The Signs of Cannabis-Induced Psychosis: What You Need to Know

Cannabis psychosis is described as “The presence of hallucinations and/or delusions that occur during or soon after cannabis intoxication.”

Cannabis Psychosis Signs

Psychosis occurs more frequently among people who use cannabis than in the general population. So if you use marijuana medically or recreationally, it’s important to understand how to spot marijuana psychosis signs. With the right information, you can substantially reduce your risk of having any problems with this challenging condition.

Understanding Cannabis-Induced Psychosis

Rates of cannabis use around the world have steadily risen for over a decade.

In fact, the 2022 United Nations World Drug Report states more than 209 million people (or 4% of the world’s population) reported using cannabis over the past 12 months, making it the most commonly used drug across the globe.

Perhaps more concerningly, however, is a trend that as cannabis legalization has progressed, rates of cannabis-related harms have also increased. This is attributed to the greater availability of high-potency marijuana products. Interestingly, the types of harms most commonly reported are psychiatric, such as cannabis-induced psychosis.

What Is Cannabis-Induced Psychosis?

Cannabis-induced psychosis can be defined as:

The presence of hallucinations and/or delusions that occur during or soon after cannabis intoxication.  

Cannabis-induced psychosis can vary in severity. And in milder cases, it’s not always harmful.

To give some examples, many people who use marijuana report unusual thoughts or feelings when under the influence. These might include things like odd body sensations, mild paranoia, or becoming so immersed in a TV show that you temporarily lose touch with where you are.

To some degree, these experiences are part of the marijuana “high.”

They are generally not problematic when:

  1. The user has insight into the surreal nature of their experiences
  2. They don’t result in unsafe behavior
  3. The symptoms go away within a few hours

However, not all marijuana psychosis signs are harmless. So it’s important to be able to recognize when symptoms are cause for concern.  

Recognizable Symptoms of Cannabis Psychosis

Psychosis is a term used to describe a range of symptoms that affect the mind.

Psychotic symptoms may involve many different aspects of thoughts and bodily sensations (like touch or smell). But the common thread is all involve some form of loss of contact with reality.

Cannabis psychosis signs and symptoms can look similar to other mental health conditions, like schizophrenia and psychotic disorders. However, in the case of cannabis-induced psychosis, symptoms are brought on directly by cannabis intoxication. They can also come on quite suddenly, be very intense, and last for extended periods.

Common Cannabis Psychosis Symptoms

Below is a list of some of the more common groups of cannabis psychosis signs.

When reading these, keep in mind that for a person experiencing cannabis-induced psychosis, symptoms can seem entirely real (no matter how unusual they may sound).

Hallucinations

A hallucination may be a vision or feeling of something that isn’t there.

Hallucinations are generally described by the sense with which they are perceived.

For example, visual hallucinations involve seeing something that’s not there. Tactile hallucinations have to do with touch (e.g., bugs crawling on the skin). And olfactory hallucinations involve smells.

Delusions

Unusual thoughts and beliefs which have no basis in reality can be called delusions.

Delusions might be obvious to spot if the person openly shares their thoughts (such as the belief that radio waves are controlling a person’s mind).

But sometimes, people experiencing delusions can become withdrawn and preoccupied with what’s going on inside their head (like if someone isolates themselves to complete a secret mission). 

Paranoia

In its milder forms, paranoia involves general suspiciousness. It may be directed at an individual or a group/organization. And often results in unease around people, as the individual may feel others are “out to get them.”

When paranoia becomes severe, one might fear for their life. This is incredibly unpleasant. And can become dangerous if a person decides to take action to ensure their safety. 

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Anxiety

Any of the psychotic symptoms described above could result in anxiety, particularly when they’re scary and/or overwhelming.

In these cases, the person experiencing cannabis-induced psychosis might get anxious because of their psychotic symptoms.

However, it’s worth keeping in mind that cannabis can also induce panic attacks and anxiety in certain individuals, regardless of whether a person experiences psychosis.

Agitation

Similar to the situation with anxiety, the intense and sudden nature of cannabis-induced psychotic symptoms can result in a person feeling highly agitated.

Agitation may present as distress, anger, or fear.

It may be safe to “ride out” agitation with a supportive person until the effects of marijuana wear off. But in some cases, a person experiencing marijuana psychosis signs could pose a threat to themselves or other people.

Disorganized Thinking

Also referred to as “thought disorder,” disordered thinking occurs when a person has trouble stringing logical thoughts together.

Forgetting how to do something or having difficulty holding a conversation are common signs of thought disorder.

In a supportive environment thought disorder isn’t a big problem, as a person can be kept safe until their thinking becomes more clear. But if a person with disorganized thinking goes to drive a car or cook a meal, for example, the consequences can be dangerous.

Risk Factors and Vulnerability

We don’t know exactly what causes cannabis-induced psychosis. But research suggests three key factors that can increase the risk of experiencing cannabis-induced psychosis.

Being mindful of these risk factors can significantly reduce the likelihood of experiencing psychosis (and other adverse effects) from marijuana and THC products.

  • Consumption of High THC Products

The old saying,“the dose makes the poison,” rings true here.

Cannabis has proven therapeutic effects for many physical and mental health conditions. But like all drugs (legal, medical, and otherwise), benefits require a careful medically supervised dosing regimen.

Research consistently relates the use of high THC-containing products with increased risk of psychosis. The most likely reason is the fact such products make it easier to consume unusually high amounts of THC.

