The relationship between cannabis and schizophrenia is rife with taboo. For decades, reefer madness era propaganda drove home the idea that cannabis causes psychosis. Not only was this propaganda unfair to the cannabis plant, but it exploited mental illness by portraying psychosis as something that should strike fear in the hearts of the masses. But, what actually happens if you smoke weed as a schizophrenic? How does cannabis relate to psychosis? There is still much to learn about the topic, but here’s what some emerging research has to say on the subject.
Schizophrenia and cannabis
While we still have a long way to go, mental health advocacy and emerging cannabis research have debunked some of the prejudices that took root in the mid-1930s. Scientists now know that cannabis consumption is not the cause of schizophrenia.
However, that doesn’t mean that it isn’t important for those schizophrenia and psychotic disorders to pay close attention to the way in which cannabis affects them.
Generally speaking, if you smoke cannabis with schizophrenia there’s a good chance that you’ll feel euphoric and “high” just like everybody else.
However, there’s also a very real risk that psychoactive cannabis is a stressor that can exaggerate some of the symptoms of schizophrenia, especially when consumed at a young age and in high doses.
There is also evidence that those with schizophrenia and psychotic disorders are more likely to feel extreme ups and downs with cannabis consumption. This suggests that they may be more sensitive to psychoactive cannabis and may need to remain cautious with the herb.
A complicated link
The link between cannabis, schizophrenia, and psychotic disorders is way more complicated than you might expect.
Research suggests that those with schizophrenia and psychotic disorders are more likely to smoke cannabis than consumers without the mental health condition, which may have detrimental effects on health in some cases. According to one estimate, up to 42 percent of patients with schizophrenia also meet the criteria for a cannabis use disorder.
Cannabis use disorder is the polite way of suggesting that someone has a cannabis addiction.
Just like any other person, each individual with schizophrenia may react differently to cannabis. For some, the herb is a surefire path to a bad time. Some evidence even suggests that cannabis may temporarily feel good to patients with schizophrenia, but there is a chance that it may worsen symptoms after it wears off.
In other studies, however, researchers have found that patients with schizophrenia who used cannabis at some point in their lives had superior cognitive function than those who did not. This includes superior working memory, visual memory, and executive functioning.
Apart from listening to your body, working with professionals, and paying close attention to symptoms before and after cannabis consumption, here are three factors that influence what happens if you smoke cannabis with schizophrenia:
1. Age of onset
There is a growing body of evidence that suggests that young people with a predisposition to psychotic disorders should not smoke cannabis. Research suggests that chronic teen cannabis consumption is associated with an earlier age of onset of schizophrenia symptoms than those who did not consume the herb.
While this research cannot definitely say that cannabis is the ultimate cause of the earlier age of onset, chronic cannabis consumption in teens and adolescents is not considered healthy. In this case, chronic cannabis consumption early in life was associated with an onset of symptoms 2.7 years earlier than nonconsumers.
2. Genetic predisposition
Increasing amounts of research suggests that certain mental health ailments like major depression and schizophrenia share overlapping genes with those associated with cannabis dependence.
This suggests that at least a certain subset of schizophrenia patients may be particularly drawn to cannabis due to biological reasons.
This is interesting considering that additional research suggests that those with schizophrenia are more sensitive to both the positive and negative effects of psychoactive cannabis.
While the euphoric qualities of cannabis may feel great to someone with schizophrenia, they may also be more likely to experience undesirable side effects of the herb more strongly.
Further research from 2016 discovered that cannabis-induced anxiety and psychosis is associated with certain mutations in the AKT1 gene. Changes in these genes were detected in healthy young people who were more likely to experience anxiety, paranoia, and visual distortions after cannabis use.
3. Type of cannabis
The primary cause of concern with cannabis and schizophrenia is a molecule called tetrahydrocannabinol (THC). THC is the primary psychoactive in the cannabis plant. It’s the compound that causes the classic cannabis “high.”
Unfortunately, one way that THC works its magic in the brain is by triggering the release of dopamine. Dopamine is a neurotransmitter that allows you to feel pleasure, pain, and motivation. Dopamine is also implicated in schizophrenia and psychotic disorders.
In psychotic conditions, one theory suggests that the brain produces too much of this compound in the wrong place at the wrong time.
Since THC also increases dopamine and is known to cause paranoia and anxiety. These qualities may not make it the best match for people with schizophrenia.
However, not all cannabis produces high levels of THC. In fact, another cannabis compound, cannabidiol (CBD), was found to be a successful adjunct therapy in an early clinical trial of 88 patients with treatment-resistant schizophrenia.
The trial was conducted by GW Pharmaceuticals and the proof-of-concept study found that CBD improved the quality of life and overall functioning in patients when combined with conventional antipsychotic medications. In preclinical models, CBD has been found to be a powerful antipsychotic.
While THC may not be good for those with schizophrenia, CBD and high-CBD cannabis cultivars do hold some early promise in potentially easing symptoms of the psychotic disorder.
There is no doubt that the relationship between cannabis and psychiatric conditions is complex. At this point, there is little research available that firmly identifies just how the herb impacts those with psychotic disorders and why. Until more research is completed, it’s best to stay as safe as possible and work with trusted medical professionals.