Peter is a 36-year-old American male stuggling with mental health issues and cannabis use. He has been a heavy marijuana user since he was a teenager. He was in his early twenties when he experienced his first episode of psychosis, withdrawing from his family, and even becoming aggressive towards and threatening loved ones who tried to reach him. Cases like Peter’s are becoming familiar to mental health and addiction professionals, as substance use comorbidity in psychotic disorders has become more the rule than the exception.

Though it is rare, psychosis triggered by use of marijuana is an extremely serious side effect of the drug. Some people who use marijuana have been reported to experience symptoms of psychosis. These symptoms are often of sudden onset and could be temporary, especially if there are no underlying mental disorders. Psychosis is usually managed as an emergency.

Marijuana—also called cannabis, weed, herb, pot, grass, mary-jane and a wealth of other slang names—is a mixture of dried flowers of the cannabis sativa plant. In many parts of the world, marijuana is is an illegal substance, although legalization is making inroads in many countries including in the United States. Some of the risk factors for abusing marijuana include social pressure, abuse of other substances, family problems and difficulties in coping with other mental illnesses.

The word psychosis, according to the National Institute of Mental Health, describes conditions affecting the mind in which there is some loss of contact with reality. Marijuana induced psychosis is therefore a set of psychotic symptoms triggered by the use of marijuana. It can also cause irritation to the lungs when smoked, leading to increased risk of lung infections, irritating cough and frequent chest infections.

Marijuana contains chemicals known as cannabinoids, the main ingredient being tetrahydrocannabinol (THC). The more the THC component, the stronger the effect of the marijuana. When inhaled or injested, this chemical travels to the brain and affects how the brain communicates with the rest of the body by causing imbalances.

Marijuana is characterized by the ‘high’ feeling that it gives the users. It can make one feel happy, extremely relaxed, and unusually giddy. People who use it say that they notice colors around them are brighter and sounds are louder and sharper. This feeling of pleasantness, however, lasts only for a few hours. More long-lasting side effects include changes in appetite, increased or reduced, impaired memory, learning difficulty and altered mood, mostly tending towards depressive mood episodes characterized by lack of motivation to carry out day to day activities.

Symptoms of marijuana induced psychosis are marked by loss of touch with reality. These include:

• Hallucinations. One may experience feelings, hear sounds, see images and other sensations that are not real. However, the individual experiencing these sensations may insist that they are real. For instance, someone may hear voices talking to them or see wild animals in their room or feel creatures that are unseen by others walk-in on their skin.
• Delusions. This is a false belief that someone has in spite of evidence to the contrary. For example, a person may believe he is the president of a nation when in reality he is not, nor has he never been.
• Paranoia and suspicion of people. The person may be wary of even people who intend no harm and in constant fear that they are unsafe.
• Disorganized thoughts and speech. Others may not understand what they are saying.
• Increasingly hostile and overly aggressive.
• Unusual behaviors or movements. For instance, they may be seen pacing around or lying down on the floor or banging tables.
• Depersonalization. The individual may report the feeling of being detached from their own body.
• Dissociation. The individual may also report that he or she is experiencing the feeling of being detached from his surroundings, or like people around them are not real.

The use of marijuana may trigger a mental illness or cause it to develop in an individual who is genetically predisposed. Individuals who experience psychotic episodes after taking marijuana could also have an underlying mental disorder, schizophrenia or bipolar disorder with psychotic symptoms, for example.

Apart from inducing psychosis, the use of marijuana increases the risk of other mental health illnesses including depression, anxiety disorders and suicide.

In the event an individual experiences acute onset psychosis you suspect to have been induced by use of marijuana:

Avoid confrontations!
Don’t engage in arguments or physical fights with the affected individual. It may be hard to do, but ignore their insults and stay calm

Call for help!!
Do not approach the individual alone or try to control them by yourself especially if they seem aggressive. You may call your other family members, neighbors or professionals who may be nearby.

Seek professional help. A treatment facility may have an admission opening, or they may be able to refer you elsewhere. An alternative might be to schedule an office visit with a psychiatrist for guidance to a preper course of treatment. If you’re unable to find a mental health program or professional, escort the affected person to the hospital for acute care.

Carry with you any identification, insurance cards or other medical documentation the affected person may need at the mental health facility, hospital or clinic.

On arrival at a mental health facility or rehabilitation center, professional medical clinicians will offer direction and guidance through the admissions process and treatment options. There are many treatment options and therefore a specific treatment plan can be designed, suitable for each individual. Professionals from multiple areas of specialization including a psychiatrist, a counselor, family therapist and even a social worker may be a part of the recovery team.

The first step is to be sure the patient is stabilised, calm and non-aggressive. If the patient is seen to be agitated and aggressive, he or she may quickly receive some medication via injection to calm them down or perhaps even cause them to sleep. This will facilitate the medical professionals an opportunity to take a history from loved ones who have brought the patient to hospital in order to understand the situation without interference.

The person will be admitted and receive residential treatment. This is to facilitate thoroughgoing treatment including:

Detoxification. This is safely removing the substance from the individual’s body system. Before detoxification begins, drug tests are applied to locate and qualify the amount of the drug in the patient’s system.

Skills training. This enables the patient to acquire skills needed for life after treatment. For example, training on assertiveness in order to avoid the social pressures of substance use, etc.

Therapy. The patient may go through sessions of therapy after the psychosis resolves in order to uncover any issues that may have led to them abusing marijuana. Also, group therapy may be an option. This encompasses bringing together other individuals who have abused marijuana and are in the recovery process. It creates an environment for them to encourage and learn from one another in the journey of recovery. Sometimes family therapy may be needed, especially when the individual is said to be abusing marijuana as a way of coping with family issues.

Family conferences. The patient’s family needs to be brought into the picture in order to understand the affected person’s problem and how they need to be supported in order to recover.

Medications. Different medications may be used to treat the mental disorders that may be co-occurring.

Once the patient is stabilised, he or she may be seen as an outpatient and followed up. Treatment is often highly successful when the patient cooperates and receives the necessary social support from family and friends.