Lots of people with anxiety are counting on cannabis’s ability to treat their

symptoms. There’s a problem: The science shows that it probably doesn’t help, and it

may make those symptoms worse.

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Cannabis companies have promoted their products as helpful for anxiety, making for

a potentially lucrative market. Anxious consumers have turned to weed and edibles

for relief as treatments for their ailments have become harder to find. The number of

available and affordable therapists badly lags demand and traditional medications

don’t work for everyone.

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Driving both users’ and businesses’ hopes is a belief that pot can make us less

anxious. Yet little independent scientific evidence shows that cannabis is an effective

treatment for anxiety problems, and some studies have found it can worsen

symptoms. Researchers say this is particularly true for products high in THC, the

substance responsible for marijuana’s intoxicating effects.

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A survey last year found that nearly two-thirds of people said they would prefer to

use cannabis rather than pharmaceuticals to treat a medical issue, according to the

survey conducted by the Harris Poll on behalf of cannabis company Curaleaf of

almost 2,000 adults who were at least 21 years old. And among the 54% of

respondents who said they had ever used cannabis, 41% of them said they consumed

cannabis to reduce anxiety.

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“I have patients who use it every day. They say it really helps,” said Dr. Beth Salcedo,

a psychiatrist and medical director of the Ross Center in Washington, D.C., who

specializes in treating anxiety disorders. “My message is that if it were really

working for you, you wouldn’t be here with me.”

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When Salcedo talks with patients about what their anxiety was like before cannabis,

she said they usually report that their anxiety is unchanged. Any transient relief they

feel may be due in part to marijuana’s high, she said.

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The messaging

Cannabis companies have promoted the idea that their products can help anxiety.

That’s a potentially lucrative market for an industry where profits have fallen short

of many entrepreneurs’ lofty expectations.

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Legal cannabis revenue was expected to reach $30 billion a year by now, according to

estimates from Harvard University economist Jeffrey Miron. It is only half that

figure. Earlier bets on selling legal pot as a salve for pain and post-traumatic stress

disorder haven’t proved as profitable as hoped.

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Irwin David Simon, chief executive of Tilray Brands, the first cannabis company to

trade publicly on a major U.S. stock exchange, said in an interview he thinks cannabis

can be a useful alternative to pharmaceuticals for many conditions, including

anxiety. He said it’s a promising market that produces repeat customers.

“Is it to replace alcohol? Pain for cancer patients? Sleep? Anxiety? I think it’s

absolutely for all of the above,” he said.

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Busy Philipps, the actor, author and influencer, described using marijuana for her

panic attacks and anxiety in a 2021 live-streamed event that was sponsored by

Curaleaf, the largest cannabis company in the U.S.

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“I immediately felt better but present and myself, but, like, the anxiety attack, the

edge had been taken off. I was calm,” said Philipps, a mother of two. “I didn’t feel

messed up or anything. I could still hang with my children and still be a mom and still

make mac and cheese.”

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Curaleaf said Philipps wasn’t paid for her appearance. Through a publicist, she

declined to comment.

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Joining Philipps on the webcast was Stacia Woodcock, then a pharmacist and

dispensary manager for Curaleaf. During the event, Woodcock said that anxiety, as

well as autoimmune disorders and arthritis, can overwhelm the endocannabinoid

system in the brain and body. (This system is involved in learning, memory, mood and

many other functions.)

“So you supplement with cannabis and it brings your body back into balance,” said

Woodcock, according to the video recording.

Woodcock said in an email that she recalls that the intention of the webcast was to

Busy Philipps, the actor, author and influencer, described using marijuana for her panic attacks and

anxiety in a 2021 live-streamed event that was sponsored by Curaleaf.

Woodcock said in an email that she recalls that the intention of the webcast was to

“discuss the stigma of cannabis use and its potential benefits for some people,” and

not as a promotion of it as a treatment for anxiety. Woodcock is no longer employed

by Curaleaf full-time but works as a pharmacist for the company on contract. Curaleaf’s former chief executive, Joseph Bayern, mentioned anxiety several times

when talking to investors about the company’s plans to grow its market.

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“Bringing in people who are currently consuming alcohol or using products in the

health and wellness market for things like sleep or anxiety, or going all the way to the

prescription drug market for the use of opioids for chronic pain relief, I mean that is a

huge addressable marketplace,” Bayern told investors in March 2021, according to a

transcript of the call.

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Anxiety is one of the most common symptoms that visitors to Curaleaf’s dispensaries

are looking to address, according to a company spokeswoman. She noted that several

states have made anxiety a qualifying condition to receive a medical marijuana card.

Curaleaf doesn’t target people with anxiety or promote cannabis specifically for

anxiety, she said, and recommends that people consult with a doctor before choosing

cannabis to address any specific need, she said.

