Can Weed Help Treat ADHD?
“I felt like someone turned on a light switch in my head,” Joseph Lazarus says of his first time smoking weed. It was a classic scene from American adolescence: He snuck out into woods near his home in York, Pennsylvania, with an older schoolmate who liked to blaze. For Lazarus, the experience was profound: “I heard the birds chirping for [what seemed like] the first time,” he says. The leaves seemed greener. He felt the wind tickle his skin. “I was one with the forest, a wooded forest. I was so calm.” He was 13.
It was one of the first times Lazarus felt normal. At age six, he was diagnosed with attention-deficit/hyperactivity disorder and prescribed the usual stimulants. They didn’t help. “I couldn’t concentrate or retain information,” he says. “I had a hard time with grammar. I couldn’t remember the rules.” He was restless, unable to focus in class and easily bored at home for his entire childhood. He says emotional trauma played a role; he had to process his parents’ divorce at about the same age he was diagnosed. “I felt like there was a stick of dynamite in me ready to go off,” he says.
But his thought pattern after smoking up? “It was like if you are on a four-lane highway with cars coming from everywhere and then you are on a country road.” Lazarus, now a 33-year-old home remodeler and still living in York, has been self-medicating with cannabis since that day in the woods. At the time, the dramatic change in his mannerisms caused a guidance counselor to start a process that got him sent to an institution for troubled teens. But he says weed has been the only treatment that has stabilized him. (Vaping is his current method of choice.) “I’m using a tape measurer and making calculations and plans every day,” he says. “I don’t think that would be possible without cannabis.”
Evidence that cannabis helps with ADHD is emerging and scant, but signs indicate that people are using it to treat their symptoms, anyway. A 2016 Duke University study of 268 ADHD-related internet threads, for instance, found that 25 percent included a post from someone indicating that it was therapeutic for ADHD. (Only eight percent of the threads included a post saying it was harmful, five percent that it was a mix of therapeutic and harmful, and two percent that it had no effect on ADHD symptoms.)
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Other studies also show promise for cannabis-based medicine, if not recreational weed. Last year, researchers at King׳s College London’s Institute of Psychiatry, Psychology and Neuroscience completed a randomized, placebo-controlled experimental study of a cannabinoid medication on adults with ADHD. Subjects who used Sativex Oromucosal Spray—which is an extract of cannabis, and therefore different from recreational weed—experienced some relief in their hyperactivity/impulsivity symptoms. They also reported more inhibition and better attention depth when compared to the group that took a placebo.
Ruth Cooper, the lead author who completed the study as part of her dissertation, says she was motivated by the knowledge that many psychiatrists and psychologists—including her advisor and co-author—recommend cannabis for ADHD. They prefer cannabis to medications often because of the more tolerable side effects, Cooper says. “There’s some research on it, but not very much,” she adds.
Cooper says her study of 30 subjects is small, but promising. “I think in the future if more evidence could be shown that it has greater effects in larger trials, it would become a common treatment,” she says. In the meantime, some physicians aren’t waiting for more scientific input. David Bearman, a private practice physician and certified cannabinoid medicine specialist, has been prescribing medical marijuana in California for 40 years, he says, and working around the laws in place. Bearman says young people and parents often contact him about cannabis-based treatments for ADHD. They complain that drugs like Ritalin increase the restlessness and nervousness that was problematic in the first place.
The effect on students with ADHD who are struggling, he says, tends to be dramatic. “Most of my patients’ [grades] went from Cs and Ds to Bs,” Bearman says. “One credited cannabis with getting his PhD.” Bearman posits—as many other researchers have—that ADHD might be the result of a lack of the neurotransmitter dopamine in the brain’s prefrontal cortex. Nerve signals might be slowed or stagnated, leading to a loss of attention and generally slower thought process. THC causes the brain to produce more dopamine, which means more of it becomes available for the essential tasks of memory and attention.
Celeste Thirlwell, a physician and sleep specialist at Apollo Cannabis Clinics in Toronto, says that the inflammation of the nervous system is a common cause of ADHD, and cannabis is a natural anti-inflammatory agent. Without deep sleep, “the nervous system is not being properly entrenched,” Thirlwell says. “It’s not being turned off properly, so you have problems with memory.”
