The Whys of Cannabis Self-Medication |
Access to medical and recreational cannabis has expanded rapidly, far outpacing rigorous scientific evidence supporting its efficacy for most clinical indications. As legalization has broadened availability and also reduced perceived risk, clinicians increasingly encounter patients viewing cannabis for symptom relief rather than as a substance of misuse. This shift raises a key question: Why has cannabis become so widely used as medicine despite limited evidence for sustained benefit and mounting evidence of harm?
Individuals often use cannabis to cope with anxiety, stress, sleep disturbance, chronic pain, depressed mood, or fear of failure. These patterns are clinically concerning because symptom-driven cannabis use is rarely sustainable and is associated with tolerance, escalation, and increased risk of cannabis use disorder (CUD).
Recent research provides persuasive evidence that stress biology plays a central role in motivating cannabis use. A longitudinal study by Park and colleagues at the Department of Integrative Physiology and Neuroscience at Washington State University examined biological and behavioral traits in rats before cannabis exposure, following them through several weeks of voluntary cannabis vapor self-administration. This work addressed a longstanding limitation in the field: Most prior animal studies relied on forced injections of synthetic cannabinoids or isolated constituents, failing to capture the complexity inherent in human cannabis use.
Researchers found that elevated basal corticosterone levels—reflecting heightened hypothalamic–pituitary–adrenal (HPA) axis activity—emerged as a strong predictor of subsequent cannabis seeking. Cortisol shifts whole-brain mechanisms, amplifying emotions and coding survival-relevant emotional memories. Researchers have found lower baseline morning levels of anandamide, a lipid mediator acting as an endogenous ligand of CB1 receptors, which are the targets for Δ9-tetrahydrocannabinol, the psychoactive ingredient in Cannabis sativa. These findings strongly support a vulnerability model in which stress-related neurobiology precedes and predicts cannabis use rather than emerging as a consequence of it. Cannabis may be seen as a self-medication for stress,........