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Associations of cannabis use, other substances, and lifestyle choices on anxiety in medical cannabis patients across 45 days
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  • Published: 26 February 2026

Associations of cannabis use, other substances, and lifestyle choices on anxiety in medical cannabis patients across 45 days

  • R. Nathan Pipitone1,
  • Benjamin Banai2,
  • Jessica Walters3,
  • Tyler Dautrich4,
  • Kelly Schuller1,
  • Martha Rosenthal5,
  • Kevin Provost4,
  • Branden Hall4 &
  • …
  • Keenan Keeling4 

Scientific Reports , Article number:  (2026) Cite this article

We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.

Subjects

  • Clinical pharmacology
  • Human behaviour
  • Psychology

Abstract

Previous research has shown medical cannabis (MC) to help reduce anxiety for some individuals, although most studies show trends using cross-sectional designs or conduct secondary analyses of preexisting data. The present study systematically tracked 416 registered MC patients in Florida across 45 days to assess daily shifts in anxiety levels. Using daily recording software, collected data included the frequency of MC use, other substances (e.g., alcohol, anxiolytic medication), other activities (e.g., exercise, meditation), length of previous MC use, and history of anxiety, among other demographic variables. Using linear mixed-effects modeling, results showed that MC use led to the largest anxiety relief across the 45-day period. When participants only used other substances or engaged in activities on certain days, they also saw anxiety reductions, but the major factor in any measurable change in anxiety when comparing different groups to one another was MC use. Age, sex, history of MC use, length of anxiety, and route of MC administration did not significantly contribute to the findings. Sensitivity analyses revealed that novice and experienced MC patients had similar anxiety reductions, although novice patients had slightly better relief outcomes than experienced patients across the 45 days. The anxiolytic effects of MC documented in this study comport with other published work conducting secondary analyses of preexisting data. Although MC can have anxiogenic effects in some individuals, others find it to be an effective way to reduce daily anxiety.

Data availability

All data will be provided at the request of the reader by contacting the corresponding author.

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Funding

MoreBetter (www.morebetter.ltd) and CannaMD (www.cannamd.com) provided funding for participant compensation (gift card raffle) and MoreBetter funded software costs and daily SMS text messaging costs throughout the study. No other funding was received for conducting this study.

Author information

Authors and Affiliations

  1. Department of Psychology, Florida Gulf Coast University, 10501 FGCU Blvd., Fort Myers, FL, 33965, USA

    R. Nathan Pipitone & Kelly Schuller

  2. Banai Analitika, Josipa Jurja Strossmayera 341, Osijek, 31000, Croatia

    Benjamin Banai

  3. CannaMD, 7932 West Sand Lake Road, Suite 205, Orlando, FL, 32819, USA

    Jessica Walters

  4. MoreBetter (Releaf App), PO Box 382, Hyattsville, MD, 20781-0382, USA

    Tyler Dautrich, Kevin Provost, Branden Hall & Keenan Keeling

  5. Department of Biology, Florida Gulf Coast University, 10501 FGCU Blvd., Fort Myers, FL, 33965, USA

    Martha Rosenthal

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Contributions

RNP, JW, TD, KS, MR created the study design and survey, TD, KP, BH, and KK provided the data, BB and RNP performed data cleaning and analysis, RNP, BB, and JW initiated the writing of the manuscript, and all other authors contributed to the editing and final writing of the manuscript.

Corresponding author

Correspondence to R. Nathan Pipitone.

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Competing interests

MoreBetter (www.morebetter.ltd) is a software, data, and research firm that's been running longitudinal studies on the use and efficacy of cannabinoids since 2016. MoreBetter created an app called Releaf App which is a free medical cannabis journaling app. They do not have a clinic or sell cannabis products of any kind. There was no collection of money from participants. The individuals from MoreBetter did not help with any hypotheses, design, analysis, interpretation of results, or decision to submit for publication. They assisted in building the survey according to our interests. They helped with data collection and sent us de-identified data to analyze. All participants were entered into a raffle after the study was completed to receive Amazon gift cards. Participants were told they may receive up to $250 amazon gift card. We sent out a total of $1,000 worth of amazon gift cards. Those were broken down into nine raffle winners. Two received $250, two received $100, two received $75, and three received $50. MoreBetter and CannaMD provided $1,000 participant compensation (split between MoreBetter and CannaMD) and MoreBetter funded: Participant recruitment costs, Software costs (from their own study management software, Penzai), and SMS costs to send the study questions to all participants for 45 days.

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Pipitone, R.N., Banai, B., Walters, J. et al. Associations of cannabis use, other substances, and lifestyle choices on anxiety in medical cannabis patients across 45 days. Sci Rep (2026). https://doi.org/10.1038/s41598-026-39086-2

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  • Received: 21 June 2025

  • Accepted: 02 February 2026

  • Published: 26 February 2026

  • DOI: https://doi.org/10.1038/s41598-026-39086-2

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Keywords

  • Anxiety
  • Daily relief
  • Real-world observation
  • Medical cannabis
  • Lifestyle choices
  • Other substances
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