsy are still relatively unknown. All the experts know is it works (and it works well!).
However, researchers suggest CBD’s anti-seizure capabilities may come down to its interaction with GPR55 and TRPV1 receptors located in certain areas of the brain and throughout the central nervous system.
This interaction is thought to decrease neuronal excitability partially through the release of adenosine, an endogenous modulator known for its anticonvulsant qualities.
What about other forms of epilepsy?
Much more research needs to be done to really gauge how CBD can help patients with other forms of epilepsy e.g grand mal.
Many studies on CBD and cannabis as a whole for other forms of epilepsy are limited to preclinical animal studies. Only a few clinical studies exist, and these almost exclusively test CBD’s safety and efficacy in children and teenagers. Very few (if any) use adult test subjects.
Some evidence suggests CBD can enhance certain antiepileptic medications (clobazam) in children with refractory epilepsy.
Other research shows Epidiolex reduced seizure frequency in 55 patients with CDKL5 deficiency disorder, Doose syndrome, Dup15q syndrome, and Aicardi syndrome.
The results of this study were positive. Patients were given doses of CBD over a 48 week period. There was a “significant difference between the percent changes in monthly convulsive seizure frequency during baseline and week 12 with no difference in seizure percent change between weeks 12 and 48”.
Swapping out opioids for cannabis
Cannabis and its compounds are thought to provide a safer alternative for patients taking prescription and nonprescription illicit opioids.
In a 2021 study examining Candian medical cannabis patients also taking prescription opioids, researchers discovered something incredibly promising.
Of the 1,145 patients included in the study, 28% reported baseline opioid use. After six months, this number dropped dramatically to 11%.
Daily opioid dosage also decreased significantly from 152 mg morphine milligram equivalent (MME) to 32 mg MME (a 78% reduction overall).
These results indicate cannabis as a viable option for prescription and non-prescription opioid users, especially in a controlled clinical environment. Not only does cannabis reduce opioid use in terms of frequency and quantity, but it also improves physical, mental, and emotional quality of life.
Related: Could Cannabis Help Combat the Opioid Crisis?
Why cannabis as a viable replacement for opioids is important
The study outlined above shows the importance of cannabis in the fight against opioid misuse and abuse, especially in the US, which currently faces an opioid epidemic.
Approximately 841,000 people have died from drug overdoses since 1999, many of which were caused by illicit opioids such as heroin and illegally imported fentanyl. In 2019, alone, approximately 50,000 people died from opioid-related overdoses, making it one of the biggest killers in the US today.
Cannabis, on the other hand, has killed no one and is infinitely safer to consume than opioids. Unfortunately, cannabis is overshadowed by the government’s need to keep people using opioids, purely for financial reasons and to maintain big pharma’s profit margins. Cannabis not being federally legalized also restricts its clinical use as an opioid replacement.
Substituting antidepressants with cannabis
There’s growing interest in how cannabis can be used to treat symptoms of anxiety and depression, and how it could potentially replace prescribed antidepressants and anti-anxiety medication.
In 2019, the University of Washington examined how cannabis affects symptoms of stress, anxiety, and depression and published the results in the Journal of Affective Disorders.
The researchers used several varieties of cannabis strain, each with varying levels of CBD and THC. They discovered cannabis significantly reduced symptoms of stress, anxiety, and depression.
Low-THC, high-CBD strains were particularly good for depression, while high-THC, low-CBD strains were better for stress.
Similarly, in a cross-sectional survey of 1429 medical cannabis users, researchers discovered 60% consumed cannabis for anxiety and just 50% for depression, indicating that self-medication is common for these mental health conditions.
THC can help but also hinder cannabis treatments for anxiety and depression
Replacing antidepressant medications with cannabis isn’t easy. It requires prior knowledge of cannabis and its chemical compounds before being used to treat depression, anxiety, and other associated mental health disorders. Why? Because THC in varying quantities can trigger negative side-effects, leading to increased anxiety, fear, and negative thoughts.
It’s, therefore, important to not only understand which cannabis product to take but also know which cannabinoids are present in the product, particularly the CBD and THC ratio.
Too little CBD and too much THC can make depression and anxiety symptoms worse, especially if the patient is a beginner user not accustomed to THC’s effects.
Likewise, too much CBD and too little THC might not be strong or effective enough to tackle the symptoms.
In order to find the perfect cannabis product or strain, we recommend speaking with an expert e.g. a certified budtender or a healthcare practitioner specializing in cannabis treatments.
CBD is the most useful cannabinoid for depression and anxiety
While CBD won’t cure depression or anxiety, it’s thought to have some positive and beneficial effects, which are reported to occur almost immediately after consumption.
The reason why CBD is thought to be an effective antidepressant and anti-anxiety treatment is its ability to target serotonin receptors.
Serotonin is the “bliss” or “happy” molecule commonly experienced after a run or physical exercise.
Serotonin receptor targeting doesn’t necessarily produce more serotonin in your body. That’s not how it works.
Instead, it utilizes the serotonin already in your body and may cause your brain receptors to respond better to it when activated. This activation and physiological response are thought to induce a sense of calm and happiness.
Can weed be a legitimate treatment for alcohol abuse, dependency, and addiction?
