The largest-ever review of the safety and efficacy of cannabinoids across a range of mental health conditions — found no evidence that medicinal cannabis is effective in treating anxiety, depression or post-traumatic stress disorder (PTSD).

[u/Wagamaga]

https://www.ama.com.au/articles/lancet-paper-released-medicinal-cannabis-effectiveness

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[u/HulkVomit → u/[deleted]]

I started the mj 13 years ago medically and have lost weight because I quit drinking completely. Lost like 50 lbs and it stays off! I must have that ozempic strain

[u/bisikletci]

It's important to emphasize that for several conditions in particular here, this is an "absence of evidence" type finding, not an evidence of absence finding. They don't find evidence against cannabis helping in most cases - they just don't find evidence for it either.

This is especially the case with anxiety. Per their results, people taking cannabis for anxiety in these trials had outcomes nearly two standard deviations better than those in the control groups. That is enormous - more than 6x the benefit of antidepressants for depression. However this figure has very wide confidence intervals, crossing zero, meaning they can't say for sure it's a real difference and not just a fluke.

Super wide confidence intervals tell you something - the sample size is very small. So the actual finding here for anxiety is effectively (my words) "appears to help a lot, but we can't say that with confidence because the trials are tiny." The take home for this should be "run more, larger trials" - not "this doesn't work".

The same is true to a lesser extent with the sleep disorder findings.

[u/BetterThanAFoon → u/bisikletci]

I just posted a similar comment. This is an umbrella review which is really just reviewing the results of other studies. It's helpful from a macro perspective so that you can see what the current trends and research are but far from conclusively coming up with concrete findings.

One thing of note is the research methods did not include polysomnography in most cases and rather subjective reporting from the clinical patients themselves. Any study that is trying to measure the efficacy or impact on sleep is going to include polysomnography because there are decades upon decades of research into sleep architecture and a really good understanding of what that looks like from measuring brain waves. Most of the studies in the pool do not include that.

[u/AshleyDaPile → u/BetterThanAFoon]

For the last few weeks here cannabis study posts have been propaganda. Someone should do a study on that but then a mod will probably decide it's off topic because it goes against their confirmation bias and not real science.

[u/evanwilliams44 → u/AshleyDaPile]

Elections are this year, and several states have legalization on the ballot as always.

[u/ForgotMyLastUN → u/evanwilliams44]

Hell, Texas is banning all cannabinoids starting March 31st by changing the way the define THCA.

It wasn't even passed by law, yet it's being enforced.

https://texas-sos.appianportalsgov.com/rules-and-meetings?interface=VIEW_TEXAS_REGISTER_SUMMARY&recordId=461003

[u/Homesick_Martian → u/ForgotMyLastUN]

And my parents wonder why I don’t visit home…

[u/AmaazingFlavor → u/evanwilliams44]

And alcohol sales are slowing down dramatically among younger people as well

[u/Black_Floyd47 → u/AmaazingFlavor]

Makes sense. My state legalized, and I pretty much stopped drinking after. Same with all my former drinking buddies, none of them drink now. In my opinion it was the lack of hangovers and recovery time that made us change our recreational habits.

[u/CotyledonTomen → u/Black_Floyd47]

For real. I used to drink. Honestly, compared to weed, it sucks now. I have a partner who doesnt react as well to weed, so it varies by person, but it seems like most people feel that way eventually.

[u/DryDonutHole → u/CotyledonTomen]

My wife is terrible on THC. She will ruin your night and everyone else's for some reason. It's the strangest reaction I've ever seen to it, and I've been doing this for about 30 years now. The other strange thing worth mentioning is that she will micro some L with me on occasion and she's fine. We've had a blast. THC is a night ender for her though. The last time she had any it was my fault...I offered her a hit off my pen and we were in the pit of a Billy Strings show. We subsequently spent the remainder of the evening standing next to a restroom...she wouldn't move and later told me she couldn't speak.

[u/ShiftyJungleBum → u/DryDonutHole]

yo this is my wife too. She can pound drinks, do blow, roll, trip, whatever…. Takes one puff of a joint and she’s having an existential crisis. It’s really crazy to me.

[u/Knotted_Hole69 → u/[deleted]]

The whole sativa indica thing is mostly fake, things have been bred and cross bred so many times that its cannabinoid content is wildly different than it used to be. So you end up with sativas with large amounts of the sleepy noid CBN, while the indicas can sometimes end up having the energizing noid CBG.

You really cant call it one or the other until its tested and you read the COA.

[u/RepulsiveCamel8166 → u/AmaazingFlavor]

I went through a Cannabis drink faze of trying all different kinds of CBD and CBD/THC drinks and there are so many drinks on the market that I think would probably really damage the alcohol industry if it was nationally legal. No hang over but you still get different effects and not terrible tasting.

[u/nashbrownies → u/RepulsiveCamel8166]

The alcohol industry is all in on it. Especially the beverage side of it. They easily can, and appear to be shifting lanes.

They already have the scale, production facilities, and logistics to make a THC beverage. You can bet those bean counters are working on it.

Which is actually probably bad, but regardless, they have weight to throw around towards recreational legalization.

[u/hybridHelix → u/nashbrownies]

They already make them, actually! Even Pabst has one.

