Is Cannabis-Induced Psychosis Actually Real?

The 1936 abomination/movie Reefer Madness has a lot to answer for. In the movie, a group of high school students smokes some marijuana after being lured into the act by evil drug pushers. All it took was a few hits to transform them from mild-mannered teens into members of the Manson family, as the drug resulted in psychotic behavior ranging from rape to manslaughter.

Despite being filled with out-and-out lies (not to mention panned as one of the worst movies ever made), this propaganda tool ultimately achieved its purpose; weed was seen as a terrible drug that would cause you to lose your mind and commit terrible deeds. Public opinion remained against cannabis for decades, and it is only recently that polls show a majority of Americans in favor of legalizing it.

However, is there a grain of truth amidst the fabrication that was Reefer Madness? Can marijuana cause psychosis? Let’s see what science has to say and delve into some real-life cases.

Does Cannabis Cause Psychosis?

Data from the United Nations suggests that between 183 million and 238 million people use marijuana worldwide, and over 40 million people in North America use the herb. According to the American Psychiatric Association, up to 1 in 13 Americans will experience a ‘psychotic episode’ by the time they are 75 years of age. With these figures in mind, it is clear that some people will smoke weed and also have a psychotic episode. The question is: “Does marijuana make it more likely?”

In a study led by Dr. Sagnik Bhattacharyya and published in the Archives of General Psychiatry in January 2012, the psychoactive compound THC increases brain processes that result in psychosis symptoms. Meanwhile, CBD, a non-intoxicating compound, counteracts these negative effects. The researchers found that THC interferes with the brain’s ability to distinguish important and irrelevant stimuli.

The study involved 15 healthy men, all of whom had used weed in the past. MRI scans were used to look at the brains of the subject after consuming a pill containing either THC, CBD, or a placebo. The conclusion was that THC increased the severity of psychosis symptoms as those who took it showed increased prefrontal cortex activity and decreased striatum activity. One theory is that THC changes the brain’s levels of dopamine. The above are known brain processes in individuals with psychosis.

Moreover, the ‘dose-response’ relationship suggests that the more weed you use, the greater the risk of psychosis. An estimated 73% of cannabis is smoked by just 9% of users, so it is these individuals who are ultimately at the greatest risk. Also, you are at risk of further episodes if you already have schizophrenia.

However, there is a significant flaw in the research that has been conducted on the topic to date. In the majority of the studies, for example, people were consuming low potency marijuana such as resin. This could be significant because higher potency marijuana typically contains higher amounts of CBD, which offers an element of “protection” from psychosis. Ideally, marijuana would be legalized everywhere as a fully regulated market would result in quality control; a fact we see in states such as California and Colorado where weed is legal for recreational use.

Interestingly enough, American marijuana users have a major advantage over their counterparts in the UK and other nations, as they normally use cannabis “on its own” whereas British users typically add tobacco. If nothing else, U.S. users who don’t already use tobacco are at a predisposed advantage simply because they are exposed less to the deadly substance. We know that a certain percentage of people have psychosis and statistically, some of them smoke weed. Here are a few of their stories.

Cannabis & Psychosis – Real Life Stories

Paul Hunziker of Family Therapy and Recovery in Renton, Washington, claims that high-strength cannabis (such as butane hash oil with a THC content of up to 90%), can cause everything from depression to paranoia. Duane Stone is a mental health specialist in Seattle and agrees with Hunziker, claiming that people who have never had issues with mental health suddenly started getting paranoid and depressed within a year or two of using ultra high-potency weed.

One of the most tragic stories was that of 19-year old Levy Thumba Pongi. In March 2014, the teenager consumed six times the recommended dose of a cannabis cookie and jumped to his death off a balcony on the fourth floor of a Holiday Inn in Denver. Pongi was an exchange student from the Republic of Congo, with no previous known history of mental illness or drug use. The cookie contained 65mg of THC, and employees of the dispensary where Pongi bought it recommended eating only one-sixth, and that it could take up to 30 minutes to feel any effects.

However, after feeling nothing within that timeframe, Pongi ate the entire cookie and two and a half hours later, jumped from the balcony. It was the first death attributed to marijuana in the state of Colorado since it became legal for recreational use. The problem here is that because Pongi was from the Congo, there is no easy way to understand his mental health history. Before he jumped from the balcony, he reportedly told friends: “This is a sign from God that this has happened, that I can’t control myself. It’s not because of the weed.” Extremely tragic, but there is perhaps more to the story than meets the eye.