Thirwell recommends her patients vape with a sativa strain to ease the inflammation and get an attention-renewing night of sleep. Not all medical professionals, however, are quite so bullish on using cannabis to treat attention deficit disorder: “ADHD is a basket of problems,” says Scott Shannon, a physician and holistic medical practitioner in Fort Collins, Colorado. “Saying you can’t pay attention is like saying [to a mechanic], ‘My car isn’t going forward.’ There are many things that could [be] wrong.”
Shannon, however, has recommended hemp-derived CBD, the non-psychoactive compound in the cannabis plant, for ADHD symptoms and other complaints related to restlessness in his patients. (He would prefer to avoid the psychoactive effects of THC.) But he cautions people not to overthink the effect. “We know that engaging the endocannabinoid system has a calming effect,” he says, “so naturally, CBD is useful for that over-arousal.”
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"I felt like someone turned on a light switch in my head."
Can Marijuana Treat ADHD?
Marijuana is sometimes used as a self-treatment by individuals with attention deficit hyperactivity disorder (ADHD).
Advocates for marijuana as an ADHD treatment say the drug can help people with the disorder handle some of the more severe symptoms. These include agitation, irritability, and lack of restraint.
They also say that marijuana has fewer side effects than traditional ADHD medications.
Read more about what research has discovered about the use of marijuana in individuals with ADHD.
Laws and research
Marijuana remains illegal at the federal level. Each year, more U.S. states have passed laws allowing the sale of marijuana for medical purposes. Some states have legalized it for recreational purposes, too. Many states still outlaw any use of marijuana. At the same time, research into the effects of the drug on health conditions and diseases has increased. This includes research on marijuana use in individuals who’ve been diagnosed with ADHD.
Online health forums are filled with comments from people saying they use marijuana to treat symptoms of ADHD.
Likewise, individuals who identify as having ADHD say they have few or no additional issues with marijuana use. But they aren’t presenting the research on adolescent use of marijuana. There are concerns for the developing brain’s learning and memory.
“Many adolescents and adults with ADHD are convinced that cannabis does help them and has fewer side effects [than ADHD medications],” says Jack McCue, MD, FACP, an author, physician, and emeritus professor of medicine at the University of California, San Francisco. “It may be that they, not their doctors, are correct.”
Dr. McCue says he’s seen patients who report classic marijuana use effects and benefits. They report intoxication (or being “high”), appetite stimulation, help with sleeping or anxiety, and pain relief, for example.
Dr. McCue says these people sometimes report effects that are often seen with typical ADHD treatments, too.
“The limited research on what patients say cannabis does for ADHD symptoms indicates that it is most helpful for hyperactivity and impulsivity. It may be less helpful for inattentiveness,” Dr. McCue says.
Research in 2016 analyzed some of these online threads or forums. Of the 286 threads the researchers reviewed, 25 percent of posts were from individuals who reported that cannabis use was therapeutic.
Only 8 percent of posts reported negative effects, 5 percent found both benefits and harmful effects, and 2 percent said using marijuana had no effect on their symptoms.
It’s important to remember that these forums and comments aren’t clinically significant. They’re also not evidence-based research. That means they shouldn’t be taken as medical advice. Talk with your doctor first.
“There are descriptive accounts and demographic surveys that report that individuals with ADHD describe marijuana as being helpful in managing inattentiveness, hyperactivity, and impulsivity,” says Elizabeth Evans, MD, psychiatrist and assistant professor of psychiatry at Columbia University Medical Center.
However, Dr. Evans adds, “while there certainly may be individuals who experience benefit in their symptoms of ADHD, or those who are not adversely impacted by marijuana, there is not sufficient evidence that marijuana is a safe or effective substance to treat ADHD.”
Cannabidiol (CBD) is also promoted as a helpful treatment for individuals with ADHD.
CBD is found in marijuana and hemp. Unlike marijuana, CBD doesn’t contain the psychoactive element tetrahydrocannabinol (THC). That means CBD doesn’t produce a “high” the way marijuana does.
CBD is promoted by some as a possible treatment for ADHD. Dr. McCue says that’s because of “anti-anxiety, antipsychotic effects of CBD.”
However, “the lack of a potential paradoxical benefit from the stimulating effects of THC make CBD theoretically less attractive,” he says.
Dr. Evans adds, “There are no large-scale clinical trials looking at CBD for ADHD. It is not considered an evidence-based treatment for ADHD at this time.”
Some people with ADHD report that they find therapeutic benefit from using marijuana. Despite these anecdotal stories, research doesn't support marijuana, or CBD, as a treatment for ADHD. Who's right?