The use of cannabis for both recreational and medicinal purposes has increased significantly in the last decade. Due to the legalization and decriminalization of weed in some states in the United States, weed is much more accessible than in the past, especially if prescribed as medicine.
Marijuana is known for its medical use for various conditions. People take it for its therapeutic effects on pain and nausea, as well as stress, anxiety, and even PTSD (LaFrance et al, 2020). However, when it comes to more serious mental disorders, like schizophrenia, the results of its health benefits have been either negative or conflicting.
Even though many people with this disorder are considering self-medication, cannabis use for schizophrenia has not been FDA approved, but there is ongoing research.
Below we’ll talk in detail about the connection between schizophrenia and marijuana use, discuss the effects of marijuana and some risk factors you need to know, and try to present both sides of the matter for clarification based on recent studies.
What Is Schizophrenia?
Schizophrenia is a serious psychiatric disorder in which people who suffer from it tend to misinterpret reality. What this means is that they often experience a state of psychosis where they can lose touch with reality and have difficulty determining what’s real and what’s not real, resulting in psychotic episodes.
This condition affects how the individual thinks and perceives the world, and subsequently, how they act on their thoughts and perceptions. They may start seeing the world around them as a jumble of impressions, pictures, and sounds. The major psychotic symptoms include hallucinations (mostly auditory), delusions, apathy, social withdrawal, and disorganized thinking or erratic behavior.
Symptoms usually appear gradually, in young adulthood. The diagnosis is mostly done on the basis of behavioral observation, rather than on the basis of an objective diagnostic test. An important part of the diagnosis is comparing the person’s behavior as perceived by the people around them with their own subjective view of the world.
Another similar condition is schizoaffective disorder, which shouldn’t be confused with schizophrenia. This disorder has a combination of the symptoms of schizophrenia, like hallucinations and delusions, and symptoms of other mood disorders, like depression.
Schizophrenia is a lifelong condition that requires regular treatment, however, with the right approach, the symptoms can be managed and the individual could have an improved quality of life.
What Are the Risk Factors?
Schizophrenia is still somewhat a mystery in regards to what causes it. However, it is generally believed that a combination of genetics, brain chemistry, and environmental conditions are some of the main risk factors (Davis et al, 2016).
The interplay between these factors causes an imbalance in neurotransmitters, the chemicals in the brain in charge of mood, behavior, and communication between cells. The individuals who are at risk of schizophrenia can be triggered by things like emotional stress or chronic lack of sleep, but also frequent alcohol and drug abuse, especially during adolescence, when the brain is still developing.
How Is It Treated?
The treatment of schizophrenia depends entirely on the individual and the severity of the symptoms. However, the conventional route is prescribing antipsychotic medications, which, unfortunately, can cause many side effects, like heart problems, weight gain, and increased risk of diabetes, among others.
Counseling is also recommended, which may involve different methods of treatment like art therapy, psychosocial therapy, cognitive behavioral therapy, social training, and others. The goal is to reduce the risk of psychosis and make schizophrenia patients as self-reliant and independent as possible and make their lives easier.
Due to the adverse side effects of conventional medication, medical marijuana is often considered as a possible treatment for the symptoms of schizophrenia, causing a lot of debate.
How Does Marijuana Affect the Body?
The human body has its own endocannabinoid system, which is a complex biological system that has an important role in regulating a number of crucial processes in the body, like mood, memory, sleep, appetite, pain sensation, and immune function.
The endocannabinoid system is made up of neurotransmitters (endocannabinoids) that bind to cannabinoid receptors throughout the body, the main ones being CB1 and CB2, in order to carry out their functions and maintain homeostasis in the body.
The two most researched compounds present in the marijuana plant, cannabinoids cannabidiol (CBD) and delta-9-tetrahydrocannabinol (THC), interact with these receptors, and in this way, they can influence the processes in the body. (Zou & Kumar, 2018)
THC binds to both receptors CB1 and CB2, allowing them to exert different effects on the body and the mind. THC is the component in weed that produces the psychotropic, euphoric “high”, and it can also alleviate pain and stimulate your appetite. However, THC can also produce intense psychoactive feelings of paranoia and anxiety, especially with higher doses or when mixed with alcohol.
