Friday, April 25, 2014

Which came first – The Anxiety Disorder or the Marijuana use?

 By Peter R. Coleman, M.D. 
There is a major social experiment going on in the US and no one has any idea of what the outcome will be. 

Marijuana has been legalized for personal use in both Colorado and Washington State and we really have no experience to know what positive changes there will be, and what long-term negative effects this will have. We may see a lot of effects in many areas - 
  • frequency and amounts of drug use, 
  • legal problems, medical 
  • psychiatric effects,
  • increased crime rates,
  • and, perhaps, many more.

Some of these will be positive effects and some will be negative. Hopefully, there will be a lot of research trying to better understand some of these issues as they come up, so we can decide if this was a good “experiment”.

A recent study supported by the National Institutes of Health (NIH) looked into cannabis use and social anxiety.  Frequently pot use and social anxiety do co-exist, and the study tried to determine how often these occurred and which caused which.

People smoke pot in a couple of different situations. Many people smoke pot in social situations with their friends, and they enjoy the social interaction. But, it is quite common that people who have smoked pot isolate themselves from others, even if they are in a social setting. Marijuana often puts people off in their own little world and they are not very interested in interacting with others. Sometimes, there can be intense anxiety about interacting with others, even getting to the stage of paranoia. At other times, some people choose to smoke pot on their own – they enjoy being alone and not having to interact with others.

The NIH study asked over 43,000 adults about their drug use, alcohol use and psychiatric symptoms. They found that 7.6 percent of the people questioned reported that they smoked so much marijuana that it caused problems at some point in their lives – they met the criteria for having a Cannabis Use Disorder (CUB). Many of these people with a CUB also reported having a high level of anxiety in social situations. In fact, 10% of the people with a CUD had such high levels of anxiety that they could be diagnosed with a Social Anxiety Disorder (SAD). This is to say that a significant number of people who smoke pot also have severe problems with social anxiety.

This can make sense in three ways.

          First, it could be that smoking a lot of pot causes social isolation. It could be that smoking marijuana frequently isolates people, or makes them paranoid, and they withdraw into themselves and become socially isolated. This social isolation could lead to a Social Anxiety Disorder (SAD).  
          Second, it could be that people who are already socially isolated start smoking pot in order to feel better about themselves. These socially isolated people may enjoy marijuana because it allows them to avoid social interactions and so their marijuana use increases to the point of becoming a problem.
          Third, the CUD and the SAD could just co-exist and neither one cause the other.

The researchers were also interested in which came first. They found that 80% reported that their SAD came first. That is, the people first had symptoms of social anxiety, then they started smoking pot, and later on, developed a Cannabis problem. Twenty percent (23%) reported that first they smoked pot, then, they developed a CUD, and after that, they developed an anxiety problem.
The research is interesting because it shows how often these problems exist together. If we are to treat people with Cannabis problems, we need to recognize that a number of them will have a SAD, and they will be best treated if we help them with both problems.

In some ways, the timing of which came first is a little irrelevant. The bottom line is that frequent marijuana use makes it very difficult to recover from anxiety or any other mental health problems.

          Marijuana is a mood altering drug, so it makes it difficult for people to understand our own feelings and emotions. It also alters perceptions and reality, so it makes it very difficult to learn social cues and how to interact with others.

          Marijuana decreases memory ability, so it makes it much harder to learn from our experiences.

If people want to get over their Social Anxiety disorder, the worst thing they can do is take a lot of drugs, like marijuana that make them more isolated and helps to avoid practicing social skills. People with an anxiety disorder do best with a form of therapy called Cognitive Behavioral Therapy. This involves recognizing and understanding feelings, and then, learning how to deal with them. Pretty hard to do this if you are stoned and off in a corner!

If you or someone you love is need of detox off of alcohol, opiates, benzos, Methadone, or Suboxone, please do not hesitate to call Jennifer Pius or Amy Stewart at 1.877.773.3869 today.  We love helping people get clean and stay clean.  Hope starts here. 

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