Approximately 2% of the world population suffer from obsessive-compulsive disorder (OCD), symptoms of which include fear of contamination by dirt or germs, constant checking, repetitive, intrusive thoughts of a somatic, aggressive, or sexual nature, extreme slowness, and an inordinate concern with orderliness and symmetry.
A new, breakthrough study published last month in the Journal of Affective Disorders shows that cannabis could be an efficient potential treatment for OCD. The researchers from Washington State University found that smoking cannabis with higher levels of CBD can quickly reduce symptoms of OCD such as anxiety, compulsions, and intrusive thoughts. However, the relief seems to be temporary, and the symptom reductions for intrusive thoughts lessened over time.
The researchers used the data from an application called Strainprint, which allows cannabis users to report their symptoms, the specific cannabis products and doses used, and the resulting impact those products had on their symptoms.
The analyzed data came from 87 individuals self-identifying with OCD, who tracked the severity of their intrusions, compulsions, and/or anxiety immediately before and after 1,810 cannabis use sessions spanning a period of 31 months.
As a result, the patients reported a 60% reduction in compulsions, a 49% reduction in intrusions, and a 52% reduction in anxiety from before to after inhaling cannabis. Higher concentrations of CBD and higher doses led to larger reductions in compulsions.
Why is CBD helping with OCD?
The endocannabinoid system (ECS) has been identified as a potential therapeutic target for OCD because it plays important role in anxiety, fear, and repetitive behaviors. This system is heavily distributed throughout the brain with cannabinoid (CB1) receptors found in high densities throughout many of the brain regions involved with OCD. Two primary constituents of the cannabis plant – tetrahydrocannabinol (THC) and cannabidiol (CBD) activate the ECS. That is the reason why scientists place high hopes in this field of research.
There is already significant scientific evidence that cannabis reduces anxiety, one of the main symptoms of OCD. According to a study from 2018, medical cannabis users perceived a 50% reduction in depression and a 58% reduction in anxiety and stress.
A case study conducted by the scientists at the Medical University of Warsaw showed a reduction of obsessions and compulsions of about 70% in a patient suffering from OCD after 20 months of smoking medical cannabis. Also, general relaxation, improved sleep, the concentration at school, and the overall improvement of quality of life were observed.
Can smoking cannabis make symptoms of OCD worse?
A 2004 study found that baseline OCD symptoms were related to more frequent cannabis use. The participants who continued to use cannabis during an 18- month follow-up period demonstrated an increase in OCD symptoms, whereas those who remained abstinent showed a decrease in symptoms, indicating cannabis use may aggravate OCD symptoms.
A recent placebo-controlled investigation of the effects of smoked cannabis on symptoms of OCD found that reductions in symptoms were not significantly larger than with placebo, but the sample size was small and the cannabis used was of low potency (THC = 7% and 0.4%).
Other studies on the effects of cannabinoids on OCD have been conducted using synthetic forms of orally administered THC (e.g., dronabinol and nabilone). Three case studies have revealed evidence that 14+ days of treatment with dronabinol, in combination with more traditional medications (e.g., clomipramine), decreased symptom severity in patients with treatment-resistant OCD (Cooper & Grant, 2016; Sachdeva et al., 2015; Schindler et al., 2008).
The legal limitations in the USA
Trends toward the legalization of cannabis in North America make it particularly important to examine the potential short- and long-term effects of cannabis on mental health. However, while changes in laws have increased public access to a wide variety of cannabis-based products, the U.S. Drug Enforcement Administration (DEA) continues to classify cannabis as a Schedule 1 illicit drug. As a result of the strict regulation of cannabis by the U.S. federal government, all researchers at federally funded institutions must undergo lengthy legal and ethical approval processes before they can administer cannabis to humans. Additionally, per federal regulations, researchers administering cannabis must use cannabis supplied by the National Institute of Drug Abuse. This research-grade cannabis is far less potent (rarely exceeding 10% THC) than the high potency products available to consumers through statewide legal cannabis markets. Cannabis flower exceeding 20% THC and cannabis concentrate containing over 60% THC are presently dominating the recreational cannabis markets. These federal restrictions have dramatically stalled the progress of research and have left the scientists with an impoverished understanding of the potential therapeutic effects of cannabis on OCD.