CBD, on the other hand, hardly causes negative side effects. It doesn’t produce the same “high” feeling as THC, probably because it doesn’t interact directly with CB1 and CB2 the way that THC does. However, it is believed that it prevents other cannabinoids from breaking down, allowing them to fully exert their effects.
On the Relationship Between Marijuana Use and Schizophrenia
Overall, marijuana is not considered a suitable treatment for its symptoms. However, there has been emerging research in recent years that suggests that there is more to the story. Below we’ll look at both sides of the argument.
The main argument against marijuana being a suitable treatment for schizophrenia is that there is enough evidence that marijuana may actually trigger psychosis or worsen the symptoms of schizophrenia. It’s important to note that this effect is believed to be due to the THC content.
THC mimics the effects of one chemical that’s part of the endocannabinoid system and that binds to the CB1 receptor. This chemical, called anandamide, participates in several different processes in the body, including the production of dopamine, the neurotransmitter responsible for mood, motivation, and memory. In fact, schizophrenia patients have elevated levels of anandamide compared to patients with other mental disorders. Therefore, THC is thought to cause an adverse reaction.
Additionally, a 2017 clinical trial published in the journal Molecular Psychiatry has discovered that genetic makeup plays a large role in the risk of developing schizophrenia if you’re a regular cannabis user. They concluded that the participants in the trial who had used marijuana had 1.37 times increased risk of developing schizophrenia compared to non-users.
Similarly, there is also evidence that adolescents under the age of 18 who become regular marijuana users are more likely to develop symptoms of schizophrenia or another mental illness as their brains before that age are still in development and more susceptible to external influence.
On the other side, there has been evidence that CBD can counteract the effects of THC and actually help regulate the symptoms of schizophrenia by reducing anxiety and paranoia, similar to antipsychotic drugs. It also seems to improve overall cognitive performance – memory and learning.
A review of the literature published on CBD and schizophrenia has deducted that CBD treatment could be beneficial in regards to “the environmental, autoimmune, and neuroinflammatory causes of the disorder.”
They further conclude that “CBD, in particular, may be a safe and effective treatment option for schizophrenia as a primary or adjunctive therapy, supporting both inflammatory causes of schizophrenia and the potential importance of targeting the ECS in treating this poorly understood disease rather than ill-tolerated antipsychotics with debilitating side effects.”
Finally, Can Marijuana Be Used to Treat Schizophrenia?
Marijuana is not a cure for schizophrenia or a substitute for the appropriate medications prescribed. Those who are at risk of developing symptoms of schizophrenia should refrain from using it, while those who are already taking medication should continue to take them.
What we can conclude from the reports presented above is that it’s much safer to consume cannabis strains (for example, Sativa strains, as they are generally milder) that are high in CBD and low in THC, even though the evidence is still not 100% conclusive.
Still, if you’re considering taking medical cannabis as an adjuvant or main therapy, it’s crucial that you consult with a medical professional and be cautious with the strain you choose, as the wrong strain may make your symptoms and mental health worse. Always monitor your responses and stop using it if you notice anything unusual. In any case, drug use or any kind of substance use when you know you’re at risk of developing a psychotic disorder is not encouraged.
Emily M. LaFrance, Nicholas C. Glodosky, Marcel Bonn-Miller, Carrie Cuttler. Short and Long-Term Effects of Cannabis on Symptoms of Post-Traumatic Stress Disorder. Journal of Affective Disorders Volume 274 2020. Pages 298-304. ISSN 0165-0327. https://doi.org/10.1016/j.jad.2020.05.132.
Davis J, Eyre H, Jacka FN, et al. A review of vulnerability and risks for schizophrenia: Beyond the two hit hypothesis. Neurosci Biobehav Rev. 2016;65:185-194. doi:10.1016/j.neubiorev.2016.03.017
Zou S, Kumar U. Cannabinoid Receptors and the Endocannabinoid System: Signaling and Function in the Central Nervous System. Int J Mol Sci. 2018;19(3):833. Published 2018 Mar 13. doi:10.3390/ijms19030833