Could Cannabis Help Treat OCD?

Medical cannabis, which is currently available for prescriptive purposes in 33 states, can be used to treat the symptoms of a variety of physical and mental health conditions, from cancer to HIV to anxiety. And now, new research has revealed it may help with obsessive-compulsive disorder.

An October 2020 study in the Journal of Affective Disorders looks at cannabis use and its effect on symptoms of OCD. Within four hours of smoking cannabis, users reported roughly a 50% reduction in symptoms like compulsions and unwanted thoughts. Cannabis with higher concentrations of cannabidiol (CBD) was associated with an even greater reduction in OCD symptoms.

Carrie Cuttler, Ph.D., lead author and an assistant professor in the department of psychology at Washington State University in Pullman, gets into the specifics. “We found an average reduction in self-reported intrusions from before to after cannabis use of 49%,” she says. “Self-reported severity of compulsions were reduced by 60% from before to after cannabis use, and anxiety ratings were reduced by 52%.”

Does this mean cannabis could eventually become a prominent treatment approach for OCD? More research is needed, but here’s what we know so far.

Living With OCD

OCD is a chronic mental disorder characterized by two key symptoms: obsessions (a.k.a. unwanted thoughts or intrusions) and compulsions. It affects around one in 100 people, or a total of two to three million adults in the U.S. People living with OCD often report uncontrollable behavior patterns, like an obsessive need to clean, organize, or check on things. They may also have serious and lasting fears that cause great anxiety in their day-to-day life.

Common OCD obsessions include:

  • Contaminants and germs
  • Fear of violence toward oneself or others
  • Frequent/“forbidden” sexual impulses
  • Excessive concern with morality (often tied to religion)
  • Worry about freak accidents
  • Superstitions

Common OCD compulsions include:

  • Excessive cleaning, of oneself or one’s environment
  • Constant checking to make sure nothing has gone wrong
  • Repeating routine activities over and over again
  • Mentally reviewing situations constantly in an effort to prevent harm

The factors contributing to OCD are multifaceted—they include genetics, brain chemistry, environment, and past traumatic experiences. The condition is typically treated with antidepressants and psychotherapy. Specifically, providers will often use a method called exposure and response prevention, where patients gradually expose themselves to their fears, then learn a new way to respond.

The Future of Cannabis OCD

Needless to say, cannabis isn’t a traditional treatment approach, but Cuttler explains that it has real potential. “We’ve found previously that acute cannabis intoxication can reduce symptoms of anxiety,” she says. “We’ve seen reductions in the intrusive thoughts characteristic of PTSD associated with cannabis use.” And now, her research is linking it directly to symptoms of OCD.

Specifically, Cuttler notes, the CBD finding may pave the way for future therapies. “It’s particularly promising because CBD does not have the intoxicating properties of THC,” she explains. “There might be fewer side effects, and there wouldn’t be the intoxication associated with it.” You’ve probably heard of CBD, but we’ll fill in the gaps: It’s a natural compound in marijuana that has no intoxicating or addictive effects, and it has been studied for its potential therapeutic impacts on chronic pain and anxiety. CBD won’t get you high, which makes it an appealing choice for medical use.

Cuttler notes that her research only looks at the effects of cannabis in the short-term, for just a few hours after consuming it. “There doesn’t seem to be any sort of long-term beneficial effect of cannabis in reducing these symptoms over time,” she says. For long-term support, “people with OCD would definitely be encouraged to seek out therapy, specifically cognitive behavioral therapy and exposure and response prevention therapy.”

This treatment approach also needs more research before being applied on a broader scale. Cuttler explains that her data, which was gathered with support from a medical cannabis data company called Strainprint, included self-reported information from participants. This can sometimes be vulnerable to personal bias. “At least some of these reductions are likely driven by people’s expectations about the effects of cannabis on these symptoms,” she says. Further clinical trials will help account for this discrepancy.

For now, hold off on trying this at home. Those new to medical marijuana should consult a medically trained specialist before using it to treat their condition. But if you know someone with OCD, it’s worth keeping an eye on this alternative therapy, which may represent a breakthrough in the coming years.