Cannabis Leaf

CBD Oil for Anxiety and Stress

Around the globe, we have a stress problem. In the United States alone, one-fifth of the adult population suffers from a clinically diagnosable anxiety disorder, and a far greater percentage of Americans suffer from chronic stress issues.(1) A quick look at the American Psychology Association’s “Stress in America Polls” reveals rampant stress: A majority of Americans are stressed about their jobs, their finances, the economy, the political climate, personal and public health, social injustice, and many other stressors. And all of these stresses have physical and mental consequences.(2) 

Reachers are now interested in the important role that cannabinoids may play in the future of managing stress and anxiety. Several studies have demonstrated the strong anxiolytics (anti-anxiety) effects of CBD and other cannabinoids. Scientists have shared that, “the ability of cannabinoids to modulate emotional responses is extremely attractive for the development of novel anxiolytic agents.”(3) 

While some cannabinoids may be able to treat anxiety directly, other cannabinoids may be more useful in providing secondary or tertiary support. For example, cannabinoids may reduce pain and inflammation to ease individuals back into exercise or they might support the creation of stress-reducing rituals. In combination, we believe that these various cannabinoids could be the cornerstone of both pharmacological and holistic approaches to treating stress and anxiety. 

In this post we’ll explore all of the ways that cannabinoids can reshape stress management and markets. To do this, we’ll examine: 

  • The current causes of stress & anxiety and our biological response to these stressors
  • How the current stress and anxiety problem is being addressed; both pharmacologically and holistically 
  • How cannabinoids can enhance the current solutions to addressing stress and anxiety

The Similarities and Differences Between Stress and Anxiety

Stress and anxiety end up getting a bad rap, but they’re actually both extremely useful evolutionary adaptations. These emotional responses can help us avoid bad situations and enhance our reactions to danger. However, chronic experiences of stress and anxiety are not just unpleasant, but also extremely unhealthy. Before we can discuss how cannabinoids can be used to manage stress and anxiety, it is important to understand what these emotions actually are. 

Our Body’s ‘Stressful’ Reaction

Stress is one of the body’s best defenses against danger. When you get into a potentially harmful situation, your body will prepare for “fight or flight” by exhibiting a stress response and releasing stress hormones like cortisol. 

This causes your heart rate and blood pressure to spike; you’ll start breathing harder, your muscles will tense up, and your blood sugar will rise. All of this is extremely helpful if you’re about to run away from a grizzly bear or rescue someone from a burning building. However, in modern life, these physical reactions are often counterproductive. 

When your body is preparing to ‘fight’ it has to prioritize certain  organ systems over others. So while a stress response will kick your cardiovascular system into overdrive, it will also suppress things like immune function and digestion.

Constant stress can be extremely harmful, as high blood pressure, high blood sugar, muscle tension, compromised immune function, and poor digestion can all cause serious problems. Those who suffer from chronic stress are at increased risk of anxiety, depression, digestive problems, headaches, heart disease, sleep problems, weight gain, and impaired memory and concentration.(4)  

Everyone will experience some sort of acutely stressful event at some point. But, in the modern setting, that is less likely to look like a confrontation with a grizzly bear, and more likely to look like an overdue bill, a car crash, or even just an argument. Ideally, your cortisol levels would return to normal after these stressors. Unfortunately, many stay stressed after these situations, leaving their body in an undesirable, chronically stressed state. 

Our Body’s ‘Anxious’ Orientation

While stress and anxiety are sometimes used interchangeably, the two emotional responses are actually quite different. Where stress is reactive, anxiety is proactive. That is, instead of preparing you to fight or flee from a threatening situation like stress, anxiety will actually lead you to avoid danger altogether. 

Just like stress, anxiety has clear evolutionary utility as a behavioral influence. For example, after getting stung by a bee, you might feel anxious about going near beehives. This is clearly useful as it will help you avoid bee stings in the future. But, if public speaking or social situations cause you great anxiety, you might end up missing out on important opportunities and connections with others.

The symptoms of anxiety and stress are nearly identical as anxiety can spike stress hormones to cause nervous feelings, rapid heart rates, tense muscles, digestive issues, and more. As we’ve previously explained, living with consistently elevated stress hormones can have terrible consequences. Long-term effects of anxiety can include depression, digestive issues, insomnia, chronic pain conditions, trouble working or socializing, substance abuse, and suicidal thoughts.(5) 

Managing Stress and Anxiety 

Now that we’ve covered the slight differences between stress and anxiety, we can discuss current treatment options for both issues. We will share modern pharmacological treatments and also important holistic approaches from experts to address this problem. 

Holistic Stress Treatments

As we look into the rapidly evolving cannabinoid market many organizations are developing products and solutions that aid in a holistic approach to stress and anxiety management. We share recommendations and practices that were compiled from resources like the American Psychological Association, Harvard University, the Mayo Clinic, and more. The list below is not meant to be prescriptive, rather informative for both businesses and consumers. All of the discussed practices are recommended by multiple top organizations. 

Be Mindful and Intentional about Stress

Nearly every resource we researched recommends being mindful and intentional about stressors. In order to do this, many groups even recommended a stress journal, to help individuals locate and track sources of stress and anxiety in their lives. 

Once you can figure out what causes you distress, you can take steps to either avoid it or confront it. For example, if a high-pressure work environment has you constantly stressed, you might consider alternative options. Or, if you have debilitating anxiety about public speaking, you might try to conquer it through exposure therapy aided by medicine or Cognitive-Behavioral Therapy (CBT).

Relaxation Techniques

Once you have identified sources of stress and anxiety, you can start actively managing them. Some sources of stress are unpredictable and unavoidable, and some types of anxiety must be painfully confronted, so it’s important that individuals learn to cope with or manage stress. Deep breathing techniques, muscle relaxation techniques, and repetitive rituals are three great ways to do this. 

When it comes to reducing stress and anxiety, breathing is one of our most useful tools. Deep and intentional breathing has been proven to induce self-reported improvements in stress and mood, as well as measurable physiological changes, such as reduced heart rate and cortisol levels.(6)

Muscle relaxation is a simple but powerful way to manage stress. One popular way of doing this is with progressive muscle relaxation (PMR) therapy: a practice that involves systematically tensing and relaxing different muscle groups. This practice has been proven to reduce muscle tension and relieve stress.(7)

Finally, evidence suggests that merely performing rituals can relieve anxiety to improve performance. You may have noticed that many athletes in stressful sport environments have pre-game rituals that help them relax and perform. So while scientists cannot say that a pair of lucky shoes will help you win, they can conclude that lacing-up your game day cleats will improve performance by reducing anxiety.

