Female smoking a marijuana joint shot from behind

The Increasing Risk of Marijuana Psychosis in Teens and Adolescents

How Normalization and Decriminalization of Marijuana and THC-containing Cannabis Products Have Contributed to The Rise of Marijuana Induced Psychosis in Younger Populations.
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In a world where the legalization and normalization of marijuana continue to gain momentum, a pressing concern looms large: the potential link between cannabis use and psychosis, particularly among teenagers and young adults. This concern isn’t just a remnant of past cautionary tales like the 1930s film “Reefer Madness” – it’s a complex issue rooted in contemporary scientific research and societal shifts.

Recent years have witnessed a dramatic transformation in public attitudes toward marijuana. Once regarded as a dangerous substance, it’s now often seen as a ‘soft’ recreational drug, comparable to having a glass of wine or a beer. This changing perception, fueled in part by legalization efforts and medicinal claims, has led to a significant increase in cannabis use among young populations. However, beneath the surface of this acceptance lies a troubling association: the risk of cannabis-induced psychosis, a condition that could have profound and lasting impacts on the mental health of our youth.

The purpose of this article is to delve into this intricate relationship between cannabis use and the onset of psychotic disorders like schizophrenia, particularly in adolescents and young adults. By examining recent studies, exploring demographic trends, and understanding the shifts in societal attitudes, we aim to unravel the complexities of this issue. We will also discuss the challenges of detection and management and the critical role that healthcare professionals and parents play in addressing this emerging public health concern.

As marijuana becomes increasingly accessible and its potency continues to rise, it’s crucial to confront the reality of its potential risks, especially for the developing brains of young individuals. This article seeks to shed light on the often misunderstood relationship between cannabis and psychosis, providing insights and guidance for a path forward in this new landscape of marijuana use.

Prevalence and Demographics of Cannabis Use

As we venture into a deeper understanding of the potential risks associated with cannabis use, it’s crucial first to examine its prevalence and demographic patterns, particularly among adolescents and young adults. Recent data paints a revealing picture of just how widespread cannabis use has become in these age groups.

A startling revelation comes from the Monitoring the Future survey. In 2019, the survey reported that 11.8% of 8th graders, 28.8% of 10th graders, and a significant 35.7% of 12th graders had used marijuana in the last year. The numbers are equally concerning for monthly use, with 6.6% of 8th graders, 18.4% of 10th graders, and 22.3% of 12th graders admitting to such frequency. These statistics are not just numbers; they represent a growing trend among our youth, where cannabis use is becoming a common part of teenage life.

The situation is similar among college students and young adults. A 2016 study indicated that approximately 22% of college students and young adults engaged in at least monthly cannabis use. This trend reflects a broader societal shift where cannabis use is no longer an anomaly but a prevalent aspect of modern youth culture.

International statistics further highlight this increasing usage. In Canada, for instance, the cannabis usage rate among youths aged 11 to 15 years was estimated at 28% in 2013, with a significant number reporting weekly or daily use. These figures not only indicate a high prevalence of cannabis use but also suggest a normalization of its use in daily life.

The gender gap in cannabis use is another critical aspect. The National Institute on Drug Abuse reports that cannabis use is more prevalent among males than females, a trend that continues to widen. By 9th grade, roughly one in three boys and one in four girls have used cannabis. This gender difference is also reflected in the use patterns, with males reporting higher frequency and quantities of use than females.

Understanding these demographics is key to grasping the full scope of the cannabis use issue. The widespread prevalence among teenagers and young adults, coupled with the gender disparities, sets the stage for a nuanced discussion on the potential risks, especially the risk of psychosis, associated with cannabis use.

Misperceptions about Cannabis Safety

In the evolving narrative of cannabis, one of the most significant factors contributing to its increased use among adolescents and young adults is the widespread misperception of its safety. Steadily gaining ground, this erroneous belief poses a substantial challenge to public health and education.

The transformation in public perception is stark. A dramatic shift has occurred over the past decade, with less than one-third of high school seniors in 2016 perceiving regular marijuana use as a ‘great risk,’ a significant decrease from the 58% reported in 2006. This diminishing concern is reflective of a broader societal trend where the hazards of cannabis are underestimated if not outright dismissed.

The changing nature of cannabis itself further exacerbates this misperception. The marijuana of today is not the same as it was in the past. The potency of THC – the primary psychoactive compound in cannabis – has surged dramatically. Where THC levels were once a fraction of what they are now, they have escalated from 8.9% in 2008 to 17.1% in 2017. This increase is not merely numerical; it signifies a profound change in the potential impact of the drug, particularly on the developing brains of adolescents and young adults.