While alcohol isn’t strictly a conventional or prescribed medication, millions of people in the US and across the world use it as a self-medication tool for anxiety disorders, depression, loneliness, and stress. This habit of self-medication through alcohol can lead to dependency and addiction, as well as exacerbated mental and physical health symptoms.
Cannabis could be a promising and effective replacement for alcohol. Closely controlled use of high-grade cannabis in a clinical setting may reduce alcohol dependency and addiction, as well as alleviate alcohol withdrawal symptoms and liver damage.
What studies say about cannabis as a legitimate replacement for alcohol
In an early study, researchers treated a 49-year-old alcoholic with a combination of Antabuse (an FDA-approved medication for alcohol abuse) and cannabis.
Within a short space of five months, they noticed a dramatic improvement in the patient’s physical and mental health and wellbeing.
After two years, liver health and functionality returned to normal. The patient noted very few negative symptoms or side effects when consuming cannabis.
In a more recent 2020 study launched in Canada and published in the International Journal of Drug Policy, researchers surveyed 2,102 people enrolled in the Candian medical cannabis program.
Of the 2,102 people, 44% (973) reported having used alcohol on at least 10 occasions over the past 12 months.
The results were very interesting and are as follows:
- 44% of the 973 participants who reported having consumed alcohol within 12 months decreased their overall alcohol intake within 30 days
- 34% (323 participants) reduced the number of drinks per week
- 8% (76 participants) reported no alcohol consumption over the initial 30 day period
What about CBD for alcohol abuse?
Cannabidiol (CBD), which is the main non-intoxicating compound found in varieties of cannabis, could potentially reduce alcohol consumption among those with alcohol use disorder (AUD).
In experimental preclinical studies using animal test subjects, researchers believe CBD could help human patients with a history of alcohol abuse reduce their drinking.
The researchers also believe CBD may lower alcohol-related steatosis and fibrosis in the liver via inflammation modulation and oxidative stress reduction, as well as counteract alcohol-related brain damage by preventing neuronal loss.
The concerns surrounding cannabis as a replacement for conventional medications
Despite cannabis’ long-standing history of physical, mental, and emotional healing, it’s not all sunshine and rainbows. Cannabis use, while incredibly beneficial, can be a cause for concern, especially in adolescents, people with pre-existing mental health conditions, and patients taking certain prescribed medications.
Why is cannabis use among adolescents a concern?
Adolescent use of high-THC marijuana can result in decreased cognitive development and functionality.
A study of 3827 seventh graders from the Montreal area indicated cannabis use caused significant reductions in working memory, perceptual reasoning, inhibitory control, and threat response. Worryingly, only a small quantity of cannabis was needed to trigger a negative impact on cognitive functioning.
Adolescents who frequently consume cannabis with large quantities of THC are also more at risk of mental health problems.
Researchers believe younger consumers of higher potency cannabis strains are five times more likely to be diagnosed with a psychotic disorder and twice as likely to develop a psychiatric disorder later in life.
Cannabis may exacerbate pre-existing mental health problems
While cannabis is not solely responsible for mental health disorders such as psychosis and schizophrenia, it does exacerbate symptoms and increase the likelihood of psychotic episodes.
Adults and adolescents with pre-existing mental health disorders as a result of environment, genetics, and family history are more at risk of cannabis-induced psychosis.
The reason why cannabis exacerbates pre-existing mental health issues is relatively unknown at this stage, though researchers believe THC and its variants are some of the main causes. Chronic cannabis consumers are often worse affected than casual cannabis consumers.
One way to counteract or reduce negative THC effects is via CBD consumption.
CBD is known to attenuate THC by restricting its binding ability at cannabinoid 1 (CB1) receptors, as well as interacting with other receptor sites such as vanilloid and serotonin.
Cannabis compounds interacting negatively with other medications
Cannabis compounds can negatively impact the efficacy of other medications. For example, when you combine CBD with certain medications, you’re running the risk of causing your body harm.
Related: How Does CBD Interact with Medications?
Let’s say you frequently consume large quantities of CBD with warfarin, a common blood thinner. On the surface, this may seem fine but it isn’t.
CBD and warfarin are metabolized by the same liver enzymes. In fact, CBD competitively inhibits these enzymes, which essentially prevents warfarin from being broken down.
A number of problems arise when this happens. The main one is warfarin staying in your body longer than normal, causing prolonged effects, excessive bleeding, and/or overdose.
It’s always worth speaking to your healthcare practitioner before consuming CBD with any prescription or non-prescription medications to avoid negative drug interactions.
The future for cannabis as a conventional medication replacement
Not only does cannabis hold so much promise as a replacement for conventional medications, but it also shines a light on its therapeutic benefits in a clinical setting.
Related: Most Credible and Impactful Studies on Cannabis
Opioid addicts and non-addicts, for example, are decreasing their opioid intake considerably, and in a very short space of time, all thanks to cannabis and its compounds. Does this spark a decrease in opioid-related deaths? The data isn’t credible enough to make any accurate opinions. But if we were to make an educated guess based on the research shown in this article, we’d say it’s a big possibility.
As for cannabis as an antiepileptic medication replacement, this data is in and we couldn’t be happier to see the FDA recognizing cannabis-centered medications as legitimate.
The concerns over cannabis and its effects on adolescents and people with preexisting mental health issues, as well as its potential to negatively interact with other medications, is real and should be considered.
With the right research, we believe cannabis could be just what the doctor ordered.