Cannabis with equal THC and CBD causes less anxiety than THC alone, especially in calm users

Both THC and THC/CBD increased state anxiety compared to placebo, but anxiety after THC/CBD was significantly lower than after THC alone. When baseline anxiety was low, CBD completely counteracted THC-induced anxiety. When baseline anxiety was high, CBD did not counteract THC-induced anxiety. THC-induced anxiety was independent of baseline anxiety levels.

Placebo-controlled, randomized, within-subjects study of 26 healthy recreational cannabis users. Four conditions: vaporized THC-dominant (13.75 mg THC), CBD-dominant (13.75 mg CBD), THC/CBD-equivalent (13.75 mg each), and placebo. Anxiety measured by STAI, visual analogue scale, and emotional Stroop task.

As cannabis products vary widely in THC-to-CBD ratios, this study provides direct evidence that balanced products may produce less anxiety, which could inform both product selection and regulation.

The finding that baseline anxiety moderates whether CBD can counteract THC-induced anxiety explains some of the conflicting results in the literature and suggests that individual factors determine who benefits from balanced products.

Small sample (26 participants). Single-dose study may not reflect repeated use. Recreational users with low tolerance may respond differently than daily users. No effects detected on the objective emotional Stroop task.