Doctors Get New Clinical Guidelines for Managing Chronic Pain With Cannabis, Courtesy of Canadian Researchers
by Bethan Rose
Psychologists and other medical professionals have long warned against the potential impact of cannabis on the brain, including presenting with psychosis as a result. Now, the Psychiatric Times has announced that there is novel insight that serves as evidence that cannabis is “associated with adverse effects of psychopathology and cognition”. This may sound alarming, but rest assured, we’ll break it down and identify preventative measures. This new insight is the result of a study that suggests there is a connection between high potency cannabis and the risk of psychosis.
Psychosis is a severe mental condition that greatly impacts the way the brain processes information causing one to break from reality. The condition can cause one to see, hear, or even believe things that aren’t real. However, it is important to know that psychosis is a symptom, not an illness itself. It is usually a result of psychotic disorders such as Bipolar Disorder and Schizophrenia, which involve episodes of psychosis.
The Psychiatric Times study, with Dr. Brain Miller, explained that it is “estimated that 47% of patients with schizophrenia also had a lifetime comorbid diagnosis of a substance use disorder” and that “cannabis is one of the commonly used” among those. They go on to explain that cannabidiol (CBD) can decrease psychotic symptoms as well as improving cognitive functioning in patients with schizophrenia but it is tetrahydrocannabinol (THC) that can induce psychosis and cognitive impairment.
In support of the connection between high potency THC and elevated risk of psychosis, the team mentioned that evidence from 69 studies has displayed that “frequent or heavy use was associated with significantly reduced cognitive functioning” but those effects “diminished with abstinence for more than 72 hours”.
Additionally, support includes the meta-analysis of 10 studies where the researchers investigated the association “between the degree of cannabis consumption and risk of psychosis”. The results were, once again, that higher levels of cannabis use were associated with an increased risk of psychosis. What’s more, Dr. Miller found evidence for a dose-response relationship.
The dose-response relationship can basically be explained as a “2-fold increase in risk (of psychosis) for the average cannabis user, and a 4-fold increase in risk for the heaviest users compared with non-users”. Dr. Miller explains that this may not be evidence of an association but it “remains a replicated factor for psychosis with a clear dose-dependent relationship”. Note that despite this study, cannabis and psychosis are still far from being proven to be in a causal relationship. This is a sentiment echoed in a 2020 statement by the National Academies of Science, Engineering and Medicine.
Lastly, this 2009 study explains that “there was no difference” between the psychiatric condition of participants “whether they had ever taken cannabis, or age at first use”. The study also found that 78% of their participants were making use of high-potency cannabis such as sinsemilla or ‘skunk’. The study concluded with its findings which were that “people with a first episode of psychosis had smoked higher-potency cannabis, for longer and with greater frequency” and that the control group supported the “hypothesis that THC is the active ingredient increasing risk of psychosis”.
Heavy cannabis use, which includes consuming high potency cannabis products for prolonged periods, can lead to cannabis use disorder (CUD). According to Dr. Miller, the research suggests that individuals who have “substance-induced psychoses” will then “transition to a diagnosis of schizophrenia”. Therefore, it is important to avoid potency and heavy consumption which could induce psychosis in heavy consumers and those whose genetics or disease predisposes them to be at greater risk for psychotic episodes and disorders. Let’s have a look at persons who may be at an increased risk as well as the preventative measures which can be taken.
When consuming high potency cannabis, or consuming cannabis heavily, in combination with the following, individuals are putting themselves at an increased risk:
Unfortunately, psychosis is complex and somewhat limits one’s ability to identify which persons would be more at risk; Healthline even states that “each case of psychosis is different and the exact cause isn’t always clear”.
Since the problem appears to be with dosage and the THC cannabinoid, the best manner to avoid the risk of presenting with cannabis is to:
As you can see, there is some reason for concern, but there is also reason not to be! The benefits of cannabis in low to moderate amounts seem to vastly outweigh the potential adverse effects according to the currently available research.
Since the high potency products and heavy cannabis consumption is linked to psychosis, avoiding both would mean a significantly reduced risk of presenting with psychosis. THC may not be for everyone. While THC can be therapeutic for some, it can be problematic for others. Still, data shows that the relative risk of becoming dependent on THC is less than that of alcohol.
Nevertheless, cannabis is full of many other cannabinoids and compounds that are worth exploring and can also offer many health benefits. And let’s not also forget the fact that this adverse effect diminishes after 72 hours, give or take a few.
Always remember to consume responsibly and consult a medical professional before attempting cannabis therapies. Your personal medical provider knows your health history and can make a suitable recommendation about whether they think THC-containing cannabis is appropriate for you or not.
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