Symptoms of Cannabis-Induced Psychosis You Must Know

Updated: Apr 3

As someone who takes—or is considering taking—medical marijuana, reports of cannabis-induced psychosis (CIP) may have caused concerns about the potential effects of cannabis on your mental health. While acute symptoms of psychosis aren’t common, there are some associations between heavy, sustained recreational marijuana use and the development of acute or chronic mental disorders.

In general, people who take large amounts of high-potency cannabis every day and people with certain genetic variants are at greater risk of developing a psychotic disorder. Becoming familiar with cannabis-induced psychosis symptoms and the primary risk factors can help you assess your risk and develop a treatment plan with your doctor that minimizes any chance of CIP.

Symptoms of Cannabis-Induced Psychosis (CIP)

The symptoms of marijuana psychosis are characterized by a loss of touch with reality. They include:

Delusions

Delusions are false beliefs that a person may think or share, and will insist are true despite all evidence to the contrary. For example, someone who is suffering from CIP may believe that he or she is a monarch or has the power to bring people back from the dead.

Hallucinations

Hallucinations occur when someone experiences sounds, feelings, voices, images, or other sensations that aren't real. For example, the person may think they are being touched when no one else is there.

Dissociation/Depersonalization

These terms refer to a feeling of being detached from reality or detached from one’s physical body. A person experiencing these symptoms can feel like they're floating outside of the confines of their own body or may think that the things or people around them aren't real.

Disorganized Thoughts

Psychosis can cause a person's thoughts to be disordered, muddled, or chaotic, causing him or her to become difficult to understand. Though this isn't dangerous, psychosis can trigger disturbing thoughts which can be distressing for the person suffering from psychosis.

Other Symptoms That May Point to CIP

Other symptoms of CIP can include:

Disorganized speech
Unusual thoughts
Confusion
Memory loss
Uncharacteristic excitement
Uncooperativeness

Though these symptoms should disappear as the effects of cannabis fade from the body, it’s critical to contact the emergency services if you think that you or someone else might put themselves or others in danger.

How CIP is Diagnosed

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th ed., a medical diagnosis of Cannabis-Induced Psychotic Disorder (CIPD) requires that the symptoms:

Remain after the high fades or disappears. These symptoms can last for days or even weeks after taking cannabis.
Cause enough disruption or distress to get in the way of normal, everyday activities such as working or socializing.
Don't fit another diagnosis, such as schizophrenia.

Fortunately, CIP is a fairly rare condition, and milder symptoms of psychosis don't necessarily mean that you will be diagnosed with CIP. Indeed, many cannabis users report mild delusions, for example, hallucinations or paranoia, as fairly common occurrences that disappear when the high fades.

If you have experienced paranoia or any of the psychosis symptoms listed above, it’s a good idea to mention it to your MMJ doctor when you go to apply for or renew your medical marijuana card. It may be that you need to take a lower dose or switch to a different delivery method or strain.

Is Cannabis-Induced Psychotic Disorder Permanent?

Substance use disorders such as CIP tend to end when the substance in question leaves the body, but in extreme cases, symptoms may be severe enough to warrant going to the emergency room for immediate treatment. This involves a supervised detox in which drugs may be administered to flush the cannabis out of the person's system quicker.

Though this treatment is relatively quick and easy, this type of reaction often indicates an underlying mental illness that should be addressed as soon as possible. If you or someone you know is predisposed to psychotic disorders such as schizophrenia or bipolar disorder, cannabis may trigger them. If you have an underlying mental disorder, it’s likely that it will require ongoing treatment, even if there are periods of remission in which you don’t experience any symptoms.

Does Marijuana Use Lead to Schizophrenia or Bipolar Disorder?

There are mixed conclusions about whether or not cannabis use can potentially contribute to or even cause the development of schizophrenia, bipolar disorder, or other mental disorders with psychotic symptoms.

Some studies suggest that there is a connection between marijuana use with schizophrenia, with young men having the highest risk of schizophrenia as a result of CIP. However, this risk is likely to be much lower if you’re taking cannabis under medical supervision, because:

Your doctor will assess your family history, individual situation, and any other medications you take so that he or she can recommend the strains and products with the highest benefit-to-risk ratio.
Many medical marijuana strains are high in CBD and low in THC (the compound most strongly associated with psychotic conditions). Some people think that medical weed is more potent than regular weed. However, the opposite is often true!

What to Do If You Suspect Someone Is Suffering From Psychosis Symptoms

Psychotic disorders must always be taken seriously and should be referred to a mental health professional as soon as possible. Medical professionals can help you or your loved one receive help both for any psychotic disorder and also address any patterns of drug abuse, if necessary.

Because psychosis tends to happen as a result of excessive consumption of cannabis, the priority is usually a reduction in cannabis use. If you take cannabis because of a medical condition, any changes to your treatment program should be undertaken in consultation with your supervising physician.

How to Lower Your Risk of Cannabis-Induced Psychosis

According to research published in the Nature journal in 2022, people are at a greater risk of cannabis-associated psychotic symptoms when:

They are under 21 years of age.
They consume high-potency cannabis resin (rather than flower).
They consume cannabis mixed with tobacco.
They have a mental health diagnosis, such as anxiety, depression, bipolar, or psychosis.

Knowing these risk factors, almost all states with an adult-use marijuana program limit purchases, possession, and use to people 21 years of age and above. Some states, including Arizona, also require dispensaries to have a Medical Director to provide supervision and oversight.

If you have a mental health diagnosis or a family history of mental illness, let your doctor know in your face-to-face or telemedicine MMJ appointment so that your individual risk factors can be taken into account when the doctor recommends delivery methods, dosages, and strains.

A Responsible Approach to Cannabis Consumption Can Lower the Risk of Psychosis

Though some research suggests a link between cannabis consumption and an increased risk of cannabis-induced psychosis and other psychiatric disorders, moderate consumption under the care of an experienced medical marijuana doctor is the best way to avoid these kinds of side effects.

If you are currently experiencing any of the cannabis-induced psychosis symptoms described above or suffer from a mental health disorder, discuss your concerns with your MMJ doctor. He or she can help you weigh up the benefits and risks of cannabis as a treatment option for your health condition, suggest alternative products, and help you reduce your consumption of cannabis if required.