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Marijuana is getting increasingly used in medical settings. However, one of its disadvantages is anxiety. Does anyone know the reason behind the anxiety? Is it from the marijuana itself, or does it result secondarily due the effects of the marijuana, because, e.g. the user is not comfortable with the effects?

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  • $\begingroup$ Really? Anxiety? Is that true for most people? My extremely intelligent roommate appeared much more mellow when he smoked everyday. (I rarely did it because it made my hypersomnia much worse.) The stereotype of the stoner does not suggest anxiety. Or, are you referring to medical marijuana and people using it for that reason. $\endgroup$ – user8546 Jun 8 '15 at 3:13
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    $\begingroup$ What is the evidence that anxiety is a result of marijuana use? $\endgroup$ – Krysta Jun 8 '15 at 11:50
  • $\begingroup$ SWIM, and some of SWIM's friends experience anxiety from marijuana, and moreso, experience anxiety as a withdrawal symptom from marijuana. there are plenty of other factors at play, but, from observation, (at the very least) marijuana seems to exacerbate anxiety in some people $\endgroup$ – Reed Nov 28 '15 at 18:18
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Cannabis can cause an acute and short-lasting episode of anxiety, which often resembles a state of panic. When taken in high doses these effects can be intense and turn into attacks of panic and phobia. About 20–30% of users show brief acute anxiety reactions after smoking the drug. These symptoms tend to occur more in drug-naive subjects and in novel or stressful environments. In contrast, long-term users typically report that cannabis reduces their anxiety (Crippa et al, 2009).

Anxiety is also one of the main manifestations of the cannabis withdrawal syndrome. Its onset is typically between the second and sixth day and lasts from 4 to 14 days.

The main active psychoactive ingredient in cannabis, delta-9-tetrahydrocannabinol (THC), affects serotonergic, noradrenergic, GABAergic and glutamatergic transmission, but there is relatively little known about how it exactly induces anxiety. One of the reasons being that the psychotic effects of cannabis consumption has received way more attention, likely because it is a more severe side effect than the anxiety symptoms. Cannabidiol has been associated with an anxiolytic effect, perhaps through its effects on 5HT1A receptors (Crippa et al, 2009).

It has been shown that the amount of anxiety also depends on the genetic make-up of the user (Otten et al., 2016).

Acute intoxication could also lead to anxiety secondary to impaired cognitive functioning and the clouding of consciousness (Crippa et al, 2009), as mentioned in the question by the OP.

References
- Crippa et al., Hum Psychopharmacol Clin Exp (2009); 24: 515–23
- Otten et al., Addict Biol (2016); [Epub ahead of print]

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  • $\begingroup$ Nice answer! +1 but couldn't you also mention that anandamide which is an endocannabinoid, changes the consciousness of the consumer, because the endocannabinoids function as neuromodulators, which can suppress the release of the neurotransmitter GABA in the hippocampus, and therefore might be responsible for changes in the perception? $\endgroup$ – Ebbinghaus Jun 7 '16 at 10:49
  • $\begingroup$ @JordiZambrino - Thanks!! As for your suggestion- the question is on anxiety, so I have not included it's other effects here. $\endgroup$ – AliceD Jun 7 '16 at 11:19

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