Understanding Cannabis-induced Psychosis

Many people see cannabis as a safe or harmless drug but using it is not without risk. Cannabis use can lead to significant side effects including psychosis.

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What is Cannabis?

After alcohol and tobacco products, cannabis or marijuana is the most used addictive drug.1 In recent years, eighteen states, two territories, and the District of Columbia have legalized cannabis for non-medical use. Thirty-six states have passed measures allowing the use of cannabis for medical purposes.2 The reduction of potential legal consequences related to marijuana possession and use could be part of the driving force behind growing addiction rates and other issues with marijuana use, including cannabis-induced psychosis. 

What Makes Up Marijuana?

Cannabis sativa or Cannabis indica are the plants from which marijuana is harvested. The term marijuana refers to the dried flowers, stems, and leaves of these plants. The plant contains a naturally occurring chemical called THC (Tetrahydrocannabinol) that, when smoked or ingested, produces mind-altering effects. 

Statistics on Marijuana Use in the US

The Centers for Disease Control and Prevention indicate as many as 22.2 million3 people in the United States use cannabis each month, and 18% of Americans used it at least once in 2019. 4

Further research shows that one in ten of those people will develop a marijuana addiction. That statistic increases to one in six individuals for teens and adolescents who began using marijuana before they turned eighteen. Research estimates that three out of ten individuals meet the diagnostic criteria for a marijuana use disorder.4   

Effects of Marijuana

Marijuana use has a direct impact on the brain. In the short term, it affects the parts of the brain responsible for attention, decision-making, coordination, memory, learning, emotional regulation, and reaction time.

In adolescents and teens, whose brains are still growing, marijuana use can have a detrimental effect on vital developmental processes. Long-term or frequent cannabis use has been linked to psychosis (sometimes referred to as marijuana-induced psychosis or cannabis-induced psychosis). Moreover, research has indicated a connection between using marijuana and schizophrenia. 

What is Cannabis-induced Psychosis?

Psychosis is a condition where the individual is disconnected from reality. In most cases, they experience symptoms including hallucinations and delusions. Cannabis-induced psychosis involves severe hallucinations, delusions, or both that occur during use or immediately after.

Drugs, including marijuana, affect people differently. Although many symptoms are common across the board, each person is likely to experience symptoms unique to their level of use and frequency of use. Symptoms of cannabis-induced psychosis follow a similar pattern. Although each is present in virtually every case, the severity and intensity of the symptoms will vary. 

Hallucinations

A hallucination is a sense or perception of something that is not real. For example, if you hear, smell, or see something that no one else does, it is a hallucination. 

Delusions

A delusion is a belief in something that is not true. For example, someone experiencing a delusion may believe that they have supernatural powers or that someone is trying to hurt them. Although likely not true, the belief is so powerful that it often takes over their ability for rational thought.

Other common symptoms of marijuana psychosis include disorganized thoughts, agitation, and disassociation (disconnecting from current reality). 

Studies on Marijuana-induced Psychosis

Several studies have been conducted to determine the connection between cannabis use and psychosis. Recent systematic examination of multiple studies previously conducted regarding cannabis psychosis shows that those who use cannabis frequently have nearly a 1 1/2 times greater risk of psychotic outcomes than those who do not.

Additionally, the purity or dose of cannabis contributes to increased psychotic outcomes. For example, the average individual who uses cannabis had a two times greater risk for developing marijuana psychosis (cannabis psychosis or weed psychosis). In contrast, someone with heavy use had a four times greater increase when compared with people who do not use marijuana.

Substance Use Disorder and Psychosis

The Diagnostic and Statistical Manual of Mental Disorders lists criteria for cannabis use disorder or cannabis-induced psychosis disorder (CIPD). In all cases, cannabis use disorder or cannabis-induced psychosis involves severe hallucinations, delusions, or both. In addition, other common symptoms may include confusion, memory loss, excitement, and others previously listed above.

Moreover, a diagnosis of cannabis use disorder requires that the symptoms linger after the “high” from cannabis use fades. For some, this means the symptoms of cannabis psychosis may last for days or weeks. Symptoms of marijuana psychosis must also be distressing enough to interfere with day-to-day activities and occur without any other explanation for their presence, such as a co-occurring disorder like schizophrenia. 

How Can Addiction Contribute to Psychosis?

Frequency of use (or addiction) may contribute to a heightened risk for weed psychosis. Research has indicated a connection between frequent and high-potency cannabis use and marijuana psychosis. Researchers are currently studying the link between cannabis use and co-occurring mental health disorders; there appears to be a strong link between marijuana use and new or worsening schizophrenia symptoms.

Risk Factors

Research into the risk factors for cannabis-induced psychosis is ongoing. Like other mental health conditions that may link to substance use, various possible risk factors may increase one’s risk. However, the presence of a risk factor may or may not contribute to developing cannabis-induced psychosis. Some of the most common risk factors may include:

  • Family history of substance use disorders or psychotic disorders
  • Personal history of schizophrenia, bipolar disorder, or depression
  • Previous head injuries
  • Birth complications or poor maternal health during pregnancy
  • Other types of drug abuse
  • Physical, emotional, or sexual abuse in childhood 

Treatment for Cannabis-induced Psychosis

Dual Diagnosis

The most effective treatment for someone struggling with symptoms of cannabis-induced psychosis is to stop using marijuana. However, stopping use is often far easier said than done. It can be challenging for someone with a marijuana use disorder to overcome an addiction without comprehensive addiction treatment.

The best option is to seek treatment at a treatment facility skilled in dual-diagnosis treatment. A dual-diagnosis program will address both symptoms and concerns related to the substance use disorder and the mental health impacts of psychosis. 

Detoxing

In many cases, detox is a necessary first step for treating cannabis psychosis. Detox is needed to rid the body of all traces of marijuana so you can begin the work of overcoming addiction. Choosing a treatment center specializing in medically supervised detox is crucial to ensure you receive the support and guidance you need to detox safely. 

Therapies

After completing detox, it is possible to transition into a treatment program. Depending on the severity of your addiction, the therapeutic portion of a treatment program may occur in an inpatient or outpatient setting. Additionally, the severity of one’s psychotic symptoms related to marijuana psychosis may dictate the level of care they need and the type of treatment program that works best for them. Any treatment plan must address your overall needs, including your physical, psychological, and spiritual health.

If you or a loved one struggles with a substance use disorder and experience psychotic symptoms related to marijuana use, it is important to seek help and comprehensive psychosis treatment. A comprehensive, evidence-based treatment program provides the opportunity to safely and successfully achieve sobriety, reduce the intensity and severity of psychosis symptoms, and achieve lasting recovery. 

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