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Cannabis Psychosis: Recognize the Signs (& What to Do)

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As more U.S. states legalize cannabis for medical and recreational purposes, the psychoactive plant has seemingly gained acceptance as a mainstream drug, like aspirin or cough syrup. At least, it appears that way.

This is a far cry from how cannabis was perceived in the early 20th century when critics and alarmists alike called it “the devil’s lettuce” and “the smoke of hell.” Today, people mock “Reefer Madness,” the propagandist, anti-marijuana film from 1936 that featured characters succumbing to murder and deviancy under the influence of the green stuff.

Yet, despite its purported legitimacy, excessive marijuana use can result in dangerous physical and psychological effects. Psychosis is chief among those threats.

There is a link between heavy cannabis use and psychosis. According to a 2019 study published in The Lancet Psychiatry, consuming pot daily, particularly highly potent variants, can increase your risk of experiencing psychosis.

The National Institute on Drug Abuse (NIDA) also cites research that people who use marijuana and carry a variant of a certain gene (the AKT1 gene) are also at an increased risk of incurring psychosis.

Some signs indicate the onset of cannabis-induced psychosis (CIP). Read on to learn what they are and what you can do about it.

WHAT IS PSYCHOSIS?

Psychosis is not an illness. Rather, it is a symptom. The National Alliance on Mental Illness (NAMI) says that psychosis is marked by disruptions to a person’s thoughts and perceptions, so much so that it becomes difficult for them to see what’s real and what isn’t. In essence, someone with this condition will either have hallucinations or delusions.

Those disruptions can manifest as seeing, believing, and hearing things that are not real. It can also declare itself when someone has strange, persistent behaviors, thoughts, and emotions.

Psychosis Symptoms

There are signs and symptoms that characterize psychosis in general. According to Medical News Today, those signs and symptoms include:

  • Hallucinations: When a person sees, hearing, or feeling things that do not exist.
  • Delusions: Delusions occur when individuals have false beliefs, especially those that are based on fear or suspicion of things that are not real.
  • Difficulty concentrating
  • Catatonia: This is the inability to move normally.
  • Disorganization: This reveals itself in behavior, thought, or speech.
  • Disordered thinking: This kind of thinking occurs when a person makes strange connections between thoughts or jump between unrelated topics.

SIGNS OF CANNABIS-INDUCED PSYCHOSIS

Cannabis-induced psychosis (CIP) differs from standard psychosis in that people with the former will show more mood symptoms.

It is not uncommon for people with CIP to show a sudden onset of mood swings and paranoid symptoms within one week of use or as soon as 24 hours after use, according to the Psychiatric Times.

The moods often associated with CIP include:

  • Anxiety
  • Depression
  • Obsessive ideation
  • Interpersonal sensitivity
  • Agitation
  • Hypomania

CIP can occur with heavy cannabis use within the past month. Hallucinations are common in both CIP and regular psychosis. However, visual hallucinations are more common and distinct in people with CIP.

Another common aspect that marks the difference between cannabis-derived psychosis and the standard condition is that a person with CIP will be aware of their condition and display greater disease insight. They will also have the ability to identify symptoms as a manifestation of a mental disorder or substance use, according to the Psychiatric Times.

Other Signs of Cannabis Use

In addition to those psychosis-related effects, MedlinePlus.govincludes these signs of cannabis abuse:

  • Red eyes
  • Decreased short-term memory
  • Impaired perception and motor skills
  • Dry mouth

SHORT AND LONG-TERM EFFECTS OF CANNABIS USE

When THC is smoked, it enters the body and transfers from the lungs into the bloodstream. The blood then carries the THC to the brain and other organs in the body. When someone eats or drinks a product laced with marijuana, the body absorbs it more slowly.

Short-Term Effects

Nevertheless, THC stimulates brain cell receptors leading users to experience a high. Besides that high, NIDA states that other short-term marijuana effects include:

  • Psychosis (when taken in high doses)
  • Delusions (when taken in high doses)
  • Altered senses (for example, seeing brighter colors)
  • Altered sense of time
  • Hallucinations (when taken in high doses)
  • Changes in mood
  • Impaired memory
  • Impaired body movement
  • Difficulty with thinking and problem-solving

Long-Term Effects

The long-term effects of cannabis indicate that there is nothing safe about this substance, legal, or not. It can inflict effects on the brain, including psychosis.

According to NIDA, the long-term, physical effects of marijuana include:

  • Breathing issues
  • Increased heart rate
  • Child development issues during and after pregnancy
  • Intense nausea and vomiting

Psychological effects that can occur from cannabis are:

  • Temporary paranoia
  • Temporary hallucinations
  • Worsening symptoms for people with schizophrenia

Teenage users have been known to develop depression, anxiety, and suicidal thoughts after using cannabis for a long time.

