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Association with Cannabis and Psychosis Confirmed

By Arturo C. Taca, Jr., MD
Diplomate-American Board of Addiction Medicine
Diplomate-American Board of Psychiatry and Neurology
Medical Director- INSynergy

More recent studies have shown clear evidence that marijuana can cause psychotic symptoms. It has been widely recognized that some persons that smoke cannabis are at higher risk of psychotic symptoms such as paranoid thoughts, auditory hallucinations, and delusions. These symptoms mimic symptoms closely related to schizophrenia.

Since the THC (the psychoactive ingredient in cannabis) amount has increased from 3-5% from the 60’s to 30% in genetically engineered plants, more psychotic behavior has been reported.
Studies have shown that “age at onset of cannabis is directly associated with age at onset of psychosis and age at first hospitalization.” This means the earlier one smokes marijuana, the earlier the onset of psychotic symptoms.

Dr. Juan A. Galvez-Buccollini and his associates wrote that “if cannabis use precipitates the onset of psychosis, efforts should be focused on designing interventions to discourage cannabis use in vulnerable individuals.”  (Schizophrenia Res. 2012;139:157-60)
His study was among several recent papers suggesting an association with cannabis smoking, psychosis, and the risk of triggering schizophrenic episodes in populations having genetic risk for psychotic illnesses.

Synthetic Marijuana
Another growing problem is synthetic marijuana called K2 or Spice. K2 or Spice is a mixture of herbs, spices or shredded plant material that is typically sprayed with a synthetic compound chemically similar to THC, the psychoactive ingredient in marijuana.

K2 is typically sold in small, silvery plastic bags of dried leaves and marketed as incense that can be smoked. It is said to resemble potpourri. Short term effects include increased agitation, seizures, vomiting, profuse sweating, uncontrolled / spastic body movements, elevated blood pressure, and palpitations. The onset of this drug is 3-5 minutes, and the duration of the high is 1-8 hours.  In addition to physical signs of use, users may experience: severe paranoia, delusions, and hallucinations. Its long term effects are unknown.

This K2 compound was first created in the mid-1990s in the lab of chemist John W. Huffman of Clemson University, who studied cannabinoid receptors. It was believed that his recipe for these pot-like molecules found its way to Europe.  It wasn’t long till it made it back to the US being wildly popular with high school students and young adults. It was believed that it was a safe alternative to marijuana but later scores of ER visits described overdoses, confusion, cardio-vascular collapse, extreme agitation, psychosis and hallucinations.

Up until 2011, K2 or Spice was regularly available for legal purchase at gas stations, head shops, convenience stores. In 2012, the DEA made it illegal to sell and distribute forms of K2 or Spice but still can be easily found on the internet as “herbs” or “potpourri” usually marked “not for human consumption”.

Wax
A new concern popping up in a few major cities is something called “Wax”. Wax is a new dangerous marijuana product that looks like ear wax or lip balm. It is synthetically derived by processing butane through marijuana leaves leaving a thick gooey substance that can be 80% to 99% pure THC.

Wax is sold in marijuana shops to customers who want a quicker, more intense buzz from pot. Because this drug is so highly concentrated, side effects such as confusion, agitation, visual and tactile hallucinations, paranoia, mania, were being seen in hospitals and treatment centers.

Officials warn of another danger: People are getting injured making Wax at home, using cannabis, solvent and butane. In fact, FEMA issued a warning earlier this year about the increase in the number of related fires and explosions on the West Coast.

Because of the growing popularity of Wax usage and its psychiatric side effects, injuries associated with making Wax, DEA chief Michele Leonhart told the House Appropriations Committee that abuse of Wax was increasing in the US and should be monitored.

Is Marijuana Medicine?
Marijuana has ignited such as strong following of opinion on both sides of fence that it has left many confused whether marijuana is a good or bad thing.

Currently there is considerable interest in the possible therapeutic uses of marijuana. As of January 31, 2014, there were 28 active grants related to this topic, funded by National Institute of Drugs and Alcohol (NIDA), in 6 different disease categories.

The American Society of Addiction Medicine (ASAM) has firmly stated that they oppose proposals to legalize marijuana anywhere in the United States citing  that marijuana use is neither safe nor harmless, will cause more car related accidents and deaths, cause more addiction, and because of more potent forms of marijuana, can cause more psychotic events.

Regardless where laws and medicine guide us on the use and role of marijuana in our society, we should be vigilant to provide education to our children, young adults, and medical providers, law makers, that cannabis, natural or synthetic, may have limited therapeutic roles in the future but  can be clearly associated with health hazards such as addiction, impaired driving, organ damage (brain), and psychosis.

Are you or a family member struggling with substance abuse, please call INSynergy
(314) 649-STOP
(314) 649-7867

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