Marijuana and Psychosis: How Cannabis Can Treat or Trigger Psychosis

For some people, the use of a substance can trigger psychosis but if someone with a substance use disorder attempts to quit using the substance abruptly, they can experience psychosis as well.

Marijuana-induced psychosis remains unknown to most people. Psychosis is a mental health condition that occurs when someone begins to lose touch with reality and experiences visual and auditory hallucinations and delusions.

It’s important to make the distinction that psychosis is more of a symptom of a mental health disorder, rather than an illness by itself. Psychosis is often linked to substance abuse or an underlying mental or physical illnesses. For example, schizophrenia is a mental health disorder that sometimes includes psychosis as a symptom of the condition.

Can Marijuana Use Cause Psychosis?

Drugs and other substances are one of the primary triggers of psychotic symptoms. This type of condition is referred to as drug or alcohol-related psychosis and can occur with the use of several substances including stimulants, or hallucinogenic drugs like LSD and alcohol. For some people, the use of a substance can trigger psychosis but if someone with a substance use disorder attempts to quit using the substance abruptly, they can experience psychosis as well.

A report released by the National Academies of Sciences, Engineering and Medicine presented evidence that people who use large amounts of marijuana frequently are more likely to trigger psychotic symptoms. If someone has an underlying or diagnosed mental health disorder and a co-occurring marijuana use disorder, they risk worsening the symptoms of the disorder.

Marijuana-Induced Psychosis

Researchers don’t label marijuana use as the cause of psychotic symptoms or the onset of mental health disorders, developing these types of conditions are often multifactorial. It’s also difficult to determine if psychosis or a mental condition would have ever developed if someone never used marijuana. There isn’t a set amount of frequency that triggers psychosis, just that the drug causes an earlier onset for patients living with psychotic symptoms or mental health conditions.

Some research has found that even if someone quits using marijuana, the psychotic symptoms can still exist. Marijuana can be thought of as the catalyst that caused the onset of psychiatric symptoms but not necessarily the sole cause of the condition. When using marijuana, people should consider if they buy the drug off the streets in an unregulated marketplace, they don’t necessarily know what else it might contain.

Symptoms of Marijuana Psychosis

When people experience acute intoxication from marijuana symptoms can include feeling separated from reality and experiencing visual or auditory hallucinations and delusions. The short-term effects of marijuana will usually disappear a few hours after using the drug, but for some people, the delusions and psychotic symptoms may last for up to a week, month or year.

In addition to hallucinations and delusions, symptoms that may accompany psychosis include depression, sleep problems, and anxiety.

Psychosis Caused by Synthetic Cannabis (Spice)

Synthetic cannabis referred to as “K2/spice” is typically made up of a mixture of two or more compounds. Common side effects following a synthetic cannabis high include paranoia, psychosis and severe agitation. These side effects can occur as early as two to six hours after use and last as long as several months.

Similar to natural cannabis, a synthetic cannabis-induced psychosis can trigger pre-existing mental conditions and cause the onset of the disorder to occur earlier. The psychosis symptoms could be resolved once someone quits using synthetic cannabis unless they had an underlying mental health disorder like schizophrenia or bipolar disorder. Symptoms of a synthetic cannabis-induced psychosis may include paranoia, thought disorders and suicidal ideations.

Synthetic cannabis is often mixed with other psychoactive drugs, so researchers found that it can be difficult to attribute which substance causes the psychotic symptoms. It is still unknown if it’s the drugs that cause the psychotic symptoms or someone’s predisposition for mental health conditions, but it was determined that drugs like synthetic cannabis could trigger these symptoms or cause an early onset of symptoms to occur.

Who’s More at Risk for Marijuana Psychosis

The likelihood of marijuana and psychosis occurring together is highest in people who are predisposed to paranoia and specific, psychosis-related symptoms. For example, people who experienced mild psychotic symptoms without the use of a substance may be at a higher risk of developing psychosis when using marijuana.