The misperceived safety of cannabis is not limited to young users. Many adults, including those from the baby boomer generation who may have used cannabis in their youth, are returning to the drug under the belief that it is harmless. This notion overlooks the significant changes in the drug’s composition over the years, particularly the soaring THC levels.

Coupled with the belief in its safety is the pervasive view of cannabis as a benign recreational substance. This view is often juxtaposed against the known dangers of other substances, leading to a comparative underestimation of cannabis’s potential risks. The relatively low lethality of cannabis, as compared to substances like opioids, has contributed to its perception as a safe option, ignoring its more insidious long-term effects.

This misperception of safety, particularly among adolescents and young adults, is a critical concern. As we delve deeper into the link between cannabis use and psychosis, it becomes increasingly clear that addressing these misconceptions is not just a matter of correcting false beliefs but is essential for safeguarding mental health.

Cannabis Use and Its Link to Psychosis

As the usage of cannabis among teenagers and young adults escalates, a compelling and concerning connection emerges between cannabis use and the onset of psychotic disorders, notably schizophrenia. This link is not merely anecdotal but increasingly supported by scientific research.

Numerous studies over the past decade have spotlighted this association. A pivotal report commissioned by the National Academies of Sciences, Engineering, and Medicine has been particularly illuminating. This comprehensive assessment, reviewing over a thousand studies, indicates that heavy and prolonged cannabis use, especially when initiated at a younger age, may significantly increase the risk of a first episode of psychosis. For individuals with a pre-existing susceptibility to mental illness, particularly schizophrenia, cannabis can exacerbate symptoms, making the condition more severe.

The relationship between cannabis use and psychosis appears to be influenced by several factors: the quantity and frequency of marijuana use, the age at which use begins, and the potency of the THC consumed. Higher potency cannabis, which is increasingly prevalent, has been linked to a greater risk of psychosis. This correlation is underscored by studies demonstrating that areas with easy access to high-THC cannabis report higher rates of psychotic disorders.

The phenomenon of dual-directionality further complicates this connection. While cannabis use can trigger or worsen psychotic symptoms, individuals predisposed to psychotic disorders may also be drawn to cannabis use at an earlier age, potentially as a form of self-medication. This creates a complex cycle where cannabis use and psychosis can reinforce each other.

The evidence, however, is not without its ambiguities. While the association between cannabis use and earlier onset of psychosis is evident, establishing a direct causal link remains challenging. Psychiatrists and researchers caution against oversimplifying this relationship. The development of psychotic illnesses is multifactorial, and while cannabis use is a significant factor, it is rarely the sole cause.

This emerging understanding of the link between cannabis use and psychosis is crucial, particularly given the increasing potency of available cannabis and the lowering age of initial use. It raises vital questions about public health strategies and the need for a more nuanced dialogue on the risks of cannabis, especially for young users whose brains are still developing.

Specific Risks for Adolescents

The growing body of research into cannabis use has cast a spotlight on a particularly vulnerable demographic: adolescents. For teenagers and young adults, the risks associated with cannabis use extend beyond the immediate effects, seeping into the very fabric of their developmental process.

Adolescence is a critical period in brain development. It’s a time when the brain undergoes significant changes in structure and function, particularly in areas responsible for judgment, decision-making, and risk assessment. The introduction of cannabis, with its psychoactive compounds, during this sensitive phase, can have profound and long-lasting implications.

The primary concern is the impact of THC (delta-9-tetrahydrocannabinol), the main psychoactive component in cannabis, on the developing brain. Studies have shown that THC can disrupt the normal maturation processes in the adolescent brain, particularly affecting areas associated with learning, memory, and impulse control. This disruption can lead to cognitive deficits and a decrease in IQ, especially in individuals who begin using cannabis in their early teens.

The potency of cannabis plays a crucial role in these risks. With THC levels far higher today than in previous decades, the potential for harm has escalated. High-potency cannabis can lead to more severe cognitive impairments and a greater likelihood of developing addiction. The increased potency also raises the risk of acute psychiatric effects, including psychosis.

Furthermore, adolescents who regularly use cannabis are more susceptible to mental health issues. Studies indicate a correlation between frequent cannabis use in teenagers and an increased risk of conditions like depression, anxiety, and schizophrenia. These risks are particularly acute for those with a family history of mental health disorders, as cannabis use can exacerbate these genetic predispositions.

