
The most commonly used natural species of cannabis include cannabis sativa, cannabis indica, and cannabis ruderalis. Strains with a high level of a compound called CBD are mostly chosen as medicinal agents, as their intoxication potential is very low. Benefits of CBD products include treatment of schizophrenia, reduction of psychotic symptoms, pain relief, lowered anxiety, used for treatment-resistant epilepsy and muscular dystrophy.
3,4 Strains with a high level of another compound called THC are chosen for recreational use, as their intoxication potential is pronounced. Products containing a 5% to 10% concentration of THC can also produce analgesic effects as an alternative to pain medication, but higher THC concentrations can actually increase pain, and increase the frequency of adverse events. Studies have also shown that consumption of high concentrations (15-30%) of THC present an estimated 6-fold risk for psychiatric symptoms such as psychosis and schizophrenia.
2,6,8 THC should be avoided in persons suffering from depression according to studies, as high levels of THC can worsen depressive symptoms, especially over long term use.
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As more and more states begin to legalize cannabis use, the popularity of both recreational and medicinal marijuana has continued to grow as well. This has led many people to either try cannabis for the first time or to try a new method of using cannabis. However, understanding the risks and benefits precisely is clearly advantageous whether your aim is safe medicinal or recreational use.
Here’s what you need to know about cannabis-induced psychosis and some answers to common questions regarding the topic.
Is There a Link Between Marijuana Use and Psychiatric Disorders?
Marijuana generally refers to recreational cannabis, which is typically sought for its significant THC content, that is 15% – 30% or greater. As marijuana use continues to grow in popularity across the country, more and more research is being done to study the effects of recreational marijuana on mental and physical health. According to the National Institute on Drug Abuse, recent studies found links between recreational marijuana use and an increased risk of psychiatric disorders, such as psychosis, schizophrenia and mood disorders like depression and anxiety, as well as physical risks such as cardiovascular and respiratory diseases.6,7
Does Cannabis Cause Psychosis?
Cannabis-induced psychosis has been recognized and studied for quite some time. It is fascinating to note Manseau’s observations that the compound THC in high quantities can induce schizophrenia and psychosis, and the compound CBD can be used to mitigate (relieve) those same symptoms.1
Another area of research suggests that certain genetic predispositions may be linked to a vulnerability to cannabis-induced psychosis. Genetics can affect how efficiently or poorly drugs are metabolized or cleared. Other combined predispositions may also exist alongside cannabis use, such as early childhood trauma and may also contribute to vulnerability in some persons who suffer drug-induced psychosis.8
What Is THC Induced-Psychosis?
THC-induced psychosis is a set of symptoms that can occur after ingesting typically high levels of THC. It’s a break with reality and is often accompanied with audio and/or visual hallucinations, paranoia, suspicion, and delusional thought. It is not at all uncommon for cannabis-induced psychosis to be misdiagnosed as schizophrenia, as the symptoms are similar. A 5-year follow-up review of patients who totally abstained after a first episode of cannabis-induced psychosis were found to never again relapse.10
Is Cannabis-Induced Psychosis Common?
The statistics on cannabis-induced psychosis have not been fully determined, but we do see that cannabis use is over-represented in the population diagnosed as schizophrenic, across the world. An interesting study by Hall and Degenhardt published in the World Psychiatry Journal concluded after a 27-year follow up, that 13% of the schizophrenia cases followed in the study could have been averted if cannabis was abstained from.11
Another clinical study out of India estimated that an astounding 50% of all schizophrenia and psychosis cases are cannabis-related.12
What Are the Symptoms of Cannabis-Induced Psychosis?
Cannabis-induced psychosis looks a lot like schizophrenia, and mimics other psychiatric disorders. If the symptoms fade away relatively quickly they are called “acute” symptoms, such as when a person can sleep it off, and wake up feeling relatively normal. THC has a “sticky” characteristic, in that it takes a long time for the body to flush out the metabolites. If the person abstains, likely the symptoms will continue to abate, and will not return. However, if the person continues to use cannabis with high concentrations of THC, it is possible that the cumulative effects may cause another psychotic episode to occur. If the symptoms are persistent, even after abstaining, then treatment is indicated. Physicians may not always identify these symptoms as drug-induced psychosis and too often, misdiagnosis can lead to the wrong treatment approach.