For most people, a stress-reducing routine could look like a morning routine that helps plan your day, or a post-work cool-down that helps you recenter. Regardless of what your ritual is, it seems that simply going through a series of symbolic and repetitive actions can help reduce stress.(8)

Take Care of Your Body with Exercise, Sleep, and Healthy Food

Another important aspect of stress management is your ability to maintain a healthy baseline through diet and lifestyle.

We’ve previously discussed the negative effects of inadequate sleep. There is a clear link between sleeplessness and stress. According to the American Psychological Association, stress and sleep may play off each other in vicious or virtuous cycles. When you don’t get enough sleep, you’re more likely to feel stressed. And when you feel stressed, it becomes even harder to sleep. Thus, for many Americans breaking the negative cycle of stress and sleeplessness can be a major quality of life improvement.(9)

Exercise is another great way to reduce stress and aid sleep. Even just 20 minutes of exercise a day can reduce stress hormones, and stimulate the production of mood-elevating endorphins. It doesn’t seem to matter whether you’re running or swimming, doing tai chi or yoga, or even just going for a stroll; Any form of daily exercise can help improve health and reduce stress.(10)

A good diet can also help reduce stress. While there are many different healthy options, it seems that some foods are particularly good at reducing stress. For example, diets high in magnesium, zinc, and omega-3s have been linked to lower anxiety.(11) (12) (13) Whole foods like leafy greens, nuts, and fish are great sources of these key nutrients. 

Lean on your Support Network

One final piece of advice that nearly every stress and anxiety expert mentioned was leaning on a support network. This could be a friend group, a family member, a professional therapist, or even all three. Regardless of what your support network looks like, it appears to be very important that you can openly discuss your stress with others. 

Research has clearly documented the importance of social support. For example, individuals with strong support networks tend to exhibit improved immune, cardiovascular, and neuroendocrine function. As well as, decreased depression, decreased anxiety, and more effective buffering against stress and its negative effects.(14)

One meta-analysis even found that social support was highly predictive of mortality, as individuals with strong support networks had a 50% higher likelihood of survival.(15) 

Cannabinoids Evolving the Stress Market 

We will now share how cannabinoids present one of the most exciting opportunities to support the future of stress and anxiety management. 

Over the past few years, a range of scientific studies and papers have proposed  that CBD and other cannabinoids could be the next best big thing in stress management. This is not only because cannabinoids may function as a direct biological treatment for stress, but also because cannabinoids may help support a holistic approach to stress management. 

Cannabinoids as Anxiolytics:

A review of cannabinoids as anxiolytic drugs reveals that they have the potential to complement or replace current stress management therapeutics like benzodiazepines. 

While most organizations recommend a holistic approach for stress and anxiety management pharmacological options are sometimes necessary. Today, the leading drugs for stress are benzodiazepines like Xanax or Valium, and SSRIs such as Prozac. While these drugs have been proven effective in clinical settings, they can come with many unpleasant risks and side-effects, including, irritability, gastric distress, dizziness, headache, insomnia, and physical dependence.(16) 

Cannabinoids have shown promise to treat similar conditions with fewer negative effects. In recent review, an international team of scientists from New York University and the Universidad Miguel Hernandez in Spain wrote, “We found that existing preclinical evidence strongly supports CBD as a treatment for generalized anxiety disorder, panic disorder, social anxiety disorder, obsessive–compulsive disorder, and post-traumatic stress disorder when administered acutely.”(17)

Another report by British scientists has explained why CBD may be so effective at treating these disorders: It turns out that endocannabinoids (cannabinoids naturally produced by the human body) play an important role in signaling fear and anxiety. Thus, compounds that influence the endocannabinoid system may be able to regulate stress and anxiety. (18)

While all phytocannabinoids (cannabinoids naturally produced by plants) can interact with endocannabinoid receptors, CBD seems to be an especially potent force.CBD can bind to CB1 receptors in the human brain to produce anti-anxiety effects. On top of that, CBD also downregulates FAAH and MAGL, two enzymes that naturally break down endocannabinoids. This is very exciting, since studies shown that inhibiting either FAAH or MAGL may decrease anxiety.(19)

This means that CBD has the potential to reduce fear or anxiety in two ways. First, it can stand in the place of endocannabinoids and bind directly to CB1 receptors. Second, it can downregulate the enzymes that normally prevent endocannabinoids from binding with CB1 receptors. 

Upon reviewing these properties, the authors concluded, “Given their acute anxiolytic effects, [CBD] and FAAH inhibitors could be used as adjuncts to first-line SSRI or SNRI treatment, which have a delayed therapeutic response. Such drugs could be an improvement over benzodiazepines, which have abuse liability, a less favourable side effect profile . . . cannabinoids could be combined with existing or novel psychological therapies to facilitate extinction enhancement and/or fear memory reconsolidation disruption, both of which may result in a lasting reduction of fear. Cannabinoid-related medicines could also be given as anxiolytics on their own but further research is needed to determine their effects.”(20)

Translation: CBD could be used to enhance the short-term effectiveness of SSRIs. It may also be a more effective anxiety treatment option than benzodiazepines like Valium and Xanax, because CBD appears to be less addictive and less dangerous than these widely used drugs. In the future, therapists may use CBD to enhance current physiological therapy practices, or they may simply prescribe cannabinoid-based medicines on their own. Further research will be needed to confirm these uses of CBD. However, in order to truly treat stress and anxiety individuals may need to incorporate holistic treatments instead of using drugs alone.

Cannabinoids Evolving Holistic Stress Solutions

While cannabinoids may reduce stress and anxiety through direct pharmacological intervention, they also can support more holistic treatments. Ways in which cannabinoids can indirectly support the management of stress and anxiety are reviewed below.

Muscle Relaxation

Muscle relaxation is often recommended as a way of managing stress and anxiety. In recent years, this has become a more accessible stress management tool, as digital applications have been developed to help individuals practice progressive muscle relaxation. 

