Cannabis & the Cost of Mental Health

In this day and age, mental health care is expensive and difficult to attain for many people—some health insurance plans don’t even cover seeing a therapist, psychologist or psychiatrist. For those that do cover it, you’ll still end up paying over $100 an hour, on average, as your co-pay depending on the doctor. Even for those of us with a full time job and health insurance, getting proper mental health care can feel overwhelming and overpriced. Now imagine that you don’t have a job, health insurance…or even a place to call home. Approximately 254,000 men, women and children experience homelessness in Los Angeles County during some portion of the year, according to the Institute for the Study of Homelessness and Poverty at the Weingart Center and an estimated 25% of these homeless individuals in Los Angeles County suffer from some form of mental illness. That means that on average, there are around 63,500 homeless individuals in Los Angeles each year struggling with mental illness who are not in a position to consistently pay to see someone or be on medication.

Recent studies have indicated that cannabis could be a viable treatment option for patients suffering from a variety of mental illnesses including anxiety, depression, bipolar disorder and schizophrenia. Success has been seen with both CBD and THC medication, depending on the particular mental illness and patient themselves. CBD (cannabidiol) has proved helpful for anxiety because it inhibits the production of fatty acid amide hydrolase (FAAH), which is an enzyme that degrades anandamide. A study conducted on mice at Vanderbilt found that the more anandamide being produced by the brain, the less anxiety was experienced by the mice. In addition, THC (tetrahydrocannabinol) in small doses aids in anxiety reduction by interacting with our endocannabinoid system very similarly to anandamide—both affecting the CB1 and CB2 receptors. For individuals suffering from depression, CBD has proved most effective, because at high concentrations, it activates the 5-HT1A (hydroxytryptamine) serotonin receptor. This causes an anti-depressant effect in the individual.

Brain chemistry plays a pivotal role in bipolar disorder as well—bipolar is believed to have a strong genetic component, but also be related to certain physical changes in the brain. For example, magnetic resonance images (MRI) have shown that the brains of those with bipolar affective disorder have “decreases in the volume of the brain’s prefrontal cortex and its subcortical connections sites, including the amygdala.” The prefrontal cortex is involved in decision making and behavior, while the amygdala is responsible for emotions, mood and motivation. All of these functions are affected by bipolar disorder. Cannabis is actually able to help restore synaptic action in the brain, allowing for nerve cells to communicate more effectively—one of the biggest problems for individuals with bipolar disorder. A study from the University of Newcastle Upon Tyne concluded that both THC and CBD are similar to standard medications being used to treat bipolar disorder. Many patients with bipolar disorder have described that cannabis works as a mood stabilizer, without making them feel numb.

Schizophrenia is perhaps one of the most difficult mental illnesses to treat due to the fact that the exact cause of it isn’t fully understood. It is also one of the most prevalent mental illnesses amongst the homeless population. Individuals with schizophrenia experience both positive and negative symptoms. Positive symptoms are anything that the individual “gains”, like delusions or hallucinations. These symptoms are thought to be caused by an increase in signaling in the subcortical areas of the brain. Conversely, negative symptoms are what the individual loses—like drive or social interaction. These symptoms are caused by a decrease in signaling in the prefrontal cortex. Many studies indicate that CBD is the best option for treating schizophrenia; however in one study, “administration of ketamine (a medication that induces schizophrenia-like symptoms) after pre-treatment with 600 mg CBD trended towards a decrease  in the psychotic symptom known as “depersonalization” (a lack of, or modified attachment to reality; individual feels that they are unable to control their behavior; may feel that they are in a dream) but increased psychomotor activity (i.e. learned, controlled movements) in participants. Best results were noted when THC and CBD were administered together, rather than when there was pre-treatment with CBD.” Another study conducted a double-blind, randomized clinical trial of cannabidiol (CBD) vs amisulpride (a potent antipsychotic)—both forms of treatment were found to be safe and led to significant clinical improvement, but CBD displayed fewer side effects than amisulpride. Those treated with CBD also saw a significant increase in serum anandamide levels, which was also directly associated with clinical improvement: “The results suggest that inhibition of anandamide deactivation may contribute to the antipsychotic effects of cannabidiol potentially representing a completely new mechanism in the treatment of schizophrenia.”

Unlike expensive prescription pills, medical cannabis is a much more economically feasible treatment option for homeless patients suffering from mental illness. Many collectives offer discounts or free samples for homeless patients, The Higher Path included. Cannabis also has far fewer negative side effects than antipsychotics, which often cause numerous other health issues for the individual taking them. The main downside for homeless patients who want to use medical cannabis? Most struggle to find a place where they even can medicate without getting in trouble. So while smoking flower may not be the best option, edibles, tinctures and vaporizers are more discreet ways that homeless patients can use cannabis to treat their mental illness. As for whether THC or CBD is better when it comes to treating mental illness, it truly depends on the patient—even if they’ve been diagnosed with the same disease, no two brains are exactly the same and thus their treatment won’t be either.

SOURCES
Homelessness in Los Angeles County
Systematic Review: Cannabidiol (CBD) in the Management of Schizophrenia
A Natural Mood Stabilizer: Medical Marijuana can Help Fight Bipolar Disorder
Project CBD: How CBD Works
Study: Cannabinoid Therapies May Help Treat Stress-Induced Anxiety Disorders
Mental Illness and Homelessness
Cannabidiol enhances anandamide signaling and alleviates psychotic symptoms of schizophrenia

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