Anxiety, Depression & a Pandemic, Oh My! Cannabis can help

Dr. Bonni Goldstein is the Medical Director and owner of Canna-Centers Wellness and Education. Her practice is dedicated to education on the medical uses of cannabis for serious and chronic conditions. Dr. Goldstein earned her medical degree at Robert Wood Johnson Medical School at the University of Medicine and Dentistry of New Jersey. She became interested in medical cannabis in 2008 when she saw firsthand its healing effects on a friend. Dr. Goldstein recently released the book “Cannabis is Medicine: How Medical Cannabis and CBD are Healing Everything from Anxiety to Chronic Pain.” Cannabis by the Sea interviewed Dr. Goldstein on cannabis and mental health.

Q: Are there any statistics or anecdotal evidence showing that more mental health professionals are willing to recommend a cannabis treatment to their patients as opposed to a standard prescription?

Dr: I am not aware of any formal statistics about mental health professionals’ willingness to recommend cannabis treatment, but, anecdotally, I have patients who reported that their psychiatrist or therapist mentioned using cannabis or CBD to treat their condition. Unfortunately, physicians still do not get education on the nuances of the different cannabinoid medicines and how to use them, leaving a large gap between just recommending the use of cannabis and actually assisting a patient to find the correct cannabinoid medicines and dosing that will help with their specific situation.

Q: Do patients typically start the discussion on cannabis as medicine or do you?

Dr: I am a cannabis specialist so when patients come to me, it is specifically because they want to use cannabis and are asking for help in figuring out their cannabis regimen.

Q What is a patient’s typical reaction?

Dr: In my talks with patients who report to me that their primary care or specialist physician recommended that they come to see me, they are grateful that their doctor mentioned it and was willing to discuss it with them.

Q: Are there pandemic-specific signs or indicators you look for in patients with anxiety and/or depression?

Dr: When I am assessing either new patients or established patients during an appointment, I ask how and if the current situation is affecting their mood/sleep/ability to function and if there are issues, we make adjustments to the cannabis regimen.

Q: What do people need to know about using cannabis as medicine? For example, dosing, tracking progress, side effects, etc.

Dr: The answer to this question is so vast that I just published a book covering all of this! There are many variables involved in using cannabis as medicine. For instance, which cannabinoid to use (CBD, THC, CBG, THCA, CBDA, etc., all are now available to consumers), dosing, timing, method of use (inhaled, sublingual, edibles, topical, etc.), potential drug-drug interactions, potential risks and side effects. For anyone with a serious chronic medical condition, a consultation with a medical cannabis specialist, such as an MD, RN or nurse practitioner, is highly recommended.

Q: What about those who want to explore on their own?

Dr: Self-medicating can be effective but often patients, especially those new to the use of cannabis, give up because they do not understand dosing or the various effects of the different cannabinoids. We cannot expect medical patients with serious conditions to get advice from non-healthcare professionals who staff cannabis dispensaries.

Q: If cannabis “cures” depression or anxiety, can the patient stop taking it?

Dr: There is no evidence that cannabis cures anxiety or depression, however there is evidence that there is an endocannabinoid deficiency in these conditions. Cannabinoids from the cannabis plant can replace the deficiency and promote homeostasis of mood and emotions. Many patients report that once they start to feel better with a cannabis regimen, they can take less in order to maintain the good results.

Q: Are there certain mental issues that should NOT be treated with cannabis?

Dr: Every condition should be approached in a caseby-case manner. Every one of us responds uniquely to all medicines, including cannabis, and there is no “one size fits all” with any medicine. Unfortunately, the conventional approach to treatment often ignores this. There are patients for whom cannabis gives extraordinary results, and there are others who don’t improve, and then there is everyone in between. The diagnosis itself is not what dictates response, it is the person’s individual response that is most important. Since cannabis has been shown over and over again to have an excellent safety profile, if a person is struggling with symptoms despite trying different treatments, cannabis is worth a try.

Q: What is the most important question one needs to ask before beginning a cannabis regimen specific to anxiety and/or depression?

Dr: The best approach is to start off by getting credible scientific information on how cannabis might help certain symptoms or conditions. I have included all of this information in my book but patients can also go to reputable non-profit organizations dedicated to helping people with this type of treatment, namely ProjectCBD.org, UnitedPatientsGroup. com, and RealmOfCaring.org.

To learn more about Dr. Bonni Goldstein, visit bonnigoldsteinmd.com.