Budding New Considerations about the Use of Cannabis in Eating Disorder Treatment
Eating Disorders and Co-Occurring Addiction
Eating disorders are complex psychopathologies, which present clinical challenges for many reasons. A major one is that eating disorders often co-occur with a Substance Use Disorder (SUD). This includes cannabis abuse, which can begin before, concurrently with, or after the onset of an eating disorder. Given this, EDCare uses an integrative model in treating the SUD, along with other eating disorders symptoms such as anxiety, OCD and depression.
Another challenge is that individuals with anorexia are empowered by resisting the temptation of eating. Therefore, the appetite stimulating properties of cannabis can’t necessarily overcome the neurobiological issues that are also intimately involved with their eating disorder.
That being said, medical cannabis might be a helpful tool for some people in conjunction with therapies such as cognitive behavioral therapy (CBT). There are three primary strains of cannabis: sativa, indica and hybrids.
- Sativa is the activating strain of cannabis that tends to energize the user and produced the “high”. It can be used relieve the symptoms of depression, fatigue and mood disorders.
- Indica is a more sedating strain that produces relaxation and full-body effects and is preferred by the majority of our eating disorder patients.
- Hybrids are varying functions of these two strains that are thought to balance the positive effects of both.
Cannabis and Eating Disorder Treatment
One EDCare patient reported that medical cannabis helped slow down her mind, allowing her to observe her irrational thoughts surrounding food. Food began to taste better making her mealtimes an enjoyable experience.
Addiction of course, is a big concern. In Denver, between 7 and 9% of our eating disorder patients who use cannabis show signs of addiction. With 364 legal dispensaries in Denver and 1,021 in Colorado, we can clearly expect that up 50% of our eating disorder patients are using. Moreover, testing an individual’s level of intoxication has proven to be a challenge due to the length of time THC takes to clear the body.
How do we deal with this dilemma? We begin with a very extensive physical and psychological diagnostic assessment for the history of the eating disorder and substances use/abuse. We need to determine whether the patient can participate in our program, and whether they are using edibles, tinctures, or smoking. Are they using Indica or Sativa? Can we wean them off the higher levels of THC with a mix of CBD and a much lower percentage of THC? And finally, what withdrawal effects such as irritability, insomnia and changes in appetite need to be treated while still focusing upon their compromised emotional and medical state due to their eating disorder?
There are many unanswered questions concerning medical cannabis usage in eating disorders. We have learned to practice “beginner’s mind” with an attitude of openness, curiosity, and lack of preconceptions or judgment when learning the adaptive function of both the eating disorder and the cannabis use.