OFFICE OF MEDICAL CANNABIS
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
OFFICE OF MEDICAL CANNABIS
2021 MN Medical Cannabis Program Medical Condition Petition Comments
Written comments received through October 1, 2021
Anxiety
Yes to anxiety.
CR, MD, MPH
I think it is very helpful for my anxiety but I qualified for chronic pain and ptsd! I believe it would help many get
off rx or cut their meds down with cannabis as a legal option and it’s great with no or little side effects!
LK
I am writing again this year to voice my support for the use of cannibus to treat severe anxiety. Marijuana helps
me to feel actual balance my life, and not feel like a hazy cloud that other medications I have been prescribed
do, such as Xanax. Giving people another option to help alleviate their issue, especially a more natural option,
only seems like a good idea. I saw the comments from medical professionals on last year's petition, and some of
the "cons" for adding anxiety as a qualifying condition seemed laughable. Marijuana will obviously not work for
everyone, and some people may even have adverse affects (increased anxiety), but to act like these same issues
don't occur with the pills they want to shove down our throats is just silly. People need to find what works right
for them, but marijuana is a relatively safe option that has proven to work for many individuals, like myself, who
suffer from severe anxiety. Please get us out of this era where we demonize marijuana, and have THEY most
strict and inefficient medical program in the country.
BC
What would be best for everyone is for big government to Bud out of our lives and let us grow this god-given
plans and consume it whichever way we choose. But anxiety is definitely reduced when I consume a lot of THC.
DD
My name is Kimberly Perrine and as a Parent, Patient, Advocate, and Insurance agent.
I am writing in support of the petition to add Anxiety Disorder to the qualifying medical condition.
Hundreds of thousands of Minnesotans use cannabis, and a significant number use cannabis for medical
reasons, with great success and relief that is not found elsewhere.
Many Minnesotans purchase Cannabis in free states and bring their choices back to Minnesota, risking safety,
consistent dosing, and freedom in simply obtaining a medicine that works for them.
Every opportunity we have as a state to work toward the end of cannabis prohibition is a win for Minnesotans.
I urge your office to approve the petition and make one more improvement to what has been the worst medical
cannabis program in the country.
Let’s change the Midwest stigma and join the educated knowledgeable Cannabis consumers already enjoying
the endless benefits.
KP2021 MN Medical Cannabis Program Petition Process – Medical Condition
Written Comments 10/1/2021
As a current patient for a condition other than anxiety disorder. I have found that the cannabis is beneficial in
reducing anxiety as well. I am diagnosed with anxiety disorder and treated by the VA. They have discussed
cannabis but cannot recommend or prescribe it due to federal laws.
I recommend you approve this condition as I have found it to be beneficial to me. And I have not suffered any
negative side effects from cannabis use.
RS
I support the state adding these as qualifying conditions. Many pharmaceuticals have a lot of harmful side
effects and people my find relief with these natural treatments.
KS
Please authorize medical cannabis for anxiety. I have never used cannabis in any form. I am a retired RN/ nursing
educator. I have been prescribed anti-anxiety oral meds in the past but found them not helpful, so I
discontinued. CBD has helped a little, so I am interested in trying oral cannabis as an anti-anxiety agent.
I am not a marijuana user as I would not risk legal issues, but would utilize cannabis medicinally.
JN
Anxiety as one of the Dx codes that needs to be on cannabis program.
JL
Why not give cannabis in its various forms a CHANCE when it comes to helping people get thru this life. Anxiety
is no joke and while I understand that cannabis MAY make anxiety worse... i feel that with proper dosages of
the various strains and combinations of thc/cbd ...anxiety should be at a minimum once each individual has
found what is best for their own body!
Marijuana should be made legal across all the states immediately!
JP
I have had generalized anxiety disorder since I was 12 years old (I am now 34). Anxiety disorders are extremely
debilitating and impact so many aspects of daily life. It is also hard to find medications that work for anxiety that
are not narcotic medications especially when you have severe anxiety combined with PTSD. Medical cannabis is
a much safer less addictive medication aside from narcotic meds that can be used to treat anxiety disorders. It
can also potentially help reduce the amount of people that end up struggling with opioid addictions If they had
access to medical cannabis.
It is important for people with anxiety disorders to have all treatment options available to them especially when
medication provides continue to be more and more hesitant to prescribe narcotic medication to treat anxiety.
Please as Anxiety Disorders to the list of approved disorders.
JK
I think this is easily my 3rd or 4th year commenting on the addition of Anxiety to the MN Cannabis Program.
I am an adult who as a child was sexually abused. As an adult I have now got PTSD, Anxiety and Depression.
Starting at about 17 I started to go through therapy. Eventually, as a young adult I was prescribed Zoloft and
Paxil. Both made me almost catatonic. I felt like I had no emotion from these meds. I was a mom of a young
child at that time also. So I went off them. I had been on Paxil first and then Zoloft.
Throughout my life i have been in and out of therapy. About 20 years ago I was put on Wellbutrin. It made me
super anxious. Again, more therapy for me. I went off of Wellbutrin. I was married about this time and we
22021 MN Medical Cannabis Program Petition Process – Medical Condition
Written Comments 10/1/2021
moved to SD from ND. A few years later it was back to therapy and I was put on Lexapro. Lexapro worked
amazingly for me. But about 15 years into using it i started getting brain fog and started to think about how it
must be affecting my brain. I went off it. It took me a full year plus to wean myself off of Lexapro and for a few
months I still felt the zings in my head from not having it in my system. I feel much pity for drug addicts who
use because their brains get used to the drugs and even though they want to quit, the side affects are awful. So
again back in therapy I went and this time I started DBT. DBT was an excellent program btw. About 10 years
ago i had bariatric surgery. Reux-N-Y specifically. Its now hard for me to be on medications as some are hard on
the stomach such as aspirin and ibuprofen. I got on the MN Cannabis Program for PTSD but mainly it was for
anxiety mostly. I have fought for the addition of flower because mostly all i can use are the vape pens. the 1:1
ratio vape pen from leafline was my saving grace for PTSD symptoms but i am still sensitive to all medicines and
have tried buspar and such for anxiety and to no avail. Adding flower i feel will be a really great thing because
one strain does NOT fill the needs of everyone. Its like taking tylenol for a cold, for allergies, for cancer pain and
for sleep issues and we all know tylenol is not a one fits all. But neither is Cannabis.
