Can Cannabis Help ADHD/ADD?
Jun 16, 2020
Many cannabis patients with ADHD report that using cannabis helps with their ADHD symptoms, and the research suggests that it may be a beneficial treatment. There is a strong link between ADHD and dysregulation of the endocannabinoid system — which suggests that activating this system could lead to improvement for some ADHD patients.
In addition, case and clinical studies indicate that ADHD sufferers may have non-standard responses to cannabis. Instead of experiencing the common cognitive side effects associated with cannabis use (such as lack of focus, short term memory loss, and lack of coordination), ADHD sufferers may actually find these areas improved with cannabis use.
How cannabis affects ADHD
To understand how cannabis might be able to impact ADHD, we first need to understand how ADHD is impacted by the endocannabinoid system — the system in the human body that cannabis activates to provide its wide range of effects. This important system is tasked with maintaining homeostasis (or internal balance) for many bodily functions, such as sleep, pain, memory, inflammation, energy metabolism, hunger, mood and even focus.
Made up of three parts, this system contains naturally produced chemicals called endocannabinoids, endocannabinoid receptors (which the endocannabinoids bind with to activate the endocannabinoid system effects) and enzymes which metabolize the endocannabinoids and clear them from the body.
In healthy individuals this system works normally on its own — but disruptions to it can cause a variety of negative health effects. Interestingly, there are also chemicals in cannabis (called phytocannabinoids or cannabinoids for short) which interact with the endocannabinoid system in the same way our natural endocannabinoids do. These cannabinoids, such as THC and CBD, are very similar to the endocannabinoids produced in our own bodies and are also able to activate endocannabinoid receptors and thus cause a wide array of effects.
In ADHD patients, this natural endocannabinoid system may be dysregulated, causing issues with focus and impulsivity. There are a few pieces of evidence that point to this.
For one thing, in rodent studies, ADHD has been tied to misfirings of the endocannabinoid system — a system that is crucial for regulating focus. Abnormal dopamine transmission is a key aspect of ADHD, and this is actually modulated by the endocannabinoid system. In particular, studies show that the CB1 receptor is crucial to this type of dopamine signaling and so its modulation or activation (perhaps using cannabis) could theoretically have a big impact on symptoms of ADHD.
This connection between ADHD, the endocannabinoid system and CB1 is further supported by genetic research into ADHD. Studies show that genetic variants for the gene associated with the CB1 receptor are correlated with ADHD. Thus it is highly possible that ADHD is a genetically inherited dysregulation of the endocannabinoid system – and in particular the CB1 receptors.
Given this strong association between ADHD and the endocannabinoid system, there is good theoretical reason to believe that cannabis can impact ADHD. But at the same time, cannabis has a bad reputation for negatively impacting focus. In healthy individuals, acute cannabis use is likely to cause disruptions in focus. So historically, there has been some worry that cannabis use would actually worsen ADHD. Still, the evidence (while limited) points in the opposite direction. Rather than worsening ADHD, the science suggests that cannabis can actually improve ADHD symptoms.
The first clues for researchers that cannabis might help ADHD were case studies of individuals with ADHD who seemed to experience a relief of their symptoms after cannabis use. One compelling case study describes a 28-year old male who showed “improper behavior and appeared to be very maladjusted and inattentive while sober.” Surprisingly, researchers found that when this man used cannabis he became “completely inconspicuous” in his symptoms, seeming more focused and stable. His doctors compared his performance in a battery of tests designed to evaluate focus and attention (including driving tests). They found that he performed far better on these measures when he had very high blood plasma levels of THC, than he did without cannabis in his system. The researchers concluded that for some individuals with ADHD, rather than causing problems with focus, attention, and coordination, cannabis could actually lead to improved abilities in these areas.
Interestingly, other studies have shown similar results for patients with Tourette’s syndrome. Rather than having the normal cognitive response to acute cannabis use, these patients suffered from no cognitive deficits when using cannabis. Tourette’s syndrome is also associated with the dopaminergic system, so it makes sense.
Still, case studies are tricky to evaluate because it’s hard to control for outside factors, such as the use of other drugs, unknown health conditions, or just about anything else that isn’t tracked by your doctor but might impact your situation. While it’s clear from this that one individual’s focus was positively impacted by cannabis – it’s not clear from this whether it is a trend for ADHD in general. But luckily the science doesn’t stop here.
