Research on Cannabis Use for ADHD

Overview

Over the past few years, the use of cannabis as a potential treatment for attention-deficit/hyperactivity disorder (ADHD) has gained popularity. Some individuals believe that cannabis can be beneficial and therapeutic in managing ADHD symptoms, such as improving focus, reducing distractions, managing anxiety, and counteracting the side effects of ADHD medication. However, it is crucial to consider the limited research available and the potential risks associated with cannabis use before making any treatment decisions.

Understanding ADHD

ADHD is a neurobehavioral condition characterized by varying degrees of hyperactivity, impulsivity, and difficulty paying attention. This condition can significantly impact an individual's daily functioning and overall achievements. The Diagnostic and Statistical Manual of Mental Disorders (DSM) categorizes ADHD into three presentation types:

1. Predominantly Inattentive: Individuals primarily struggle with attention regulation. Symptoms may include easy distraction, forgetfulness, chronic boredom, difficulty staying on task, and frequently losing belongings.

2. Predominantly Hyperactive/Impulsive: This type is characterized by excessive activity and impulsivity. Symptoms may include restlessness, difficulty sitting still, excessive talking, disruptive behaviors, and feeling constantly in motion.

3. Combined Type (ADHD-C): Both symptoms of inattention and hyperactivity/impulsivity are present.

Potential Benefits of Cannabis for ADHD Symptoms

Cannabis contains two primary components, tetrahydrocannabinol (THC) and cannabidiol (CBD), which may contribute to its potential ability to alleviate ADHD symptoms:

1. Tetrahydrocannabinol (THC): The psychoactive component in marijuana responsible for the feeling of being high. THC interacts with the body's cannabinoid receptors, which are found throughout the brain and nervous system.

2. Cannabidiol (CBD): A non-psychoactive component found in both marijuana and hemp. CBD works on different brain areas and has been shown to counterbalance the effects of THC. It is non-addictive and has gained increasing popularity in recent years.

While it is commonly believed that different cannabis strains produce distinct effects, research suggests that these differences may not be entirely accurate due to extensive cross-breeding. Indica strains are believed to have a higher proportion of CBD, which research indicates may be more beneficial for individuals with ADHD.

Research Findings: Evidenced and Controversies

1. Positive Views: Some studies suggest that cannabis can have therapeutic effects for ADHD. A qualitative analysis of online discussions in 2016 revealed a generally positive perception of cannabis as a therapeutic agent for ADHD.

2. Limited Clinical Support: Despite these positive perceptions, substantial clinical support for these claims remains limited. A 2013 study showed that individuals with ADHD who used cannabis performed worse on tests of short-term memory, verbal ability, cognitive function, decision-making, and response speed compared to those who did not use cannabis.

3. Small-Scale Studies: A 2020 study involving adults with ADHD who used medical cannabis demonstrated reduced intake of ADHD medication with higher doses of medical cannabis components, especially CBD. However, this study was relatively small, limiting the generalizability of its results.

4. Lack of Robust Evidence: A 2019 review of 83 studies on the topic found insufficient evidence to support the effectiveness of cannabis in treating mental health conditions, including ADHD.

Cautions and Recommendations

1. Adherence to Traditional Treatment Options: Dr. Rebecca Siegel, a licensed psychiatrist, cannabis medical advisor, and author, emphasizes the importance of sticking to traditional ADHD treatment options, such as medications and therapy, until more clinical trials have been conducted on the matter.

2. Combination with ADHD Medication: Combining cannabis with ADHD medications can increase the risk of unwanted side effects. A 2015 study involving adults without ADHD found that combining Adderall and marijuana produced unique and mixed effects on cardiovascular function.

3. Switching from ADHD Medication to Cannabis: Switching from ADHD medication to cannabis as a primary treatment is strongly discouraged due to insufficient evidence supporting its safety and effectiveness as a treatment option for ADHD.

Risks of Using Cannabis for ADHD Symptoms

1. Marijuana Use Disorder (CUD): Approximately 30% of individuals who use marijuana may develop some degree of CUD, a diagnosis given to those with problematic cannabis use patterns leading to clinically significant impairment.

2. Increased Prevalence in Individuals with ADHD: Individuals with ADHD have a two to three times higher prevalence of cannabis use compared to adults without ADHD, making them more susceptible to the associated risks.

3. Dependency and Worsening of ADHD Symptoms: Using cannabis to manage ADHD symptoms can lead to dependency and exacerbate ADHD symptoms, especially if the initial intention to use it for symptom relief shifts to regular use.

Conclusion

The use of cannabis for ADHD remains a topic of ongoing research and debate. While some positive viewpoints and anecdotal evidence exist, there is a lack of substantial clinical evidence supporting its effectiveness as a primary treatment option for ADHD. Traditional ADHD treatment options, such as medications and therapy, remain the standard of care until more research is conducted. Combining cannabis with ADHD medications should be approached with caution due to the potential for unwanted side effects. It is essential to discuss these matters with a healthcare provider to determine the most appropriate treatment plan for individual needs.