In addition to these methods, doctors will occasionally prescribe benzodiazepines as muscle relaxants. Aforementioned drugs like Xanax and Valium are effective muscle relaxants and anxiolytics. Although, these drugs have a somewhat worrisome potential for abuse.(21)

The good news is that cannabinoids may be a suitable aid for muscle relaxation. In a 2008 study, several Italian doctors considered if cannabinoid-based could be used for multiple sclerosis (MS). They found that the endocannabinoid system played an important role in managing muscle spasticity, and that supplementation with phytocannabinoids could help treat MS symptoms. While they were encouraged by the reduction in muscle spasms and improved mobility associated with cannabinoid treatments, they still call for further studies to be done. (22)

Ritual

Another important practice that can help reduce stress or anxiety is ritual. There are many different kinds of symbolic actions and repetitive practices that people can use to calm down. However, this method becomes more complicated when a ritual involves a biologically active compound, as the line between ritual and addiction can blur rather quickly. 

Fortunately, cannabinoids show a very favorable safety profile. While there is some potential for cannabinoid abuse, the adverse effects and addictive potential of these drugs is significantly less that of prescription opiates, benzodiazepines, nicotine, and alcohol.(23) Moreover, cannabinoids may actually help treat other dependence disorders like alcohol abuse(24) and nicotine addiction.(25)

Humans have been using cannabinoids in rituals for thousands of years. Earlier this year, several Israelis scientists found CBD, CBN, and THC residue at a shrine dating back 2,800 years. It appears that these materials were burned next to frankincense as part of an ancient spiritual ritual.(26) Clearly, humanity has been drawn to cannabinoid-based rituals for quite some time. 

Cannabinoids present as pretty good candidates for rituals. While there are endless possibilities to how you may construct a cannabinoid-based calming ritual, CBD-infused bath bombs, beverages, and oils can all play a part in that stress-reducing routine. 

CBD for Sleep

In a recent post, we discussed the many ways cannabinoids can contribute to the sleep market. These are more relevant than ever, considering that sleep and stress can play off of each other in negative feedback cycles. That is, stress can make it hard to sleep, and lack of sleep can make you easily stressed.

Fortunately, cannabinoids can break that cycle by enhancing the current sleep market. In one recent study, a daily 25mg dose of CBD was shown to quickly improve sleep scores and reduce anxiety in adults. As the three month study continued, anxiety levels continually dropped.(27) 

In another OBX blog , Dr. Andrew Salzman, MD explained, “CBN may mimic natural cannabinoid-like molecules within the body (endocannabinoids) which have been shown to promote rapid-eye-movement sleep.” If CBN can truly play a role in promoting REM sleep, it may be used alongside CBD to help break vicious sleep/stress cycles. To learn more about the potential of CBN, check out our blog. You can buy CBN isolate with OBX as well. 

Exercise

Exercise is another important component of a holistic approach to stress and anxiety management. While the fitness market is flooded with new applications and equipment that make working out fun and accessible, many individuals still do not get enough daily exercise. Cannabinoids could help. 

A recent study revealed that cannabinoids can help people exercise by removing some of the most common barriers to the activity, such as improper recovery after exercise, lack of motivation to exercise, and low enjoyment of exercise. Even though most athletes did not report cannabinoid-based performance improvements, they did see gains in recovery, motivation and enjoyment of exercise.(28) This suggests that a cannabinoid supplement regime could be helpful in encouraging regular exercise. 

When it comes to exercising, CBD is a particularly intriguing option. A clinical review published earlier this year remarked that athletes may be interested in the numerous physiological, biochemical, and psychological effects that CBD exhibits. In particular, the authors note that “there is preliminary supportive evidence for anti-inflammatory, neuroprotective, analgesic, and anxiolytic actions of CBD and the possibility it may protect against GI damage associated with inflammation and promote the healing of traumatic skeletal injuries.” However, these authors also warn that these are merely preliminary findings. More research will be needed to illuminate exactly how CBD can influence athletic performance and recovery.(29)

Diet

Another key factor in stress and anxiety is diet. While different doctors and scientists support a massive range of diets, all the way vegan to carnivore, most people at least agree on two things. You should try to eat less processed food, and you should try to eat the right amount of food. 

Early results indicate that cannabinoids may be able to help with that last part. In animal studies, CBG has been identified as a well-tolerated appetite stimulant. This makes it a promising therapeutic option for individuals with low BMI, cachexia, or other disorders where body weight regulation is warranted.(30) On the flip side, animal studies on THCV have shown that the cannabinoid may reduce appetite, and even help treat metabolic syndrome or type 2 diabetes.(31)

While there is no substitute for healthy dietary choices, a little assistance from cannabinoids may prove very helpful. The fact that different minor cannabinoids can exhibit opposite effects is exciting, and suggests that a range of cannabinoids can be used to help each individual create the right anxiety and stress management for them. 

Social Support

The final pillar of stress and anxiety management is the maintenance of a strong social support network. Cannabinoids can help with this too as they can facilitate social interactions by relieving anxiety. 

Social anxiety disorder is a condition in which individuals may feel stress or anxiety around other people. Like lack of sleep, social anxiety is a particularly tricky anxiogenic condition given that it can cause vicious cycles. An individual with social anxiety may be less likely to develop a supportive social network. This can deepen anxiety, which can be further isolating. Fortunately, CBD may be able to help. 

In a recent study, CBD was found to significantly reduce the anxiety levels in patients suffering from social anxiety disorder.(32) These findings mirror earlier studies wherein CBD was found to reduce anxiety caused by public speaking.(33) This suggests that in addition to reducing anxiety in general, CBD may be particularly effective at reducing social anxiety and breaking the vicious cycle of anxiety and social isolation. 

Beyond removing the barriers for social interactions, cannabinoids can even encourage positive social interaction. Novel cannabinoid products like CBD-infused drinks and foods can be shared, and smokeable or vaporizable cannabinoid products can be passed amongst friends. 

Towards a Better Stress Management Market

The current stress management system is not designed to treat anxiety holistically. While relief and treatment options are becoming better every day, there is still a significant opportunity for cannabinoids to transform the stress and anxiety markets. 

In order to truly provide stress and anxiety relief, cannabinoid suppliers must see beyond symptoms alone. It’s true that CBD and other cannabinoids have shown a promising ability to regulate the function of the endocannabinoid system to directly reduce stress or anxiety. But, that doesn’t mean this is where stress management should end. 

While different experts recommend a range of different treatments for stress and anxiety, a few of the most popular tips are to manage symptoms, take care of your body, and rely on a social support network. Cannabinoids can help with all of these categories, as the multi-functional molecules can aid in muscle relaxation and sleep, reduce barriers to exercise and social interaction, and support healthy diets and rituals. 

With more research and cannabinoid products appearing everyday, we are gaining more and more tools for stress and anxiety management. As this research continues to crystalize, we may finally find a truly holistic and effective approach to stress and anxiety. 