Different strains have different terpenes. I know i am sensitive to THC...its hard for me to use full fledge
THC...but the next person might need high THC products. This is why i stress the importance of allowing
different strength strains (IE: low doses of thc like 5 to 7% to higher doses of CBD like Harlequin, 1:1 (CBD:THC)
ratio strains like cannatonic strain and higher THC with no CBD strains) to the program. With different strains I
am hopeful I will be able to find a flower to dry vape that will ease my anxiety so i do not have to go back on
medications.
Please allow anxiety as a condition. Covid has been super hard on my anxiety. Super hard on millions of people
and anxiety. Anxiety is a motivating factor for people to self medicate. I am a nondrinker and non drug user and
a non smoker luckily. But I can understand people who chose to use illicit drugs because of anxiety. If you can
provide a safe way to help some people deal with their anxiety especially in this anxious time...i can't
understand why you wouldn't. If cannabis can be used for conditions like PTSD or pain I can't imagine why it
would not be ok for anxiety. Thanks for your consideration.
LR
This change would help so many people who suffer from anxiety! I believe it works better for anxiety than pain
really. The two go hand in hand at times. Yes, yes, yes .
DL
My name is Alyssa Malyon and I live in Red Wing, Minnesota. I was diagnosed with generalized and social
anxiety, as well as major depression at the age of fifteen. I am currently attending Bethel University to study
neuroscience to try and get a better understanding of my disorders, along with many other disorders like mine.
I have tried countless medications on many different dosages, but none of them seemed to help in the way that
they should. I was and currently am experiencing many side affects from my medications, including periods of
insomnia or extremely low energy, irritability, feeling numb to emotions, weight gain, and self isolation.
Marijuana has lessened many of these symptoms dramatically. It helps me regulate my sleep schedule- when I
am experiencing insomnia and my brain won’t stop spinning, smoking a little bit helps my brain to focus on one
thing at a time and I am able to fall asleep much easier. When used during the day when I am feeling
unmotivated and exhausted, it brings joy and energy to my day. In my personal experience, when using
marijuana, feeling irritable, or as if you feel no emotions at all are some of the last things that would ever come
to my mind. I oftentimes feel more sociable and have a flood of positive emotions.
It saddens me to see how much marijuana has been demonized, when it has helped so many people, including
myself. If only more people were made aware of the positive effects that it can have on someone’s life
32021 MN Medical Cannabis Program Petition Process – Medical Condition
Written Comments 10/1/2021
struggling with depression or anxiety disorders, then maybe it wouldn’t be thought of as such a scary or harmful
drug. When used safely, it is quite the opposite of that.
Thanks for your time.
AM
Yes, I vote “Anxiety Disorder” be included.
After 1 1/2 years of being lockdown due to Covid, I created anxiety when I head out the door, can’t believe I’m
the only one. Count me in AND as a patient the edibles would be welcoming as another option. Would probably
purchase more regularly.
JJ
I Kim (Red) Matthiesen am contacting you in hopes that anxiety disorders will be added as a qualification for
medicinal marijuana. I am a State of Minnesota medicinal marijuana patient ID 7821521. I experience a
reduction of my anxieties after the use of marijuana. My wife, who does and never has used any illicit drugs,
often instructs me to "go smoke some marijuana" when I become to anxious. She observes the reduction after
use.
KM
With regard to the comment period for anxiety. Of course anxiety should be a qualifying factor, however, no
one will be able to afford it given the limited program that excludes small growers and businesses that could be
thriving in local communities. I would like to be notified of any progress regarding opening up the
qualifications for growers in Minnesota. This has been an issue since the program inception that limits access to
patients and creates a state sponsored duopoly.
JB
Thank you for maybe okaying this for anxiety. I've suffered from it most of my life.
CL
I would like to add my support to the petition to add anxiety disorders to the medical cannabis program. From
personal experience, I know that my anxiety & depression is much more manageable when I am able to use THC
products, such as delta 8 THC. Due to work-related related drug testing, I am unable to continue the beneficial
regimen I had built and no longer have any drive to do self-care as I used to. THC is an invaluable medical
resource for many mental health conditions - anxiety & depression included - and users should not be punished
in any way.
For these reasons, anxiety disorders should be qualifying conditions for the medical cannabis program.
LS
Please allow.
MK
As an experienced person in this matter, I would strongly recommend cannabis as an anxiety disorder
treatment.
TM
42021 MN Medical Cannabis Program Petition Process – Medical Condition
Written Comments 10/1/2021
I am on medical cannabis for PTSD and it greatly helps my anxiety that I have had for 2 decades.
TS
First, I petition to legalize cannabis for the general public.
Second and thirdly, I petition to add anxiety disorder as a qualifying condition and add edibles as a delivery
method.
CC
Reiteration of previously submitted petition.
EE
As a person diagnosed with General Anxiety Disorder, I am petitioning to add Anxiety Disorder for the Medical
Cannabis Program. I experience side effects with my anti-anxiety medication and I believe Medical Cannabis is a
good alternative. I appreciate having more options to curb anxiety.
Thank you for your consideration.
MS
Yes I believe both these disorders should be added to the qualifying for medicinal cannabis...anxiety
especially..is gets debilitating along with pain...please consider adding
MH
Adding Anxiety to the Dx's that are covered under the cover of the cannabis program. Anxiety is the one Dx that
has to have help . Please adding anxiety will help so many people. Anxiety is very real and people with it does
not want to use all the other medications. Please add anxiety to the cannibis, program.
JL
You should consider medical cannabis for anxiety disorder
SW
As a concerned citizen with horrible anxiety disorder, I feel adding anxiety to the list of medical cannabis
accepted conditions would help many many people, including myself. I've been waiting for them to take this
step since MN first passed medical Marijuana legislation.
Thank you for your time.
AD
I am writing to support adding anxiety disorder as a qualifying medical condition and to weigh in on the
proposed limitation to those 25 or older. As someone who has just received approval to receive medical
cannabis for Osteoarthritis, I am convinced that this type of edible would be very beneficial to patients needing
help with anxiety chronic pain, PTSD, or any number of a variety of medical issues. I, too, suffer from anxiety and
have benefitted from the benefits of this miraculous plant!
52021 MN Medical Cannabis Program Petition Process – Medical Condition
Written Comments 10/1/2021
CH
I am writing in support of adding Anxiety Disorders to the list of qualified conditions for the medical cannabis
program. I am a long time sufferer of generalized anxiety disorder and have been in therapy to help cope. The
only other option at this time is to take medication that has many side effects. I have tried medications but have
not found them helpful, but rather more hindering. Cannabis has been proven to reduce the symptoms of
anxiety as well as greatly improve the quality of life for persons who suffer from anxiety and I would love to be
able to use this option in a legal and regulated manner. It would be a big step for Minnesota to add anxiety
disorders to the list of qualified conditions and I fully support this addition.