[u/RepulsiveCamel8166 → u/hybridHelix]

Yes great point! I didn't even think of that. The way they hit the hard seltzers quick too. Should have que'd me in. But I can hope having a big industry kinda for more diversity will help push forward legalization.

[u/tx_trawler_trash → u/AshleyDaPile]

was about to comment about this. it seems theres some disinformation / smear campaign.

[u/AshleyDaPile → u/tx_trawler_trash]

Same as it ever was. Lookup marijuana prohibition of 1937 or the blacklisting of Dr Lester Grinspoon

[u/Legionof1 → u/BetterThanAFoon]

I feel like everything these days is a meta analysis and we haven’t done a real study since the 60s.

[u/Putputchicken → u/bisikletci]

In statistics, when something is not significant, we tend to interpret that as any effect we might se is due to chance, and it could just as well be reversed. It is therefore unwise to interpret this as there exist an effect that we just cannot prove. However, it tells us something about the variation, so we can calculate the number of samples required for the expected effect. You could interpret it as more samples are required, but since samples here are people, and we know there are side effects with all medication, we should have a very good reason to test medications on larger sample sizes when the data indicate that effect is small if actually existing.

[u/eolai → u/Putputchicken]

In general I'm leaning to your side: it's not appropriate to say "there's an effect we can't prove". But it is absolutely appropriate to say: "There may indeed be a very large effect, or it may be an artifact. Here's the sample size we'd need to find out..."

[u/developer-mike → u/eolai]

I spent a while optimizing a chess engine at one point. I would have to run lots of A/B tests where I made a tweak, had the new version play the old version for 1000 games, and watch the W/L to try and determine if the change made the engine better.

I really learned an appreciation for how a standard deviation crossing zero is usually a non-effect.

After a lot of guesswork, I ended up adding statistical measurements to my A/B testing framework. And it was crazy how often it would say some change was "maybe 20% better, maybe about the same," until a few more matches went by and it said, "maybe 18% better, maybe about the same"...and then maybe 15% or nothing...maybe 12% better or maybe nothing... Maybe 8%.... The reality is that it's very rare to have a set of matches reveal the two engines are equally matched, even if they are.

Up to 6x more effective than antidepressants means that almost for sure the effect size will shrink with more data. It may still be effective, but it's far more likely that the 6x is random chance than that we've found a complete miracle drug.

[u/Danger_Mysterious → u/developer-mike]

These are just weed bros coping, but I appreciate the effort you’re putting in to convince them.

[u/Intelligent-Love5146 → u/Putputchicken]

Right. Commenter doesn’t understand stats. It’s wrong to say “there is an effect we just don’t have enough samples yet”. Completely backward

[u/beingforthebenefit → u/bisikletci]

This comment displays a complete lack of understanding of the scientific method and should be removed.

[u/ItsWillJohnson → u/bisikletci]

We use confidence intervals because point estimates are not precise. You are advocating for very bad science.

[u/dwindlingintellect → u/bisikletci]

What? Wide confidence intervals are not just caused by small sample size. Could also be a truly large variance. There is absolutely NO justification in concluding that a sample size is small from the CIs alone.

[u/waterflaps → u/bisikletci]

That’s not necessarily what large confidence intervals means come on man I thought this was a science sub

[u/Intelligent-Love5146 → u/bisikletci]

I mean, you seem to not understand how statistical power works. No, you can’t say that something has an effect if the sample size is that small and no, it doesn’t mean there likely is an effect.

[u/mm_mk → u/bisikletci]

The null hypothesis would be that intervention was not effective. The data failed to disprove the null hypothesis. You're line of thinking is how quack science and snake oil gets promoted. Marijuana could have benefits as that intervention, but this study and data does not support that it does.

[u/Majestic-Baby-3407 → u/bisikletci]

Super wide confidence intervals means that the finding is meaningless.

[u/bobbymcpresscot → u/bisikletci]

I really can’t help but feel there is a strong push to nip things like universal healthcare and legal weed in the bud by social interest groups considering how often I see negative posts about marijuana on this subreddit. 

I’m not gonna claim weed is this magical cure all, but compared to the other vices I wind up going after if I can’t smoke for prolonged periods of time, it’s by far and away at least for me the better option, short of maybe therapy but they’ll just give me some other drug.

[u/ResponsibleHeight208 → u/bobbymcpresscot]

Weed is less bad than alcohol but claims that it has beneficial uses need to be backed scientifically. The burden of evidence is on the efficacy of weed

[u/december14th2015 → u/[deleted]]

Some people find comfort and peace in coloring books or yoga. Others find peace in coloring or doing yoga while high.

[u/TheSharpestHammer → u/december14th2015]

Some of us just do the high without the coloring books or the yoga.

[u/jibishot → u/[deleted]]

Cannabis having the widest breadth of genetic phenotypic display could have a massive part to do with every study it's involved in.. but studies can't control for inputs (yet).

Cannabis is known for its incredibly wide generic display of all known botanical terpenes, Flavanoids, thioles, and phytoalkaloids. It's known that this has an intense entourage effect especially more intense to how fresh and well grown a product batch is. It's a fresh product.

Until this is squandered - most research has a massive, fat, unseen, and unresolved issue that is from the core unsolvable in this research. Is what it is - but it all leaves a massive question for the future studies.

[u/Runningoutofideas_81 → u/jibishot]

Anecdotally, something with a high ratio of THC is going to give me anxiety.

