I have noticed a troubling trend in my caseload and in the referrals, I have been receiving for the last 4 years. The call usually begins with a distraught mother, father, or other relative calling me because their loved one is in crisis. Their loved one is irrational, argumentative, agitated, threatening violence, irritable, and, embarrassingly, delusional or hallucinating. When in my questioning to assess the situation, I ask if the individual has stopped using cannabis yet, the concerned family member seems surprised, sometimes mystified, and befuddled. How did I know? How could I have known?
The answer may not be popular in our society that has long encouraged and supported cannabis and cannabis-related products as a wonder drug, as natural, and as created by God. I am not disputing the medicinal effectiveness of cannabis, either inhaled or edible, buds or extract, or even CBD. Though to be honest, the problems noted in the news with vaped cannabis and the complications for the lungs (e-cigarette or vaping product use-associated lung injury (EVALI)) do concern me. I am writing this short article to share a concern I have noticed as a trend when, usually young, people seem to suddenly develop severe behavioral symptoms and psychosis after they have been using, usually large, amounts of cannabis for a long period of time.
Several risk factors seem to make this tendency particularly strong. I have done research and found several scholarly articles that support what had, up to recently, been based only on my clinical observations. In one article, Drs. Semple, McIntosh, and Lawrie found 11 previously published studies, and in another article. Drs. Fergusson, Poulton, Smith, and Boden, looked at 6 previously published studies. In all this research, these esteemed doctors confirmed what I had already noticed. Individuals who began using pot at a young age, those who used pot for a long time, those who used large amounts, those who had symptoms of psychosis before using pot, and those who had mental illness running in their families, had up to a 3 times greater risk for developing symptoms of psychosis.
Now, they were all careful to note that cannabis use did not CAUSE psychosis, but they were clear that there is a strong relationship. Dr. Fergusson and his colleagues point out that those who develop symptoms of psychosis are a minority of those that use cannabis. However, they also point out that those who do may deserve some consideration by public health officials.
If you, or someone you love, has been using cannabis and developed symptoms of psychosis, please consider taking these steps:
1. Please stop using cannabis.
2. Seek treatment by a qualified psychiatrist to be stabilized on antipsychotic medications.
3. Consider seeking individual treatment with someone who understand stabilizing psychosis and supporting someone who is in early recovery from drug use.
The good news is that if you stop using cannabis and seek help, you can stabilize. If you stay sober and get properly medicated soon enough, there is a chance that you might not need to be maintained on antipsychotics for a lifetime, which can happen if the drug use triggers full-blown Schizophrenia. Please seek help, and please let me know if I can be of any assistance in your recovery. Dr. Jodi – Stay Safe. Stay Strong, Be Healthy.