Let’s preface this article by saying that attention deficit hyperactivity disorder (ADHD) is not a big pharma invention, nor is it simply a case of ‘kids being kids’. Just about every major health organisation in the world recognises ADHD as a legitimate psychiatric condition; the fact that the number of people with ADHD seems to have risen dramatically in recent years (in the U.S., for example, the prevalence of ADHD in kids aged between 4 and 17 rose from 7.8 per cent in 2003 to 11 per cent in 2011, according to the Centers for Disease Control and Prevention) is not due to conspiracy so much as advances in the diagnostic process.
Nevertheless, with the rate of ADHD diagnosis continuing to rise in many countries, the need for new, safer treatment options has become more pronounced. While existing amphetamine and methylphenidate-based medications are effective in the short-term at alleviating the symptoms associated with ADHD, they often cause a variety of negative health effects that both patients and doctors are rightfully wary of.
Is it possible that medical cannabis could be used to treat ADHD? From the outset, it might seem as though the loss of focus often associated with marijuana use would make it a poor candidate for ADHD treatment, but a growing body of anecdotal evidence suggests cannabis may be a legitimate option for those living with the disorder – and now researchers are beginning to consider the possibilities, too. We’ve delved deep into the research to bring you everything you need to better understand the complex relationship between medical marijuana and ADHD.
What is ADHD?
ADHD is a behavioural disorder. As the New Zealand ADHD Association explained, ADHD affects 2-5 per cent of children in Aotearoa, with the diagnosis rate around three times higher in boys than girls (though it’s believed that the true incident rate is equal between sexes ). Although many people associate ADHD with youngsters, it can and does affect many adults, with around 50-70 per cent of all children diagnosed with ADHD experiencing impairing symptoms in their grown-up years.
What exactly do these symptoms look like? Well, according to the Mental Health Foundation, ADHD can manifest itself in a number of different ways, including:
● Difficulty concentrating
● Obsession with the current task
● A tendency to avoid challenging endeavours
● Hyperactivity and/or restlessness
● Poor listening skills
● Trouble with time management
● Poor ability to control emotions
A lot of research has been conducted into the origins of ADHD. While the general consensus in the medical community is that a genetic component is responsible for most cases of ADHD, the exact cause of the disorder remains a mystery.
Understanding the relationship between ADHD and cannabis
The link between substance abuse and ADHD is well documented. One study published in Current Psychiatry Reports noted that the risk of substance use disorder was about twice as high among people with ADHD as those without. Research from the National Institute of Health found that as many as 38 per cent of all cannabis users have ADHD.
Statistics such as these have led some people to believe that cannabis is responsible for causing ADHD, but that isn’t the case – it’s simply that those with ADHD are more inclined to use marijuana to self-medicate than people living without the disorder.
There’s a wealth of anecdotal evidence supporting this theory, but it’s only recently that the trend has been validated by science. Research from the University at Albany, New York, combined the results of a study on rodents with an analysis of 2,811 U.S. cannabis users to determine that the strong correlation between cannabis use and ADHD really is due to patients attempting to self-medicate and use marijuana to relieve their symptoms.
How is ADHD treated?
As it stands, there is no known cure for ADHD. Treatment options are symptomatic, meaning that healthcare professionals seek to prescribe medication that reduces the severity of ADHD’s aforementioned symptoms.
In New Zealand, currently prescribed ADHD medicine is almost entirely methylphenidate-based, and includes brands such as Ritalin, Ritalin LA and Concerta, amongst others. Amphetamine compounds are very rarely prescribed and in some cases are not available at all. For example, Adderall and its variants are illegal in New Zealand due to their perceived higher risk of addiction.
Although methylphenidate-based medications are effective at treating many of the symptoms of ADHD, use of these stimulants is often accompanied by a range of undesirable side effects. For instance, a double-blind, crossover trial published in American Academy of Pediatrics found that methylphenidate can cause appetite suppression, while a Harvard Health Publications report indicated that the medication is linked with increased blood pressure, heightened heart rate, growth suppression, and potential for abuse and addiction.
Given the side effects of these stimulants, perhaps it isn’t too surprising that patients and medical professionals alike are calling for alternative treatment methods. With recent law reforms in many parts of the world allowing for more marijuana-focused studies than ever before, some researchers are exploring whether medicinal cannabis may offer any value as a form of ADHD treatment.
Can medical marijuana be used to treat ADHD?
At the time of writing, there have been very, very few studies into the use of cannabis as ADHD medication, and there is no conclusive evidence to suggest that medical marijuana can be used to treat the disorder.
However, there are some promising leads. A team of German researchers analysed the effects of cannabis in 30 patients for whom traditional ADHD treatment methods (methylphenidate, atomoxetine, dexamphetamine, lisdexamphetamine and amphetamine juice) had proven to be ineffective. In the study, which was presented at the 2015 European Workshop on Cannabinoid Research, twenty-two patients treated their ADHD symptoms using cannabis only, while the remaining eight used a combination of marijuana and conventional stimulant medication.