References

1) Anxiety and Depression Association of America. Facts and Statistics. https://adaa.org/about-adaa/press-room/facts-statistics. 

(2) American Psychological Association, APA Working Group on Stress and Health Disparities. (2017). Stress and health disparities: Contexts, mechanisms, and interventions among racial/ethnic minority and low-socioeconomic status populations. Retrieved from http://www.apa.org/pi/health-disparities/resources/stress-report.aspx

3) Tambaro S, Bortolato M. Cannabinoid-related agents in the treatment of anxiety disorders: current knowledge and future perspectives. Recent Pat CNS Drug Discov. 2012;7(1):25-40. 

4) Mayo Clinic Staff. Chronic Stress Puts Your Life at Risk. Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress/art-20046037.

5) Leonard J. Anxiety can impact physical and mental health. There are short- and long-term effects on both the mind and body. Medical News Today. https://www.medicalnewstoday.com/articles/322510.

6) Perciavalle, V., Blandini, M., Fecarotta, P. et al. The role of deep breathing on stress. Neurol Sci 2017, 38: 451–458.

7) Healthwise Staff. Stress Management: Doing Progressive Muscle Relaxation. Michigan Medicine: University of Michigan. https://www.uofmhealth.org/health-library/uz2225. 

8) Brooks AW, Schroeder J, Risen J, Gino F, Galinsky A, Norton M, Schweitzer. Don’t stop believing: Rituals improve performance by decreasing anxiety. Organizational Behavior and Human Decision Process. 2016, 137: 71-85. 

9) American Psychological Association. Stress and Sleep. APA. https://www.apa.org/news/press/releases/stress/2013/sleep#:~:text=Adults%20who%20sleep%20fewer%20than,6.2%20hours).

10) Ratey JJ. Can Exercise Help Treat Anxiety? Harvard Medical School: Harvard Health Publishing. 2019. https://www.health.harvard.edu/blog/can-exercise-help-treat-anxiety-2019102418096

11) Sartori SB, Whittle N, Hetzenauer A, Singewald N. Magnesium deficiency induces anxiety and HPA axis dysregulation: modulation by therapeutic drug treatment. Neuropharmacology. 2012;62(1):304-312. 

12) Torabi M, Kesmati M, Harooni HE, Varzi HN. Effects of nano and conventional zinc oxide on anxiety-like behavior in male rats. Indian J Pharmacol. 2013;45(5):508-512. 

13) Kiecolt-Glaser JK, Belury MA, Andridge R, Malarkey WB, Glaser R. Omega-3 supplementation lowers inflammation and anxiety in medical students: a randomized controlled trial. Brain Behav Immun. 2011;25(8):1725-1734. 

14) Umberson D, Montez JK. Social relationships and health: a flashpoint for health policy. J Health Soc Behav. 2010;51 Suppl(Suppl):S54-S66.

15) Holt-Lunstad J, Smith TB, Layton JB. Social Relationships and Mortality Risk: A Meta-analytic Review. Plos Medicine. 2010. https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1000316#references. 

16) WebMD. Understanding Generalized Anxiety Disorder — Diagnosis and Treatment. WebMD. 2017. https://www.webmd.com/anxiety-panic/guide/understanding-anxiety-treatment?

17) Blessing EM, Steenkamp MM, Manzanares J, Marmar CR. Cannabidiol as a Potential Treatment for Anxiety Disorders. Neurotherapeutics. 2015;12(4):825-836. 

18) Papagianni, E.P., Stevenson, C.W. Cannabinoid Regulation of Fear and Anxiety: an Update. Curr Psychiatry Rep 21, 38 (2019).

19) ^Ibid

20) ^Ibid.

21) ^Ibid

22) Malfitano AM, Proto MC, Bifulco M. Cannabinoids in the management of spasticity associated with multiple sclerosis. Neuropsychiatr Dis Treat. 2008;4(5):847-853.

23) Panlilio LV, Goldberg SR, Justinova Z. Cannabinoid abuse and addiction: Clinical and preclinical findings. Clin Pharmacol Ther. 2015;97(6):616-627. 

24) Kleczkowska P, Smaga I, Filip M, Bujalska-Zadrozny M. Cannabinoid Ligands and Alcohol Addiction: A Promising Therapeutic Tool or a Humbug?. Neurotox Res. 2016;29(1):173-196. 

25) Gamaleddin IH, Trigo JM, Gueye AB, et al. Role of the endogenous cannabinoid system in nicotine addiction: novel insights. Front Psychiatry. 2015;6:41. Published 2015 Mar 25. 

26) Arie E, Rose B, Namdar D. Cannabis and Frankincense at the Judahite Shrine of Arad. Journal of the Institute of Archaeology of Tel Aviv University. 2020: 1:47. 

27) Shannon S, Lewis N, Lee H, Hughes S. Cannabidiol in Anxiety and Sleep: A Large Case Series. Perm J. 2019;23:18-041. 

28) YorkWilliams SL, Gust CJ, Mueller R, et al. The New Runner’s High? Examining Relationships Between Cannabis Use and Exercise Behavior in States With Legalized Cannabis. Front Public Health. 2019;7:99. Published 2019 Apr 30. 

29) McCartney D, Benson MJ, Desbrow B, Irwin C, Suraev A, McGregor IS. Cannabidiol and Sports Performance: a Narrative Review of Relevant Evidence and Recommendations for Future Research. Sports Med Open. 2020;6(1):27. Published 2020 Jul 6. 

30) Brierley DI, Samuels J, Duncan M, Whalley BJ, Williams CM. Cannabigerol is a novel, well-tolerated appetite stimulant in pre-satiated rats. Psychopharmacology (Berl). 2016;233(19-20):3603-3613. 

31) Wargent ET, Zaibi MS, Silvestri C, et al. The cannabinoid Δ(9)-tetrahydrocannabivarin (THCV) ameliorates insulin sensitivity in two mouse models of obesity. Nutr Diabetes. 2013;3(5):e68. Published 2013 May 27. 

32) Crippa JA, Guimarães FS, Campos AC, Zuardi AW. Translational Investigation of the Therapeutic Potential of Cannabidiol (CBD): Toward a New Age. Front Immunol. 2018;9:2009. Published 2018 Sep 21. 

33) Bergamaschi MM, Queiroz RH, Chagas MH, et al. Cannabidiol reduces the anxiety induced by simulated public speaking in treatment-naïve social phobia patients. Neuropsychopharmacology. 2011;36(6):1219-1226.

