Adhd and smoking weed
THE PERCEPTION THAT MARIJUANA IS THERAPEUTIC FOR ADHD continues to increase in popularity. Anecdotes from people with ADHD who feel that recreational cannabis use provides therapeutic benefits are common. There is little clinical research to support these claims, however.
Despite an absence of research, there is much chatter online. A relatively recent study looked at the content of online forum threads on ADHD and marijuana use. At least three times as many comments advocated for its therapeutic effects on ADHD compared to comments that cannabis was either harmful, was both therapeutic and harmful, or had no effect on ADHD. (These findings were specific to ADHD. They did not generalize to mood, non-ADHD psychiatric conditions, or general quality of life.)
The study concluded that comments favoring therapeutic effects mostly had to do with the belief that cannabis improved the inattentive symptoms as opposed to the hyperactive-impulsive symptoms of ADHD. Also, while there were relatively few comments comparing cannabis to ADHD medications, many commenters said they considered cannabis “medicinal.”
Although the belief that recreational cannabis is therapeutic for ADHD may be widespread, currently there are no clinical recommendations or evidence supporting this belief. As more jurisdictions legalize cannabis, it remains to be seen whether legalization will also pave the way for systematic clinical research.
A look at the statistics
Marijuana is one of the most widely used psychoactive substances worldwide after tobacco and alcohol. Higher rates of all substance use disorders are well documented among adults with ADHD. Compared to people who do not have ADHD, those with ADHD are at increased risk for early initiation of cannabis use, for heavy use, and for developing a cannabis use disorder.
The National Epidemiological Survey on Alcohol & Related Conditions in the United States determined that adults with ADHD use cannabis two to three times more than adults without ADHD. Some research suggests that over their lifetime, people with ADHD are almost eight times as likely to use cannabis compared to those who do not have ADHD.
Cannabis use disorder is also more common in adults with ADHD. Studies show they are more than twice as likely to meet the criteria than adults without ADHD. Looking at the rates from a different perspective, we learn that among individuals who seek treatment for a cannabis use disorder, the rates of ADHD are estimated to be 34 to 46 percent.
What research says about presentations of ADHD
Are particular presentations of ADHD in childhood more or less predictive of a substance use disorder in adulthood? Some research suggests that impulsivity and oppositionality during childhood seem to predict increased risk of cannabis consumption in adulthood. The combination of ADHD and a substance use disorder is also associated with a worse prognosis and quality of life.
Some research shows that inattentive symptoms are more predictive of substance use disorders. Other research shows that hyperactive/impulsive symptoms are more predictive of substance use disorders.
Research indicates that individuals with ADHD who use cannabis use all categories of substances more commonly than those with ADHD who do not use cannabis. More specifically, rates of nicotine, alcohol, and drug use are significantly greater in those who use cannabis. Rates of alcohol use disorders, nicotine dependence, and drug use disorders are significantly greater among people with ADHD who use cannabis, compared to those with ADHD who do not. The most common drug use disorders in adults with ADHD who use cannabis involve cocaine, followed by opioids, and then amphetamines.
In some studies, no significant differences were found in the prevalence of ADHD subtypes among individuals with ADHD who report cannabis use. However, some research suggests that the average age of initiation of cannabis use is significantly younger among those with ADHD with the hyperactive/impulsive presentation, compared to those with the inattentive presentation.
Research also suggests that individuals with the hyperactive/impulsive presentation tend to begin their most intensive period of cannabis use earlier than those with the inattentive presentation. The age of cannabis abuse tends to be younger among those with the combined presentation of ADHD, compared to those with the inattentive presentation.
Efforts at self-medication
There are several possible explanations for substance use and substance use disorders in adults with ADHD. The risk is particularly striking in people whose childhood ADHD symptoms persist into adulthood, when substances are more readily available. Recreational cannabis use may be associated with impulsivity, sensation-seeking, poor choices in peer groups, impaired occupational and social functioning, and the desire for intoxication.
Both recreational substance use and substance use disorders may be associated with efforts at self-medication of the various ADHD symptoms themselves. The co-occurrence may reflect efforts to self-medicate with respect to negative emotionality, such as anger, sadness, anxiety, and inadequate emotional regulation. Self-medication may not necessarily be specific to ADHD symptoms, but rather a way of relieving co-occurring mood and anxiety-related symptoms that are common in people with ADHD.
For some individuals, stimulant medication for the treatment for ADHD may cause adverse effects such as excessive arousal and insomnia. Cannabis use may be an attempt to try and counter those adverse effects.
Dopamine neurotransmission has been shown to be involved in both ADHD and substance use. In the case of ADHD, this has to do with an underproduction of dopamine and norepinephrine. Studies show that acute use of THC (the psychoactive component of cannabis) causes increased dopamine release, while long-term THC use is associated with blunting of the dopamine system. Thus, cannabis use may also be an attempt at self-medicating—that is, “chasing dopamine.”
In addition, studies show that cannabis use (in particular, early-onset use and ongoing use) and ADHD are both associated with deficits in neurocognition, including attention, memory, and executive functions. Both ADHD and regular cannabis use are associated with motivational issues.
Determining a diagnosis of ADHD in individuals who are actively using cannabis—or in those who have recently been abstinent following active cannabis use—can be quite difficult. The clinician must tease out whether those neurocognitive deficits are more cannabis-induced, true ADHD, or a combination of both.
