John J. Miller, MD: Guidance on Cannabis Use in Psychiatry


CBD has shown promise in treating anxiety and psychosis.

Cannabis use in psychiatry is something that has become much more complex in recent decades.

Whether or not the drug has positive psychiatric effects can be largely based on the individual percentages of the 2 main compounds of marijuana--tetrahydrocannabinol (THC) and cannabidiol (CBD).

In an interview with HCPLive®, John J. Miller, MD, Medical Director, Brain Health Website, Seacoast Mental Health Center and co-chair of the 2022 Annual Psychiatric Times™ World CME Conference in San Diego, explained how complicated the guidance for promoting cannabis is for patients with conditions like depression and anxiety.

“One of the biggest issues currently is that cannabis is a very vague and general term,” Miller said. “Back in the early 60s when it was being used recreationally it was from the original plant. Those strains of cannabis had about 2% THC and 2% CBD.”

Miller said the CBD molecule is the part that has shown efficacy in treating conditions like psychosis and anxiety, while also having inflammatory properties.

He also said 1 of the issues with current studies is they will use the term “cannabis” without breaking down the percentages of THC and CBD.

“A lot of the literature because it doesn’t differentiate the components of the cannabis it is hard to draw evidence based conclusions that we can apply clinically,” Miller said.

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