KD
I support adding anxiety disorder as a qualifying medical condition support adding anxiety disorder as a
qualifying medical condition and I oppose raising the age to 25. Stop gentrifying medicinal herb.
RZ
Currently it costs about $400 to get a special doctor to sign off on a medical marijuana request and the State to
approve it.
Many poor people cannot afford this requirement, so it disenfranchises a significant part of the population. This
is discrimination and penalizes those who may need it the most.
Legislation should make medical marijuana available from any personal physician and affordable by accepting
insurance like any other prescription.
RR
I am writing this message to support adding anxiety disorders as a qualifying medical condition for cannabis in
Minnesota. I am currently a medical cannabis patient here and I also suffer from severe anxiety. I would hope
that our state follow suit of the other states qualifying conditions. Many people could benefit from adding more
qualifying conditions to our already very short list.
JK
People already use Cannabis to treat anxiety. They should be free to do so without worrying about racist laws
destroying their responsible lifestyles and contributions to society.
AS
Hello - I'm emailing you in support of adding anxiety as a qualifying medical condition for medical cannabis, as
well as GI edibles as a delivery method.
I've suffered generalized anxiety disorder (GAD), major depressive disorder, and obsessive compulsive disorder
most of my life, and I've been medicated for them for the last 5 years. The medications I've taken often have
undesirable side effects, the worst being insomnia. While I no longer experience the symptoms of GAD or
depression, sleep deprivation has negatively impacted my health in many other ways. But given current
treatment options, I'm stuck with choosing between the lesser of two evils.
I'd also like to see GI edibles as an option for consumption. Over the years, I've tested many cannabis products,
and edibles are the delivery method I'm most comfortable with. I'm also concerned about the health impacts of
vaping or smoking cannabis - of which the long-term health consequences don't seem to be as clear.
Thank you for accepting my comments - I look forward to seeing these changes to Minnesota's Medical
Cannabis Program.
62021 MN Medical Cannabis Program Petition Process – Medical Condition
Written Comments 10/1/2021
PS
I am in support of adding GI edibles as an additional delivery method. I am also in support of adding anxiety
disorder to the list of qualifying conditions.
EFT
As someone who previously lived in a state where anxiety is a qualifying condition for medical marijuana, I can
honestly say that in my experience it made a world of difference in alleviating my symptoms. It may well be true
that some people with anxiety find marijuana to be an ineffective treatment, or even exacerbate some of their
symptoms. However, this decision needs to be made in light of the principal medications prescribed for
managing anxiety, benzodiazepines and antidepressants..
I truly cannot believe that anyone would in good faith believe that cannabis is not a safer alternative to drugs
that can lead to dependence, addiction, suicidal ideation and overdose. If doctors can prescribe these
medications to their patients in spite of the potentially life threatening consequences, why should Minnesotans
be barred from considering cannabis instead? Much of the argument for adding intractable pain as a qualifying
condition centered around the fact that mairjuana provides patients a safer alternative to opiates to manage
their pain symptoms, and allowing cannabis for anxiety would surely offer similar benefits. Those who see no
benefit from using medical marijuana could still access the other treatment options that are currently available.
As for the argument that the resultant increase in medical marijuana users would lead to more underage
children obtaining cannabis, would its proponents deny that a sizable market for illicit marijuana already exists
in Minnesota? Bringing even a small portion of the vast black market trade into a regulated system would
reduce underage Minnesotans' access to cannabis, not increase it.
While many of this proposal's detractors will point to the lack of evidence that cannabis is an effective anxiety
treatment, the fact is that until relatively recently, doing any scientific research involving cannabis was nearly
impossible. This means that it will be years, if not decades before a sufficient body of evidence to satisfy these
critics can emerge. Until then, how much suffering will Minnesotans like me have to endure?
I sincerely hope that this panel will finally listen to myself and the many other anxiety sufferers who have made
their voices heard on this matter year after year.
BP
I am sending this email in support of adding anxiety and panic disorders as qualifying conditions to the medical
cannabis program. As a person who suffers from extreme anxiety, this medication would be another option for
me.
CB
Please consider adding anxiety disorder to your list of medical needs that can be helped by the adult use of
medical cannabis. There is a long list of scientific and anecdotal evidence to show that cannabis is not only
helpful but far safer than many other options to relieve anxiety.
BP
72021 MN Medical Cannabis Program Petition Process – Medical Condition
Written Comments 10/1/2021
I am a board-certified adult and child and adolescent psychiatrist practicing in Rochester, Minnesota. I primarily
work on an inpatient adolescent unit, but I also see adults and youth in the outpatient setting.
From my clinical experience, the prevalence of youth using marijuana admitted to our inpatient psychiatric unit
has been increasing over the recent years. We are seeing more and more young people who have increased
anxiety, particularly panic attacks, and depression when using marijuana. We are also seeing more young
people with psychotic symptoms that appear in the context of heavy marijuana use. Marijuana on the
developing brain (which can be into the mid to late 20’s) is something I think we need to be very cautious
about. From my clinical practice seeing hundreds of young people per year, those who use marijuana struggle
more with anxiety and mood. Additionally, medications we typically use for anxiety do not seem as efficacious
when marijuana is present.
As marijuana has been legalized around the country or promoted for medical reasons, I see more and more
young people think that marijuana is okay (and their parents not uncommonly have the same view). I’m seeing
more youth who are driving while using marijuana as well. I see more youth who use marijuana to “chill out” or
“calm down,” but the long-term effects of this seem to actually worsen their anxiety and depression.
I am strongly against recommending marijuana for the indication of anxiety. Thank you for your time.
JVV, M.D.
I am a Minnesota psychiatrist who has practiced for 22 years at Regions Hospital as an acute care inpatient
psychiatrist followed by 10 years as an addiction psychiatrist at the Hazelden Betty Ford Foundation. Before that
I was a community psychiatrist in Superior, Wisconsin for 3 years at a community mental health center. I am no
longer affiliated with any of those institutions and this email is based on my cumulative clinical experience.
