Can Cannabis Help With ADHD?
There’s little conclusive research on cannabis and ADHD
Kelly Burch is a freelance journalist who has covered health topics for more than 10 years. Her writing has appeared in The Washington Post, The Chicago Tribune, and more.
Elizabeth Molina Ortiz, MD, MPH, is a board-certified specialist in family medicine and is the former medical director of a community health center.
Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental condition that affects 11% of school-aged children and an estimated 4.4% of adults.
ADHD is characterized by an inability to sit still, trouble focusing, and impulsive behavior. Because cannabis (Cannabis sativa) has been linked to relaxation, many people are curious whether the medicinal herb can be helpful in managing ADHD symptoms.
The research on whether cannabis can provide short-term relief of hyperactivity in people with ADHD is mixed. And researchers are still trying to learn more about cannabis and ADHD. Here’s what you should know about the effects of cannabis on people with ADHD.
How Cannabis Could Help With ADHD Symptoms
To understand how cannabis might provide relief for ADHD symptoms, it’s important to understand the two components of cannabis, which are:
- Tetrahydrocannabinol (THC): THC is a psychoactive component that gives the “high” associated with cannabis. It acts on the areas of the brain that control focus, coordination, and reaction time. (CBD): CBD is a nonpsychoactive component in cannabis and hemp (a type of cannabis plant that contains 0.3% or less THC). It acts on different areas of the brain and can counteract the effects of THC. CBD has been shown to help regulate brain activity.
When you smoke or consume cannabis, you take in both THC and CBD.
Cannabis for ADHD: What Research Says
There isn’t much research on using cannabis for ADHD because federal research on cannabis has been restricted by the drug’s schedule 1 status (drugs not currently accepted for medical use that have a potential for abuse). However, the research that is available gives a mixed answer to the question of can cannabis help with ADHD, including:
- A small 2020 study of 112 adult patients with ADHD who used medical cannabis found that those who took a higher dose of medical cannabis components, like CBD, took fewer other ADHD medications.
- A 2019 medical review of 83 studies found that there was “scant” and “insufficient” evidence on the effectiveness of cannabis to treat mental health conditions, including ADHD.
- A 2021 study of 1,700 students found that those with ADHD self-reported that using cannabis improved their ADHD symptoms and lessened their side effects from their ADHD medication.
- A 2016 study that analyzed online posts mentioning cannabis and ADHD found that 25% of those posts stated a positive impact of cannabis on ADHD symptoms, as opposed to 8% that said it was harmful.
More research is needed to determine if cannabis can have benefits for adults with ADHD. However, at this time, most states with medical cannabis programs do not include ADHD as a qualifying condition for getting a license.
Cannabis and Kids
Although ADHD is most often diagnosed in children, cannabis should not be used by most young people. Even states with recreational cannabis laws don’t allow people under 21 years old to purchase or consume cannabis. Medical cannabis programs for children are extremely limited, and ADHD is not a qualifying condition.
Using Cannabis With ADHD Medications
There’s limited research on how cannabis interacts with ADHD medications, such as Adderall ( dextroamphetamine – amphetamine ). A small 2015 study of adults without ADHD found that when Adderall and marijuana were taken together, they produced unique effects (neither positive nor negative) compared with either medication taken alone.
If you’re on ADHD medications, it’s important that you be upfront and honest with your healthcare provider about your cannabis use. Cannabis use is becoming mainstream and is legal in some places. Your healthcare provider can help you understand the benefits and risks of using cannabis with ADHD medications.
Cannabis Effects by Strain Type
Some people believe that different strains of cannabis produce different effects. Strains are different varieties of the cannabis plant. Common marketing distinguishes between these two strains:
- Sativa is believed to energize.
- Indica is believed to have calming and pain-reducing effects.
However, research shows the differences between strains are not necessarily accurate. The effects of cannabis are dictated by its levels of THC and CBD, with each having different effects on the brain and body. Most Indica strains are thought to have a higher proportion of CBD, which lends them their calming effects.
Most research in favor of cannabis for ADHD shows benefits of CBD, so you may want to choose a cannabis strain with a higher proportion of CBD (such as an Indica product) or try CBD oil (or other CBD-only product) instead of cannabis.
When Does Cannabis Use Become a Substance Use Disorder?
About 30% of people who use cannabis will develop a substance use disorder. A substance use disorder occurs when substance use begins to interfere with a person’s day-to-day functioning.
Research shows that CBD alone, without THC, is not addictive. So, if you are concerned about developing a substance use disorder, you may want to choose a product with only CBD as opposed to both CBD and THC.
There’s little research on whether cannabis can help with ADHD. The research that exists is mixed: Some studies have found that cannabis can help with ADHD symptoms, while others conclude there is insufficient evidence to make that conclusion.
In most cases, ADHD doesn’t qualify for state medical cannabis programs, and cannabis should never be used to treat ADHD in people under age 21. It's best to have an open and honest conversation with your healthcare provider about using cannabis if you have ADHD.
A Word From Verywell
It’s normal to wonder whether cannabis can treat your ADHD symptoms. Unfortunately, there’s no clear answer. Luckily, researchers are continuing to explore the medical potential of cannabis. Hopefully, within a few years, we’ll have a better idea of the impact of marijuana on people with ADHD.