Cannabis Leaf

CBD Oil for Anxiety and Stress

Around the globe, we have a stress problem. In the United States alone, one-fifth of the adult population suffers from a clinically diagnosable anxiety disorder, and a far greater percentage of Americans suffer from chronic stress issues.(1) A quick look at the American Psychology Association’s “Stress in America Polls” reveals rampant stress: A majority of Americans are stressed about their jobs, their finances, the economy, the political climate, personal and public health, social injustice, and many other stressors. And all of these stresses have physical and mental consequences.(2) 

Reachers are now interested in the important role that cannabinoids may play in the future of managing stress and anxiety. Several studies have demonstrated the strong anxiolytics (anti-anxiety) effects of CBD and other cannabinoids. Scientists have shared that, “the ability of cannabinoids to modulate emotional responses is extremely attractive for the development of novel anxiolytic agents.”(3) 

While some cannabinoids may be able to treat anxiety directly, other cannabinoids may be more useful in providing secondary or tertiary support. For example, cannabinoids may reduce pain and inflammation to ease individuals back into exercise or they might support the creation of stress-reducing rituals. In combination, we believe that these various cannabinoids could be the cornerstone of both pharmacological and holistic approaches to treating stress and anxiety. 

In this post we’ll explore all of the ways that cannabinoids can reshape stress management and markets. To do this, we’ll examine: 

  • The current causes of stress & anxiety and our biological response to these stressors
  • How the current stress and anxiety problem is being addressed; both pharmacologically and holistically 
  • How cannabinoids can enhance the current solutions to addressing stress and anxiety

The Similarities and Differences Between Stress and Anxiety

Stress and anxiety end up getting a bad rap, but they’re actually both extremely useful evolutionary adaptations. These emotional responses can help us avoid bad situations and enhance our reactions to danger. However, chronic experiences of stress and anxiety are not just unpleasant, but also extremely unhealthy. Before we can discuss how cannabinoids can be used to manage stress and anxiety, it is important to understand what these emotions actually are. 

Our Body’s ‘Stressful’ Reaction

Stress is one of the body’s best defenses against danger. When you get into a potentially harmful situation, your body will prepare for “fight or flight” by exhibiting a stress response and releasing stress hormones like cortisol. 

This causes your heart rate and blood pressure to spike; you’ll start breathing harder, your muscles will tense up, and your blood sugar will rise. All of this is extremely helpful if you’re about to run away from a grizzly bear or rescue someone from a burning building. However, in modern life, these physical reactions are often counterproductive. 

When your body is preparing to ‘fight’ it has to prioritize certain  organ systems over others. So while a stress response will kick your cardiovascular system into overdrive, it will also suppress things like immune function and digestion.

Constant stress can be extremely harmful, as high blood pressure, high blood sugar, muscle tension, compromised immune function, and poor digestion can all cause serious problems. Those who suffer from chronic stress are at increased risk of anxiety, depression, digestive problems, headaches, heart disease, sleep problems, weight gain, and impaired memory and concentration.(4)  

Everyone will experience some sort of acutely stressful event at some point. But, in the modern setting, that is less likely to look like a confrontation with a grizzly bear, and more likely to look like an overdue bill, a car crash, or even just an argument. Ideally, your cortisol levels would return to normal after these stressors. Unfortunately, many stay stressed after these situations, leaving their body in an undesirable, chronically stressed state. 

Our Body’s ‘Anxious’ Orientation

While stress and anxiety are sometimes used interchangeably, the two emotional responses are actually quite different. Where stress is reactive, anxiety is proactive. That is, instead of preparing you to fight or flee from a threatening situation like stress, anxiety will actually lead you to avoid danger altogether. 

Just like stress, anxiety has clear evolutionary utility as a behavioral influence. For example, after getting stung by a bee, you might feel anxious about going near beehives. This is clearly useful as it will help you avoid bee stings in the future. But, if public speaking or social situations cause you great anxiety, you might end up missing out on important opportunities and connections with others.

The symptoms of anxiety and stress are nearly identical as anxiety can spike stress hormones to cause nervous feelings, rapid heart rates, tense muscles, digestive issues, and more. As we’ve previously explained, living with consistently elevated stress hormones can have terrible consequences. Long-term effects of anxiety can include depression, digestive issues, insomnia, chronic pain conditions, trouble working or socializing, substance abuse, and suicidal thoughts.(5) 

Managing Stress and Anxiety 

Now that we’ve covered the slight differences between stress and anxiety, we can discuss current treatment options for both issues. We will share modern pharmacological treatments and also important holistic approaches from experts to address this problem. 

Holistic Stress Treatments

As we look into the rapidly evolving cannabinoid market many organizations are developing products and solutions that aid in a holistic approach to stress and anxiety management. We share recommendations and practices that were compiled from resources like the American Psychological Association, Harvard University, the Mayo Clinic, and more. The list below is not meant to be prescriptive, rather informative for both businesses and consumers. All of the discussed practices are recommended by multiple top organizations. 

Be Mindful and Intentional about Stress

Nearly every resource we researched recommends being mindful and intentional about stressors. In order to do this, many groups even recommended a stress journal, to help individuals locate and track sources of stress and anxiety in their lives. 

Once you can figure out what causes you distress, you can take steps to either avoid it or confront it. For example, if a high-pressure work environment has you constantly stressed, you might consider alternative options. Or, if you have debilitating anxiety about public speaking, you might try to conquer it through exposure therapy aided by medicine or Cognitive-Behavioral Therapy (CBT).

Relaxation Techniques

Once you have identified sources of stress and anxiety, you can start actively managing them. Some sources of stress are unpredictable and unavoidable, and some types of anxiety must be painfully confronted, so it’s important that individuals learn to cope with or manage stress. Deep breathing techniques, muscle relaxation techniques, and repetitive rituals are three great ways to do this. 

When it comes to reducing stress and anxiety, breathing is one of our most useful tools. Deep and intentional breathing has been proven to induce self-reported improvements in stress and mood, as well as measurable physiological changes, such as reduced heart rate and cortisol levels.(6)

Muscle relaxation is a simple but powerful way to manage stress. One popular way of doing this is with progressive muscle relaxation (PMR) therapy: a practice that involves systematically tensing and relaxing different muscle groups. This practice has been proven to reduce muscle tension and relieve stress.(7)

Finally, evidence suggests that merely performing rituals can relieve anxiety to improve performance. You may have noticed that many athletes in stressful sport environments have pre-game rituals that help them relax and perform. So while scientists cannot say that a pair of lucky shoes will help you win, they can conclude that lacing-up your game day cleats will improve performance by reducing anxiety.