In those 35 years of practice I have done thousands of comprehensive psychiatric evaluations that typically
include an assessment of any associated substance use disorder. One of my standard questions in those
assessments is "Were you ever a daily marijuana smoker?" In following up that question I ask about the duration
and why they may have stopped. The typical reason for stopping is that they started to get high anxiety and
panic attacks. Depending on the degree of euphoria from cannabis - some people continue to use it and expect
that their anxiety or other symptoms can be treated so that they can continue to use it.
As an acute care psychiatrist, I saw many people who were psychotic or manic as either the direct effect of
cannabis or because it exacerbated an underlying major psychiatric disorder. In the outpatients that I have
treated cannabis was associated with chronic depression and cognitive symptoms that were often seen by the
patient as evidence that they needed treatment for attention-deficit/hyperactivity disorder. In both scenarios,
cannabis use was more than a psychiatric diagnosis - it led to these patients having significant impairment in
their relationships, vocational achievement, and general ability to function. Some tried to stop and developed
cannabis hyperemesis syndrome or other symptoms of withdrawal.
As part of my comprehensive evaluations, every patient I saw was also assessed for suicide and aggressive
potential. Populations of people seeing psychiatrists will be biased in that direction because in many settings
suicidal and aggressive thinking is why they are scheduled to see us. There is a clear link between cannabis use
and increased suicidal thinking. More recent research also suggests that Black/African American,
Hispanic/Latinx, and Native Americans were at elevated risk for suicidal ideation if they have a cannabis use
disorder and Black/African American and Hispanic/Latinx groups using cannabis were at higher risk for suicide
attempts.
Many of the patients I see have complicated medical problems that can be compounded by cannabis use.
Cannabis has a significant hypotensive effect that typically triggers a rapid heartbeat and "heart pounding
effect." That is a potential problem for people with cardiovascular problems or who take antihypertensive
82021 MN Medical Cannabis Program Petition Process – Medical Condition
Written Comments 10/1/2021
medications. In a recent large study of 18-44 year olds, cannabis users (defined as use more than four times a
month) were more than twice as likely to experience a heart attack.
There are better and safer treatments for anxiety disorders. There are better and safer treatments for anxiety
disorders that do not respond to first line treatments. I recommend against an anxiety or panic attack indication
for medical cannabis because in the vast majority of people I have seen it caused significant anxiety and panic. It
also obscures psychiatric diagnoses and considering that most people will not have access to a psychiatrist - will
probably result in more medications to treat the cannabis induced symptoms. At a time where this is more
focus on suicide prevention, cannabis use is implicated in suicidal ideation and suicide attempts. Finally when
there has been concern about the lack of medical research on cannabis for positive effects, the negative effects
are becoming more apparent.
GD, M.D., DFAPA
As a child, adolescent, and adult psychiatrist, I am committed to public health of all ages (including as it pertains
to the still-growing brains of 25-year-olds and younger). I am also committed to a world of medicine/health care
that supports interventions based upon strict level-of-evidence criteria (evidence of benefit compared to
evidence of harm).
The studies which promote cannabis’ efficacy for anxiety, including panic, are of limited quality in their ability to
prove that risks and benefits have been appropriately gauged. True benefit (distinct from a “high” or
“numbing”) is scant, and risks (including a 5 times greater likelihood compared to non-cannabis users of
developing psychosis) are significant.
Please reject the motion for adding anxiety disorders as a qualifying condition.
SS, M.D.
Yes to cannibas for anxiety.
JFL
I work with the substance use population and believe that having medical grade marijuana for anxiety would be
extremely helpful for the clients I serve. Many use THC recreationally and they are unsure of what other
substances may be included with the THC they are purchasing off the street. Many have anxiety and use it for a
calming and relaxing effect but can put themselves at risk by being involved with those that deal substances and
they could be exposed to other substances or lifestyles they did not initially intend on being a part of. As a
licensed drug and alcohol counselor in Minnesota, I would highly support this becoming a law.
MH, L.S.W., L.A.D.C.
I support adding anxiety 120%. I believe that the benefits of MJ is much better than temporary medications that
are current used for the medical condition.
DN
After suffering with anxiety attacks, PTSD and generalized anxiety disorder for the past 30 years or more, I can
say I have tried almost everything to try to make those horrible feelings go away. Finally my doctor put me on
Ativan about 12 years ago and that has helped a lot. Only problem with that is the withdrawal symptoms start
even if I'm an hour or 2 late with my next dose. This is a very scary situation for me to be in! I would be grateful
for the opportunity to try cannabis edibles to tackle my anxiety as well as to help wean myself off the
benzodiazipam (Ativan).
92021 MN Medical Cannabis Program Petition Process – Medical Condition
Written Comments 10/1/2021
BB
My name is Tracy and I have been struggling with panic/anxiety disorders all my life. I have tried multiple,
multiple medications all of which have not helped. I have been on disability for yrs struggling with this as well as
other health issues. I would like to see this petition go through to see if this could potentially be helpful. I'm
willing to try anything at this point.
TS
I am writing in support of adding anxiety disorder as a new qualifying medical condition to Minnesota's Medical
Cannabis Program. I have suffered from anxiety for almost my entire life and began treatment when I was just
six years old. I have utilized many methods of treatment including psychotropic medications, numerous
therapeutic approaches, and cannabis when I lived in a state with legal cannabis. I felt my best when I had
cannabis medicine on hand that I could use as necessary and found that I was less anxious knowing I had a tool
in my toolkit to help me eat, sleep, and generally function that had no negative side effects for me. The research
on the benefits of moderate cannabis use for treatment of anxiety is sound and I know there are thousands, if
not millions, of others like me that have found relief through cannabis. I am a public health professional with an
advanced degree that contributes greatly to my state and community. I do not feel I am unique among those
with anxiety that have or hope to use medical cannabis and are simultaneously able to build safe, connected,
healthy communities in Minnesota. I hope that the legislature acknowledges the benefits of cannabis medicine
for treating anxiety disorder and the myriad benefits that adding this disorder to the Medical Cannabis Program
could bring to their constituents.
LC
I saw that you have considered adding anxiety disorder to our medical cannabis program and I am in full support
of this.
I've experienced anxiety since I was a child. I have sensory processing issues and often felt "fight or flight" when
things weren't actually dangerous. I get easily overloaded by stimuli and lost years of my work and social life to
panic attacks. I would frequently visit the emergency room due to perceived ailments.
When I started using cannabis more regularly, my anxiety calmed down tremendously. I've used it since then to
regulate panic and anxiety.
