Small clinical trials have long struggled to provide clear answers about medical cannabis and anxiety. New data tracking almost 1,900 anxiety patients at the medical cannabis clinic Releaf found that nearly 70% reported an improvement in their symptoms.
A systematic review published this year in the Journal of Affective Disorders Reports examined a straightforward question: does THC-containing medical cannabis help with anxiety? Researchers screened 6,453 studies but identified only five that met their strict criteria for controlled, patient-level evidence. These included trials involving fibromyalgia, obsessive-compulsive disorder, Parkinson’s disease, multiple sclerosis, and one observational study of chronic pain.
The results were mixed. Most studies found no significant change in anxiety, while one reported a measurable worsening of symptoms. The researchers rated the overall quality of the evidence as low to moderate, citing small sample sizes and short follow-up periods, and concluded that “no consistent evidence of benefit was observed.”
Graham Woodward, Chief Medical Officer at Releaf, says the key issue is not the review itself, but what the available evidence was actually able to test. “There have been relatively few large, high-quality, double-blind, placebo-controlled randomised clinical trials evaluating prescribed medical cannabis specifically for anxiety disorders,” Woodward explains. “Much of the published literature relies on systematic reviews and meta-analyses of relatively small and heterogeneous studies, using different formulations, doses, and patient populations, making it difficult to draw definitive conclusions.”
The detail that stands out to him most is that, in all five studies included in the review, anxiety was measured only as a secondary symptom in patients being treated for a different primary condition. None involved patients whose main diagnosis was an anxiety disorder.
It is a gap that Releaf’s own patient data may help to address. Between April 2025 and July 2026, 5,168 patients completed at least one GAD-7 questionnaire, a validated clinical scale used to assess generalised anxiety.
Among the 1,862 patients tracked over time, 69.9% reported feeling less anxious, while 47.5% showed a clinically meaningful improvement, defined as a reduction of four or more points on the GAD-7 scale. The pattern was consistent across the major condition groups treated, including the 877 patients whose primary diagnosis was anxiety. Of these, 50.1% achieved a clinically meaningful improvement.
“Our real-world evidence consistently demonstrates that patients prescribed medical cannabis report meaningful reductions in anxiety, alongside improvements in overall quality of life,” says Woodward. “We also see significant improvements in sleep, appetite, daily functioning, and social engagement.”
Two cases in particular stand out to him. Both patients were young adults, aged 18–20, living with severe social anxiety that was so debilitating that neither regularly left home or attended education. Within three months of starting carefully titrated, low-dose medical cannabis treatment, both began driving lessons. One went on to accept a door-to-door census job, interacting with members of the public daily, while the other began actively seeking work as a waiter.
“These are examples of profound improvements in confidence, independence, and social functioning that are difficult to ignore,” Woodward says.
Woodward is careful not to overstate the case. “As with any medical treatment, it is expected that not every patient will respond. This is true for antidepressants, analgesics, and virtually every other therapeutic intervention.” But he believes a significant number of patients never reach a therapeutic dose in the first place. “Many patients commence medical cannabis cautiously, because of stigma, misconceptions, or concerns about intoxication, dependence, or judgement from others. Consequently, some remain on doses below the therapeutic range and discontinue treatment before adequate dose optimisation has occurred.”
For Woodward, the takeaway is not that clinical trials have got it wrong, but that they have not yet been designed to ask the right question. “I am not suggesting that medical cannabis is effective for every patient or every condition,” Woodward says. “However, our real-world clinical experience, supported by validated outcome data collected from thousands of patients, indicates that appropriately prescribed and carefully titrated medical cannabis can produce substantial improvements for many people living with anxiety.”
The findings add to the ongoing discussion around medical cannabis and mental health, particularly the potential role of prescribed cannabis in supporting anxiety management when carefully monitored under clinical guidance. Further large-scale trials focused specifically on primary anxiety diagnoses would help strengthen the evidence base for patients and clinicians alike.