You may be familiar with the signs of ADD or ADHD in yourself or someone close: racing thoughts, impulsiveness, disorganization, restlessness, inability to concentrate, and the easy slide toward frustration and overwhelm. These symptoms can affect anyone from kids to working adults to older people and can also seriously impact quality of life — making it harder to study, stay on task at the office, or have satisfying relationships. That’s why millions of Americans turn to some kind of pharmaceutical medication to manage the disorder.
After college, Arlene Guzman was working in a demanding PR job and found it increasingly more difficult to stay focused at work. She spent many a long day at the office, and eventually, she told Civilized, it began to affect her personal life, too. “Things that should have taken me one hour were taking me three and a half hours — for no other reason than I’d have fifty tabs open on my browser and would jump around doing all kinds of different things instead of the task on hand.” So, Guzman, now a 34-year-old resident of Los Angeles, tried the stimulant often prescribed for ADD or ADHD — Adderall.
For a while, Adderall was great. “I was able to kick ass at work,” said Guzman. But when she and her husband decided to have children, she went off all medications to be safe. A few years later, she once again found workday focus elusive and cautiously decided to renew her Adderall prescription. By then, she had been eating clean and focusing on natural health, so the thought of adding a synthetic stimulant wasn’t appealing. Still, she knew she needed something.
Opting to take Adderall only during the work week, she soon found withdrawal symptoms kicking in when she was home with her family on the weekends. “My nickname for it is ‘Madderall,’” she told Civilized, because it amplified feelings of anger and frustration. “As a mom, you’re always in search of this unicorn of work-life family balance and it was doubly hard for me — feeling like if my work productivity was good, I’d be in a terrible mood at home," she said. "Or, I wouldn’t be as productive at work [if I wasn’t taking Adderall], but I could be pleasant and fun — and feel like myself — on the weekends.”
About a year ago, she discovered an alternative. A high-THCV strain of cannabis gave her the energy and mental presence she needed to stay focused at work and didn’t negatively affect her mood at home. (The cannabinoid THCV, sometimes called "the new CBD" offers a clear-headed cerebral high known to help with focus, and often suppresses munchies.) With THCV — specifically Doug’s Varin by California Cannabinoids — Guzman says that she will set goals and expectations for the work she intends to accomplish before consuming. “Otherwise, I might end up in my closet organizing everything by color and channeling my inner Marie Kondo,” she said.
It's been a few months now since Guzman has taken Adderall, and she's happy with her choice. “Cannabis is not as potent as Adderall for me — I’ll be honest,” she said. “But as far as natural products go, it’s definitely the thing that gets me closest to the zone.”
Replacing or Reducing Adderall with Cannabis
Guzman isn’t alone in her search to replace or reduce her use of Adderall. Many people who take the drug find that it has diminishing returns over time. "What I often see with patients who take ADHD stimulants is that they need to continually increase their dose, and then eventually the stimulants stop working," said Dr. Mandeep Singh, a psychiatrist at Apollo Cannabis Clinics in Toronto, who has helped over 1,200 medical cannabis patients, including many with ADD/ADHD. When a higher dose of a stimulant stops working, doctors will often prescribe a new brand or variety that works initially and becomes less effective over time. But Dr. Singh doesn’t see the same diminishing returns happening as often with cannabis. “I have patients who have been on the same dose of medical cannabis for years, and who are experiencing the same benefits as when they first started," he said.
Many of those Dr. Singh works with have reduced their Adderall usage, but few, he says, have completely eliminated the pharmaceutical. “Most ADHD patients find that a combination of stimulants coupled with medical cannabis provides them with the best symptom control,” said Dr. Singh.
Rosalia Yoon, Ph.D., a research scientist at Apollo Applied Research cautions that there isn’t definitive evidence yet to show that cannabis can substitute for pharmaceuticals. However, she told Civilized that many patients have indeed found medical cannabis to help them in the management of ADHD symptoms like hyperactivity, racing thoughts, and certain attention deficits. Patients also report feeling better able to cope with peripheral ADHD symptoms like anxiety and depression. Managing the side effects of ADHD medications — such as the irritability that Guzman experienced, as well as poor appetite and sleep problems often caused by drugs like Adderall — is another way medical cannabis can help.
One Size Doesn’t Fit All
Cannabis medicine is personalized medicine because individual endocannabinoid systems respond differently. Yoon emphasizes the need for more research, but factors like cannabinoid and terpene (aromatic compound) profiles, and individual differences in metabolism, among other things, all come into play when calibrating a patient’s ideal dose and delivery method.
"Mental health issues generally respond more favorable to CBD than THC, and a 20:1 ratio often works best," Dr. Zinia Thomas, a board-certified psychiatrist in St. Louis, told Civilized. She recommends starting with a low dose of THC and gradually increasing it until reaching the desired effect, while also maintaining the 20:1 ratio with CBD. Confirming many people’s lived experience, she said that sativas can be more helpful for daytime use because of their uplifting, energizing and stimulating effects, while indicas are “known to relax restlessness in the body and stop the racing mind so one can get better sleep.” Essential oils, she added, have been used to treat a variety of mental health challenges for much longer than pharmaceuticals have been on the scene. Limonene, linalool, beta-caryophyllene, and pinene, said Dr. Thomas, are four terpenes also found in cannabis that can help those with ADD/ADHD.
Focus-Enhancing Cannabis Products On the Rise
More and more products on the market today are aimed at increasing mental clarity and the ability to focus. While not specifically formulated for ADD/ADHD and not intended to replace medication or a physician’s care, a San Francisco company called Mighty Health offers two cannabinoid/nootropic combination products that could potentially help those with certain attention deficits. The formulations, said CEO Matthew Runeare, are meant to, “declutter the mind and quiet the noise around you — which allows you to enter more deeply into whatever you want to do, whether that’s being mindful while hanging out on the beach or locking into a spreadsheet.”
Mighty Health’s CBD product, Balance, features an adaptogenic, mood-elevating herb called ashwagandha, and phenylethylamine HCL, a stimulant that plays a role in mood and concentration. Another product, Focus, is a low dose 1:1 THC to CBD formulation with a nootropic called piracetam, which may improve cognitive health and memory, L-theanine for mood stabilization, theobromine from cacao for a physical lift, and B vitamins. The nootropics combined with the cannabinoids can heighten the effects of both, according to Runeare, who calls them “complementary and synergistic.”
Runeare encourages anyone who tries the products to find their minimum effective dose by starting with a small amount and gradually adding on until the desired effect is achieved. Ideally, the THC product yields mild psychoactivity while at the same time honing concentration. “The idea is, ‘I want to get lifted, I want to get elevated—but I don’t want to feel like I’m high,'" he said. "And riding that edge maximizes the opportunity to be productive.”
Holistic psychiatrists often recommend therapy, skill-building, good sleep, nutrition, or even such alternative modalities as float therapy and cryotherapy as part of a mind-body approach to treating ADHD, too. For Janelle Lasalle, a writer living in Portland, cannabis helps sharpen focus, but not in the traditional way. Using just the terpenes from Green Crack in a diffuser gives her what she needs without any distracting psychoactive effects. “It helps a lot with my dread, you know, that feeling of sitting at a computer and staring at the screen,” she told Civilized. “With the terpenes blasting in the diffuser I find myself able to get to work faster, and if I put some pinene in there too it’s a great combination of focus and energy that’s very useful for getting work done.”
Certainly, a lot more research into the effects and benefits of cannabis for ADD, ADHD, and a host of other mental health challenges is necessary, but one thing is clear to many people who have long used and loved cannabis: Beyond getting you high, there’s a whole lot more that this plant can do.