In 2012, I moved to Colorado to be able to acquire legal cannabis. Though that aspect was wonderful, I couldn't
stay away from my family any longer and eventually moved back in 2018. Since I've been back, cannabis
acquisition has been stressful, expensive, and inconsistent.
Cannabis is an invaluable resource. It's also very lucrative! When I lived in Colorado, residents got to vote on
whether to receive a stimulus or donate the excess to the schools. We overwhelmingly voted to let it go to
education.
AG
I fully support adding anxiety as a qualifying condition. I am a medical cannabis patient with PTSD. It helps me
with the anxiety I feel during PTSD episode and I feel the benefits should be extended to those with anxiety
disorder.
Please add Anxiety as a qualifying condition.
JR
102021 MN Medical Cannabis Program Petition Process – Medical Condition
Written Comments 10/1/2021
I’m writing in to share my support for Anxiety Disorder as a qualifying condition for medical cannabis.
I suffer from Anxiety disorder myself and currently work in a mentally and physically demanding work
environment. Anxiety disorder is a huge burden on my life and I often have to use Delta-8 to prevent panic
attacks. I have a huge fear of getting addicted to Opioids which makes me very hesitant to take Anxiety
medications, especially when Cannabis is the perfect alternative for someone like me.
The option to buy Medical Cannabis would be life-changing as it would not only be cheaper for me but buying
from a dispensary would be a lot safer too.
Please consider legalizing Medical Cannabis for people suffering from Anxiety Disorder. It’s a lot more than just a
recreational drug for us. It helps us live our lives in comfort.
AE
I'm writing to you to share my comments regarding the addition of anxiety disorders to the list of qualifying
conditions for medical cannabis in Minnesota.
I suffer from chronic depression and anxiety, a condition that runs in my family and that became severe enough
for me that I had to begin seeking treatment for it approximately 10 years ago. At my low points, my anxiety can
be debilitating, rendering me absolutely unable to function. Initially, I was prescribed SSRI medications for my
depression and Xanax/alprazolam for my anxiety, which was sufficient to manage the most severe symptoms,
but which did little to lower the general level of anxiety I dealt with on a day-to-day basis. I could calm a panic
attack, but I couldn't prevent it from happening. I also found it difficult to stop using Xanax without side effects
and withdrawals, which was rather disconcerting.
When I moved to Washington DC, I was able to enroll in the city's medical cannabis program at the
recommendation of a doctor in DC, and I found a level of relief from my symptoms that I hadn't previously
thought possible. Through the daily use of a sublingual cannabis tincture, I found my anxiety symptoms to be
completely gone- I never experienced a panic attack while using medical cannabis and I was even able to stop
taking my depression medications. When I would travel and be without it, I never experienced withdrawals or
side effects- my symptoms would return, but I never felt a craving for it as I did for Xanax.
I moved to Minnesota just over a year ago, and I unfortunately do not qualify for medical cannabis under the
current laws. I've therefore had to return to using SSRI medications and Xanax to manage my symptoms, and
I've again found that the medications are only effective at dealing with acute symptoms rather than preventing
them altogether. Further, I'm well aware of the dangers of Xanax addiction and would really like to be using a
less harmful medication to manage my anxiety. Cannabis has a very low potential for abuse, much lower than
that of Xanax, so the fact that it is not available as a treatment had been frustrating. My experience is that
cannabis has been an effective and safe treatment for my anxiety disorder, and I wholeheartedly support adding
anxiety disorders to the list of qualifying conditions.
JT
Our home is supportive of this consideration for the use of medical cannabis for anxiety disorder!
SW
As someone who is a patient of medical cannabis and someone who has a brain injury along with GAD I fully
support anxiety being added. Many times benzodiazepines are prescribed to those who need medication.
Benzodiazepines can be extremely addicting and misused by many. Treating anxiety with medical cannabis vs an
112021 MN Medical Cannabis Program Petition Process – Medical Condition
Written Comments 10/1/2021
addictive medication is a much safer option for many. I guarantee those who are on the program and have
anxiety have seen positive effects from medical cannabis in this area already. We need government officials and
medical providers to understand our needs and desires for a safer alternative to medications in some ways.
Please add anxiety as a treatable condition. You will be helping thousands!
DL
I think that anxiety should be added as a qualifying medical condition for cannabis use. As someone who suffers
from GAD and panic attacks, I am looking for more natural, non-pharmaceutical options for treatment. With
proper dosage and usage, cannabis offers treatment with less side effects or risks than certain prescription
drugs.
HRO
I am reaching out as a current patient in the program due to continual back pain.
Now I also started the program also having generalized anxiety, depression and PTSD from my time in service
with the Military.
Personally, after beginning the program I was on different mental medication (SSRI) BuProprion and Sertraline
but after a year I actually was able to stop use of these medications from an associated use from the medical
cannabis.
Understanding that of course it may not impact everyone the same, for me I can say it has been an unintentional
complete success, and hope for not only the addition of anxiety, but eventually the pieces needed to include
veterans through the VA opposed to needing to seek outside physicians for a beneficial medication opposed to
SSRIs with side effects.
JL
I think that medical cannabis should include Anxiety disorder and I can vouch for it as someone who is diagnosed
with anxiety. The only relief from my anxious, thoughts running through my brain is the legal delta 8 Marijuana
you can buy at a smoke shop. I believe that adding Anxiety to the list would help so many others like myself by
giving them the relief that quiets all the panicking thoughts and allowing them to enjoy their time being able to
focus on the good around them.
MG
I'm a patient in my home state but also have a career in cannabis. I educate patients how to use the products
for their qualifying condition and help them choose their preferred format.
Please add anxiety as a medical condition. I have been a medical patient in two different states, both
conservative and medical only, both list anxiety as an approved condition.
Please assist in helping people make safer medical decisions by accepting anxiety as an approved condition, and
use other states, like Maryland and PA as an example.
TS
I support adding anxiety as a list of qualifying disorder.
JN
I am a full time practicing psychiatrist at the Minneapolis VA Health Care System. I am a graduate of UMN
Medical School. I completed adult psychiatry residency at the Mayo Clinic and a geriatric psychiatry fellowship
at the University of Minnesota.
122021 MN Medical Cannabis Program Petition Process – Medical Condition
Written Comments 10/1/2021
I am writing to urge you not to include anxiety disorders in the state’s medical cannabis program. Through years
of training and work in psychiatry, I can say for certain that I have never sat across from a patient with any
anxiety disorder and thought “you know what this patient needs? Some cannabis.”
