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ADHD and Medical Cannabis: Big Questions

Approximately four percent of American adults live with attention deficit hyperactivity disorder (ADHD). Typically diagnosed in childhood between the ages of three to six, this neurological disorder persists well into adulthood, with symptoms that make it difficult to focus, stay organized, and complete tasks.


Many adults (sometimes beginning in early adolescence) manage the symptoms of ADHD with cannabis.

But, as is the case with depression and cannabis, the relationship between ADHD and cannabis use is complicated. People with ADHD are more likely to use cannabis, but is there a benefit? Does it improve any of the symptoms or quality of life?


The Prevalence of Patients Treating ADHD with Cannabis


Whether the clinical research supports medical cannabis for ADHD or not, it hasn’t deterred people with these conditions from seeking relief from its use.


Since January 1, 2018, patients have logged 30,643 sessions for ADHD and attention deficit disorder (ADD) within the RYAH Data ecosystem. These neurological disorders are, respectively, the 9th and 18th most commonly treated conditions in the app. 


Researchers have also reported on the “increasingly popular perception” that cannabis is a helpful ally for ADHD and ADD.


In 2016, researchers John T. Mitchell, Maggie M. Sweitzer et al. dove into popular forums to explore what patients and caregivers believed about ADHD and medical cannabis. After systematically analyzing more than 400 individual online posts about this topic, the authors discovered substantially more reports that cannabis was helpful (25 percent) versus harmful (eight percent).


As per Mitchell and Sweitzer et al., “Despite that there are no clinical recommendations or systematic research supporting the beneficial effects of cannabis use for ADHD, online discussions indicate that cannabis is considered therapeutic for ADHD.” 


This 2016 study found many posts that described the benefits of cannabis for treating the symptoms of ADHD, including statements like, “In regard to the ADD, while you are high … you will be able to focus much, much better than you normally would,” and, “Medical marijuana improves the ability to concentrate in some types of ADD.”


With more people than ever before seeking medical advice via the internet, the authors predict the many pro-cannabis posts populating these informal forum communities could shift perceptions among those with ADHD.

Another study, this time a 2015 survey entitled “From badness to illness: Medical cannabis and self-diagnosed attention deficit hyperactivity disorder,” also noted commonly reported benefits among a Norwegian demographic. These included improving their ability to concentrate and overall level of function. 


Harmful? The Confusion Around Cannabis and ADHD


Despite the widespread use of cannabis for the treatment of ADHD and the seemingly growing social acceptance, the research so far hasn’t found robust clinical evidence.


In fact, in many of the most cited studies, ADHD and cannabis use is associated with increased risk of cannabis use disorder and other problematic psychiatric comorbidities.


According to a 2020 publication in Molecular Psychiatry, “ADHD is associated with a significantly increased risk for substance use, abuse and dependence,” with an eight times greater likelihood of cannabis use than a non-ADHD diagnosed demographic.


With so many patients reporting cannabis use for ADHD, is this relationship a therapeutically beneficial or a harmful one?


Helpful? Case Studies and a Single Clinical Trial 


Many studies have explored the negative facets of the ADHD–cannabis use relationship, but few have attempted to measure the positive impacts cannabinoids may offer patients. This bias may reflect the historical tendency of cannabis research to focus on the presumed harms rather than the potential benefits.


Still, a few published studies have attempted to explain why so many patients with ADHD turn to cannabis for relief. In 2018, “Medical Cannabis for Adult Attention Deficit Hyperactivity Disorder: Sociological Patient Case Report of Cannabinoid Therapeutics in Finland” summarized the most notable existing research. 


A single clinical trial existed at the time of writing, completed among a group of UK patients who received a preparation of Sativex (THC:CBD 1:1). At the end of the controlled study, the researchers did not find any “statistically significant” differences between the Sativex group and the placebo group regarding cognitive performance. 


However, the researchers noted “that the active group (n = 15) achieved better results than the placebo group (n = 15) and reported reduced hyperactivity/impulsivity symptoms as well as improved emotional lability.”


Several documented case studies have also confirmed a therapeutic benefit for cannabis for ADHD, especially among treatment-resistant populations. For example, in the 2018 case study mentioned above, a Finnish male who has experienced adverse effects from long-term use of conventional ADHD medicines sought alternatives via cannabinoid-based therapies. 


With the assistance of a supportive physician, the patient used cannabinoid-based medicines for five years. The authors reported, “The patient found relief for his ADHD symptoms, the cannabinoids offering reduced hyperactivity as well as improved focus, impulse control, and better frustration tolerance.” Other case studies are supportive of these findings.


Cannabis a Popular Treatment Among Patients with ADHD, But More Research Needed


While these individual case studies are a small sample base, they importantly offer a counterpoint to the anti-cannabis threads stringing much of the current literature together. 


Although much of the research ties ADHD to an increased risk of cannabis use disorder, what qualifies this condition? 


As noted in the Finnish case study, “Many patients were diagnosed before with cannabis use disorders by psychiatrists in hospitals or medical practices due to misinterpretation of effective illegal self-medication. Patients reported that their therapeutic experiences were not taken seriously by most physicians and that they were not listening to them due to strong prejudices.” 


There needs to be much more work done to unpack the relationship between ADHD and increased cannabis use. Yes, this relationship does exist, but is it beneficial? Are there any long-term or serious adverse effects? 


These are all important questions, which will help researchers understand why patients with ADHD continue to seek relief from this plant-based medicine.

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