For most people, a stress-reducing routine could look like a morning routine that helps plan your day, or a post-work cool-down that helps you recenter. Regardless of what your ritual is, it seems that simply going through a series of symbolic and repetitive actions can help reduce stress.(8)

Take Care of Your Body with Exercise, Sleep, and Healthy Food

Another important aspect of stress management is your ability to maintain a healthy baseline through diet and lifestyle.

We’ve previously discussed the negative effects of inadequate sleep. There is a clear link between sleeplessness and stress. According to the American Psychological Association, stress and sleep may play off each other in vicious or virtuous cycles. When you don’t get enough sleep, you’re more likely to feel stressed. And when you feel stressed, it becomes even harder to sleep. Thus, for many Americans breaking the negative cycle of stress and sleeplessness can be a major quality of life improvement.(9)

Exercise is another great way to reduce stress and aid sleep. Even just 20 minutes of exercise a day can reduce stress hormones, and stimulate the production of mood-elevating endorphins. It doesn’t seem to matter whether you’re running or swimming, doing tai chi or yoga, or even just going for a stroll; Any form of daily exercise can help improve health and reduce stress.(10)

A good diet can also help reduce stress. While there are many different healthy options, it seems that some foods are particularly good at reducing stress. For example, diets high in magnesium, zinc, and omega-3s have been linked to lower anxiety.(11) (12) (13) Whole foods like leafy greens, nuts, and fish are great sources of these key nutrients. 

Lean on your Support Network

One final piece of advice that nearly every stress and anxiety expert mentioned was leaning on a support network. This could be a friend group, a family member, a professional therapist, or even all three. Regardless of what your support network looks like, it appears to be very important that you can openly discuss your stress with others. 

Research has clearly documented the importance of social support. For example, individuals with strong support networks tend to exhibit improved immune, cardiovascular, and neuroendocrine function. As well as, decreased depression, decreased anxiety, and more effective buffering against stress and its negative effects.(14)

One meta-analysis even found that social support was highly predictive of mortality, as individuals with strong support networks had a 50% higher likelihood of survival.(15) 

Cannabinoids Evolving the Stress Market 

We will now share how cannabinoids present one of the most exciting opportunities to support the future of stress and anxiety management. 

Over the past few years, a range of scientific studies and papers have proposed  that CBD and other cannabinoids could be the next best big thing in stress management. This is not only because cannabinoids may function as a direct biological treatment for stress, but also because cannabinoids may help support a holistic approach to stress management. 

Cannabinoids as Anxiolytics:

A review of cannabinoids as anxiolytic drugs reveals that they have the potential to complement or replace current stress management therapeutics like benzodiazepines. 

While most organizations recommend a holistic approach for stress and anxiety management pharmacological options are sometimes necessary. Today, the leading drugs for stress are benzodiazepines like Xanax or Valium, and SSRIs such as Prozac. While these drugs have been proven effective in clinical settings, they can come with many unpleasant risks and side-effects, including, irritability, gastric distress, dizziness, headache, insomnia, and physical dependence.(16) 

Cannabinoids have shown promise to treat similar conditions with fewer negative effects. In recent review, an international team of scientists from New York University and the Universidad Miguel Hernandez in Spain wrote, “We found that existing preclinical evidence strongly supports CBD as a treatment for generalized anxiety disorder, panic disorder, social anxiety disorder, obsessive–compulsive disorder, and post-traumatic stress disorder when administered acutely.”(17)

Another report by British scientists has explained why CBD may be so effective at treating these disorders: It turns out that endocannabinoids (cannabinoids naturally produced by the human body) play an important role in signaling fear and anxiety. Thus, compounds that influence the endocannabinoid system may be able to regulate stress and anxiety. (18)

While all phytocannabinoids (cannabinoids naturally produced by plants) can interact with endocannabinoid receptors, CBD seems to be an especially potent force.CBD can bind to CB1 receptors in the human brain to produce anti-anxiety effects. On top of that, CBD also downregulates FAAH and MAGL, two enzymes that naturally break down endocannabinoids. This is very exciting, since studies shown that inhibiting either FAAH or MAGL may decrease anxiety.(19)

This means that CBD has the potential to reduce fear or anxiety in two ways. First, it can stand in the place of endocannabinoids and bind directly to CB1 receptors. Second, it can downregulate the enzymes that normally prevent endocannabinoids from binding with CB1 receptors. 

Upon reviewing these properties, the authors concluded, “Given their acute anxiolytic effects, [CBD] and FAAH inhibitors could be used as adjuncts to first-line SSRI or SNRI treatment, which have a delayed therapeutic response. Such drugs could be an improvement over benzodiazepines, which have abuse liability, a less favourable side effect profile . . . cannabinoids could be combined with existing or novel psychological therapies to facilitate extinction enhancement and/or fear memory reconsolidation disruption, both of which may result in a lasting reduction of fear. Cannabinoid-related medicines could also be given as anxiolytics on their own but further research is needed to determine their effects.”(20)

Translation: CBD could be used to enhance the short-term effectiveness of SSRIs. It may also be a more effective anxiety treatment option than benzodiazepines like Valium and Xanax, because CBD appears to be less addictive and less dangerous than these widely used drugs. In the future, therapists may use CBD to enhance current physiological therapy practices, or they may simply prescribe cannabinoid-based medicines on their own. Further research will be needed to confirm these uses of CBD. However, in order to truly treat stress and anxiety individuals may need to incorporate holistic treatments instead of using drugs alone.

Cannabinoids Evolving Holistic Stress Solutions

While cannabinoids may reduce stress and anxiety through direct pharmacological intervention, they also can support more holistic treatments. Ways in which cannabinoids can indirectly support the management of stress and anxiety are reviewed below.

Muscle Relaxation

Muscle relaxation is often recommended as a way of managing stress and anxiety. In recent years, this has become a more accessible stress management tool, as digital applications have been developed to help individuals practice progressive muscle relaxation. 