Frequently Asked Questions
Yes, you should always talk with your healthcare provider before stopping ADHD medications. Sometimes finding the right medications for ADHD can take time. Rather than stopping your medications, reach out to your medical provider to discuss your concerns.
If your cannabis use is interfering with your day-to-day functioning, it’s time to seek help. Remember that even in states with recreational cannabis programs, cannabis is illegal for people who are under the age of 21.
There’s little research about the effects of different forms of cannabis for people with ADHD. However, CBD seems to show more promise for treating ADHD, compared to cannabis that contains THC and CBD. Talk to your healthcare provider about your specific situation.
There’s not enough research to conclude whether cannabis helps people with ADHD. This includes microdosing, or the practice of taking ultra low doses of cannabis to help manage symptoms without a high. If you’re interested in microdosing to help control ADHD, talk with your healthcare provider.
Attention Deficit Hyperactivity Disorder/Attention Deficit Disorder (ADHD/ADD)
Attention Deficit Hyperactivity Disorder/Attention Deficit Disorder (ADHD/ADD) and Medical Cannabis
ADHD, which was formerly known as ADD, is a neurodevelopmental mental disorder, characterized by problems paying attention, excessive fidgeting and difficulty controlling behavior.
Potential Efficacy / Quality of Evidence (Low, Average, High) of Medical Marijuana for Attention-Deficit Hyperactivity Disorder / Attention Deficit Disorder (ADHD/ADD)
Cannabinoids, Terpenes/Terpenoids, Strains and Ratios that May Help
THC, CBD, pinene, limonene and beta-caryophyllene may be of particular use.
CBD:THC 20:1; CBD:THC 3:1; CBD:THC 1:1.
Medical Cannabis Pros
As most medications for ADHD are essentially amphetamines, they come with all sorts of nasty side-effects, such as insomnia, nausea, vomiting, headaches, numbness, tingling, heart palpitations and more. Cannabis does not have the range of negative side-effects Ritalin, Adderall and similar medications have. Cannabinoids may be used to control hyperactivity and impulsivity.
CBD and THC act on dopamine and norepinephrine receptors in a non-direct way, as well as enhancing serotonin receptor activity. Limonene, pinene and beta-caryophyllene are terpenoids that could provide an energizing effect and relieve stress, as well as providing an aid to sleep in high doses in the case of pinene.
Some qualitative evidence for the efficacy of cannabis for ADHD.
Medical Cannabis Cons
Might not be effective for everyone with ADHD – adults with ADHD may respond better to cannabinoid treatment than children with ADHD. This could be due to THC sensitivity.
Some people with ADHD/ADD may be particularly sensitive to THC due to a compromised hypothalamic-pituitary-adrenal axis (HPA axis), which controls reactions to stress. Too much THC may cause anxiety and compromise further. Long-term THC use may potentially have this affect as well. This is more theory, and not every person with ADD/ADHD will necessarily react this way.
Some people may have rebound effects from THC cessation. This suggests that endocannabinoids can play a key role in regulating the HPA axis and stress responses, but care must be taken in which cannabinoid-terpene profile is used and how much (and at what age).
May make keeping focus difficult for some people.
Dry mouth is still an issue.
More About the Condition
Symptoms of ADD/ADHD usually appear before the age of 12 years old and last for at least 6 months, with significant problems at home, school and during recreational activities.
ADHD is estimated to affect 51.1 million people globally. It is estimated that ADHD affectS about 5% – 7% of children and 2% – 5% of adults, depending upon which criteria are used. According to the CDC, around 11% of children (6.4 million) suffered from ADHD in 2011-12 in the US.
Treatments include counselling, planned routines and lifestyle changes and stimulant medications such as methylphenidate (Ritalin) and dextroamphetamine (Adderall) . It is thought that ADHD is linked to sub-performance of dopamine and norepinephrine receptors. Methylphenidate is also a weak 5-HT1A agonist, and CBD could be a potential safer alternative.
ADHD is also associated with neurofibromatosis and mutations in the NF1 gene. This gene may be involved in encoding for a specific endocannabinoid, and utilizing CBD and other phytocannabinoids may be helpful in replacing the lost cannabinoids, helping treat pain and mood disorders.
Quotes from Experts
"The EMA-C trial (Experimental Medicine in ADHD-Cannabinoids) was a pilot randomised placebo-controlled experimental study of a cannabinoid medication, Sativex Oromucosal Spray, in 30 adults with ADHD. The primary outcome was cognitive performance and activity level using the QbTest. Secondary outcomes included ADHD and emotional lability (EL) symptoms. From 17.07.14 to 18.06.15, 30 participants were randomly assigned to the active (n=15) or placebo (n=15) group.
For the primary outcome, no significant difference was found in the ITT analysis although the overall pattern of scores was such that the active group usually had scores that were better than the placebo group (Est=-0.17, 95%CI-0.40 to 0.07, p=0.16, n=15/11 active/placebo). For secondary outcomes Sativex was associated with a nominally significant improvement in hyperactivity/impulsivity (p=0.03) and a cognitive measure of inhibition (p=0.05), and a trend towards improvement for inattention (p=0.10) and EL (p=0.11). Per-protocol effects were higher.