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Bayern, the former CEO, said he stands by his belief that cannabis “can be used as a

natural alternative to prescription drugs and alcohol” and that he has spoken to

hundreds of people who have shared stories of cannabis helping with anxiety, pain

relief and PTSD. Curaleaf declined to provide a comment from its current CEO.

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Product guidance

At the same time, cannabis companies train their retail staff—dubbed “budtenders”

—to recommend products depending on customers’ needs, ailments or moods.

Anne Hassel became a $15-an-hour budtender for a New England Treatment Access

dispensary in 2015, leaving a higher-paying job as a physical therapist because she

Anne Hassel became a budtender at a Massachusetts dispensary in 2015 because she

believed then that pot could help people su#ering dispensary in 2015, leaving a higher-paying job as a physical therapist because she

believed pot could help people suffering from various medical conditions.

“This was my dream job,” she said. “I was very evangelical about it. I really believed.”

Hassel, 56, worked at the Northampton, Mass., dispensary until 2017, when she quit

over what she perceived as dangerous sales practices by her employer; she has since

spoken out against the cannabis industry. Hassel said company materials stated that

NETA couldn’t give medical advice. She said budtenders also received a chart from

management recommending ways to guide customers toward certain pot products

depending on their ailment. The Wall Street Journal reviewed both documents.

The chart, labeled “NETA product guidance,” advised budtenders to suggest

products with high levels of THC for stress that manifests with headaches and lower-

THC indica strains for customers trying to “get away from anxiety meds or sleeping

meds.”

Kevin Fisher, a NETA founder, said he couldn’t comment because he is no longer

affiliated with the company. A spokesman for NETA’s owner, cannabis company

Parallel, said, “We have serious concerns about the accuracy of the information you

have received and have no further comment.”

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The science

Two recent studies show the potential problems with treating anxiety with

cannabis.

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Cannabis use was significantly associated with increased odds of developing anxiety

conditions, according to a review of research published in 2020 in the Canadian

Journal of Psychiatry. Recent cannabis use from various medical conditions.

was associated with more severe symptoms in people with anxiety and mood disorders,

according to another review published in 2018 in the Journal of Clinical Psychiatry.

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The industry has funded its own studies.

In one study published in 2022, researchers affiliated with Harvest Medicine, a chain

of cannabis clinics and a telehealth service in Canada, found that people using

medical cannabis for anxiety saw clinically significant improvement on a measure of

anxiety. In some surveys, cannabis users have reported that they have felt relief from anxiety

symptoms after consuming cannabis. There is some evidence that cannabidiol, or CBD, which is a nonintoxicating

substance derived from cannabis, may relieve anxiety symptoms. But the science is

limited. Companies and scientists say federal restrictions, which may soon lift, have

hampered research on cannabis.

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The complexity of the cannabis plant—and the many cannabis products available—

make it difficult to study and determine how best to use it therapeutically, said Ziva

Cooper, director of the Center for Cannabis and Cannabinoids at the University of

California, Los Angeles.

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The composition of products can also vary from batch to batch, said Cooper. Products

have different effects on people depending on their age, usage and other factors too.

“When you go to the pharmacy, the Prozac you get is going to be just like the Prozac

that you got last month. There’s a great deal of very controlled research to provide a

road map of how to use it. With cannabis, we don’t have that,” Cooper said.

Anne Marie Albano, director of the Columbia University Clinic for Anxiety and

Related Disorders, said that marijuana can interfere with treatment for anxiety.

‘I feel like I was duped [into believing] it’s not addictive, it’s just a plant, it will cure your anxiety,’

said Jordan Davidson.

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The most evidence-based non-drug treatment for anxiety disorders, cognitive

behavioral therapy, involves approaching the situations that make you anxious and

learning how to tolerate the uncomfortable feelings. Being high can get in the way of

that, she said.

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The risks

Using cannabis regularly comes with a significant risk of addiction. Among people

who reported using marijuana in the past year, about 30% have cannabis use

disorder, according to an analysis of federal data. Marijuana use can become a

disorder when people need to use an increasing amount to get the same effect and

when the use interferes with work and relationships, among other symptoms.

Marijuana users also run a higher risk of delusions and psychosis, research has

found.

Jordan Davidson, 22, was diagnosed with generalized anxiety disorder as a kid

growing up in Connecticut. In high school, he started using high-potency THC

products, which at first, he said, made him have fewer anxious thoughts. But soon,

when he didn’t have marijuana, he felt like his skin was crawling; he couldn’t sleep.

Ultimately, he decided to get help and hasn’t used cannabis since 2018, he said. He joined

a group dedicated to convincing lawmakers in Washington that the substance is

dangerous.

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“I feel like I was duped [into believing] it’s not addictive, it’s just a plant, it will cure

your anxiety,” he said. “We were played.”

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Write to Andrea Petersen at andrea.petersen@wsj.com and Julie Wernau at

julie.wernau@wsj.com

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