We have some decent tools (both pharmacologic and non-pharmacologic) for treating anxiety disorders, though
we surely wish they were much better. Anxiety disorders are challenging. We don’t have easy answers.
Is it possible that some individuals find that they have anxiety symptoms that are transiently improved when
they use cannabis? Probably. But that is way, way different than promulgating cannabis as a medical
therapeutic for specific anxiety syndromes. There is nowhere near the type of scientific evidence that is
necessary for approval of cannabis as a medical therapy or to use it in any kind of off label way for anxiety
disorders.
The Minnesota Psychiatric Society is sharing with your office extensive details about why psychiatrists think this
is a really bad idea. Please take their input very seriously.
If there are people or institutions out there who suspect cannabis is an effective medical therapy for a specific
anxiety disorder, they can certainly go ahead and run the experiments, collect and analyze the data, submit it for
peer review, and thereby prove it. And after that they can then run the necessary studies to describe proper
dosing, toxicology, and so forth.
There will be a huge audience of psychiatrists eager to hear of such discoveries that withstand the rigors of
scientific scrutiny—not only because we bear witness to all manner of horrible suffering that we wish to help
relieve, but also because we are keenly aware of the long history of supposed treatments for psychiatric
illnesses that decidedly did not withstand such scrutiny.
BB, M.D.
I am the President of the Minnesota psychiatric Society, that represents over 450 psychiatrists in the state of
Minnesota. I am writing to express my solemn opposition to the inclusion of "anxiety disorders" as a condition
approved for treatment with Medical Cannabis. The complete position paper of MPS is attached here
(attachment available upon request). Here, I have briefly summarized my reasons for this opposition:
1. Anxiety disorders have several, effective, non-habit forming, evidence based treatments available. These
include both pharmacological and non-pharmacological treatment options.
2. There is very little evidence for the efficacy of Cannabis in the treatment of anxiety disorders.
3. Cannabis is a habit forming substance with potential for abuse.
4. There is evidence in medical literature to indicate that Medical Cannabis causes damage to the
developing brain, all the way up to the age of 25.
I respectfully request that the body making this decision consider the medical evidence, and pay heed to the
voice of medical experts in making this decision.
CG, M.D., D.F.A.P.A.
As a physician who has provided psychiatric consultations on medical and surgical patients in the general
hospital throughout my 35 years in medicine (and have been working exclusively with this population for the last
15 years) I earnestly hope the DoH does not approve the use of medical cannabis for anxiety.
Anxiety is omnipresent in one form or another. Sometimes it serves salutary, constructive purposes. Sometimes
it is intrusive and destructive. But virtually everyone experiences it, sooner or later. The longing to obliterate it
with a substance is not uncommon but not uniformly productive.
And on the other hand, I have seen untold numbers of people using cannabis for a variety of reasons and note
that over time they are more likely to be blunted, less vigorous in their ambitions, less industrious in their
132021 MN Medical Cannabis Program Petition Process – Medical Condition
Written Comments 10/1/2021
pursuits, and more apathetic about life. The evident negative consequences of cannabis use overwhelmingly
outweigh the occasional positives that I see in the hospital, day-in and day-out, month after month, year after
year.
To wed an ever-present ingredient in life, i.e., anxiety, with approval for cannabis use will send a dreadful
message to uninformed individuals who do not have the privilege of a perspective from which the net effects of
cannabis can be appreciated. There are plenty of other safe alternatives for the treatment of anxiety; cannabis is
not necessary and is more likely to have many sad unintended consequences.
KP, M.D.
1: "On the other hand, the antipsychotic effects of some cannabinoids have been investigated in recent studies.
Cannabidiol (CBD) and Δ9-tetrahydrocannabivarin (THCV) may have therapeutic potential for the treatment of
psychosis." DOI: https://doi.org/10.1016/j.eurpsy.2017.02.117 )
2: Recreational Cannabis Reduces Rapes and Thefts: Evidence from a Quasi-Experiment
Exploiting the recent staggered legalization enacted by the states of Washing-ton (end of 2012) and Oregon (end
of 2014) we show, combining difference-in-difference sand spatial regression discontinuity designs, that
recreational cannabis caused a significant reduction of rapes and thefts on the Washington side of the border in
2013-2014 relative to the Oregon side and relative to the pre-legalization years 2010-2012.
https://www.researchgate.net/publication/318008537_Recreational_Cannabis_Reduces_Rapes_and_Thefts_Evi
dence_from_a_Quasi-Experiment
3: Crime and the legalization of recreational marijuana. The legalization also increased consumption of
marijuana and reduced consumption of other drugs and both ordinary and binge alcohol.
https://www.sciencedirect.com/science/article/abs/pii/S0167268118300386
4: Over 110 cannabinoid receptors' ligands have been isolated from Cannabis sativa, of which some have
neuromodulating properties. In the Nineteenth and twentieth centuries, hemp was used to treat sleep
disorders, pain, and increase appetite.
https://www.frontiersin.org/articles/10.3389/fpsyt.2021.620073/full?utm_source=S-
TWT&utm_medium=SNET&utm_campaign=ECO_FPSYT_XXXXXXXX_auto-dlvrit
5: There is very low quality evidence that pharmaceutical THC (with or without CBD) leads to a small
improvement in symptoms of anxiety among individuals with other medical conditions.
https://www.sciencedirect.com/science/article/abs/pii/S2215036619304018
6: Medical cannabis users perceived a 50% reduction in depression and a 58% reduction in anxiety and stress
following cannabis use. Two puffs were sufficient to reduce ratings of depression and anxiety, while 10+ puffs
produced the greatest perceived reductions in stress. High CBD (>9.5%)/low THC (11%)/high THC (>26.5%) cannabis
produced the largest perceived changes in stress.
https://www.sciencedirect.com/science/article/pii/S0165032718303100
7: Cannabidiol (CBD) levels were generally not associated with changes in symptom intensity levels. In a
minority of cannabis use sessions (< 13%), cannabis users reported anxiogenic-related negative side effects (e.g.,
142021 MN Medical Cannabis Program Petition Process – Medical Condition
Written Comments 10/1/2021
feeling anxious, irritable, paranoid, rapid pulse, or restless), whereas in a majority of sessions (about 66%), users
reported positive anxiolytic side effects (e.g., feeling chill, comfy, happy, optimistic, peaceful, or relaxed).
https://jcannabisresearch.biomedcentral.com/articles/10.1186/s42238-020-00051-z
8: The findings suggest the majority of patients in our sample experienced relief from distress-related symptoms
following consumption of Cannabis flower, and that among product characteristics, higher THC levels were the
strongest predictors of relief. The effectiveness of inhaled Cannabis flower for the treatment of
agitation/irritability, anxiety, and common stress | Journal of Cannabis Research | Full Text
BV
I have had severe anxiety for the better part of 12 years now. You can’t always tell from the outside perspective
when someone is dealing with anxiety.
