For people dealing with anxiety, stress, or panic disorders, finding effective treatment can be challenging. Benzodiazepines (benzos) are commonly prescribed medications that have helped millions manage anxiety and related symptoms. However, as medical marijuana gains popularity as a treatment option, many wonder whether cannabis might be a safer or more effective alternative. As a seasoned medical cannabis physician, I’ve seen both benefits and drawbacks with each approach. Let’s take a closer look at medical marijuana and benzodiazepines, comparing their effectiveness, safety, side effects, and other factors to help you decide which option might work best for you.
Benzodiazepines: What Are They and How Do They Work?
Benzodiazepines are a class of drugs primarily prescribed to treat anxiety, panic disorders, and, in some cases, insomnia. Some common benzos include Xanax (alprazolam), Ativan (lorazepam), and Klonopin (clonazepam). These drugs work by enhancing the effects of gamma-aminobutyric acid (GABA), a neurotransmitter in the brain that helps to calm nervous activity. By increasing GABA, benzodiazepines quickly relieve symptoms of anxiety and promote relaxation.
While benzodiazepines are very effective at reducing anxiety, they’re generally intended for short-term or occasional use due to the risk of dependency, side effects, and tolerance.
Medical Marijuana: A Different Path to Relief
Medical marijuana, derived from the cannabis plant, contains cannabinoids such as THC (tetrahydrocannabinol) and CBD (cannabidiol). Unlike benzodiazepines, which target GABA, cannabis interacts with the body’s endocannabinoid system, which helps regulate mood, stress, pain, and even immune responses.
While THC is known for its psychoactive effects and can lift mood and reduce anxiety temporarily, CBD is non-psychoactive and has shown promising results in managing anxiety and calming the mind. People using medical marijuana for anxiety often prefer strains or products high in CBD and low in THC to minimize the “high” and avoid any risk of paranoia.
Comparing Effectiveness: Benzodiazepines vs. Medical Marijuana
Benzodiazepines and Anxiety Relief
Benzodiazepines are very effective for short-term anxiety relief, often working within 30 minutes to an hour. This quick onset makes them a popular choice for people who need immediate relief from panic attacks or intense anxiety. Research shows that benzos can reduce anxiety symptoms significantly, but they are typically recommended for brief periods to avoid the risk of dependency and tolerance.
Medical Marijuana and Anxiety Relief
Cannabis, especially CBD-dominant products, can offer relief from anxiety, though its effects may be more subtle than benzodiazepines. CBD is often praised for its calming and anti-anxiety effects, and many people experience relief without the drowsiness or cognitive impairment associated with benzodiazepines. THC can also help some individuals relax, though for others it may exacerbate anxiety, particularly in high doses.
Unlike benzodiazepines, cannabis doesn’t lead to physical dependency in the same way, though frequent users may develop a psychological habit. However, because everyone’s body reacts differently to cannabinoids, the effectiveness of medical marijuana for anxiety can vary from person to person.
Safety and Side Effects
Benzodiazepines: Common Side Effects and Risks
Benzodiazepines are generally safe for short-term use but come with a significant risk of dependency if used for extended periods. Common side effects include drowsiness, dizziness, confusion, and impaired coordination. These side effects can impact daily life, especially activities that require alertness, such as driving.
A major concern with benzodiazepines is that they can lead to tolerance, meaning that over time, higher doses are needed to achieve the same effect. Dependency is also a risk, and people who try to quit benzodiazepines after long-term use may experience withdrawal symptoms, including rebound anxiety, insomnia, and even seizures in severe cases. For these reasons, doctors often prescribe benzodiazepines as a temporary solution rather than a long-term fix.
Medical Marijuana: Side Effects and Risks
Medical marijuana has its own set of side effects, particularly for products high in THC. Common side effects include dry mouth, dizziness, increased heart rate, and impaired short-term memory. THC can also cause feelings of paranoia or anxiety in some individuals, especially if taken in high doses, which can be counterproductive for anxiety treatment.
On the other hand, CBD is generally well-tolerated with fewer side effects. In high doses, CBD can cause mild side effects like drowsiness or gastrointestinal discomfort. Unlike benzodiazepines, cannabis does not create the same risk of physical dependency, though individuals using THC-heavy products regularly may develop a psychological habit.
