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Tremors — From marijuana use or anxiety?

Dear Alice,

I have smoked marijuana on and off for about a year, not ever more than about once every other week. The last two times I smoked, I experienced uncontrollable tremors in my leg. It wasn't painful like a muscle spasm, but it was uncomfortable and unsettling. Was this merely nervousness (this was the first time I had people "over" at my own suite to smoke and I was a little worried that my roommates would be angry)? Or, could this be a side effect of the drug?

Signed,
Reefer Madness

Dear Reefer Madness,

It's unsettling when our bodies do something seemingly without our control. Tremors, which refer to any involuntary rhythmic muscle movement, are a common side effect of both marijuana and anxiety, which makes it difficult to discern whether your own tremors were caused by the weed you smoked or your worries about your roommates. Additionally, tremors can occur due to a number of health conditions. Due to this, only a health care provider could determine whether the tremors are a result of the marijuana, your anxiety, the combination of the two, or another underlying health concern. 

When you experience anxiety or panic, it activates your fight or flight response, even if there's no imminent danger. This triggers a rush of anxiety, which constricts the blood vessels and can then cause the shaking and trembling of the limbs to occur. Thus, when tremors are attributed to anxiety or panic, it's most often due to the increase in adrenaline in the body.

While the link between anxiety and tremors is fairly straightforward, marijuana and tremors have a bit more of a complicated relationship. Limited research is available on the association between marijuana and tremors, but the different studies that have been conducted have found varying results. One study showed that marijuana appears to reduce the occurrence of tremors in motor-related diseases. A previous study done on rats deduced that marijuana dramatically altered the rats' responses to environmental stimuli and diminished their locomotor responses. However, tremors have also been found to be a physical side effect of marijuana along with nausea, headaches, and increased appetite. Marijuana has also been known to lower the seizure threshold for those with seizure disorders, which means it can make having a seizure more likely for those predisposed to them.

So, while both anxiety and marijuana can have an effect on tremors, it doesn't answer the question of what specifically caused your tremors. It's impossible to say for sure through the Internet. It’s possible that the uncontrollable leg-shaking may not have been caused by just one or the other, but rather, the combination of marijuana in your system and nerves about your roomies could have served as somewhat of a perfect storm for these tremors. Studies have shown that the two compounds in marijuana, cannabidiol (CBD) and tetrahydrocannabinol (THC), each have a different effect on feelings of anxiety: while CBD has been shown to ease or reduce feelings of anxiety, THC has been shown to actually increase feelings of anxiety. Since there's a higher concentration of THC than CBD in marijuana, it’s possible that the weed you smoked exacerbated your already-present anxiety about having guests over, which then caused tremors you may not have experienced otherwise. It's also possible that you experienced the tremors due to your anxiety or due to the marijuana without one having an effect on another. You may also be experiencing a tremor that is completely unrelated to either the anxiety and marijuana, and the timing happened to be coincidental. There are many variables at play, and it's hard to determine what the cause may have been. 

When smoking in the future, try to ensure that you're in an environment where you feel comfortable and with people around whom you feel safe in order to reduce the chances of these tremors reoccurring. If the tremors do sneak up on you again, taking a moment to collect your thoughts and do some deep slow breathing may help get you the extra oxygen and calming rhythm you need to relax your muscles and your mind. If you continue to notice the tremors, checking in with a health care provider can help you get to the root cause of them and they can suggest any potential treatments as well. 

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Last updated Aug 05, 2022
Originally published Jan 01, 1994