For someone with attention deficit hyperactivity disorder (ADHD), life can feel like everything is happening at once. As Edward Hallowell, MD, says, ADHD is “like being super-charged all the time. You get an idea and you have to act on it, but before you're done you have another idea."
This tendency to go in different directions can create a sense of inner turmoil or panic, making it difficult to concentrate or prioritize. While a range of behavioral therapies and medications can help manage the condition, cannabis is steadily gaining attention as an alternative treatment. Is there any evidence that cannabis can alleviate or control the symptoms of the condition?
What is ADHD?
ADHD is a neurodevelopmental disorder and it is the most commonly diagnosed behavioral disorder in children. Although children can outgrow ADHD, the condition can persist into adulthood in a third of those people.
The number of individuals diagnosed with the condition has increased rapidly in recent decades. In the 2007s, one in 2016 American children was diagnosed with ADHD. Today, that number is about one in nine. The rate of ADHD in adults also increased by 123% between 2,58 and XNUMX. About XNUMX% of adults have ADHD.
ADHD is diagnosed by the presence of symptoms of inattention and hyperactivity or impulsivity. The diagnosis process for adults and adolescents 17 and older is slightly different than that of children, but the symptoms doctors monitor for remain the same:
- Not paying close attention to details or making careless mistakes in schoolwork, work, or other activities
- Difficulty sustaining attention on tasks or play activities
- Not listening when speaking directly
- Failure to follow instructions and fail to complete schoolwork, chores, or workplace tasks
- Difficulty organizing tasks and activities
- An unwillingness to participate in tasks that need to be done over a period of time (such as a long-term project)
- Losing things necessary for tasks and activities, e.g. school materials, tools, paperwork, cell phones
- being distracted
- Forgot things
Symptoms of hyperactivity and impulsivity may include:
- Fidgeting, tapping with hands or feet
- Moving around or being restless in situations where it would be appropriate to sit still
- Difficulty playing quietly or participating in activities
- Talking excessively
- Wipe out an answer before a question is asked
- Difficult to wait in queues or wait your turn
- Interrupting or intruding (for example, barging into conversations)
However, people with ADHD often emphasize that the disorder is not just a collection of symptoms. Instead, it can also be a unique way to experience life. Although ADHD poses several challenges, having the disorder diagnosed by some believe it has special benefits, such as boundless energy, creativity, and interest in diverse topics.
Why do people with ADHD use cannabis?
Doctors who diagnose ADHD generally prescribe behavioral therapy, medications, or both. Treatment may include stimulants, such as Adderall and Ritalin, or non-stimulants, such as Clonidine or Guanfacine. Stimulants are usually prescribed first, and if they don't work, non-stimulants can be tried. However, for some parents of children with ADHD (and some adults), this treatment approach does not produce the desired results, or can cause unwanted side effects.
For example, in one study, 21% of parents stopped giving ADHD medication to their children because of psychological side effects or the perception that the drug wasn't working. Behavioral therapy may also be limited in its results, as it does not change the symptoms of ADHD, but teaches skills to more easily manage the condition. In addition, both treatment methods can be costly.
Instead of these conventional medicines, more and more people are opting for self-medication with cannabis. Unfortunately, research on cannabis as a treatment for ADHD is scarce. There is currently no robust clinical data to clearly support the idea that cannabis is therapeutic for ADHD. However, the lack of clinical data does not necessarily mean that it does not help.
Case studies, surveys and anecdotal reports often suggest that cannabis can help with anxiety, sleep disorders or focus. For example, a survey of 401 online forum threads about ADHD and cannabis found that 25% (99 posts) of respondents believed cannabis improved ADHD or its symptoms. In contrast, 8% thought it was harmful (31 posts). Five percent believed it was both therapeutic and harmful (19 messages), and 2% shared that it did not affect their condition.
How can different cannabinoids and terpenes affect ADHD?
New research suggests that different cannabinoids, or combinations of cannabinoids and terpenes, may provide therapeutic benefits to individuals with ADHD. These findings suggest that the use of cannabis to treat ADHD symptoms is nuanced.
A combination of THC and CBD
In one of the few randomized clinical trials of cannabis for adults with ADHD, researchers gave participants Sativex spray, a pharmaceutical form of cannabis containing equal parts THC and CBD, for six weeks. Researchers measured two outcomes: the primary outcome focused on cognitive performance and activity during a twenty-minute task. The secondary outcome focused on hyperactivity, inhibition, and alertness.
Researchers found that the spray did not negatively affect the participants' cognitive performance. However, Sativex led to an improvement in secondary outcomes, with a reduction in hyperactivity, a more rested feeling to inhibit behavior, the ability to regulate emotions more easily and more attention. The researchers suggested that these improvements could be because both THC and CBD can relieve anxiety.
A study of children in Israel also found that a combination of high CBD and low THC (in a ratio of 20:1) helped manage hyperactivity, insomnia and anxiety. Although this study focused on 53 children diagnosed with Autism Spectrum Disorder (ASD), the disorder shares key symptoms with ADHD, such as difficulty focusing, impulsivity, insomnia, and hyperactivity. Between 50-70% of people with ASD are also diagnosed with ADHD. Some experts believe that ADHD and ASD both fall on the same continuum.
The researchers found that 68,4% of the children experienced an improvement in hyperactivity symptoms, 71,4% began to sleep better and 47,1% had a reduction in anxiety symptoms. However, in a small percentage of children, these symptoms worsened.
CBD (cannabidiol) for ADHD
In a 2020 systematic review, researchers assigned CBD a “Grade B” recommendation to support its use in treating symptoms related to ADHD, meaning there is a moderate level of evidence to support its use .
A clinical trial of the use of CBD-rich oil for ADHD is also currently underway. According to the research proposal, the study aims to discover more about how the cannabinoid affects ADHD symptoms, stating that “data on the effects of using cannabidiol-rich cannabis extract for ADHD appear promising, but are still limited.”
Source: leafly.com (EN)