Over the course of the trial, all participants experienced positive changes to their symptoms, including improved focus, greater quality of sleep and reduced impulsivity. The results of the study led the researchers to conclude that “for adult patients with ADHD, who experience side effects or do not profit from standard medication, cannabis may be an effective and well-tolerated alternative.”
The Germans aren’t the only ones advocating for cannabis as ADHD medication. Over in the U.S., Dr David Bearman, a consummate expert and thought leader on all things medical marijuana, is a long-time proponent of using medicinal cannabis to treat ADHD. His reasoning is founded on the way cannabinoids affect how the human brain stores and releases dopamine.
“Cannabis appears to treat ADD and ADHD by increasing the availability of dopamine,” explained Mr Bearman, as quoted by Leafly.
“This then has the same effect but is a different mechanism of action than stimulants like Ritalin (methylphenidate) and dexedrine amphetamine, which act by binding to the dopamine and interfering with the metabolic breakdown of dopamine.”
You can get more insight into Mr Bearman’s views on ADHD and marijuana in the following YouTube video from Medical Marijuana 411.
Anecdotal evidence in support of cannabis for treating ADHD
As noted, there’s little empirical evidence to support the use of medical cannabis as ADHD treatment. However, when it comes to anecdotal evidence, there’s a tonne. Perhaps due in part to marijuana’s reputation for alleviating loss of appetite, anxiety and insomnia – three symptoms closely associated with ADHD – the media is awash with stories of people self-medicating their disorder with cannabis.
In December 2015, Sydneysider Cherie Dell made headlines when it emerged that she was using cannabis oil to illegally treat her six-year-old son, Wyatt, who has ADHD. Despite the fact that she was breaking the law, Ms Dell defended her decision, stating that his behaviour had improved considerably since substituting his prescribed ADHD medicine for the cannabis oil.
“He is calmer, he is not having outbursts, we don’t have as many issues with him hurting his brothers and sisters. I am giving my child a quality of life he doesn’t have on the ADHD medication,” said Mrs Dell, as quoted by The Daily Telegraph.
Of course, this is just the tip of the iceberg; not all cases of self-medicating make the papers. Visit any ADHD- or cannabis-related online message board and you’ll see dozens of posts from users proclaiming that medical marijuana has helped them manage their ADHD symptoms more than any stimulant-based medicine ever has.
Amazingly, the prevalence of these user-submitted reports has also come to the attention of scientists. Earlier this year, a team of researchers at Duke University set out to better understand the belief among everyday people that cannabis is therapeutic for ADHD. Conducting a qualitative analysis of 401 randomly selected posts from 258 relevant online forum discussions, all of which had been submitted by adults self-medicating their ADHD with cannabis, the researchers found that:
● 25 per cent of posts described cannabis as being therapeutic for ADHD.
● 8 per cent of posts reported that it was detrimental
● 2 per cent of posts indicated that it had no effect
The study was the first to successfully identify a trend in the evolving perception of medical marijuana as ADHD treatment. It may serve as the basis for further research, as well as provide valuable information for patients and caregivers.
What is the best strain of marijuana for treating ADHD?
Despite the lack of evidence supporting their use, a number of medicinal cannabis products have popped up that promise to help users alleviate the symptoms of ADHD. For example, Matt Price over at Medical Jane wrote a comprehensive review of CBD Mendo Focus, a tincture comprised of a 1:1 mix of CBD and THC, which claims to boost focus and concentration. Taking just half a drop of the tincture, Mr Price noted a reduction in his anxiety and an overall calming effect. Mendo Focus doesn’t come cheap, though, with a 30ml bottle costing around US$90.
Specific strains of cannabis may also be beneficial for ADHD. Leafly noted that sativa-dominant strains such as Sour Diesel, Cinex and Harlequin are effective at feeding creativity and improving focus, while indica-dominant variants such as True OG, Goo and Jupiter OG are best used for relaxing and stimulating appetite. Hybrids like Harle-Tsu and Blueberry Headband strike a balance between the two.
Looking ahead at medical marijuana and ADHD
The relationship between cannabis and ADHD is still in the embryonic stage. While there are some undeniable problems with conventional stimulant-based medicines, there is currently little empirical evidence to suggest that medical marijuana is effective for treating ADHD.
However, with people like Dr David Bearman at the vanguard, opinions in the medical world and among the general population are slowly evolving, and it seems probable that we’ll see more thorough research into cannabis and ADHD in the months and years that follow.
Please note that this article does not constitute medical advice. For better or worse, if you’re living with ADHD here in New Zealand you’re more or less limited to conventional medicines unless you’re prepared to do some serious experimentation – and given our marijuana industry’s lack of regulation and the absence of evidence supporting the efficacy of cannabis for treating ADHD, we strongly advise against doing so 🙂
A small but important minority have voiced their opinions on our information sources, these will be included on all articles moving forward.