Long-Term Use: Dependency and Tolerance
Benzodiazepines
Long-term use of benzodiazepines is typically discouraged due to the risk of tolerance and dependency. With regular use, individuals may need increasingly higher doses to achieve the same relief, leading to dependence. Benzodiazepine withdrawal can be severe, with symptoms including heightened anxiety, insomnia, and in extreme cases, seizures.
Medical Marijuana
Medical marijuana carries a lower risk of dependency compared to benzodiazepines, especially with CBD-dominant strains or products. However, there is a potential for psychological dependence, particularly if THC is used frequently as a means of coping with anxiety. THC can also lead to some tolerance, but this is generally less severe than with benzodiazepines. As with any medication, it’s best to use medical marijuana under the guidance of a healthcare professional to avoid dependency risks.
Practical Considerations: Cost, Access, and Lifestyle
Benzodiazepines
Benzodiazepines are usually affordable and often covered by insurance, making them a cost-effective option. However, they require a prescription, and due to their potential for misuse, they may require frequent doctor visits for refills. Additionally, benzos can affect daily activities due to their sedative effects, which can be inconvenient for those with active lifestyles.
Medical Marijuana
Medical marijuana costs vary widely depending on where you live and whether insurance covers it (which it often doesn’t). Access to medical cannabis can also depend on local regulations, as it’s not legal in every state. While medical marijuana offers more flexible dosing options, such as oils, tinctures, and edibles, cost and legality can be barriers for some people. Luckily, ReThink-Rx uses telehealth to bring medical evaluations to patients throughout the Commonwealth of Virginia. With less overhead, they are passing the savings on to patients.
Finding the Right Fit: When Benzodiazepines or Medical Marijuana May Be Better
Here are some scenarios where one option might make more sense than the other:
If you need rapid, intense relief from panic attacks or severe anxiety, benzodiazepines may offer the immediate calming effects you need.
If you’re looking for a natural or holistic approach, or prefer a treatment with a lower risk of physical dependency, medical marijuana might be worth considering.
If you have a history of substance misuse, benzodiazepines might pose a higher risk due to their dependency potential, so medical marijuana or CBD alone may be safer options.
For those prone to paranoia or with certain mental health conditions like schizophrenia, THC-heavy marijuana might not be the best choice, and CBD-only products or alternative therapies could be safer.
Combining Benzodiazepines and Medical Marijuana: Proceed with Caution
Some people wonder whether it’s possible to combine benzodiazepines and medical marijuana for better results, particularly for anxiety management. While combining these treatments might seem like a good way to maximize their effects, doing so carries risks. Both cannabis and benzodiazepines can cause drowsiness, dizziness, and impaired coordination, which can be dangerous when combined. Additionally, using both may increase the risk of cognitive impairment, making it difficult to concentrate or complete tasks safely.
If you’re considering combining benzodiazepines and medical marijuana, consult with a healthcare professional who understands both options. They can provide guidance on how to do so safely or advise alternative options tailored to your needs.
The Takeaway: Choosing the Right Approach for You
Both benzodiazepines and medical marijuana have their roles in managing anxiety and related conditions. Benzodiazepines provide fast, potent relief and are highly effective for short-term anxiety management, but they come with a risk of dependency and withdrawal symptoms if used long-term. Medical marijuana, particularly CBD-rich options, can offer more gradual, calming effects and may work well for those seeking a natural approach or a lower dependency risk.
When deciding between these options, consider factors like your lifestyle, how you plan to use the treatment, and your long-term health goals. For some, a short course of benzodiazepines followed by ongoing medical marijuana use may work well, while others might prefer one approach exclusively. Consulting with a knowledgeable physician is essential to finding the best path for you, whether it’s benzodiazepines, medical marijuana, or a combination that helps you achieve lasting relief from anxiety.

Dr. Nicholas Marsh has been a respected board-certified anesthesiologist in Northern Virginia for over 35 years. Recognized as a top doctor by FindaTopDoc.com, his vision for providing top-quality medical services is driven by his passion for patient comfort and dignity.