People with anxiety tend to be sensitive to their environment. You feel things more deeply, are more aware of
small differences.
It comes out in ways that are confusing to others and confusing to us and even more so for those around us.
It’s a smile. It’s a frown.
It’s anger over something so small.
It’s the sudden need to be alone.
It's bitting your bottom lip until it bleeds not knowing you were doing that so hard.
It’ll cancel plans last minute.
It’ll be a text instead of a phone call.
An email instead of a face to face.
It's brushing people off for no reason because you just need to get away, or not responding to important
emails/messages for the fear of the response.
Needing someone to come with you to do something simple like ordering food.
There are times when it manifests as fear, and that fear sometimes leads to a self-isolation during which I don’t
want to be around anyone or have anyone see me. Which only gets worse when that self-isolation is forced from
outside individuals.
As a mom, as a wife, as a business owner and as a female entrepreneur with anxiety, I (and everyone like me)
need to have access to this for our health. Not only for physical but for our mental health too. I crave the deeper
relationships other moms have with their teens. I crave the ‘normal’ feeling of leaving the house without fear or
worry.
So please consider the implications for many who this will help in so many different ways. It is time for us to be
able to experience a new ‘normal’ and live life the way it was intended.
LR
The Minnesota Psychiatric Society, representing nearly 500 Minnesota psychiatric physicians, believes that all
policy decisions impacting access to marijuana should be informed by scientific findings. Among the MPS
members are experts in addiction medicine and experts in brain development. MPS opposes authorization of
the use of medical cannabis for treatment of every and all anxiety disorders.
The membership has taken a position to caution the public and governmental agencies about the harms of
cannabis, its lack of efficacy in anxiety, and current effective treatments of anxiety. Since Minnesota’s medical
cannabis program began, science has advanced our knowledge to demonstrate the lack of effectiveness, clinical
impact and potential harms.
MPS Position:
152021 MN Medical Cannabis Program Petition Process – Medical Condition
Written Comments 10/1/2021
1. Anxiety is a treatable condition.
2. It can be treated with non-addicting medications and psychotherapy. For some forms of anxiety,
psychotherapy is the preferred treatment. Treatments are readily available through in-person or
telemedicine.
3. Cannabis is not a benign drug. Its use causes a significant amount of addiction, and it also causes a
number of psychiatric disorders.
4. Some psychiatric disorders are destabilized by cannabis to the point that the person may require
hospitalization.
5. Cannabis may be a cause of psychosis.
6. Recent data suggests that there may be significant cardiovascular morbidity and mortality associated
cannabis.
7. Cannabis has no proven efficacy in the treatment of anxiety or any other psychiatric disorder.
We base our position on the following points:
All anxiety is not the same. Anxiety disorders can be chronic disorders, and treatment may extend for weeks to
months or years. Adjustment to a stressful experience or developmental issue can leave the person with worry
and anxiety. These symptoms may likely pass when the situational issue resolves and psychological support is
provided. These transient situational problems are best treated with support, compassion, understanding and
psychological tools that are effective in time limited situations. Another serious concern is the choice of cannabis
for one of the anxiety disorders namely separation anxiety disorder. MDH should be aware that separation
anxiety is a common developmental issue in children around the age of two and three years. For some children a
separation anxiety disorder may arise at the time of preschool. Significant emotional distress and limitations in
community access may be a consequence. To suggest that this is one of the disorders that would be eligible for
cannabis treatment is problematic. The scientific literature on the damage to the central nervous system to
youth up to age 25 by cannabis is clear. (Bura et al)
There is a wealth of psychotherapeutic treatments which are effective and readily available.
• Recognized evidence-based therapies are diverse and effective. Psychotherapeutic treatments with
response rates of 46–77% include cognitive-behavioral therapy, mindfulness, exposure therapy,
meditation therapy, nonspecific behavior therapy, muscle relaxation therapy, computer platform
cognitive-behavior therapy and others.
• Therapy is accessible and available in person and via telehealth. Investments in telemedicine and
telepsychiatry provides care through virtual computer platforms have changed the accessibility and
availability of therapy.
• Patient Centered Treatment is designed to best fit each person and adjust as needed. Therapists plan
treatment and make modifications to fit each patient’s needs, preferences, pace, processing and
linguistic ability so that treatment is person centered. Also, behavioral interventions that may be less
language based are readily available.
• Medication treatments of SSRI/SNRIs are evidence based and definitive treatments for anxiety
disorders. They are FDA approved including dosage guidelines. They are not intended to solely provide
temporary relief of symptoms as argued in the petitioner’s inaccurate and misleading statement. Using
cure rather than effectiveness as a reason to authorize cannabis ignores the many years of research into
the genetic, environmental and traumatic causes of mental illness and the thousands of clinical trials
that have established the effectiveness of therapies for mental illness. Benzodiazepines are not the
standard of care for the management of anxiety disorders due to lack of evidence for effectiveness as
162021 MN Medical Cannabis Program Petition Process – Medical Condition
Written Comments 10/1/2021
well as their potential for addiction. Clinical management of side effects is what clinicians do for anxiety
or for treatment of high cholesterol with statins or many other conditions. Side effects from medications
are not unique to mental illness or SSRIs: there are clear adverse effects from cannabis. Medical
advances equip clinicians with a wide range of medication options. Physicians use genomic testing to
identify specific metabolic pathways that may predispose some patients to side effects. Medications are
effective. Physicians are aware of medication side effects, and they have time honored methods of
mitigating them.
There are barriers to treatment, but that is a complex issue without a simple solution; cannabis is not the
solution. There are campaigns to reduce the stigma surrounding mental illness so that people feel comfortable
seeking help.
The neurobiologic basis for our position:
Studies of the neurobiology of anxiety disorders show that the transmitter glutamate plays a pivotal role in the
development of anxiety disorders with acute stress enhancing glutamate release in the amygdala, the emotion
center. Cannabis affects glutamate signaling in the human brain; it causes a perturbation of physiologically
available glutamate. The neurophysiological model shows that the anxiety disorders are complex biological,
emotional, and behavioral conditions but have a unifying neurobiological connection to glutamate transmission.