  • Frequency of Use

While the dose is still an important variable here (regular high doses pose the greatest risk), frequent cannabis use does tend to increase a person’s overall risk of experiencing psychotic symptoms.

This is particularly the case where a person has already experienced problematic cannabis-induced psychosis.

In this situation, continued use can result in a situation where psychotic symptoms gradually become more severe and longer lasting.

  • Individual Vulnerabilities

Finally, individual vulnerabilities play an important role in the risk of experiencing cannabis-induced psychosis.

The main risk factor in this regard is having a family history of psychosis or schizophrenia.

Individuals who have a relative with schizophrenia are already at a higher risk of developing this devastating condition. And there is solid evidence that regular and heavy cannabis use increases a person’s risk of schizophrenia and other psychotic conditions.

Marijuana use can also make underlying mental health conditions worse (such as bipolar disorder). So if you have experienced challenges with your mental health previously, please consult a medical professional before using marijuana.

Differentiating Cannabis-Induced Psychosis from Other Conditions

Psychotic conditions can be thought of as existing along a continuum.

On one end are temporary psychotic “episodes.” Psychosis caused by cannabis or other drugs (such as methamphetamine/ice) are examples of temporary or transient psychosis. These episodes usually resolve within one to several days, with or without mental health treatment.

When a psychotic episode lasts a long time, someone might be diagnosed with a psychotic disorder. In this case, psychotic symptoms can last for many months, then reduce significantly or go away completely with treatment.

On the most severe end of psychotic conditions is schizophrenia. Schizophrenia is long-lasting and may be permanent. It involves psychotic symptoms of multiple types and severely impacts a person’s ability to function in daily life.

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What About Cannabis-Induced Psychosis?

A big challenge with cannabis-induced psychosis is that it can present similarly to other psychotic conditions.

For example, even for experienced mental health professionals, the hallucinations, delusions, and disorganized thinking from marijuana-induced psychosis can seem identical to those in other psychotic disorders. Most of the time, the only way to tell between the two is to have someone stop using cannabis for a period to see if the symptoms go away.

If you think you’re experiencing cannabis induced-psychosis, please consult a mental health professional right away.

An experienced practitioner can do a full psychiatric evaluation and advise on likely causes and treatment options.

The Importance of Early Recognition

If not treated early, cannabis-induced psychosis can have severe and long-lasting effects.

Potential complications include:

  • Damage to a person’s relationships and reputation (from unusual behavior)
  • Poor academic and work performance
  • The development of a more severe and persistent psychotic condition
  • Physical harm due to self-neglect
  • An increased risk of other mental health conditions

Fortunately, when recognized and addressed early, outcomes for marijuana-related psychotic disorders tend to be quite good.

Management of Cannabis-Induced Psychosis

The ideal approach to managing cannabis-induced psychosis varies between individuals. Treatments and management strategies can include:

  • Counseling and psychoeducation
  • Antipsychotic medication
  • Reducing or abstaining from marijuana use
  • Individual, family, or group therapy

Overall, the earlier a person gets treatment, the better their chance is to make a full recovery.

Getting help early can also reduce the risk of experiencing subsequent bouts of cannabis-induced psychosis, as a person can learn how to manage their own specific risk factors (e.g., not using high-potency THC products).

Conclusion

Marijuana can be a safe and useful therapeutic product and recreational drug. However, like all psychoactive substances, all marijuana users should be aware of certain risks.

Cannabis-induced psychosis is one of the most important of these risks.

Cannabis-induced psychosis can occur even with moderate and infrequent use. It involves the user experiencing one or several symptoms that involve a “break from reality.” These symptoms can include hallucinations, delusions, and paranoia.

In its milder forms, cannabis-induced psychosis is short-lived (up to a few hours) and doesn’t cause a significant amount of distress to the individual. But when it’s more severe, psychosis from marijuana use can be long-lasting and result in substantial harm.

If you or someone close to you has psychotic symptoms after using marijuana, please get professional help as soon as possible.

The sooner treatment is provided, the greater the chances are of making a full recovery. Input from a mental health professional can also help reduce the risk of any future episodes of psychosis.

FAQs

Is cannabis-induced psychosis permanent?

If recognized and treated early, cannabis-induced psychosis usually isn’t permanent. However, individuals who experience cannabis-induced psychosis are at increased risk of developing other psychotic conditions throughout life, so it’s important to get professional help to assess the situation.

Does everyone who uses cannabis experience psychosis?

No. In fact, most people who use cannabis don’t experience psychosis. But certain patterns of use, like high THC products regularly can increase the risk of cannabis-induced psychosis. Using marijuana moderately and infrequently can reduce the risk of psychotic symptoms.     

Can cannabis-induced psychosis be treated?

Yes. There are effective treatments for cannabis-induced psychosis. Appropriately trained mental health professionals can deliver therapy, psychoeducation, or medication to treat symptoms of psychosis. They may also give advice regarding whether ongoing marijuana use is safe in your situation.

There could be a link in some vulnerable individuals. The National Institute on Drug Abuse advises, “The relationship between cannabis (marijuana) use and psychiatric disorders is complex, and more research is needed to better understand the short- and long-term impacts of cannabis use on mental health.

Eamon McGrath - BSW, PGCert

Eamon McGrath - BSW, PGCert

Before starting his writing business, Eamon worked as a clinical social worker, psychotherapist, and health coach for nearly two decades in the medical, mental health, substance misuse, and justice systems. This professional experience gave Eamon a deep understanding of psychopharmacology and healthcare, which he uses to create high-level content and copy in all his writing projects.

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