Yes – there are factors that will make one person more likely than another to experience psychosis that is linked to their cannabis use.
Some of these factors are specific to you as a person, and others depend on how you use cannabis, which makes the latter easier to control if you do choose to use.
Some things that are out of your control but are still important to consider are childhood trauma and abuse, sometimes referred to as “adverse childhood experiences”.Having a personal history of childhood abuse or trauma (for example, sexual, physical or neglect) is a strong risk factor for developing problematic substance use and mental illness later in life. Additionally, young people growing up with close family members with problematic substance use and mental illness may be at increased risk for developing addiction or mental illness compared to peers who do not share this vulnerability. Although it is important for you to understand your own vulnerability, it is also important to note that youth who have experienced abuse and trauma can recover and heal with the right support and treatment.
Another thing that’s impossible to control, but could have a dramatic influence on your risk for psychosis related to your cannabis use is having a family history of psychosis or schizophrenia. You can check this by asking a trusted biological family member (since the research shows that it’s really the genetic component that matters, more than the social one). However, sometimes, the family may keep past histories secret through embarrassment, shame or fear of stigma or even have no awareness of details.
Schizophrenia and psychosis are both pretty medical terms, so you may also want to check for things like a “mental breakdown” or a “break with reality”. If this happened, it doesn’t necessarily mean it was psychosis or schizophrenia, but it can help give you an idea of potential instances. Note that schizophrenia does not mean “split personality” – this is a common misconception.
“I think it could play a role to speed up the things that happened – psychosis, definitely. I think it triggers for some people susceptible, but not necessarily all people.”
If you have a family history of psychosis or schizophrenia, what’s for sure is that it is safest not to use cannabis. This is particularly true the closer or more direct the link, such as a parent, sibling and highest in an identical twin. But we’re not here to tell you what to do, so here are some ways to try to reduce your risk of psychosis if you still choose to use cannabis:
Try to delay starting to use at least until you’re 17 or 18 (if you’re older and haven’t started using yet but want to, 25 is an even safer age to wait for). The reason for this is that the brain continues to mature till about 25 and is therefore more vulnerable to stress and the use of cannabis. Studies have also found that starting to use before 15 or 16 years (depending on the study) has been linked to higher risks of psychosis.
If you’ve already started using and delaying use isn’t an option, there are still ways you can try to reduce your risk:
- Consider reducing how often you use, since it’s heavy use in particular that’s linked to psychosis. Reducing will depend on where you’re at: if you’re smoking 3 joints a day, skipping the middle one will already mean 7 fewer joints a week. If you’re consuming a very potent edible every day, maybe you’ll want to start alternating between a full dose and a half dose, which is already a 20-30% reduction in overall quantity used, depending on if you do 3 or 4 days with a half dose. If you do use quite frequently, using less often can also have some additional benefits like your tolerance going down (so it’s less expensive to get high) and you enjoying each time more because it’s more special and less of a routine thing.
- Consider switching to a lower THC and higher CBD cannabis. If you’re not really sure what THC is, we talk about it more here. If your cannabis comes from a legal source, you’ll be able to see the THC and CBD content on the package. If it comes from the illicit market, this information might be harder to get, but it can be a good idea to ask whoever supplied you with the cannabis. Talking about THC and CBD is more and more common, and actually, more and more people are looking for high CBD strains, so the supplier might know. Decreasing the amount of THC content in cannabis usually goes hand in hand with having higher CBD content, which can be protective of the risks that THC poses for psychosis. Like reducing your frequency of use, reducing your THC content can actually be enjoyable – you might experience a different kind of high or be able to be more active during your session. If you don’t know about the THC content in your cannabis, you can always consume less per session in order to be ingesting less THC overall.
These are all things that will make someone more or less likely to experience psychosis that is linked to their cannabis use, and ways to try to mitigate that risk if you’re wondering about your own use. The thought of developing psychosis can be quite worrisome, and if you’re concerned, we talk about this a bit more here.