Cannabis vs. benzodiazepines for anxiety

Cannabis and benzodiazepines — sometimes called “benzos” — are commonly used to help ease anxiety.

While both options can relieve symptoms like racing thoughts and restlessness, they do so in different ways.

When deciding on an anxiety treatment, it’s important to weigh the risks and benefits of both cannabis and benzodiazepines.

Keep in mind that these two substances can also interact with each other, so you should use caution when taking them together.

Cannabis vs. benzodiazepines for anxiety

Cannabis and benzodiazepines affect anxiety symptoms differently.

Cannabis compounds called cannabinoids may offer anti-anxiety effects. Certain cannabinoids, such as tetrahydrocannabinol (THC) and cannabidiol (CBD), help regulate:

• Mood
• Stress
• Fear response
• Sleep

Benzodiazepines are a class of prescription medications used to treat anxiety as well as other health issues like insomnia, seizures, and muscle spasms. Common benzodiazepines include:

• Alprazolam (Xanax)
• Clonazepam (Klonopin)
• Diazepam (Valium)
• Lorazepam (Ativan)

Benzodiazepines work by increasing levels of gamma-aminobutyric acid (GABA), a brain chemical that makes you feel calm, helping to ease anxiety.

Research on cannabis vs. benzodiazepines for anxiety

Studies show that both cannabis and benzodiazepines may be effective forms of anxiety treatment.

An animal study found that low doses of THC may offer anti-anxiety effects. CBD was also found to help lower anxiety as well as insomnia in a series of human case studies.

While early research suggests that cannabis may have anti-anxiety effects, research is ongoing, and more high-quality studies are needed.

Benzodiazepines are also effective for treating anxiety. However, they’re usually prescribed for short-term use, with exceptions made for people who don’t respond to other forms of anxiety treatment. Because of this, the long-term safety and effectiveness of benzodiazepines for anxiety is unclear.

Safety of using cannabis vs. benzodiazepines for anxiety

When choosing between cannabis and benzodiazepines to help with anxiety, it’s important to consider their risks.

Cannabis is generally well-tolerated, but it’s not entirely risk-free. It may cause certain side effects, such as:

• Dry mouth
• Dry eyes
• Dizziness
• Drowsiness
• Confusion
• Impairment
• Headache
• Nausea

In rare cases, long-term use of high doses of cannabis can lead to a condition known as cannabis hyperemesis syndrome. This condition can cause severe nausea and vomiting.

Common side effects linked to benzodiazepines include:

• Headache
• Nausea
• Drowsiness
• Confusion
• Diarrhea
• Tremors

Benzodiazepines can also come with more serious side effects, such as:

• Difficulty breathing or slow, shallow breathing
• Sedation
• Loss of consciousness
• Hallucinations
• Seizures
• Dependency
• Fatal overdose

Neither cannabis nor benzodiazepines are universally safe for everyone, especially for those with certain mental health conditions, heart conditions, or a history of a substance use disorder.

Your doctor can help you find the best treatment option by considering your personal risks and health-related needs.

Addiction risk

Benzodiazepines carry boxed warnings from the Food and Drug Administration (FDA), which are the strongest warnings found on prescription medication labels.

These medications are known to be highly addictive. Stopping use of benzodiazepines can be dangerous, and should only be done under the supervision of a healthcare professional or an addiction specialist.

Cannabis use also carries a risk of dependency, sometimes called cannabis use disorder, which occurs in an estimated 30% of people who use cannabis.

Risks of using cannabis and benzodiazepines together

Some people consider taking cannabis and benzodiazepines together to help manage anxiety. However, this should only be done under strict medical supervision due to the risk of potentially dangerous combined side effects.

Mixing cannabis and benzodiazepines may increase your risk of:

• Confusion
• Drowsiness
• Sedation
• Slow or shallow breathing

Cannabis can also inhibit liver enzymes that help your body break down and process benzodiazepines. This means that taking them together may strengthen and prolong the effects of the benzodiazepine.

According to some research, cannabis may help individuals lower their intake of benzodiazepines or stop taking them altogether. However, reducing your benzodiazepine dose should only be done under medical supervision.

The bottom line: Weigh the pros and cons of cannabis vs. benzodiazepines for anxiety

Both cannabis and benzodiazepines may help you manage anxiety symptoms. Consider the benefits and risks of both options when choosing which one is right for you.

To learn more about how cannabis and benzodiazepines can help address anxiety, speak with a Leafwell pharmacist who can provide personalized guidance.

Always talk with a licensed healthcare provider before starting or stopping any medication or cannabis product.

Resources

• Benzodiazepine toxicity. https://www.ncbi.nlm.nih.gov/books/NBK482238/
• Benzodiazepines. https://www.ncbi.nlm.nih.gov/books/NBK470159/
• Benzodiazepines use, misuse, and abuse: A review. https://pmc.ncbi.nlm.nih.gov/articles/PMC6007645/
• Benzodiazepines: Uses, dangers, and clinical considerations. https://pmc.ncbi.nlm.nih.gov/articles/PMC8629021/
• Cannabidiol in anxiety and sleep: A large case series. https://www.thepermanentejournal.org/doi/10.7812/TPP/18-041
• Cellular mechanisms underlying the anxiolytic effect of low doses of peripheral Δ9-tetrahydrocannabinol in rats. https://www.nature.com/articles/1301330
• Cannabinoid interactions with cytochrome P450 drug metabolism: A full-spectrum characterization. https://pubmed.ncbi.nlm.nih.gov/34181150/
• Cytochrome P450 3A4 and benzodiazepines. https://pubmed.ncbi.nlm.nih.gov/12875231/
• Effectiveness of benzodiazepines: Do they work or not? https://pubmed.ncbi.nlm.nih.gov/18671662/
• Need for a realistic appraisal of benzodiazepines. https://pmc.ncbi.nlm.nih.gov/articles/PMC4471984/
• Reduction of benzodiazepine use in patients prescribed medical cannabis. https://pmc.ncbi.nlm.nih.gov/articles/PMC6757237/
• Short- and long-term use of benzodiazepines in patients with generalized anxiety disorder: A review of guidelines. https://www.ncbi.nlm.nih.gov/books/NBK254089/table/T7/
• Understanding your risk for cannabis use disorder. https://www.cdc.gov/cannabis/health-effects/cannabis-use-disorder.html

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