People who use marijuana regularly or have a marijuana use disorder are also at a higher risk for developing psychotic symptoms. Researchers have also found that age can be a risk factor in the development of psychotic symptoms from marijuana use. Adolescents who use marijuana or have a marijuana use disorder are at a higher risk of developing marijuana-induced psychosis or triggering an onset of a mental health disorder.

Can Marijuana Help Treat Psychosis?

The suggestion that the same substance that triggers psychotic symptoms could also help treat the mental condition seems redundant. However, a study by the King’s College London found that one of the major chemical compounds in the marijuana plant, cannabidiol (CBD), works in opposition of the plant’s other ingredient, tetrahydrocannabinol (THC). While THC is what causes someone to get high after marijuana use and is a significant risk factor for marijuana psychosis and other mental health disorders, CBD reportedly reduced abnormal brain activity in people with psychotic symptoms.

Researchers are conducting more studies using CBD oil with the hopes of using it as a form of psychosis treatment. Another promising characteristic of CBD is that it’s not psychoactive and is not known to cause dependence or addiction. In the United States, CBD oil is licensed for treating rare epilepsy cases in children.

Treatment Options for Marijuana Psychosis

The best treatment option for marijuana-induced psychosis is abstinence. It can be difficult to quit using marijuana for people who have a marijuana use disorder or have used the drug for an extended period. Getting addiction treatment at a rehab facility can be a useful treatment option for psychosis and a marijuana use disorder.

The first step for treating marijuana psychosis is to go through detoxification to rid the body of the toxins from marijuana. Abstaining from marijuana use typically resolves most cases of marijuana-induced psychosis. However, if psychotic symptoms persist, treatment providers may choose to use medications to manage these symptoms. It’s essential to medically detox at a treatment facility to avoid the discomfort and dangerous side effects of withdrawal.

After detox completes, the patient may enter an inpatient or outpatient program depending on the severity of their addiction. The severity of their psychotic symptoms may also determine the type of treatment plan that the rehab facility creates. A patient’s treatment plan will likely consist of a type of therapy and medication to manage their psychotic symptoms. The kind of therapy a clinician chooses to use is determined by a patient’s:

• Mental health disorder
• Overall health
• Social needs
• Recovery goals
• Potential threats to sobriety

In addition to therapy treatment, patients may also be prescribed medications to manage the psychotic symptoms they’re experiencing. The type of medications prescribed includes antipsychotic medications, like Abilify and Zyprexa, antidepressants, like Prozac and Zoloft; and anti-anxiety medications, like Paxil and Celexa.

Key Points: Cannabis and Psychosis

Some relevant facts to remember about psychosis and marijuana include:

• People who use marijuana frequently and in large amounts are more likely to trigger psychotic symptoms
• If someone has an underlying or diagnosed mental health disorder and a co-occurring marijuana use disorder, they risk worsening their symptoms by using marijuana
• The effects of a marijuana intoxication will usually disappear a few hours after using the drug, but for some people the delusions and psychotic symptoms may last up to a week, month or year
• Similar to natural cannabis, a synthetic cannabis-induced psychosis can trigger pre-existing mental conditions and cause the onset of the disorder to occur earlier
• Adolescents who use marijuana or have a marijuana use disorder are at a higher risk of developing marijuana-induced psychosis or triggering an onset of a mental health disorder
• Getting addiction treatment at a rehab facility can give someone a higher chance for effective treatment of the psychosis and marijuana use disorder

If you or someone you know struggles with a substance use disorder and psychotic symptoms, help is available. At The Recovery Village, a team of professionals can design an individualized treatment plan to address your specific disorders.

Call and speak with a representative to learn more about which treatment program could work for you.  

Editor – Thomas Christiansen

With over a decade of content experience, Tom produces and edits research articles, news and blog posts produced for Advanced Recovery Systems. Read more