Ethos Ho, BSc Pharm Student
A New Domain of Uncertainty
Although the date for the legalization of recreational marijuana in Canada has been delayed, many questions remain about its potential uses and implications in medicine. Healthcare providers are working hard to hash out the evidence behind medical cannabis and how to incorporate it as a standardized treatment option. So far, we’ve talked about the potential value of using medical cannabis for the treatment of chronic pain and cancer. As research continues on the many possible uses of medical cannabis, psychiatric disorders such as depression, anxiety, and ADHD are receiving a great deal of attention. Today’s article examines the evidence behind cannabis in the treatment of ADHD, though stay tuned for future pieces from myself on cannabis’ use in other psychiatric disorders!
How Could Cannabis Treat Symptoms of ADHD?
The mechanism by which cannabinoids may produce therapeutic benefits in ADHD is largely unknown. One theory suggests that they help enhance dopaminergic transmission in the brain, which is believed to be depleted and have reduced functionality in individuals with ADHD.1 This mechanism is similar to how conventional stimulants decrease ADHD symptoms and improve cognitive performance.1 However, findings to support this theory have been inconsistent and other mechanisms could be involved.1
What Does the Evidence Say?
A look at the current primary research for cannabis use in ADHD yielded no quality studies that assessed the effectiveness of cannabis in a standardized way. On the other hand, though, there are many case studies and anecdotal examples of individuals who believed they benefitted strongly from using medical cannabis.
One study provided an initial evaluation of the effects of Sativex® Oromucosal Spray, a spray containing equal portions of both delta-9-tetrahydrocannabinol – commonly known as THC and cannabidiol or CBD, for short. This combination in ADHD was linked to significant improvements in hyperactive-impulsive symptoms, as well as an overall pattern of improvement in other symptoms in ADHD.1 Additionally, no side-effects on cognitive performance were reported in the study population.1 However, though promising, these findings are still considered clinically inconclusive; further investigations with more participants and a more extended follow-up period are required before definite conclusions can be made.
A different study investigated the association between subtypes of attention-deficit/hyperactivity disorder (ADHD) and cannabis use and found that individuals with hyperactive-impulsive subtypes were more likely to benefit from its use.3 This could confirm a potential role for cannabis as a viable treatment option for those who experience hyperactive-impulsive symptoms of ADHD.3
Another study that seems to support the findings reported above looked at the association between marijuana use, ADHD symptoms, and sleep quality in 56 men and 20 women with ADHD. The results found moderate to strong correlations between marijuana use and inattentive symptoms in men and decreased sleep quality in women.4 These findings suggest that men with inattentive subtypes of ADHD would likely not benefit from cannabis and may experience increased inattention from its usage.4
Lastly, one unique research project analyzed online forum discussions for those who use cannabis for ADHD to determine attitudes regarding its effectiveness method. According to the results, 25% of individual posts indicated that cannabis is therapeutic for ADHD, whereas 8% of posts had opinions that cannabis was harmful. Also, 5% of people felt that cannabis is both therapeutic and harmful, and 2% felt that it did not affect ADHD.2 Naturally, these are all subjective opinions, but it’s interesting to note that a quarter of responders agreed that cannabis had a positive effect on symptom control.
Bottom Line
With the legalization of recreational marijuana just over the horizon, there is increased interest in the medical uses of cannabis to manage various diseases and conditions. One such use is the treatment of ADHD, a psychiatric disorder characterized by symptoms of inattention and lack of focus. A look at the current evidence shows that uncertainty still remains. However, there is abundant information suggesting that cannabis may someday play a role in helping those with ADHD – especially those who suffer from hyperactive/hyper-impulsive symptoms. And not only that – some individuals are already taking things into their own hands and using cannabis to control their conditions. From a clinical standpoint, professionals aren’t ready to make solid recommendations yet; more research is needed, and until then it’s best to stick with conventional treatments. Nonetheless, shortly we may very well see a paradigm shift as more information becomes available.
As always, we hope you took away something valuable from this piece. If you have any questions or concerns regarding this article or others, feel free to reach out to us on Instagram, Facebook, or at ask@orbishealth.ca with your feedback. We’d love to hear from you.
RESOURCES
- Cooper, R., Williams, E., Seegobin, S., Tye, C., Kuntsi, J., & Asherson, P. (2017). Cannabinoids in attention-deficit/hyperactivity disorder: A randomised-controlled trial. European Neuropsychopharmacology, 27(8), 795-808. doi: 10.1016/j.euroneuro.2017.05.005
- Mitchell, J., Sweitzer, M., Tunno, A., Kollins, S., & McClernon, F. (2016). “I Use Weed for My ADHD”: A Qualitative Analysis of Online Forum Discussions on Cannabis Use and ADHD. PLOS ONE, 11(5), e0156614. doi: 10.1371/journal.pone.0156614
- Loflin, M., Earleywine, M., De Leo, J., & Hobkirk, A. (2013). Subtypes of Attention Deficit-Hyperactivity Disorder (ADHD) and Cannabis Use. Substance Use & Misuse, 49(4), 427-434. doi: 10.3109/10826084.2013.841251
- Ly, C., & Gehricke, J. (2013). Marijuana use is associated with inattention in men and sleep quality in women with Attention-Deficit/Hyperactivity Disorder: A preliminary study. Psychiatry Research, 210(3), 1310-1312. doi: 10.1016/j.psychres.2013.08.003