Another real-life account of marijuana-induced psychosis involves a young man by the name of Devan Fuentes. Fuentes had never been a habitual marijuana smoker, but in his early twenties became exposed to the herb and within just a year or two, was smoking four to five joints a day. As he increased his consumption, however, it was clear to him that instead of the weed relaxing him or mellowing him out, it enraged him and revved up psychotic delusions and impulses.

After around a year of heavy weed smoking, things came to a head when he began furiously scribbling his thoughts on pieces of paper before throwing them against a wall in frustration. Devan walked in and out of his house several times before accidentally locking himself out. He had the presence of mind to go to a neighbor’s house and hand over his weed supply, in the belief it was the cause of his psychotic episode.

After returning home, he tried to scale the roof of his house but fell off the trash can and injured himself. Devan remembered feeling frightened by the entire incident, but was unable to wipe a strange grin off his face. After going to the hospital, he was diagnosed with schizo-affective disorder, which is a combination of mood disorder and schizophrenia symptoms.

In Devan’s case, he had hallucinations of gore and zombies while the faces of strangers morphed onto those of people he knew. While in the hospital, he had the belief that one patient was an undercover officer posing as a doctor, and spying on patients for the government. When he tried to harm himself, he was placed in restraints. Ultimately, Devan ended up acknowledging the notion that while the marijuana was not 100% responsible for his psychotic behavior, it without a doubt exacerbated his underlying (and possibly even dormant) condition of schizophrenia.

All in all, there are a number of mental health specialists from around the world that remain adamant that cannabis induces psychosis – particularly among patients who already portray minor underlying symptoms, and/or have experienced other “emotional abnormalities” in the past. According to Theresa Nguyen of Mental Health America, however, these “pre-psychotic” patients find it hard to quit their marijuana use, even though they realize it exacerbates their condition. She bizarrely compared it to the difficulties one faces when trying to curb an addiction to junk food; even though we realize it’s bad for us, it doesn’t necessarily make it easy to quit! She said that once patients are clean for a few days, however, the feelings of paranoia begin to quickly fade.

Final Thoughts on Cannabis & Psychosis

It was interesting to note that Nguyen also admitted that when psychosis symptoms remain after a patient has been ‘off’ weed for 72 hours, blame is placed solely on the brain, rather than the drug. The problem, then, is determining whether or not:

  • Cannabis is an actual cause of psychosis.
  • Marijuana exacerbates existing symptoms, or perhaps brings such symptoms to the fore in people who are likely to experience psychosis later in life even – if they never touch weed.
  • Those prone to psychosis are more likely to be attracted to marijuana.

Even anti-marijuana campaigners are forced to admit that the drug has very different effects from person to person. Moreover, it is often consumed in concert with other drugs such as alcohol and pharmaceuticals, which are known to exacerbate any potential adverse effects.

All in all, what it boils down to is a classic argument of causation versus correlation; marijuana use is correlated with psychosis, but that doesn’t mean it causes it (compare that to tobacco cigarettes, which we know for fact is a direct cause of lung cancer).

In cases where weed users are diagnosed with psychosis, however, how do we know which one happened first; the marijuana use or the psychotic episodes? Conclusive evidence that cannabis is the cause of psychosis is practically non-existent. It is far more likely that the THC in weed simply exacerbates existing mental issues, which is why individuals who fit into this category should steer clear of high potency, THC-laden cannabis.

As a matter of fact, individuals who are already predisposed to psychotic symptoms may benefit greatly from high CBD/low THC cannabis. A study led by Philip McGuire of King’s College London and published in the December 2017 edition of the American Journal of Psychiatry, focused on 88 patients with schizophrenia. One group received a placebo, while the other was given 1,000mg of CBD per day over a six-week period. The researchers discovered that those who consumed CBD, ultimately displayed lower levels of psychotic symptoms.

To conclude, there’s no getting around the fact that it will take a lot more research to gain a definitive answer to the question: “Is cannabis-induced psychosis a real thing?” While people with psychotic tendencies may be drawn to weed, and high-THC marijuana could make existing symptoms worse, it is practically impossible to determine how many cases of psychosis are actually caused by cannabis — if any.

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