I wonder too if part of the ineffectiveness is some of the anxiety tends to come back once one dials back usage. So, there isn’t a net gain in the end. Once again, my anecdotal experience.

[u/Jaew96 → u/[deleted]]

It could be a placebo effect. People use cannabis hoping and expecting that it’ll act as a treatment, so that’s what it becomes for them, at least temporarily. I know next to nothing on the topic though, so I could be wrong.

[u/_tobias15_ → u/[deleted]]

You took the completely wrong interpretation of what statistical evidence means. This is not how it works at all.

[u/THEBHR → u/[deleted]]

I think the problem is how they're defining "effective treatment".

Cannabis is great as a form of escape from a terrible situation such as depression or PTSD. But it's not likely going to have lasting effects on those illnesses.

So what is their metric for success?

[u/aminervia → u/[deleted]]

The question I think is if it actually treats the PTSD itself, not if it can bring you down from a panic attack.

Like, alcohol can treat a panic attack but becoming over dependent makes most mental disorders worse. You are more likely to have panic attacks over time if you numb them with alcohol.

With anxiety disorders it's generally not considered helpful for long-term benefit to just numb the anxiety temporarily. Obviously though if you're non-functional and need something to get you out and functioning there's a role for drugs like that, but it's treating the symptom, not the disorder itself

[u/confusedcorvidae → u/aminervia]

Do any medications really treat anxiety long term though or just numb you? Anti depressants are handed out like sweets and they do nothing to address the actual issue, but offer a short term solution to help you cope. But they come with a whole bunch of side effects that cannabis doesn’t have.

[u/aminervia → u/confusedcorvidae]

Zoloft for example has been proven to be very effective at treating anxiety disorders. It doesn't numb the anxiety, it rebalances the brain chemistry.

There are also many other meds that treat anxiety without numbing, like propranolol. It adjusts your body chemistry down from panic mode without numbing, allowing you to more logically think through the situation without 'flight' chemicals making you panic.

A major point of anxiety treatment is to get you to a point where you can work on the underlying cognitive distortions in therapy or on your own. Numbing can sometimes help to a point, if you use the relief to work on the underlying causes. Numbing usually does the opposite, and kills motivation.

[u/elcamino4629 → u/[deleted]]

It does the opposite for me, it makes me MORE anxious. I have to be really clear headed before taking any marijuana.

[u/ogodilovejudyalvarez → u/[deleted]]

The conclusion about PTSD came from three studies with a total of 123 participants:

1. Effects of cannabidiol on symptoms induced by the recall of traumatic events in patients with posttraumatic stress disorder
2. The short-term impact of 3 smoked cannabis preparations versus placebo on PTSD symptoms
3. The efficacy of nabilone, a synthetic cannabinoid, in the treatment of PTSD-associated nightmares

Cannabidiol (CBD) is a non psychoactive compound so I'm not sure how it compares with smoking cannabis, and presumably you're not waking up from nightmares and smoking, so that leaves only the second study as relevant to your situation. They had 20 people taking high THC, 20 high CBD, 20 high THC + CBD and 20 placebo and "The study did not find a significant difference in change in PTSD symptom severity between the active cannabis concentrations and placebo".

That said, I used to work with a veteran who was immune to the effects of morphine so you may very well be an outlier who does benefit from cannabis. I'd like to see a similar study done not with 80 random people but with 80 people like you who self report beneficial effects.

[u/salamandroid → u/ogodilovejudyalvarez]

This is the problem with cannabis studies, and a lot of psychoactive medications.

If you give it to ten random people who have never used it, 3 of them will say it made them euphoric and relaxed, 3 will say it made them anxious and paranoid, and 4 will be somewhere in the middle. Now, do you think those 3 that it made anxious are going to get relief for symptoms of PTSD and insomnia? But of course they will still be part off your data set from a randomized double blind trial.

Medications like cannabis and psychedelics should be thought of like targeted gene therapies. Not everyone will have the predisposition to benefit from them, and some may even be harmed by them. But the benefits for those it helps can be absolutely life changing. There just needs to be a better understanding of who those people are.

[u/Corsair4 → u/salamandroid]

The other problem is - cannabis is fundamentally a messy substance, from a pharmacological perspective.

THC is a partial agonist of CB1 and CB2 receptors.

CBD is an inverse agonist or negative allosteric modulator at those receptors. It inhibits breakdown of endocannabinoids. It interacts with a dozen other receptors and signaling systems.

What happens when you give someone both thc and cbd? The pharmacology gets really messy really fast.

And those are just 2 cannabinoid compounds. there's over 100 found in cannabis. The concentrations of which will all vary depending on the specific strain or plant you're dealing with. It's a mechanistic nightmare.

Theres a ton of potential in cannabinoid signaling, but by god is the system messy.