Other scientists took this to the next step and put together a placebo-controlled study to look at the phenomena of ADHD patients self-medicating with cannabis to determine whether cannabis actually improved ADHD symptoms, in comparison to a placebo. In this study, which included 30 adults with ADHD, researchers gave half the subjects Sativex Oromucosal Spray (a cannabinoid-based medication) and the other half a placebo. Then they evaluated their cognitive performance, activity levels, and ADHD symptoms. While the results didn’t meet statistical significance for cognitive performance or activity levels, cannabis users tended to score higher on these measures than the placebo group — suggesting that (at the very least) cannabis didn’t seem to cause the cognitive deficits and sedative effects usually seen in acute cannabis use for these ADHD patients. In addition, when it came to the ADHD symptoms, the cannabis-using group outperformed the control group, showing improvement in scores for hyperactivity/impulsivity, inhibition, and inattention. Still, these results were not statistically significant after the full analysis was complete so more research is needed to confirm or disconfirm these results. Nonetheless, researchers in this study reported that it suggests “adults with ADHD may represent a subgroup of individuals who experience a reduction of symptoms and no cognitive impairments following cannabinoid use.”
In addition to this study on ADHD and cannabis, another study looked at cannabis use in ADHD patients who were seeking treatment for cocaine addiction. Researchers studied 92 cocaine dependant ADHD patients in a clinical trial for methylphenidate (a drug used to treat ADHD) in an outpatient setting. Sixty-nine percent of those patients were using cannabis as well during their treatment. The analysis found that moderate cannabis users actually had improved retention rates in the program. Parallel to that, cannabis has shown very promising evidence on helping treat addiction.
We also see some evidence from animal studies. One study looked at hyperactivity in rats, using a nose-poking test where rats had two holes in their cage that they could poke with their nose to get a food reward. For one hole, the food was delivered immediately but in a small amount. For the other hole, the food was delayed but was a larger amount, which got progressively larger each time. The less impulsive rats were able to delay gratification and show preference for the delayed larger amount of food. Researchers found that stimulating CB1 receptors normalized impulsivity behavior in hyperactive rats, while having no effect on healthy control rats. This suggests that stimulating CB1 (such as with THC) can improve this aspect of ADHD.
The research, as a whole, does point to the possibility that cannabis could improve ADHD symptoms such as inattention, hyperactivity, impulsivity and addiction to other dopamine stimulants, for some. Still, the research is very limited with mostly small sample sizes, and positive results that are often not statistically significant. More large scale, controlled clinical research is needed before we can say for sure that cannabis can help with ADHD.
Despite the positive potential for cannabis and ADHD, cannabis comes with a wide array of potential side effects — which can be a deterrent for some. Cannabis use may cause effects like temporary cognitive deficits, short term memory loss, focusing issues and impaired coordination — although these effects are less prevalent in patients with ADHD. It can also cause mood-related issues like anxiety, paranoia, or depression, and it may cause respiratory symptoms such as asthma, coughing and increased phlegm production when inhaled.
Cannabis can increase the risk of psychosis for schizophrenic patients, and it can also increase the risk of certain cardiac conditions. For a minority of patients, cannabis can also lead to addiction.
The Cannigma content is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Always consult with an experienced medical professional with a background in cannabis before beginning treatment.
ADHD, or attention-deficit/hyperactivity disorder, is a brain disorder that affects millions of children and adults. ADHD makes it difficult to focus and complete tasks and often involves impulsive and/or hyperactive behavior.
There used to be two different conditions: attention deficit disorder, or ADD, which covered trouble paying attention but without hyperactivity, and ADHD, which included hyperactivity. Today, they are both included in the diagnosis of ADHD.
There are three types of ADHD:
Predominantly inattentive ADHD, which used to be called ADD
- Predominantly hyperactive/impulsive ADHD
- Combined ADHD, which combines the symptoms of inattentive and hyperactive/impulsive ADHD
- Predominantly inattentive ADHD, which used to be called ADD
It’s important to get the right diagnosis, as the treatment could often be different.
The symptoms of ADHD can appear as early as three years old, but almost always before the age of 12, and affects boys more often than girls. On average, symptoms appear around the age of 6. Worldwide, around 7.2% of children aged under 18, and 3.4% of adults have ADHD. However, rates differ widely in different countries. In the US, for example, 9.4% of children have ever been diagnosed with ADHD, but fewer than 1% of children in the UK have received that diagnosis.