In addition to these methods, doctors will occasionally prescribe benzodiazepines as muscle relaxants. Aforementioned drugs like Xanax and Valium are effective muscle relaxants and anxiolytics. Although, these drugs have a somewhat worrisome potential for abuse.(21)

The good news is that cannabinoids may be a suitable aid for muscle relaxation. In a 2008 study, several Italian doctors considered if cannabinoid-based could be used for multiple sclerosis (MS). They found that the endocannabinoid system played an important role in managing muscle spasticity, and that supplementation with phytocannabinoids could help treat MS symptoms. While they were encouraged by the reduction in muscle spasms and improved mobility associated with cannabinoid treatments, they still call for further studies to be done. (22)

Ritual

Another important practice that can help reduce stress or anxiety is ritual. There are many different kinds of symbolic actions and repetitive practices that people can use to calm down. However, this method becomes more complicated when a ritual involves a biologically active compound, as the line between ritual and addiction can blur rather quickly. 

Fortunately, cannabinoids show a very favorable safety profile. While there is some potential for cannabinoid abuse, the adverse effects and addictive potential of these drugs is significantly less that of prescription opiates, benzodiazepines, nicotine, and alcohol.(23) Moreover, cannabinoids may actually help treat other dependence disorders like alcohol abuse(24) and nicotine addiction.(25)

Humans have been using cannabinoids in rituals for thousands of years. Earlier this year, several Israelis scientists found CBD, CBN, and THC residue at a shrine dating back 2,800 years. It appears that these materials were burned next to frankincense as part of an ancient spiritual ritual.(26) Clearly, humanity has been drawn to cannabinoid-based rituals for quite some time. 

Cannabinoids present as pretty good candidates for rituals. While there are endless possibilities to how you may construct a cannabinoid-based calming ritual, CBD-infused bath bombs, beverages, and oils can all play a part in that stress-reducing routine. 

CBD for Sleep

In a recent post, we discussed the many ways cannabinoids can contribute to the sleep market. These are more relevant than ever, considering that sleep and stress can play off of each other in negative feedback cycles. That is, stress can make it hard to sleep, and lack of sleep can make you easily stressed.

Fortunately, cannabinoids can break that cycle by enhancing the current sleep market. In one recent study, a daily 25mg dose of CBD was shown to quickly improve sleep scores and reduce anxiety in adults. As the three month study continued, anxiety levels continually dropped.(27) 

In another OBX blog , Dr. Andrew Salzman, MD explained, “CBN may mimic natural cannabinoid-like molecules within the body (endocannabinoids) which have been shown to promote rapid-eye-movement sleep.” If CBN can truly play a role in promoting REM sleep, it may be used alongside CBD to help break vicious sleep/stress cycles. To learn more about the potential of CBN, check out our blog. You can buy CBN isolate with OBX as well. 

Exercise

Exercise is another important component of a holistic approach to stress and anxiety management. While the fitness market is flooded with new applications and equipment that make working out fun and accessible, many individuals still do not get enough daily exercise. Cannabinoids could help. 

A recent study revealed that cannabinoids can help people exercise by removing some of the most common barriers to the activity, such as improper recovery after exercise, lack of motivation to exercise, and low enjoyment of exercise. Even though most athletes did not report cannabinoid-based performance improvements, they did see gains in recovery, motivation and enjoyment of exercise.(28) This suggests that a cannabinoid supplement regime could be helpful in encouraging regular exercise. 

When it comes to exercising, CBD is a particularly intriguing option. A clinical review published earlier this year remarked that athletes may be interested in the numerous physiological, biochemical, and psychological effects that CBD exhibits. In particular, the authors note that “there is preliminary supportive evidence for anti-inflammatory, neuroprotective, analgesic, and anxiolytic actions of CBD and the possibility it may protect against GI damage associated with inflammation and promote the healing of traumatic skeletal injuries.” However, these authors also warn that these are merely preliminary findings. More research will be needed to illuminate exactly how CBD can influence athletic performance and recovery.(29)

Diet

Another key factor in stress and anxiety is diet. While different doctors and scientists support a massive range of diets, all the way vegan to carnivore, most people at least agree on two things. You should try to eat less processed food, and you should try to eat the right amount of food. 

Early results indicate that cannabinoids may be able to help with that last part. In animal studies, CBG has been identified as a well-tolerated appetite stimulant. This makes it a promising therapeutic option for individuals with low BMI, cachexia, or other disorders where body weight regulation is warranted.(30) On the flip side, animal studies on THCV have shown that the cannabinoid may reduce appetite, and even help treat metabolic syndrome or type 2 diabetes.(31)

While there is no substitute for healthy dietary choices, a little assistance from cannabinoids may prove very helpful. The fact that different minor cannabinoids can exhibit opposite effects is exciting, and suggests that a range of cannabinoids can be used to help each individual create the right anxiety and stress management for them. 

Social Support

The final pillar of stress and anxiety management is the maintenance of a strong social support network. Cannabinoids can help with this too as they can facilitate social interactions by relieving anxiety. 

Social anxiety disorder is a condition in which individuals may feel stress or anxiety around other people. Like lack of sleep, social anxiety is a particularly tricky anxiogenic condition given that it can cause vicious cycles. An individual with social anxiety may be less likely to develop a supportive social network. This can deepen anxiety, which can be further isolating. Fortunately, CBD may be able to help. 

In a recent study, CBD was found to significantly reduce the anxiety levels in patients suffering from social anxiety disorder.(32) These findings mirror earlier studies wherein CBD was found to reduce anxiety caused by public speaking.(33) This suggests that in addition to reducing anxiety in general, CBD may be particularly effective at reducing social anxiety and breaking the vicious cycle of anxiety and social isolation. 

Beyond removing the barriers for social interactions, cannabinoids can even encourage positive social interaction. Novel cannabinoid products like CBD-infused drinks and foods can be shared, and smokeable or vaporizable cannabinoid products can be passed amongst friends. 

Towards a Better Stress Management Market

The current stress management system is not designed to treat anxiety holistically. While relief and treatment options are becoming better every day, there is still a significant opportunity for cannabinoids to transform the stress and anxiety markets. 

In order to truly provide stress and anxiety relief, cannabinoid suppliers must see beyond symptoms alone. It’s true that CBD and other cannabinoids have shown a promising ability to regulate the function of the endocannabinoid system to directly reduce stress or anxiety. But, that doesn’t mean this is where stress management should end. 

While different experts recommend a range of different treatments for stress and anxiety, a few of the most popular tips are to manage symptoms, take care of your body, and rely on a social support network. Cannabinoids can help with all of these categories, as the multi-functional molecules can aid in muscle relaxation and sleep, reduce barriers to exercise and social interaction, and support healthy diets and rituals. 

With more research and cannabinoid products appearing everyday, we are gaining more and more tools for stress and anxiety management. As this research continues to crystalize, we may finally find a truly holistic and effective approach to stress and anxiety. 