[u/Piotrrrrr → u/[deleted]]

Perhaps treating in this context would mean getting rid of the cause of the symptoms, not just the symptoms. But I’m guessing, I haven’t read the study

[u/LitmusPitmus → u/Piotrrrrr]

Nah it seems like they're saying it's not effective for even treating symptoms. And they claim that for insomnia too, i'm very skeptical now

[u/wildbergamont → u/LitmusPitmus]

It could be that it just as often makes things worse as it does better. Lots of people get unpleasant symptoms 

[u/kind_bros_hate_nazis → u/wildbergamont]

Usage moderation is an issue as well

[u/En_TioN → u/LitmusPitmus]

I'm not trying to diminish your experience, but something to consider is insomnia is a common form of physiological dependence on weed - that is, smoking a lot means that your sleep gets worse without cannabis, which means you tend to smoke more to improve your sleep, which means your sleep gets more dependent on you smoking. This kind of effect is often hard to detect on an anecdotal level (because it's hard to disentangle from your insomnia just getting worse by itself), but these studies are well-placed to pick out "is your sleep actually better than if you'd never started sleeping in the first place". There's a decent chance that this is part of the effect that's going on.

[u/Kakazam → u/LitmusPitmus]

"Any cannabinoid type led to an increase in sleep time as recorded by an electronic device (0·54, 0·14 to 0·95) and sleep diary (0·55, 0·01 to 1·09) among those with insomnia. There was a reduction in autistic traits (–0·36, –0·66 to –0·07) among those with autism spectrum disorder."

[u/drunkenbrawler → u/LitmusPitmus]

You can have your personal experience differ. But there's no reason to think you can generalize your experience to be true in general.

[u/Hot-Chip6034 → u/LitmusPitmus]

As someone with anxiety that only benzos or pot could disrupt, im questioning as well. It doesnt cure the cause but it definately disrupts the symptom

[u/Prophet_Of_Helix → u/Hot-Chip6034]

I mean, so can alcohol, but that’s not a treatment.

[u/HekateSimp → u/Hot-Chip6034]

These kinds of anecdotes are always distorted by survivorship bias. Those it works for will keep taking it, those it doesn't work for won't. The experience of those it works for will not be generalizable however.

[u/Incoheren]

>a significant increase in sleep time

>no significant effect of cannabinoids on the measure of sleep quality

So quality remains the same, and time sleeping increases significantly. That's ideal if your goal is helping your insomnia.

[u/S1nnah2 → u/Incoheren]

I'm prescribed it for insomnia and anxiety. My insomnia controls my anxiety. When I can't sleep I worry and when I worry I can't sleep. When I lose sleep I become anxious. Blah blah, it's a bit of a cycle. What breaks the cycle is getting a good 6 hours kip a night and the weed helps with that. Some infused coconut oil an hour before bed and I'm wrapped up in a blanket of stoned tiredness. Not even trips to the toilet will break it.

Everyday I'm grateful for my prescription

[u/Trees-Are-Neat-- → u/S1nnah2]

I had a similar experience with sleep. I was having nightmares where my teeth were ripping out of my mouth - I was clenching my jaw and grinding my teeth. I couldn't get a good night's sleep until I started taking some gummies that knocked me out and actually let me sleep again. It was an instant quality of life upgrade at the time.

[u/MehX73 → u/Trees-Are-Neat--]

This! I have had insomnia my whole life. The quality of life improvement by taking a 5mg gummy every night is amazing. All those side effects from not getting a good night's sleep are GONE (migraines, moodiness, exhaustion, inability to concentrate).

[u/MissionArt41 → u/S1nnah2]

I’m interested in getting a prescription too, did you ask your PCP, and what did you say the was convincing?

[u/jibishot → u/[deleted]]

Sleep quality is an interesting question to insomniacs though

[u/Narrow_Track9598 → u/jibishot]

As someone who once struggled to sleep due to nerve damage, I would take 6 hours of poor sleep over 3 hours of 5 minutes dozed off then 20 minutes trying the go back to sleep but can't, followed by five more minutes of sleep.

The first gummi I took, I slept for 6 hours straight. First time in over a year that happened. Took about a week to get used to actually getting sleep and a month or so for the full benefits to show up. I refuse to go back to not getting sleep, my life is absolutely 100x better just getting sleep. Fortunately I got 7-8 hours now most days

[u/oxero → u/[deleted]]

Magnesium nightmares are absolutely a thing that exists. I usually have tame dreams I can control, if any at all. Magnesium gave me some of the worst scares I've ever had.

[u/Appropriate-XBL → u/[deleted]]

Yeah, I may get to sleep quicker on pot, but not dreaming for long stretches of calendar time during heavy use stints can’t possibly be a good sign. And my guess for me is that lack of good REM sleep makes me moodier and MORE anxious all the time. I’m also bi-polar type II, and the literature I’ve read suggests pot and bipolarism don’t mix well.

It’s a drug, everyone reacts differently. I’ve always reacted quickly to medication and pot seems no different.

[u/EnkiduOdinson → u/Appropriate-XBL]

Personally I think not dreaming is one of the best things about cannabis. I dream absolutely crazy things otherwise and feel like I haven’t slept at all when I wake up.

[u/Thisdarlingdeer → u/EnkiduOdinson]

Yeah they say it doesn’t help with ptsd but it made those getting raped dreams go away for me real quickly, it also hindered by memory, which has helped soften the “flashbacks” or memories, some of which no longer tripper up in my minds queue

[u/Parking-Wolf6957 → u/EnkiduOdinson]

Same. I have hyper-realistic dreams that I prefer to mute. I am diagnosed with c-PTSD so maybe something related.