SPECIAL DANGERS OF HIGHLY POTENT MARIJUANA

This isn’t your dad’s marijuana. This isn’t even your big brother’s weed. The cannabis of today is exceptionally potent, especially marijuana concentrates. The primary psychoactive ingredient in cannabis, tetrahydrocannabinol (THC), is what generates the plant’s hallucinogenic effects, and it is at higher levels than ever before.

The average THC content in confiscated cannabis was 3.7 percent for marijuana and 7.5 percent for sinsemilla (a more potent form of marijuana) in the early 1990s.

In 2013, however, those percentages jumped to 9.6 percent for marijuana and 16 percent for sinsemilla, according to NIDA.

Those percentages are dwarfed by hash oil, an extract from marijuana plants that is ladened with THC. Ingesting this oil, either by smoking or eating, delivers unparalleled levels of THC to the user. The average marijuana extract contains more than 50 percent of THC, with some products having levels that exceed 80 percent (!!!), according to NIDA.

So it follows that marijuana concentrates that contain extremely high levels of THC can induce more psychologically and physically devastating effects than standard, plant-based marijuana.

However, the long-term effects of marijuana concentrates are not fully known.

What’s more, street marijuana can also be cut with other hallucinogenic substances that can be more dangerous, causing side effects such as:

  • Seizures
  • Sudden high blood pressure with headache
  • Chest pain and heart rhythm disturbances
  • Heart attack
  • Stroke
  • Extreme hyperactivity and physical violence
  • Sudden collapse (cardiac arrest)

TREATMENT FOR CANNABIS-INDUCED PSYCHOSIS

If CIP has taken hold over you or a loved one’s life, then professional treatment can safely and effectively address symptoms to help restore your mind. It can also provide physical and mental stabilization and arm you with strategies to avoid relapse.

Professional treatment begins with medical detox. In detox, the cannabis is removed from your body, and any withdrawal symptoms that arise are medically treated. In the case of CIP, FDA-approved medicines can be utilized to treat psychosis symptoms.

Depending on the severity of the addiction and co-occurring psychosis symptoms, a client could be recommended for dual diagnosis treatment. Dual diagnosis addresses a person’s substance abuse and mental health disorder at the same time.

The types of therapy offered under dual diagnosis treatment include:

  • Cognitive behavioral therapy
  • Family therapy
  • Yoga
  • Meditation

Sources

Forti, M. D., Ph.D., Quattrone, D., MD, Freeman, T. P., Ph.D., Tripoli, G., MSc, Gayer-Anderson, C., Ph.D., & Quigley, H. (2019, May 1). The contribution of cannabis use to variation in the incidence of psychotic disorder across Europe (EU-GEI): A multicentre case-control study. from https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(19)30048-3/fulltext

Grewal, R. S., & George, T. P. (2017, July 14). Cannabis-Induced Psychosis: A Review. from https://www.psychiatrictimes.com/substance-use-disorder/cannabis-induced-psychosis-review/page/0/2

Grewal, R. S., MD, & George, T. P., MD. (2017, August 4). 8 Distinguishing Features of Primary Psychosis Versus Cannabis-Induced Psychosis[PDF File]. Psychiatric Times. Date retrieved: July 29, 2019. from https://www.psychiatrictimes.com/schizophrenia/8-distinguishing-features-primary-psychosis-versus-cannabis-induced-psychosis

IMDb (Internet Movie Database). (2002, November 16). Reefer Madness. from https://www.imdb.com/title/tt0028346/

MacGill, M. (2017, December 14). Psychosis: Causes, symptoms, and treatments. from https://www.medicalnewstoday.com/articles/248159.php

MedlinePlus.gov. (n.d.). Marijuana intoxication: MedlinePlus Medical Encyclopedia. from https://medlineplus.gov/ency/article/000952.htm

National Alliance on Mental Illness. (n.d.). NAMI. from https://www.nami.org/earlypsychosis

National Institute on Drug Abuse. (n.d.). Is there a link between marijuana use and psychiatric disorders? from https://www.drugabuse.gov/publications/research-reports/marijuana/there-link-between-marijuana-use-psychiatric-disorders

National Institute on Drug Abuse. (n.d.). Marijuana. from https://www.drugabuse.gov/publications/drugfacts/marijuana

National Institute on Drug Abuse. (n.d.). A Rise in Marijuana's THC Levels. from https://archives.drugabuse.gov/rise-in-marijuanas-thc-levels

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