Cannabis & Psychosis

EXPLORING THE LINK

The Basics

Whether you’re a young person or a parent/educator supporting young people, here are the basics you need to know about cannabis, psychosis and the link between them.

The Basics

Whether you’re a young person or a parent/educator supporting young people, here are the basics you need to know about cannabis, psychosis and the link between them.

Psychosis

Psychosis 101

What is psychosis?

Psychosis, at its core, is a disconnection from reality. People experiencing psychosis can have different experiences and symptoms, such as:

hallucinations: seeing / hearing / feeling / smelling / tasting things that aren’t really there
delusions: fixed beliefs that aren’t grounded in reality
other symptoms: such as
- Disorganization – in thought, speech, or behavior
- Disordered thinking – jumping between unrelated topics, making strange connections between thoughts
- Catatonia – unresponsiveness
- Difficulty concentrating

Causes of psychosis?

There are many different factors that play into the development of psychosis. Some of the key factors include:

Genetics: having certain genes can predispose you to psychotic disorders
Sleep: prolonged lack of sleep can trigger psychosis
Substance use: some substances trigger psychosis, some mimic its effects
Brain changes: the environmental impact of stressors and risk factors on the developing brain.

Explanations for psychosis?

There are a few different explanations for psychosis:

Biochemical model – psychosis is a product of too much dopamine in certain sections of the brain
Stress bucket model – Psychosis is the result of the brain getting overwhelmed by stressors
Substance misuse – using substances can trigger episodes of psychosis, and put someone at risk of developing future episodes of psychosis
Spiritual model – psychosis is the process of transcending our previous self and rebuilding our sense of identity, e.g. shamanism.

More about psychosis

Find out more here:

camh.ca
becauseyourmindmatters.ca

Is recovery possible?

Yes. There are different factors that influence recovery (protective factors, number of episodes, length of time untreated, effectiveness of medications, post traumatic growth and the development of coping strategies). But recovery is possible for everyone given the right supports. One thing to keep in mind is that recovery will look different for everyone, and people will have different goals and beliefs that guide their recovery, but a life well lived is not precluded by psychosis.

The Link

What do we know about the link between cannabis and psychosis?

Research has shown that cannabis use can impact psychosis. Psychosis is a break with reality characterized by hallucinations, false beliefs (delusions), impaired thinking and lack of motivation.

Cannabis use, particularly frequent use of high-THC cannabis, can cause a substance-induced psychosis in some people. This is not the same thing as having a “bad trip”, or a negative experience from being overly intoxicated. Substance-induced psychosis is a medical disorder where people can experience psychosis symptoms for up to a month, brought on by using cannabis or other substances. This usually follows heavy use of highly potent cannabis.

You may know someone who has had a bad trip. We talk more about this here . While there is no reliable scientific evidence linking bad trips to developing psychosis, having negative experiences when you’re high may be a sign that cannabis isn’t for you. If you’re feeling like when you get high, it’s not the same for you as it is for your friends (maybe you get more anxious or paranoid), you’re not the only one. We have recognized this pattern among ourselves and youth in our surroundings, who have benefitted from taking a step back and recognizing that unfortunately, cannabis does not work for them like it might work for their friends.

Some people are at higher risk of developing psychosis. A number of things can influence people’s risk, such as:

the age an individual starts using regularly (especially under the age of 16, and 3 or more times a week)
the THC content of the cannabis being used (especially if it contains over 15 % THC)
a genetic vulnerability for serious mental illness, such as a family history of schizophrenia or other psychotic disorders
a history of trauma or abuse in childhood

Some of these risk factors you can have some control over, like using less frequently, delaying use until you’re older, or using less potent cannabis. We talk more about these things here.

Other risk factors are impossible to control, like genetic vulnerability or the impact of trauma and abuse. We talk more about the factors associated with being at higher risk of developing cannabis-induced psychosis here

The final way that cannabis use is associated with psychosis is that it prevents or complicates recovery in individuals already diagnosed with a psychotic disorder.

Cannabis

Cannabis 101

What are the basic facts about cannabis?