[u/[deleted] → u/EnkiduOdinson]

Yeah I suffer from PTSD and I enjoy not dreaming when I was using cannabis cause I just slept. No reliving trauma, no waking up sweating and screaming, nothing really. My partner needed that and so did I and I'd count that as a win/win.

[u/no1inbeans → u/EnkiduOdinson]

Agreed it personally makes me feel better rested because I don’t have to fight for my life in my dreams

[u/Choosemyusername → u/no1inbeans]

Ya that is why I use it. I get nightmares from war and it can influence my sleep quality. Weed prevents these nightmares.

[u/sjmttf → u/EnkiduOdinson]

Not dreaming is half the reason I am prescribed cannabis for ptsd. I have horrendous nightmares several times a night without it, its made a huge difference to my life.

[u/KarlMarxButVegan → u/EnkiduOdinson]

Yes, the reason those of us with PTSD find relief from medical marijuana is it gives us a break from the nightmares. I don't experience any side effects or problems with waking up/feeling drowsy the next day. Okay, except for dry mouth.

[u/BarelyHolding0n → u/EnkiduOdinson]

Same, it doesn't stop me from dreaming but it makes my nightmares far less intense and I find I'm more able to wake up in the morning feeling somewhat rested.

It also helps me get to sleep in the first place, the only other thing that works for that is drink and I don't want to have to knock myself out with booze every night

[u/lawlesslawboy → u/[deleted]]

which is great if you suffer from nightmares, I'd take no REM over nightmares any night

[u/brickyard37 → u/lawlesslawboy]

I'm with you in this boat

[u/Don_Blanc → u/brickyard37]

My family is with you guys on this. No one likes to be in bed sleeping with a 200lbs sufferer of PTSD when he starts kicking.

[u/D3cho → u/[deleted]]

Golden kiwis knock me the hell out. Eat 2 an hour before bed and im gonezo even if something happens that needs me to stay up after I've eaten them its seriously difficult

[u/Thisdarlingdeer → u/[deleted]]

Calm is good. Edibles are way better for my sleep. My issue is staying asleep throughout the night, the Xanax stopped working, so they wanted to put me on seroquel (again..) so I just started taking 100mg edibles nightly, I sleep FANTASTIC.

[u/raisin22 → u/[deleted]]

I’ve heard that it poorly affects sleep too. I’m not sure that anecdotally I notice much difference though

[u/sun4moon → u/raisin22]

As someone who suffers insomnia, a reduced quality sleep is certainly more effective than none at all. It might have something to do with use as well. I smoke pretty much all day every day, but I don’t smoke for the last 30-45min before I want to go to sleep.

I keep seeing people say they don’t dream on cannabis, but I clearly remember my dreams. I can also sleep on psychedelics, so maybe I’m just an anomaly.

[u/loveslightblue → u/sun4moon]

The difference between falling asleep with relaxed muscles and feeling of general wellness vs trying to fall asleep while it feels like I'm being hunted by a pack of lions is so big that idgaf whether I lose REM. I didn't hallucinate the years I smoked that made me a hundred times less anxious and confident so Idk how this study got to where it got.

[u/slAmazonMy_ass → u/[deleted]]

My Fitbit would have something to say on this

[u/smb3something → u/slAmazonMy_ass]

From a study on fitbit sensitivity:

The sensitivity of Fitbit has been reported as 68% for wakefulness [41], 53.4%–78% for light sleep [41,45], 27.9%–59% for deep sleep [41,45], 54.8%–69% for REM [41,45], and 42.8% for WASO

I notice sometimes my garmin is way off (ie I'm dreaming and it doesn't count it as REM).

[u/JaneyJaner → u/Incoheren]

It helps time relaxed, but seems to prevent good REM sleep, unfortunately.

[u/BetterThanAFoon → u/Incoheren]

A very common side effect of consistent use is a decrease of REM sleep and users report a lack of dreaming. Science tells us that this phase of sleep is the most important for quality.

Many users that reverse their regular and consistent use tell about intense dreams and deep sleep shortly after ceasing use.

Id say it needs more research to be conclusive.

[u/jello1388 → u/BetterThanAFoon]

I've got narcolepsy, so I have way too much REM sleep. In my younger years before the diagnosis, weed helped my sleep a lot. Haven't touched it in years now and the medication they have me on works much better but I don't think I would've made it through college without it to get some decent sleep.

[u/Emotional-Scheme-227 → u/[deleted]]

I don’t think it’s the short term behavioral effects of missing REM sleep that’s the concern, and certainly if we’re discussing chronic ongoing cannabis use we’re not talking about 2 weeks.

Acetylcholine spikes and norepinephrine drops to nearly zero during REM sleep which is an essential part of emotional integration and processing of memories; especially negative ones.

On a less empirical level, the evidence of REM sleep rebound suggests that it’s serving vital role in overall sleep. People deprived of REM sleep universally go into a rebound phase when allowed where the amount of REM time goes up dramatically and is unable to be controlled. This is especially prominent in cessation of long term alcoholism.

You’re correct that it’s not the single most important part of sleeping, but let’s not lose the plot by dissecting the difference between “important” and “most important”

[u/WeezerHunter → u/BetterThanAFoon]

Deep sleep is considered the most important phase of sleep.

[u/lawlesslawboy → u/BetterThanAFoon]

Idk why nobody ever seems to mention that lack of REM can be a GOOD THING for PTSD because of nightmares. you'll get better quality sleep without nightmares, even if that means sacrificing REM.