The long-term implications are equally concerning. Habitual cannabis use during adolescence can lead to reduced academic achievement and hinder professional and personal growth. The drug’s impact on motivation, attention, and memory can significantly derail an adolescent’s life trajectory, affecting everything from educational success to social relationships.

The specific risks for adolescents using cannabis are multifaceted and far-reaching. They underscore the need for targeted public health interventions and education to safeguard this vulnerable group from the potential long-term consequences of cannabis use.

Misunderstood Benefits and Dual Use with Other Substances

Amid the discourse on the risks of cannabis, there exists a parallel narrative of misunderstood benefits and the problematic dual use of cannabis with other substances. This narrative is particularly relevant among adolescents and young adults, where misconceptions about the benefits of cannabis and its interaction with other drugs can lead to serious health implications.

One common misconception is the belief that cannabis is a benign aid for conditions like attention-deficit/hyperactivity disorder (ADHD). Many young individuals experiencing symptoms such as poor concentration or hyperactivity are turning to cannabis as a self-prescribed remedy. However, this choice is not grounded in substantial medical evidence. In fact, the temporary relief perceived may mask underlying issues, potentially leading to a worsening of symptoms in the long term.

The interaction of cannabis with prescribed medications, especially stimulants commonly used to treat ADHD, poses another significant risk. When used concurrently, cannabis and stimulants can have synergistic effects. Low quantities of THC, when combined with stimulants, may lead to increased excitatory effects, potentially heightening the risk of adverse reactions, including psychosis. On the other hand, high quantities of THC might seem to counterbalance the stimulant effects, offering a sense of relaxation. However, this combination can lead to excessive neurotransmitter release, pushing the user towards a psychotic state.

This dual use extends beyond prescription drugs. The combined use of cannabis and alcohol, a common occurrence among young adults, can compound the risks. Both substances have their own set of effects on brain function and development, and their combined use can exacerbate these effects, particularly in the developing brains of adolescents and young adults.

Another aspect of this misunderstood narrative is the belief in the relaxation and sleep-inducing properties of cannabis. While some individuals, including young adults, use cannabis for its perceived calming effects or as a sleep aid, they might be unaware of the long-term consequences. Regular use of cannabis for these purposes can lead to dependency and disruption of natural sleep patterns and mood regulation.

The misunderstood benefits of cannabis, coupled with its dual use with other substances, create a complex landscape of risk for adolescents and young adults. It highlights the need for clear, evidence-based information about the effects of cannabis, especially when used in conjunction with other substances, and underscores the importance of cautious, informed decision-making regarding its use.

Detection and Management of Cannabis-Induced Psychosis

The rise in cannabis use among adolescents and young adults, coupled with its stronger potency, has brought to the forefront the challenge of detecting and managing cannabis-induced psychosis. This condition, while complex, requires a nuanced approach to ensure timely intervention and effective treatment.

Detection of Cannabis-Induced Psychosis

Early detection is crucial. Warning signs of cannabis-induced psychosis often manifest as changes in behavior, mood, and cognitive function. Adolescents and young adults may exhibit declining academic performance, social withdrawal, mood swings, or unusual thoughts and perceptions. Family members, educators, and healthcare providers should be vigilant for these signs, particularly in individuals known to use cannabis regularly.

Physicians and mental health professionals play a critical role in detection. During routine check-ups or mental health evaluations, specific questions about cannabis use should be asked, including the frequency, method of use (smoking, vaping, edibles), and any changes in mental health symptoms following cannabis use. Understanding the pattern of use and its correlation with psychiatric symptoms is key to identifying cannabis-induced psychosis.

Management of Cannabis-Induced Psychosis

Once detected, the management of cannabis-induced psychosis involves a multifaceted approach:

For those presenting with acute psychosis, immediate psychiatric intervention is essential. This may include stabilization in a safe environment, antipsychotic medication, and monitoring for any comorbid conditions.

Central to the management is addressing the underlying cannabis use. This involves counseling the individual on the risks of continued use, especially in the context of their psychotic symptoms, and devising a plan to reduce or cease use. Withdrawal symptoms, such as anxiety, irritability, and cravings, should be managed appropriately.

For those with persistent psychotic symptoms, a long-term treatment strategy should be developed. This might include ongoing psychiatric care, psychotherapy, and medication management. The treatment plan should be tailored to the individual’s needs, taking into account their mental health history, the severity of symptoms, and their cannabis use patterns.

Engaging family and social support systems is crucial in management. Education about cannabis-induced psychosis and guidance on how to support the individual can significantly improve outcomes.