Adhd and smoking weed THE PERCEPTION THAT MARIJUANA IS THERAPEUTIC FOR ADHD continues to increase in popularity. Anecdotes from people with ADHD who feel that recreational cannabis use provides
Experts Weigh In: Marijuana and ADHD
Marijuana and ADHD—it’s a topic that can be both controversial and confusing for parents. Can marijuana help kids with ADHD (also known as ADD), or does it make symptoms worse? What about cannabis-related products like CBD oil?
Read what three experts have to say about marijuana and ADHD.
Can marijuana help with ADHD?
Elizabeth Harstad, pediatrician: There’s no evidence that using marijuana can help with ADHD symptoms. In fact, studies show it can worsen executive function and working memory . These are areas where kids with ADHD struggle. Neither medical marijuana, nor street marijuana, which is usually stronger and may contain other chemicals, should be used to treat ADHD.
It’s also important to know that marijuana may counter the benefits of ADHD medication. And kids using marijuana are less likely to keep up with their medication.
Stephanie Sarkis, licensed and board-certified mental health counselor: Studies have found marijuana decreases executive function when you have ADHD. It can cause you to have a harder time focusing. It can impact your ability to get started on tasks or manage time. Even short-term use has this effect.
What I do see is that more of my teen and adult patients with ADHD and anxiety use marijuana. They report it helps reduce their anxiety. However, based on assessments, their executive function performance has also decreased.
The effect on anxiety is mixed, as well. Using marijuana seems to reduce anxiety for some. But it can result in more anxiety, including paranoia, for others.
Thomas Brown, clinical psychologist: There is no scientific evidence that ADHD symptoms can be relieved by using marijuana. And there is evidence that it can make symptoms worse. That’s particularly true for younger teens and if marijuana use is frequent. Frequent use also can lead to not caring enough about things that are important to care about, like schoolwork, for example.
What is cannabidiol (CBD) oil, and can it help with ADHD?
Thomas Brown: Cannabis is the plant that marijuana comes from. One product from the same plant is cannabidiol (CBD) oil. It doesn’t have THC, which is the psychoactive chemical in marijuana that makes you feel “high.” Using CBD oil is different than smoking marijuana.
There’s no evidence that CBD oil can help with ADHD. Ongoing research is testing whether CBD may help to improve some other disorders. However, right now there isn’t enough evidence to show that it’s safe or effective.
It is important to be clear that CBD oil is not the same as hashish oil. The latter has very high THC content. It is usually heated and smoked in a process called “dabbing.” Hashish oil is extremely addictive and harmful to health.
Elizabeth Harstad: There is no good medical evidence showing that CBD oil should be used to treat ADHD, and it may be harmful.
Stephanie Sarkis: Some people report that CBD seems to help with their ADHD. However, this appears to be caused, in part, by the placebo effect. The mind has a lot of power over the body. If you think something might work well for you, there is a pretty good chance that it will.
It’s kind of like when your mom put a menthol rub like Vicks on your chest when you had a cold. There are no inherent healing properties to it, but it sure made you feel better. That’s the placebo effect at work.
What should I do if I suspect my child is smoking marijuana?
Thomas Brown: Parents should be aware that marijuana is used by significant numbers of middle and high school students. So it can be helpful to have a conversation about it with your child—even a young teen.
Talk about what your child is hearing about “weed” from other kids and how to respond to any opportunities to use it. Help your child understand that having or consuming marijuana by smoking or in “edibles” is against the law for minors, even in states where it may be legal for adults.
If you know your child is using marijuana, don’t ignore it. Approach your child and explain that it can worsen ADHD symptoms. Talk about how it can cancel out the benefits of ADHD medication. And discuss how frequent use can lower motivation and the ability to do well in school. If the problem persists, consult your pediatrician or a mental health professional to get some help.
Stephanie Sarkis: If you suspect that your child is smoking marijuana, it’s important to be up-front and ask. Honest, open communication works wonders. Find a time to talk to your kid when you both are not rushed and are really able to talk.
It’s also important to be compassionate. When kids and adults have brain-based issues like ADHD, depression and anxiety, they may look for a way to self-medicate. Your child may be smoking marijuana to try to fix what he knows isn’t working well.
In my practice, I give my teen and adult patients executive function tests. When they see how much marijuana decreases their executive function performance compared to before use, they’re often surprised. It helps them understand the impact.
Elizabeth Harstad: One thing to know is that the marijuana people used 10 or 20 years ago is very different from what’s available now. It’s much more potent today.
The risks here are very real. People with ADHD are 2.5 times more likely to develop a substance abuse problem. That may be with alcohol, marijuana or another drug. If kids start using marijuana at a young age, it’s even more likely. If you know or suspect your child is using marijuana, it’s important to intervene.
More Things You Can Do
You can also read about what to do if your teen stops talking to you. And consider joining one of our secure, online community groups, where you can connect with other parents of kids with ADHD.
About the Author
About the Author
The Understood Team is made up of passionate writers and editors. Many of them have kids who learn and think differently.
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Experts Weigh In: Marijuana and ADHD Marijuana and ADHD—it’s a topic that can be both controversial and confusing for parents. Can marijuana help kids with ADHD (also known as ADD), or does it