Brazilian researchers have published in JAMA Network Open a paper entitled “Efficacy and Safety of Cannabidiol Plus Standard Care vs Standard Care Alone for the Treatment of Emotional Exhaustion and Burnout Among Frontline Health Care Workers During the COVID-19 Pandemic: A Randomized Clinical Trial.”

Here are the “key points” as summarized by Crippa, Zuardi, and colleagues:

Question Is cannabidiol (CBD) therapy capable of reducing emotional exhaustion and burnout symptoms among frontline health care professionals working with patients with COVID-19?

Findings In this randomized clinical trial of 120 frontline health care professionals, emotional exhaustion scores were reduced among participants receiving CBD plus standard care compared with those receiving standard care alone. Five participants who received CBD plus standard care experienced serious adverse events, with full recovery after discontinuation.

Meaning The study’s findings suggest that CBD may act as an effective agent for the reduction of emotional exhaustion and burnout symptoms among frontline health care professionals, although it is necessary to balance the benefits with potential undesired effects when making decisions regarding the use of CBD.

The study involved physicians, nurses, and physical therapists at a teaching hospital in Sao Paulo. In one arm the participants received two daily 150mg doses of CBD plus standard care; the controls got standard care only. Standard care consisted of “motivational and instructional videos on low-impact physical exercise plus weekly consultations with psychiatrists.”

Evaluations were made using the Maslach Burnout Inventory for Medical Personnel, which is said to measure “Emotional exhaustion (feelings of being emotionally overextended and exhausted by one’s work); Depersonalization (an unfeeling and impersonal response toward patients); and Personal Accomplishment (feelings of competence and successful achievement in one’s work).”  Secondary outcomes —anxiety, depression and PTSD symptoms— were measured by using other “validated” questionnaires. 

Based on their answers, the CBD users were determined to have gotten “substantial” symptom reduction in most categories and “significant” reduction in “emotional exhaustion.”  (The serious adverse events, all in the treatment group, included four cases of elevated liver enzymes and an undefined skin disorder.)

Cannabis as Soma

What’s unsettling about this study is the implicit promotion of cannabis as Soma —the drug provided to all citizens in Aldous Huxley’s novel Brave New World to make unbearable conditions seem acceptable. Isn’t burnout a warning sign that should be heeded? Healthcare workers in Brazil (and the US) are being overworked and gratuitously jeopardized. Should they be advised to pop CBD and keep on keeping on? 

In a section of their paper on “Procedure,” Crippa et al provide the kind of detail that validates their study in the eyes of peer reviewers: “The CBD vials were weighed before they were delivered to the participant and after they were returned at the end of the clinical trial to assess treatment adherence.” Buried in the four paragraphs devoted “Procedure” was a sentence that seemed much more significant: “Hospital executives maintained a safe and supportive working environment by repeatedly offering personal protective equipment, modifications to work schedules, and ongoing testing as well as hiring new personnel and providing a specific outpatient treatment unit.”

In the US today, as in Brazil, hospital workers are not only physically jeopardized and exhausted, but their morale is undermined by fellow citizens unwilling to get vaccinated. It’s a nightmare situation, and CBD is not going to resolve it.