Broadly, preventive education targeting adolescents and young adults about the risks of cannabis use and its potential to induce psychosis is necessary. Outreach programs in schools, colleges, and community centers can play a pivotal role in raising awareness and preventing cannabis-induced psychosis.

The detection and management of cannabis-induced psychosis require a collaborative effort involving healthcare providers, mental health professionals, families, and the broader community. Through early detection, targeted intervention, and ongoing support, the impact of this condition can be mitigated, paving the way for healthier outcomes.

Key Takeaways and Looking Ahead

As we navigate through the complex and evolving landscape of cannabis use and its associated risks, particularly in relation to psychosis in adolescents and young adults, several key insights emerge. Our journey through scientific research, societal perceptions, and clinical observations reveals a multifaceted issue that requires a nuanced and informed approach.

The increasing prevalence of cannabis use, driven by changing legal landscapes and shifting societal attitudes, underscores the need for heightened awareness about its potential risks. The link between cannabis use and psychosis, particularly among vulnerable young individuals, is a matter of significant concern. This association, highlighted by numerous studies, calls for a careful reevaluation of how we view and manage cannabis use in our society.

The risks associated with cannabis are not uniformly understood or acknowledged. Misconceptions about its safety, coupled with a lack of recognition of the heightened potency of modern cannabis, contribute to a potentially harmful underestimation of its risks. Addressing these misconceptions, especially among adolescents, is crucial in preventing long-term psychological and developmental harm.

The management of cannabis-induced psychosis requires a concerted effort from healthcare professionals, educators, parents, and policymakers. Early detection and intervention, comprehensive treatment strategies, and strong support systems are key to effectively addressing this challenge. Moreover, preventive education and outreach initiatives are essential in equipping young individuals with the knowledge to make informed decisions about cannabis use.

As we move forward, it’s clear that more research is needed to fully understand the long-term effects of cannabis use, especially in light of its increasing potency and prevalence. This knowledge will be vital in shaping policies and practices that safeguard the mental health of our younger generations.

The conversation about cannabis and its impact on mental health is far from over. It’s a dynamic and ongoing dialogue that demands our continued attention, critical thinking, and proactive measures. By fostering a deeper understanding and a more responsible approach to cannabis use, we can better protect and support the mental well-being of our adolescents and young adults in these changing times.

FAQs About Marijuana Psychosis

Marijuana Psychosis refers to a range of psychotic symptoms, such as hallucinations, delusions, and paranoia, that can occur following the use of cannabis, especially in high doses or in individuals with underlying vulnerabilities.

Marijuana, particularly its psychoactive component THC, can affect brain chemistry and function. In susceptible individuals, this can disrupt normal thought processes and perceptions, leading to psychotic symptoms. The exact mechanism is complex and involves multiple factors, including genetic predisposition and the potency of the THC consumed.

The risk is higher in individuals with a family history of mental illness, particularly schizophrenia. Adolescents and young adults are also at increased risk due to the ongoing development of their brains. Heavy, frequent users and those using high-potency strains are more susceptible as well.

While some individuals may experience transient psychotic symptoms, others, especially those with pre-existing mental health conditions or continued use of cannabis, may develop chronic psychiatric disorders, including schizophrenia.

The outcome can vary. Some individuals may recover fully, especially with prompt cessation of cannabis use and appropriate treatment. However, in cases where there’s a pre-existing mental health condition or prolonged heavy use, the psychosis may evolve into a more persistent mental health disorder.

Treatment typically involves cessation of cannabis use, antipsychotic medications, and psychotherapy. Supportive care, including counseling and family support, is also crucial. In cases of co-occurring substance use or mental health disorders, integrated treatment approaches are often necessary.

Prevention strategies include educating young people about the risks of cannabis use, especially high-potency strains, and early intervention in cases of substance misuse. Awareness of personal and family mental health history can also guide informed decisions about cannabis use.

Strains with high THC content and low CBD (cannabidiol) levels are generally considered to pose a higher risk for inducing psychotic symptoms. CBD is thought to have antipsychotic properties and may counteract some of THC’s effects.

It’s important to seek medical help immediately. A healthcare professional can provide the necessary assessment and treatment. Avoiding further cannabis use is also crucial to prevent worsening of symptoms.

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Clinically Reviewed By:

Jamie Mantell, PsyD, LMFT

Jamie Mantell, PsyD, LMFT

Jamie Mantel is a Licensed Marriage and Family Therapist, with a Psy.D. in psychology. Jamie has worked for non-profits for over 20 years working with agencies, as well as her private practice in Huntington Beach, California.