References

1) Anxiety and Depression Association of America. Facts and Statistics. https://adaa.org/about-adaa/press-room/facts-statistics. 

(2) American Psychological Association, APA Working Group on Stress and Health Disparities. (2017). Stress and health disparities: Contexts, mechanisms, and interventions among racial/ethnic minority and low-socioeconomic status populations. Retrieved from http://www.apa.org/pi/health-disparities/resources/stress-report.aspx

3) Tambaro S, Bortolato M. Cannabinoid-related agents in the treatment of anxiety disorders: current knowledge and future perspectives. Recent Pat CNS Drug Discov. 2012;7(1):25-40. 

4) Mayo Clinic Staff. Chronic Stress Puts Your Life at Risk. Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress/art-20046037.

5) Leonard J. Anxiety can impact physical and mental health. There are short- and long-term effects on both the mind and body. Medical News Today. https://www.medicalnewstoday.com/articles/322510.

6) Perciavalle, V., Blandini, M., Fecarotta, P. et al. The role of deep breathing on stress. Neurol Sci 2017, 38: 451–458.

7) Healthwise Staff. Stress Management: Doing Progressive Muscle Relaxation. Michigan Medicine: University of Michigan. https://www.uofmhealth.org/health-library/uz2225. 

8) Brooks AW, Schroeder J, Risen J, Gino F, Galinsky A, Norton M, Schweitzer. Don’t stop believing: Rituals improve performance by decreasing anxiety. Organizational Behavior and Human Decision Process. 2016, 137: 71-85. 

9) American Psychological Association. Stress and Sleep. APA. https://www.apa.org/news/press/releases/stress/2013/sleep#:~:text=Adults%20who%20sleep%20fewer%20than,6.2%20hours).

10) Ratey JJ. Can Exercise Help Treat Anxiety? Harvard Medical School: Harvard Health Publishing. 2019. https://www.health.harvard.edu/blog/can-exercise-help-treat-anxiety-2019102418096

11) Sartori SB, Whittle N, Hetzenauer A, Singewald N. Magnesium deficiency induces anxiety and HPA axis dysregulation: modulation by therapeutic drug treatment. Neuropharmacology. 2012;62(1):304-312. 

12) Torabi M, Kesmati M, Harooni HE, Varzi HN. Effects of nano and conventional zinc oxide on anxiety-like behavior in male rats. Indian J Pharmacol. 2013;45(5):508-512. 

13) Kiecolt-Glaser JK, Belury MA, Andridge R, Malarkey WB, Glaser R. Omega-3 supplementation lowers inflammation and anxiety in medical students: a randomized controlled trial. Brain Behav Immun. 2011;25(8):1725-1734. 

14) Umberson D, Montez JK. Social relationships and health: a flashpoint for health policy. J Health Soc Behav. 2010;51 Suppl(Suppl):S54-S66.

15) Holt-Lunstad J, Smith TB, Layton JB. Social Relationships and Mortality Risk: A Meta-analytic Review. Plos Medicine. 2010. https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1000316#references. 

16) WebMD. Understanding Generalized Anxiety Disorder — Diagnosis and Treatment. WebMD. 2017. https://www.webmd.com/anxiety-panic/guide/understanding-anxiety-treatment?

17) Blessing EM, Steenkamp MM, Manzanares J, Marmar CR. Cannabidiol as a Potential Treatment for Anxiety Disorders. Neurotherapeutics. 2015;12(4):825-836. 

18) Papagianni, E.P., Stevenson, C.W. Cannabinoid Regulation of Fear and Anxiety: an Update. Curr Psychiatry Rep 21, 38 (2019).

19) ^Ibid

20) ^Ibid.

21) ^Ibid

22) Malfitano AM, Proto MC, Bifulco M. Cannabinoids in the management of spasticity associated with multiple sclerosis. Neuropsychiatr Dis Treat. 2008;4(5):847-853.

23) Panlilio LV, Goldberg SR, Justinova Z. Cannabinoid abuse and addiction: Clinical and preclinical findings. Clin Pharmacol Ther. 2015;97(6):616-627. 

24) Kleczkowska P, Smaga I, Filip M, Bujalska-Zadrozny M. Cannabinoid Ligands and Alcohol Addiction: A Promising Therapeutic Tool or a Humbug?. Neurotox Res. 2016;29(1):173-196. 

25) Gamaleddin IH, Trigo JM, Gueye AB, et al. Role of the endogenous cannabinoid system in nicotine addiction: novel insights. Front Psychiatry. 2015;6:41. Published 2015 Mar 25. 

26) Arie E, Rose B, Namdar D. Cannabis and Frankincense at the Judahite Shrine of Arad. Journal of the Institute of Archaeology of Tel Aviv University. 2020: 1:47. 

27) Shannon S, Lewis N, Lee H, Hughes S. Cannabidiol in Anxiety and Sleep: A Large Case Series. Perm J. 2019;23:18-041. 

28) YorkWilliams SL, Gust CJ, Mueller R, et al. The New Runner’s High? Examining Relationships Between Cannabis Use and Exercise Behavior in States With Legalized Cannabis. Front Public Health. 2019;7:99. Published 2019 Apr 30. 

29) McCartney D, Benson MJ, Desbrow B, Irwin C, Suraev A, McGregor IS. Cannabidiol and Sports Performance: a Narrative Review of Relevant Evidence and Recommendations for Future Research. Sports Med Open. 2020;6(1):27. Published 2020 Jul 6. 

30) Brierley DI, Samuels J, Duncan M, Whalley BJ, Williams CM. Cannabigerol is a novel, well-tolerated appetite stimulant in pre-satiated rats. Psychopharmacology (Berl). 2016;233(19-20):3603-3613. 

31) Wargent ET, Zaibi MS, Silvestri C, et al. The cannabinoid Δ(9)-tetrahydrocannabivarin (THCV) ameliorates insulin sensitivity in two mouse models of obesity. Nutr Diabetes. 2013;3(5):e68. Published 2013 May 27. 

32) Crippa JA, Guimarães FS, Campos AC, Zuardi AW. Translational Investigation of the Therapeutic Potential of Cannabidiol (CBD): Toward a New Age. Front Immunol. 2018;9:2009. Published 2018 Sep 21. 

33) Bergamaschi MM, Queiroz RH, Chagas MH, et al. Cannabidiol reduces the anxiety induced by simulated public speaking in treatment-naïve social phobia patients. Neuropsychopharmacology. 2011;36(6):1219-1226.

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