People with ADHD can have trouble concentrating, are disorganized, move about constantly and can’t sit still or stop talking, and act impulsively and without thinking. Many people find their ADHD symptoms lessen as they get older, but they rarely go away entirely.
The right treatment can help reduce the symptoms and help you find strategies to succeed with ADHD.
The main symptoms of ADHD are inattention, often together with hyperactive and impulsive behaviors. Although everyone loses focus from time to time, if you have ADHD you’ll lose focus more often, and your inattention has a serious impact on your social interactions, education, and/or work.
ADHD can present differently in different people. Boys with ADHD are more likely to be hyperactive/impulsive as well as inattentive, while girls are more likely to quietly lose concentration, but any child can have any combination of symptoms.
Symptoms of inattention include:
- Having trouble sustaining attention in class, conversations, while reading, or during long games, and being easily distracted
- Failing to notice details, making careless mistakes in schoolwork
- Seeming like you’re not listening when someone talks to you
- Having trouble staying organized, following through on instructions, and finishing tasks
- Frequently losing possessions
- Forgetting regular activities, like chores or extracurricular events
Symptoms of hyperactivity/impulsivity include:
- Constantly fidgeting, squirming, and wriggling
- Always moving around, running when it’s not appropriate, and having trouble staying seated
- Finding it hard to play, read, or do a quiet activity
- Talking non-stop, blurting out answers or thoughts, often interrupting someone else.
- Having trouble waiting for their turn
- Interrupting or intruding on others
The experience of being frequently being reprimanded for inattention and/or hyperactive/impulsive behavior, and struggling to succeed academically, can lead to poor self-esteem and depression. Children with ADHD can have trouble being accepted socially, and are at greater risk of alcohol and drug abuse.
Diagnosing ADHD is a complicated process, so it’s important to go to a doctor with experience in this area. Sometimes anxiety disorders, depression, sleep disorders, vision or hearing problems, autism spectrum disorders, and other disorders can be mistaken for ADHD.
ADHD is only diagnosed if the symptoms were present before the age of 12. There’s no test for ADHD, but you can expect your doctor to spend time asking about and observing symptoms, taking a full medical exam, and gathering information from other people who spend time with the child. Your doctor will also use ADHD rating scales, and ADHD diagnostic criteria from the American Psychiatric Association.
Diagnosing ADHD in adults for the first time is difficult because it relies on your ability to remember symptoms from before you turned 12. It’s generally agreed that ADHD never develops for the first time in adulthood.
Often, there are other factors that can lead to similar symptoms of ADHD such as poor sleep, stress, anxiety, and depression, and those factors should be ruled out before a diagnosis of ADHD is given.
There’s a great deal of uncertainty about what causes ADHD. Some of the factors that might contribute to developing ADHD include:
- Genetics, since ADHD tends to run in families
- Differences in the brain structure
- The chemical imbalance that affects the operation of neurotransmitters in the brain
- Environmental toxins, like lead, during pregnancy or at a very young age
- Premature birth (before the 37th week of pregnancy), or born with a very low birth weight
- Having epilepsy
- Having brain damage, either from birth or later in life
So far, no research has found a link between consuming sugar and ADHD.
There’s no cure for ADHD, but the symptoms can be treated using a combination of medication, psychotherapy, and education. It can take some time to find the right combination of treatment for each person.
The most common types of medication for ADHD are stimulants. You’re most likely to be prescribed amphetamines, like Ritalin, Focalin, Concerta, Adderall, or Vyvanse. Often it can also take some trial and error to hit the right dose and they often include side effects such as abdominal pain, diarrhea, weight loss, and headache.
There are also some non-stimulant medications that are prescribed when stimulants aren’t effective. These include:
Non-stimulant medications tend to take more time to work than stimulants, so it might take as long as several weeks to see the full effect.
There are a few therapies that help people with ADHD learn strategies to succeed with ADHD.
- Behavioral therapy helps parents and teachers encourage positive behaviors using rewards and timeouts, and structure activities in ways that are easier for children with ADHD to handle.
- Social skills therapy helps children to learn how to behave in social situations.
- Psychotherapy and CBT help older children and teens with ADHD to talk about and change how they feel about ADHD, in order to change their behavior.
- Parenting training and education teach parents specific ways to guide their children and support them to improve attention and behavior.
Some people have found that changing a child’s diet and giving them omega-3 and omega-6 fatty acid supplements can help with the symptoms of ADHD. Practicing yoga, meditating, and using neurofeedback training are other ways that people improve their attention span without medication.