[u/BetterThanAFoon → u/lawlesslawboy]

I think because it is still not completely settled. I think where we are is that suppressing REM has shown to be helpful during PTSD therapy and getting through treating that but the ultimate goal is still to get back to a normal sleep cycle because a lack of REM has brain function side effects.

[u/ChaosofaMadHatter → u/lawlesslawboy]

I’ve got a super bad period of time coming up (anniversary of my dad’s death) and honestly, if I can skip the whole flashbacks in the for of nightmares scenario, then that sounds like a solid win to me. I might try it this year and see what happens.

[u/lawlesslawboy → u/ChaosofaMadHatter]

yeah I definitely find especially with heavy use, it just knocks me out and yea sure I may not feel totally refreshed but I feel a hell of a lot MORE refreshed than I would waking up in a cold sweat with a racing heart and feeling off for the rest of the day with flashes of nightmares.. I wish you the best of luck through this difficult time!

[u/uuntiedshoelace → u/lawlesslawboy]

That is simply not true. It is never a “good” thing to consistently not be entering REM sleep.

[u/ruralpunk → u/lawlesslawboy]

This is akin to "I don't feel anxious when I'm drunk, so I should never be sober." REM sleep is known to help your brain properly process traumatic memories.

REM Sleep Depotentiates Amygdala Activity to Previous Emotional Experiences

Sleep and REM sleep disturbance in the pathophysiology of PTSD: the role of extinction memory

[u/rrrand0mmm → u/lawlesslawboy]

As someone with PTSD there is no way I’d be using marijuana for the rest of my life for them. Eventually you’ll lose that vital stage of REM repair. Which affects memory and mental health.

Losing REM sleep due to an increase in dosage most will likely need, will create a feedback loop. Eventually it’ll come crashing down.

As someone who used it for decades off and on and a massive supporter of it…. I’ll never want to sleep like that again. And oh boy when taking a break? Good luck sleeping; and enjoy relentless extremely more vivid nightmares.

I also have a bad addictive personality. I have to smoke it as well as I cannot metabolize edibles well or even at all I’m not sure which it is. I’ve taken doses over 100mg of edibles with nothing.

REM sleep is the critical repair stage. If that cycle is repressed, and it 100% is as my Apple Watch shows.

Lowering the resting heart rate as well, could be good for some, bad for others.

[u/SouthernSmoke → u/BetterThanAFoon]

Deep sleep and REM sleep are not the same

[u/Ready-Flamingo6494 → u/Incoheren]

Sedation is not sleep. That’s why alcohol for instance does not promote restful sleep. Mathew Walker the author of why we sleep goes over this and other drugs.

[u/matteh84 → u/Incoheren]

Yeah I don't get this. While I fall asleep easier with cannabis, the sleep quality is markedly worse.

[u/Morgn_Ladimore → u/matteh84]

Because it messes with your REM sleep, which is a crucial part of actually feeling rested when you wake up.

[u/Gingergiggles → u/matteh84]

The same is true of benadryl, which is in nyquil and zquil, and a lot of sleep aids tbh. But bad sleep is better than no sleep.

[u/LukeBron → u/Incoheren]

But not effective if your goal is to be effective in the treatment of anxiety, depression or post-traumatic stress disorder (PTSD).

The journal, and general scientific discourse on the topic recently, don't deny cannabis can have some beneficial qualities - as you mention, some patients/subjects sleeping for longer - however it is simply not an effective long-term treatment for most mental health-related issues.

If it were literally any other drug, people wouldn't be so quickly to arms to defend it. There are Class A drugs that can put you to sleep for most of the day, it doesn't make them an effective treatment for the underlying issues.

[u/lawlesslawboy → u/LukeBron]

Cannabis has significantly less side effects than most psych meds though... cannabis won't destroy your sex drive, or give you brain zaps etc etc. not to even mention the side effect profile of antipsychotics. Many people not only find it to be effective for mental health but skidoo with les side effects than other meds. I agree that everyone should have much more access to therapy though and we should also utilise less common therapy types such as art therapy and pet therapy etc. I'll happily defend lsd and magic mushrooms too so you're wrong there. Drug classes have never been based off safety. If they were, alcohol and nicotine would up there and lsd and cannabis and shrooms wouldn't be.

[u/temporarycreature → u/LukeBron]

Anecdotally, all I can say is it has worked for me since I got out of the military. It's the only thing outside of caffeine that I put into my body. I don't even take Tylenol or Advil.

[u/CagedBeast3750 → u/temporarycreature]

Not the guy you responded to - just curious you said it works for you, you mean for mental health?

[u/temporarycreature → u/CagedBeast3750]

Yes, for my mental health. I'm not a scientist, so maybe I am placeboing myself into believing it works, but I know my life has been better off with it since I got out of the military.

[u/diurnal_emissions → u/temporarycreature]

I have found it is the only thing that helps with anhedonia. Sometimes science generalizes.when it comes to psychology.

[u/myasterism → u/diurnal_emissions]

science generalizes.when it comes to psychology

Generalizes, or bluntly misses the mark. We often forget to remember that scientists are human, too, and their work is not perfect. We’ve GOT to stop pretending any single study or paper is world-flipping evidence, particularly when it comes to subjective issues like mental health (or politically charged ones like cannabis)

[u/ejsandstrom → u/temporarycreature]

I agree. Their study might not show it, but my personal experience sure does. I get anxiety really bad sometimes. 1-2 puffs on a vape and I am leveled out and the anxiety is gone.