This is a great place to start, but we’re warning you – there is a lot to know even just about the basics! A good resource to get you started is the Canadian Public Health Association’s Cannabasics document, which covers products and ingredients, methods of consumption, some reasons people may use cannabis, and some ways to reduce its potential harms. We’ve also discussed the reasons for use in more detail here, as well as some ways to reduce harms here

You may also have heard about different cannabis “strains” (fun fact, there is now a movement to more accurately describe varieties of cannabis as “cultivars” or “chemovars” as these descriptors of plants and chemical combinations, respectively, are more appropriate to use for cannabis than “strain” which is used for viruses and bacteria). Although there is a lot of information out there about the different properties of the two main strains, Sativa vs. Indica, scientifically (and legally), there is no difference between these two types of cannabis plants. All cannabis plants are now considered to be Cannabis Sativa L.

They were originally different strains of cannabis that came from different regions of the world. However, due to years of interbreeding, cannabis species have cross-pollinated, and studies have shown that there is no longer a difference in plant genetics between plants labeled Indica versus plants labeled Sativa. Interbred plants are sometimes referred to as ‘hybrids’, but effectively most of what’s out there is now a hybrid. The existence of different species of cannabis and how many there are is currently under dispute.

What to look for to get a better idea of what’s in cannabis:

Two key compounds called Tetrahydrocannabinol (THC) and Cannabidiol (CBD).

There are many more important characteristics and differences between different types of cannabis especially when it comes to THC and CBD content.

THC is the compound that is mostly responsible for the “high” feeling (in more scientific terms, it has a greater psychoactive and intoxicant effect), while CBD does not have an intoxicant effect and contributes to the “chill” feeling. CBD is responsible for several medical benefits of cannabis (although THC also has its merit in the medical cannabis world). High THC strains are also usually low in CBD. In previous decades there was more of a balance between the ratio of THC to CBD, but nowadays, cannabis tends to be higher in THC, so finding a high CBD variety can be a bit more difficult, although it might have some payoffs for your health.

Want to learn more?

WATCH OUR LAST ASK THE EXPERT

Through Our Eyes Part 2 – Lived Experience with Cannabis and Psychosis

Part 1 is available here

Fast Facts

32% of consumers don’t know how much THC and CBD is in their cannabis

Source: Canadian cannabis survey 2019 summary

Global average percentage of THC in weed by decade

1970

1980

1990

2000

2010

2018

Source: Seizure Data

References

References for Quantity of THC in weed (seizure data)

1970s ¹ <1.5% THC

1980s¹ 3.3% THC

1990s ¹ 4.3% THC

2000s ^2,3 8% THC

2010s ^2,3 14.3% THC

2018 ⁴ up to 28% THC

ElSohly MA, Ross SA, Mehmedic Z, Arafat R, Yi B, Banahan BF 3rd. Potency trends of Δ9-THC and other cannabinoids in confiscated marijuana from 1980-1997. J Forensic Sci. 2000 Jan;45(1):24-30.
Potter DJ, Hammond K, Tuffnell S, Walker C, Di Forti M. Potency of Δ9 -tetrahydrocannabinol and other cannabinoids in cannabis in England in 2016: Implications for public health and pharmacology. J Forensic Sci.2010 Sep;55(5):1209-17.
ElSohly MA, Mehmedic Z, Foster S, Gon C, Chandra S, Church JC. Changes in Cannabis Potency Over the Last 2 Decades (1995-2014): Analysis of Current Data in the United States. Biol Psychiatry.2016 Apr 1;79(7):613-9.
Murray, R. M., Quigley, H., Quattrone, D., Englund, A., & Di Forti, M. (2016). Traditional marijuana, high‐potency cannabis and synthetic cannabinoids: increasing risk for psychosis. World Psychiatry, 15(3), 195–204. http://doi.org/10.1002/wps.20341

55% of people who use cannabis do so 3 days a month or less

Source: Canadian cannabis survey 2019 summary

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“Legalization is so much bigger than weed itself. We’re opening up opportunities for research and starting conversations about drugs in ways we never have before.”

Kira London-Nadeau, Exploring the Link Strategic Advisor

“Legalization is so much bigger than weed itself. We’re opening up opportunities for research and starting conversations about drugs in ways we never have before.”

Kira London-Nadeau, Exploring the Link Strategic Advisor

Get Help

If you or someone you care about is in immediate danger,
call 911 or go to your local emergency department.

Crisis Support

Resources

Get Help

If you or someone you care about is in immediate danger, call 911 or go to your local emergency department.

Crisis Support

Resources