Overview of Stress
Stress as a concept is relatively new in terms of academic exploration. Early research into the homeostatic processes of the body unveiled that our fight and flight response was an innate adaptation to “environmental disturbances” which we know today as stress. This response is critical in the understanding of what stress is and how it affects our minds and bodies. When we experience stress, whether it be from work deadlines, familial problems, or violent attacks our body’s react in the same way with varying intensity. The first step in our stress response that prepares us to fight or flight is the release of adrenaline. This causes increased blood flow, glucose absorption, and removal of metabolic by-products that aids in our ability to perform at the highest mental and physical level. Additionally, adrenaline reduces blood flow to cutaneous blood vessels which helps minimize blood loss from physical trauma and promotes blood clotting (Robinson, 2018). This response was designed by nature to happen in small bursts, such as running from a large predator. It was not, however, designed to be chronically stimulated by work deadlines, traffic jams, inflammatory food, and all the other environmental stressors we face every day in modern life. Being exposed to such a wide variety of physical and mental stressors over long periods of time can lead to high levels of glucocorticoids, such as cortisol and other stress hormones. These glucocorticoids have the ability to become neurotoxic in high concentrations. This can lead to reductions in the size of the amygdala, hippocampus, and frontal cortex which is associated with chronic stress (Lupien, Juster, Raymond & Marin, 2018). These brain regions are critical for learning, memory, and emotional regulation. Finding novel ways to combat the effects of chronic stress is paramount for our future as modern human beings.
Cannabis and Psychological Stress
72% of daily cannabis users report that they use cannabis to relax or relieve tension (Cuttler, Spradlin & McLaughlin, 2018). Many anecdotal reports suggest that cannabis helps alleviate mental stress but until recently this had not been extensively studied. A recent 2018 study published in the Journal of Affective Disorders looked at the self-reports of 726 cannabis users using an application which allows cannabis users to track changes in symptoms as a function of different doses, routes of administration, and chemotype of cannabis. The researchers wanted to determine perceived changes in symptoms of stress as a function of dose and concentration of THC and CBD. In the 3,717 dosing sessions that were tracked by cannabis users, 93.3% resulted in decreased feelings of stress. 2.7% of the session resulted in an increased feeling of stress and 4% showed no effect at all. In terms of variety, high CBD (>11%) and high THC (>26%) content provided the best results. There was a positive linear relationship between dose and stress relief meaning that more inhalations provided more relief (Cuttler, Spradlin & McLaughlin, 2018).
Cannabis and Physical Stress
Often times when we think of stress we fail to consider what is happening on a physiological level because we are overwhelmed by its psychological components. One of the primary ways we measure the physiological stress response is by looking at the level of salivary cortisol. Cortisol is a hormone that is produced by the body in larger quantities in times of stress and is, therefore, a good indicator of the physiological response to stress. A 2017 study published in the Journal of Psychopharmacology looked at differences in physiological stress response between chronic cannabis users and non-users. The researchers found that chronic cannabis users demonstrated no increase in salivary cortisol concentration in response to the stress manipulation compared to non-users (Cuttler et al., 2017). They also found that cannabis users showed a diminished increase in subjective stress ratings during the acute stressor relative to non-users. The main findings of this study support the body of evidence that indicates that chronic cannabis use is associated with blunted amygdala activation and emotional reactivity (Cuttler et al., 2017).
Know Your Dose
Most patients in the medical cannabis community are experiencing some level of stress due to their health concerns as well as the stressors of everyday life. It is imperative that we help those patients understand that stress can increase the severity of their symptoms both physically and psychologically. Below are some ideas around using cannabis to reduce stress and tips on lifestyle practices to do the same.
- Research suggests that high CBD (>11%) and high THC (>26%) content is ideal for stress. In terms of inhalation, 10 + puff was found to be optimal for stress reduction (regular users). For oral consumption, 7.5mg decreased the emotional effects of stress whereas 12.5+ increased the emotional effects of stress due to the biphasic action of THC (Cuttler, Spradlin & McLaughlin, 2018).
- Terpenes make a huge impact on the perceived effects of Cannabis. Strains high in trans-nerolidol, myrcene, and beta-caryophyllene are consistently selected for their anxiolytic action. Strains high in terpinolene should be avoided due to its ineffectiveness in relieving feelings of anxiety indicative of stress (Kamal, Kamal & Lantela, 2018).
- For patients who are sensitive to the psychoactive effects of THC, using a different approach may be beneficial. Recent studies suggest a 40:1 ratio of CBD to THC is needed to mitigate THC psychoactivity (Solowij et al., 2019). This will allow the patient to avoid any unwanted side effects which can increase feelings of stress.
- Outside of cannabis, there are a variety of relaxation techniques that can aid in reducing stress. Mindfulness, deep breathing, yoga, and meditation may assist in lessening physiological manifestations of stress (Scotland-Coogan & Davis, 2016). These techniques can be used alone or in combination with cannabis. It is important to incorporate tools outside of cannabis to promote overall health and wellbeing.
Derek Espinoza, Baked Bros Director of Education
Cuttler, C., Spradlin, A., Nusbaum, A., Whitney, P., Hinson, J., & McLaughlin, R. (2017). Blunted stress reactivity in chronic cannabis users. Psychopharmacology, 234(15), 2299-2309. doi: 10.1007/s00213-017-4648-z
Cuttler, C., Spradlin, A., & McLaughlin, R. (2018). A naturalistic examination of the perceived effects of cannabis on negative affect. Journal Of Affective Disorders, 235, 198-205. doi: 10.1016/j.jad.2018.04.054
Kamal, B., Kamal, F., & Lantela, D. (2018). Cannabis and the Anxiety of Fragmentation—A Systems Approach for Finding an Anxiolytic Cannabis Chemotype. Frontiers In Neuroscience, 12. doi: 10.3389/fnins.2018.00730
Lupien, S., Juster, R., Raymond, C., & Marin, M. (2018). The effects of chronic stress on the human brain: From neurotoxicity, to vulnerability, to opportunity. Frontiers In Neuroendocrinology, 49, 91-105. doi: 10.1016/j.yfrne.2018.02.001
Robinson, A. (2018). Let’s talk about stress: History of stress research. Review Of General Psychology, 22(3), 334-342. doi: 10.1037/gpr0000137
Scotland-Coogan, D., & Davis, E. (2016). Relaxation Techniques for Trauma.
Solowij, N., Broyd, S., Greenwood, L., van Hell, H., Martelozzo, D., & Rueb, K. et al. (2019). A randomised controlled trial of vaporised Δ9-tetrahydrocannabinol and cannabidiol alone and in combination in frequent and infrequent cannabis users: acute intoxication effects. European Archives Of Psychiatry And Clinical Neuroscience, 269(1), 17-35. doi: 10.1007/s00406-019-00978-2