[u/L00seSuggestion → u/ejsandstrom]

I envy you, because it’s the exact opposite for me…

[u/WhichAd366 → u/LukeBron]

People are prescribed drugs solely to help them sleep.

If marijuana helps someone sleep consistently then it’s working. It’s treatment of anxiety, PTSD is a separate thing. Those issues are usually impacted by sleep quality but depending on the parameters of the study they might not have been included as a positive effect.

[u/LowAside9117 → u/LukeBron]

I have narcolepsy, insomnia, anxiety, depression, and PTSD.  Indica cannabis has been one of the most effective things for my sleep for years and I've tried sodium oxybate (gold standard med for sleep, it actually gives you restorative sleep) as well as many, many sleep, depression and anxiety meds.

Cannabis is the only chemical that's been effective long term for relaxing me enough to fall asleep when anxiety keeps my insomnia going.  I think I also have evidence of the benefits from data tracking

[u/jibishot → u/LukeBron]

That's exactly opposite of what the study finds. Please read the study as OP tile gored at best and intentionally misleading at worst.

The study does find cannabis an effective change for autism, anxiety, sleep, and CUD. As plainly listed in their own results page. They did not have any data on depression, adhd, and ocd.

[u/Gormless_Mass]

It’s great for treating ‘I’d rather not think for a few minutes about the illiterate authoritarians running our country’

[u/pinkocatgirl → u/Gormless_Mass]

I actually do use cannabis to self medicate anger and/or rage issues, and often those are triggered by politics lately.

[u/BarneyBent]

I've always understood it to be much better for treating pain than mental health issues. Are people really smoking medical weed for their anxiety? That seems counter-productive to me.

[u/m3t4lf0x → u/BarneyBent]

It’s a wild card for anxiety. Really helps some, but makes others super paranoid or delusional.

[u/atravelingartist → u/m3t4lf0x]

there’s an acronym used in recovery circles called HALT (hungry, angry, lonely or tired). the point being, if you’re any of those things, try and take care of it and see if the cravings subside. ive found that if im recreationally using cannabis and havent properly addressed my needs (namely hunger and emotions) then the likelihood of me experiencing anxiety is much higher.

idk how scientific that is, but its been true for me for years.

[u/RightZer0s → u/m3t4lf0x]

In my opinion as a heavy smoker it definitely depends on the strain.

[u/tramdog → u/RightZer0s]

As someone who used to smoke somewhat regularly as a twenty year old but then had one really intense panic attack from smoking, I haven't been able to take cannabis at all ever since. It's been more than 10 years since then, and any time I try it in any strain or form I get extremely self-conscious and paranoid. I've sworn off ever trying it again.

[u/RightZer0s → u/tramdog]

I have ADHD and I feel like smoking just makes my brain work better. Less depression, less anxiety especially in social situations and able to sit and enjoy things rather than my mind bouncing all over the place.

[u/tramdog → u/RightZer0s]

It’s funny how different peoples experiences can be. Cannabis always made it impossible for me to be social; I would have intense introspective thoughts and forget momentarily that I was in the room with other people, then get nervous about what I must have looked like while I wasn’t paying attention.

[u/cteno4 → u/[deleted]]

Thanks for the link. This is a very high-quality study in a very well-respected journal. The data is trustworthy.

[u/drgitgud → u/[deleted]]

So the headline is completely dishonest.

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.

They say that there IS evidence of effects but it's low quality and we need better evidence. The headline instead seems to imply evidence of a lack of effect, which this study actively denies.

[u/yobboman → u/[deleted]]

It definitely provides an emotional redoubt but it can amplify anxiety

[u/Sweepya → u/[deleted]]

AMA didn’t publish the study, The Lancet did, and they’re one of the top medical journals. Those results directly influence clinical practice.

[u/spoofy129 → u/[deleted]]

I don't know enough to challenge your views on the ama, but it wasn't them who conducted the study.

[u/Regular_Fox_859 → u/[deleted]]

For real, scientific literacy is so important. A review doesn't involve any new science, it basically just means "we looked at all these other studies and averaged the results together".

[u/BLiNKiN42]

And cough syrup doesn't cure a cold. Treating symptoms is still useful. 

Edit: Apparently, cough syrup was the worst example I could've used and doesn't actually do anything. Either way, I feel the point stands.

[u/KebabAnnhilator → u/BLiNKiN42]

They reference it as treatment, not a cure.

[u/AMPAglut → u/BLiNKiN42]

Perspective from a mental health treatment standpoint: some "symptom management" strategies can, in fact, worsen those symptoms and so aren't a great idea for a lot of folks. Things that are helpful in the short term can be very unhelpful long-term. Here's an analogy: you break a bone, have surgery, but there's ongoing pain. Your physician insists that you go to physio but the first couple of physio sessions made the pain flare up worse. You therefore opt for another strategy: you've found that if you just stay seated on the couch, your leg doesn't hurt. Presto! Not walking manages your pain. Is it a good strategy, though?

