Physical Activity Level Moderates Cannabis-Associated Reductions in Negative Affect in Anxious Individuals.

PURPOSE Emerging research indicates that the use of cannabis products, particularly those higher in cannabidiol (CBD), may be anxiolytic. Physical activity is another modality observed to have anxiolytic effects. Despite evidence of cannabis and physical activity being paired together, there is limited research on the possible synergistic effects of physical activity and cannabis use on reductions in negative affect.

METHODS These secondary analyses included 178 individuals with mild or greater anxiety who intended to use cannabis to reduce symptoms. Participants were randomly assigned to use 1 of 3 cannabis chemovars (CBD-dominant, Δ-9-tetrahydrocannabinol (THC)-dominant, or THC+CBD) ad libitum for 4 weeks. The Depression, Anxiety, and Stress Scale-21 was used to measure changes in negative affect from baseline to week 4. Minutes of moderate to vigorous physical activity (MVPA) per day were measured via actigraphy during the final 2 weeks of the study.

FINDINGS Although negative affect decreased over time in all cannabis groups (z = -3.47; P < 0.001), a significant 3-way group by time by physical activity interaction was observed (z = 2.55; P = 0.01). Negative affect significantly decreased over time in participants using THC-dominant products, and this was moderated by MVPA. As MVPA increased from low to high (low vs high MVPA: difference = -12.00; SE = 5.12; P = 0.02), the decrease in negative affect became less steep. This moderating effect was not observed in participants using CBD-dominant (low vs high MVPA: difference = -1.03; SE = 3.38; P = 0.76) or THC+CBD (low vs high MVPA: difference = 3.21; SE = 2.95; P = 0.28) products.

IMPLICATIONS This study is the first to describe cannabis associated reductions in negative affect being moderated by physical activity. These findings suggest that this association is dependent upon the cannabinoid concentration in the cannabis product being used.

CLINICALTRIALS gov identifier: NCT03491384.