The Interactions Between Xanax and THC

It’s no secret that many people turn to cannabis for relief from anxiety. According to the ADAA, “Anxiety Disorders are the most common mental illness in the US, affecting 40 million adults, age 18 and over, every year.” 

The most common conventional treatment for anxiety in the US comes from a class of pharmaceutical drugs, called benzodiazepines. According to the National Institute of Health, “12.5% of adults in the U.S. used benzodiazepines, which extrapolates to about 30.5 million persons.”

Xanax (alprazolam) is one of the most common benzodiazepines in the US. It’s often prescribed to treat generalized anxiety disorders (GAD) and other anxiety disorders, like panic disorder and agoraphobia. 

But with more and more people turning to cannabis to treat anxiety, it’s led them to wonder, “Is cannabis safe to use while taking Xanax?”

What Is Xanax?

Xanax is the brand name of alprazolam, a benzodiazepine commonly prescribed to treat anxiety disorders. Like other benzodiazepines, Xanax works by boosting signals from the GABA neurotransmitter to send calming messages in the brain.

Despite how commonly Xanax is prescribed, it has a fairly extensive list of possible – albeit uncommon – side effects.

• Headaches
• Dizziness
• Drowsiness
• Tiredness
• Light-headedness
• Irritability
• Being overly-talkative
• Dry mouth
• Difficulty concentrating
• Increased salivation
• Nausea
• Constipation
• Diarrhea
• Changes in sex drive
• Erectile dysfunction
• Changes in appetite
• Weight gain
• Weight loss
• Joint pain
• Difficulty urinating

More severe side effects of Xanax can include:

• Seizures
• Shortness of breath
• Severe skin rashes
• Jaundice (yellow skin or eyes)
• Problems with speech
• Confusion
• Decreased coordination

Xanax and other benzodiazepines share a high risk of dependence¹ and abuse.² Not only is Xanax potentially addictive, but dependency also carries with it a higher risk of unpleasant side effects and withdrawal symptoms. 

The Effects of THC on Anxiety

Tetrahydrocannabinol (THC) is the cannabinoid in cannabis that produces its intoxicating effects. 

THC mimics endocannabinoids that the body naturally produces to send messages throughout the body. The endocannabinoid system (ECS) is composed of a system of receptors that help regulate a number of important internal processes, and it’s these receptors that cannabinoids like THC bind to. 

Research suggests that the endocannabinoid system plays a crucial role in managing anxiety and processing stressful situations.³ Because cannabinoids like THC bind to these ECS receptors, it’s been theorized that the psychoactive compound can aid in managing anxiety in some patients. Anecdotal reports from people using medical cannabis to treat anxiety, stress, and depression corroborate these findings. According to one study, medical cannabis patients reported a 50% reduction of depression, on average, and a 58% reduction in stress and anxiety.⁴

Further research examined the endocannabinoid system’s role in regulating fear and anxiety. The study revealed that the endocannabinoid system interacted heavily with the same nerve cells as GABA and played a key role in mediating anxiety and fear responses.⁵

The current body of evidence is growing, but further study is required before we can say conclusively that THC is an effective treatment for anxiety or depression.

The lack of concrete evidence hasn’t prevented people from using cannabis to treat anxiety and depression. In fact, mental wellness is among the most common reasons people use cannabis medicinally.

Before incorporating medical marijuana as a part of your anxiety treatment, it’s important to consider the potential side effects that may come with cannabis. When consumed in high doses, THC can actually increase feelings of anxiety and paranoia in some users. This makes it all the more important to receive guidance and dosage recommendations from a qualified medical practitioner prior to incorporating cannabis into anxiety treatment.

Common side effects of cannabis, particularly at high doses, include:

• Anxiety
• Paranoia
• Hunger
• Drowsiness
• Giggling
• Increased heart rate
• Altered perception of time
• Temporary memory problems

Interactions and Dangers of Mixing Xanax and Marijuana

There is currently no research available that directly explores the interaction between Xanax and cannabis. But because both substances are known as central nervous system depressants, there is potential for cannabis to increase the depressant effects, which could increase the severity of side effects like drowsiness and impaired coordination. 

Additionally, CBD is known to be a potent CYP3A4 inhibitor, which could reduce the rate at which benzodiazepines like Xanax are metabolized (further increasing the severity of potential Xanax side effects).

As a result, many experts agree that Xanax and cannabis shouldn’t be combined without the support of a qualified medical practitioner.

Possible side effects of mixing Xanax and cannabis include:

• Dizziness
• Drowsiness
• Slurred speech
• Confusion
• Problems concentrating
• Impaired judgment
• Problems with coordination

Xanax: A Separate Potential Addiction

Regardless of someone’s cannabis use, Xanax is an addictive drug with a risk of dependence. According to the American Addiction Centers, “ it is considered one of the most addictive benzodiazepine medications on the market today.” 

Because of the high potential for addiction, some experts recommend that benzodiazepines, like Xanax, be used for no more than two weeks. After two weeks, the risk of dependence grows. People who have used them long-term may need to gradually withdraw from benzodiazepines over a period of 3-12 months or face potentially dangerous withdrawal symptoms.

The potential side effects and addictive nature of benzodiazepines have many consumers considering natural alternatives like cannabis. If you’re considering discontinuing your Xanax medication or adding cannabis, consult your doctor before making any changes. 

Conclusion 

If you have any questions about cannabis and the medications you’re taking, consult a medical professional before adding to or changing your treatment regimen in any way. Benzodiazepines, like Xanax, are potent drugs that can pose potentially serious health risks, especially when stopping suddenly or combining with other medications.

Sources:

¹ Brett, Jonathan, and Bridin Murnion. “Management of Benzodiazepine Misuse and Dependence.” Australian Prescriber, vol. 38, no. 5, 1 Oct. 2015, pp. 152–155, www.ncbi.nlm.nih.gov/pmc/articles/PMC4657308/, 10.18773/austprescr.2015.055.

² Hayhoe, Benedict, and James Lee-Davey. “Tackling Benzodiazepine Misuse.” BMJ, 27 July 2018, p. k3208, 10.1136/bmj.k3208.

³ Lutz B, Marsicano G, Maldonado R, Hillard CJ. The endocannabinoid system in guarding against fear, anxiety and stress. Nature Reviews Neuroscience. 2015;16(12):705-718. doi:10.1038/nrn4036

⁴ Cuttler C, Spradlin A, McLaughlin RJ. A naturalistic examination of the perceived effects of cannabis on negative affect. Journal of Affective Disorders. 2018;235:198-205. doi:10.1016/j.jad.2018.04.054

⁵ Ruehle S, Rey AA, Remmers F, Lutz B. The endocannabinoid system in anxiety, fear memory and habituation. Journal of Psychopharmacology. 2011;26(1):23-39. doi:10.1177/0269881111408958

The information in this article and any included images or charts are for educational purposes only. This information is neither a substitute for, nor does it replace, professional legal advice or medical advice, diagnosis, or treatment. If you have any concerns or questions about laws, regulations, or your health, you should always consult with an attorney, physician or other licensed professional.