The endocannabinoid system has an interaction with glutamate and an agonist of the endocannabinoid system
is cannabis. The conclusion is that cannabis is a perturbation of physiologically available glutamate and has an
adverse relationship to anxiety disorders.
The relationship of anxiety disorders to cannabis:
Little data is available that tests the efficacy of cannabis for people with generalized anxiety disorder and data
for the other anxiety disorders are without empirical evidence. Literature reports cannabis to both increase
and decrease anxiety. At the same time, cannabis has been associated with adverse events including increased
anxiety, psychosis, neurocognitive impairment, and addiction, which presents significant limitations to its use as
a treatment. For instance, feelings of anxiety and panic often follow cannabis use, and are reported to drive the
high rates of hospital emergency room visits in users. Unfortunately, neither the compound, nor users, have
been characterized well enough to determine who will have an anxiogenic versus anxiolytic response following
use. An additional concern with cannabis use relates to the increased risk of psychosis in those with a preexisting
genetic vulnerability to schizophrenia with regular cannabis use. Similarly, there was moderate evidence to
suggest a negative effect of regular cannabis use and incidence of social anxiety disorder and suicidal ideation,
attempts and completions. A recent meta-analysis of 31 studies attempted to discern the temporal relationship
between anxiety disorders and cannabis use. This analysis showed that a cohort of those using cannabis at
baseline was significantly more likely to have symptoms of anxiety at follow-up in studies adjusted for
confounders.
The opposite relationship was investigated in one study: there was no association between anxiety at baseline
and regular cannabis use at follow-up. When assessed for cannabis use in this study among those with anxiety
disorder, cannabis use did not increase suggesting in this naturalistic study that patients with anxiety disorder
did not manage their anxiety with cannabis This evidence makes it clearer that cannabis may be a path to
anxiety disorder and that anxiety need not be a path to cannabis use especially with effective treatments being
available. (Kedzior and Laeb)
Cannabis statistics:
• 9% of all users get addicted to it. (Anthony et al. Lopez-quintero et al.)
• 17% of people who start using cannabis in their teens will develop a cannabis use disorder. (Anthony;
Hall et al.)
172021 MN Medical Cannabis Program Petition Process – Medical Condition
Written Comments 10/1/2021
• Cannabis can cause a number of disorders associated with frequent use including: cannabis induced
intoxication, withdrawal, psychosis, anxiety disorder, sleep disorder, and delirium. (DSM-5 p 482; NIDA
2021.).
References:
1. Bura et al., Cannabis and Synaptic reprogramming of the developing brain; Nature Review Neuroscience
21 May 2021.
2. Bergink, H.J. van Megen, H.G. Westenberg Glutamate and anxiety Eur Neuropsychopharmacol, 14
(2004), pp. 175-183
3. Garakani, S.J. Mathew, D.S. Charney Neurobiology of anxiety disorders and implications for treatment
Mt Sinai J Med, 73 (2006), pp. 941-949
4. E.P. Bauer, G.E. Schafe, J.E. Ledoux NMDA receptors and L-type voltage-gated calcium channels
contribute to long-term potentiation and different components of fear memory formation in the lateral
amygdala J Neurosci, 22 (2002), pp. 5239-5249
5. M.S. Fanselow, J.J. Kim, J. Yipp, O.B. De Differential effects of the N-methyl-D-aspartate antagonist DL-2-
amino-5-phosphonovalerate on acquisition of fear of auditory and contextual cues Behav Neurosci, 108
(1994), pp. 235-240;
6. L.R. Reznikov, C.A. Grillo, G.G. Piroli, R.K. Pasumarthi, L.P. Reagan, J. Fadel Acute stress-mediated
increases in extracellular glutamate levels in the rat amygdala: differential effects of antidepressant
treatment Eur J Neurosci, 25 (2007), pp. 3109-3114
7. Cratty, D.L. Birkle, N-methyl-D-aspartate (NMDA)-mediated corticotropin-releasing factor (CRF) release
in cultured rat amygdala neurons1810 Peptides, 20 (1999), pp. 93-100;
8. Millan The neurobiology and control of anxious states, Prog Neurobiol, 70 (2003), pp. 83-244
9. Cortese, K.L. Phan, The role of glutamate in anxiety and related disorders CNS Spectr, 10 (2005), pp. 820-
830.)
10. EnriqueBaca-Garcia New perspectives in glutamate and anxiety Pharmacology Biochemistry and
Behavior Volume 100, Issue 4, February 2012, Pages 752-7
11. Bara, Ferland, Rompala, Szutorisz, Hurd; Cannabis and Synaptic reprogramming of the developing brain,
Nature Reviews in Neuroscience, 5/21.21.
12. MarcoColizzi, PhilipMcGuire, ;SagnikBhattacharyya Effect of cannabis on glutamate signaling in the
brain: A systematic review of human and animal evidence Neuroscience & Biobehavioral Reviews
Volume 64, May 2016, Pages 359-381
13. Turna Patterson, Ameringen,Is cannabis treatment for anxiety,mood, and related disorders ready for
prime time? Jasmine Depress Anxiety. 2017;34:1006–1017.
14. Kedzior and Laeber, A positive association between anxiety disorders and cannabis use or cannabis use
disorders in the general population- a meta-analysis of 31 studies BMC Psychiatry 2014, 14:136
http://www.biomedcentral.com/1471-244X/14/136
15. Anthony JC, Warner LA, Kessler RC. Comparative epidemiology of dependence on tobacco, alcohol,
controlled substances, and inhalants: Basic findings from the National Comorbidity Survey. Exp Clin
Psychopharmacol. 1994;2(3):244-268. doi:10.1037/1064-1297.2.3.244
16. Lopez-Quintero C, Pérez de los Cobos J, Hasin DS, et al. Probability and predictors of transition from first
use to dependence on nicotine, alcohol, cannabis, and cocaine: results of the National Epidemiologic
Survey on Alcohol and Related Conditions (NESARC). Drug Alcohol Depend. 2011;115(1-2):120-130.
doi:10.1016/j.drugalcdep.2010.11.004
17. Anthony JC. The epidemiology of cannabis dependence. In: Roffman RA, Stephens RS, eds. Cannabis
Dependence: Its Nature, Consequences and Treat:ment. Cambridge, UK: Cambridge University Press;
2006:58-105.
18You can also read