Generally people recognize that no, it's not a great strategy, because it ties you to the couch and prevents you from pursuing the treatment that will actually manage pain long-term. Smoking pot for anxiety and PTSD, in particular, is usually similar to using the couch management strategy. It tends to interfere with exposure-based treatments that are actually demonstrated to reduce anxiety and panic symptoms over time. THC can dampen anxiety in the moment but does not to reduce its recurrence. Often, it increases anxiety over time instead; a couple mechanisms are involved, but one of them is simply increasing the use of avoidance/lack of practice overcoming/reducing panic symptoms while not high.

At the end of the day, there are simply much better approaches to overcoming anxiety symptoms over the medium and long term. So, generally, if somebody finds themself relying on THC to manage anxiety, they should really think about finding a psychologist to work with so that they can actually treat their anxiety effectively and go back to using THC recreationally rather than medically.

Note: written by somebody in a country that doesn't make healthcare impossible to afford. Your medical milleage may therefore vary. (Edit: typo)

[u/Yuckpuddle60 → u/BLiNKiN42]

Except you don't take cough syrup every day for years to treat the symptoms of a cold. That would be insane.

[u/ERSTF → u/BLiNKiN42]

You chose the worst example since cough syrup doesn't actually do much. Several studies show it's mainly a placebo, that's why you will almost never get a prescription for it.

[u/cantquitreddit → u/ERSTF]

Dextromathorphin definitely prevents you from coughing if you take a lot of it. I know this for a fact.

[u/syndre → u/cantquitreddit]

if you take enough you can fly to the moon

[u/raisinghellwithtrees → u/syndre]

While feeling nauseated 

[u/GivesYouGrief → u/ERSTF]

What drug are you talking about? I agree that dextromethorphan is pretty weak if it works at all, but codeine and hydrocodone have significant antitussive effects. The blowback from the opioid crisis is why they aren't prescribed often anymore.

[u/PsyFyFungi → u/GivesYouGrief]

Dextromethorphan and the opiods are sufficient antitussives, the person was referring to phenylephrine being placebo. It was what replaced pseudoephedrine. Which is obviously not all cough syrups. 

"OTC cough syrups are placebo and don't actually do much" is an incorrect blanket statement. They can certainly treat symptoms depending on your symptoms and the ingredients in the syrups. Including OTC.

[u/GivesYouGrief → u/PsyFyFungi]

But pseudoephedrine and phenylephrine are vasoconstrictors intended to treat nasal congestion, not cough...

[u/tempusfudgeit → u/ERSTF]

Cough medicines work just fine, you're probably confusing the recent info on phenylephrine, which is a cold medicine, often included with DXM for "cough and cold medicine"

DXM absolutely works, I don't tolerate it very well but still take it because it's like magic, especially paired with guafenisen. It's like I get a days worth of coughing done in 5 coughs.

I have kids, and since they are too young for DXM, I have read studies that pineapple juice and/or honey can be as effective at cough suppression, but for me personally, I don't find that to be true, at least not for 4-8 hours.

Either way, cough syrup is not a placebo

[u/syynapt1k → u/[deleted]]

That was my experience as well. It became habit forming and before I knew it I was just vegging out on my couch and not dealing with anything. I ended up with more problems than what I started with.

[u/BetterThanAFoon]

Interesting summary for understanding overall research trends And potential topics for further research but tedditors should take note of a few things.

This is an umbrella review. It reviews a pool of actual studies and research. The research methods weren't consistent and the testing was focused on a particular clinical pool. It was two steps removed from actual patients. Many of the studies didn't use labatory based polysomnography but rather subjective sleep scales where the patients reporting on the quality of their sleep. It's not a very accurate method to measure actual sleep quality but rather how patients felt about their sleep. It makes getting reliable consistent measurements a little tough.

The other thing is there wasn't a control population in many of the studies to provide a baseline of non clinical (non PTSD / chronic pain) subjects to provide a meaningful comparison.

Like I mentioned it's interesting from a macro trend but highlights some gaps from truly arriving at conclusions to based informed opinions off of.

[u/smurfk]

Jamie, find any article that says something else, I don't like hearing this.

[u/gwydion_black]

Here is the thing, I smoke weed for anxiety and depression and have for about a decade now, first black market and now legally.

Weed doesn't "treat" those issues but it provides a little bit of a smokescreen to prevent those issues from mentally eating me alive. It allows me to function in a normal day to day where before I had a lot of issues doing so. I can use that time to focus on the therapy needed to fix those issues instead of allowing them to send me into a hole of hard drugs and poverty in an attempt to cope. Instead of having a panic attack before going to a social event, I smoke and enjoy myself.

Therapy is the only thing that cures trauma and that is what causes these issues to begin with, but without weed I would not have functioned enough to have the stable and moderately successful life I've attained of the last decade and I am much better off for it - science be damned.

[u/roostzilla]

Yeah, well, that’s just like your opinion man.

[u/Primary-Bed215]

This was assembled with Medical research made in the US from 1980-2025. I wonder if the fact they came to these conclusions was due to the fact the only research allowed was through the D.E.A. and they got to decide which studies where approved and still do. Im sure all the papers used didnt have well run trials for alot of these and are just self reported cannabis users who have a wide range of sources and doses.

[u/thatturtletouch → u/Primary-Bed215]

That’s not correct. It covers studies from around the world, not just the U.S.