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Study breakdown

Higher doses of the minor cannabinoid CBN were associated with lower ADHD symptom scores in medical cannabis patients

Cross SectionalPreliminary evidence
The takeaway

In 59 medical cannabis patients with ADHD, higher monthly cannabis doses were associated with stopping ADHD medications, and higher cannabinol (CBN) consumption specifically was associated with lower ADHD symptom scores.

ADHD researchers, medical cannabis providers, and patients interested in cannabinoid-specific effects.

CBN (not THC) associated with lower ADHD symptom scores

What the researchers found

Higher cannabis dose consumers and those with lower ADHD symptom scores more frequently reported stopping all ADHD medications. An association was found between lower ADHD symptoms and higher CBN doses, but not with THC doses. Lower ADHD scores also correlated with lower anxiety.

Why it matters

CBN is a minor cannabinoid that has received little research attention. The association with lower ADHD scores, independent of THC, suggests that specific cannabis components beyond THC and CBD may have therapeutic relevance.

The numbers in context

59 patients surveyed, chemovar data available for 27. High-dose group: 40-70 g/month. Low-dose group: 20-30 g/month. Lower ADHD scores associated with higher CBN doses. THC dose was not associated with ADHD scores.

How the study worked

Cross-sectional questionnaire study of 59 adult medical cannabis patients with physician-diagnosed ADHD. Cannabis chemovar data (cannabinoid and terpene content) could be calculated for 27 patients. Patients were stratified by monthly dose and ADHD symptom severity.

What this study cannot tell us

Very small sample, especially for chemovar analysis (n=27). Cross-sectional design cannot determine if cannabis improved ADHD or if patients with milder ADHD chose higher doses. Self-reported ADHD diagnosis and outcomes.

How to read the evidence

Preliminary: very small cross-sectional study with limited chemovar data.

When this study was published

Published in 2020 in Rambam Maimonides Medical Journal.

The bigger picture

If confirmed, the CBN finding could shift focus from THC-dominant products to cannabis formulations enriched in minor cannabinoids for ADHD management, though the evidence is far too preliminary for clinical recommendations.

Questions still open

  • Would a controlled trial of CBN show ADHD symptom improvement? Why was CBN but not THC associated with lower symptoms? Is the medication reduction a result of symptom improvement or patient preference?

Common questions

What is CBN?
Cannabinol (CBN) is a minor cannabinoid that forms when THC degrades over time. It is present in small amounts in aged cannabis and has been associated with sedative effects, though it has received far less research than THC or CBD.
Should people with ADHD use cannabis?
This study is far too small and preliminary to recommend cannabis for ADHD. The CBN finding is intriguing but needs replication in controlled studies. Current evidence does not support cannabis as an ADHD treatment.

Read the original research

Cannabinoid and Terpenoid Doses are Associated with Adult ADHD Status of Medical Cannabis Patients.

Rambam Maimonides medical journal, 11(1)

Citation

Hergenrather, Jeffrey Y; Aviram, Joshua; Vysotski, Yelena; Campisi-Pinto, Salvatore; Lewitus, Gil M; Meiri, David. (2020). Cannabinoid and Terpenoid Doses are Associated with Adult ADHD Status of Medical Cannabis Patients.. Rambam Maimonides medical journal, 11(1). https://doi.org/10.5041/RMMJ.10384

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