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Mental Health And Substance Abuse

The Link Between Cannabis Use and Schizophrenia

The Link Between Cannabis Use and SchizophreniaCannabis is one of the most frequently used drugs in the United States, with an estimated 18.7% of the U.S. population using at least occasionally. That’s more than 52.5 million people. Cannabis and marijuana are more and more often accepted as a relatively safe drug for medical and recreational use. Yet, heavy use is also more and more often linked to behavioral health disorders like schizophrenia and paranoia. Schizophrenia is a complex mental health disorder linked to genetics, but research shows that cannabis use could trigger dormant schizophrenia. For that reason, it’s important that you be aware of the risks and how they might affect you or your loved one before using.

This doesn’t mean that cannabis can immediately trigger schizophrenia the first time you use. Instead, the relationship is likely complex, related to heavy use, and heavily dependent on genetics. For many people, cannabis only increases the risk of receiving a cannabis diagnosis. That does mean that understanding the risks will contribute to your ability to use safely.

How does Cannabis Contribute to Schizophrenia

Cannabis is widely regarded as increasing vulnerability to schizophrenia. Often, that means the individual had an underlying but dormant schizophrenic disorder. It’s not yet known if cannabis can cause schizophrenia in a person without genetic inclination for the disorder, but it is thought that the answer is no. This means that genetics play a very large role in cannabis contributing to schizophrenia.

  • Increased Risk of Psychosis – Most people are aware that if you smoke too much cannabis, you get paranoid. Even if you’ve never smoked, everyone has seen the friend being paranoid. Even that mild psychosis can contribute to schizophrenia. In fact, paranoia is one of the first symptoms of schizophrenia, with one study of over 15,600 participants showing that people who experience paranoia when smoking cannabis are at an increased risk of developing schizophrenia than those that don’t experience paranoia when smoking cannabis.
  • Poor Coping Mechanisms – People who smoke cannabis often do so to self-medicate and to alleviate existing symptoms and mental health problems. That can be using cannabis to relax. It can also mean using cannabis to treat early symptoms of schizophrenia instead of getting help for them.
  • Genetic Triggers – Some research shows that people with certain gene expressions will have an increased likelihood of a schizophrenia diagnosis after smoking cannabis. These currently include AKT1 C/C and COMT gene expressions, both of which increase the psychotomimetic effects of cannabis. Essentially, persons with those genes experience more psychosis than individuals without those gene expressions, which can mean a higher risk of schizophrenia – or that those genes are linked to underlying schizophrenia already being there.

Cannabis Increases Your Likelihood of a Schizophrenia Diagnosis

Schizophrenia DiagnosisToday, it’s estimated that some 0.5-1% of the population has schizophrenia and that more than 3% of the population are vulnerable to schizophrenia. This means that 3% or more of the population carry all of the risk factors for schizophrenia, or what is otherwise known as “Dormant” schizophrenia.

However, studies that take individuals with high risks based on genetics show that individuals who smoke cannabis and have genetic risks are 40% more likely to receive a diagnosis than those that do not. Of course, that could also be related to a mix of factors such as:

  • Persons experiencing schizophrenia symptoms are more likely to self-medicate
  • Individuals with schizophrenia are more likely to take risks (e.g., drugs)
  • People who smoke cannabis are more likely to be from low-income homes and unable to receive proper mental health treatment

While it’s likely to be a combination of everything, multiple studies show that individuals who smoke cannabis are typically diagnosed with schizophrenia as early as 2.8 years sooner than family members with the same background and risks who do not smoke cannabis.

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What are Known Risk Factors?

man holding a cannabis rollThere are plenty of risk factors that can contribute to your likelihood of a schizophrenia diagnosis related to cannabis usage. The following include some of the most common:

  • Gender – Men are both more likely to smoke cannabis and more likely to receive a schizophrenia diagnosis
  • Age of Usage – If you begin using cannabis before the age of 25, it may increase the risks of schizophrenia at a later age. That’s linked to the fact that the brain is more plastic and in development under the age of 25, meaning that changes to dopamine and serotonin regulation by cannabis are more likely to become permanent functions of how the brain works. This also means that reducing risks means waiting to smoke until after the age of 25. However, young adults aged 18-35 make up the most statistically significant population of cannabis users.
  • Amount of Usage – The more you smoke, the more you are at risk of developing complications, including psychosis. For example, studies show that even smoking a single joint per week can develop schizophrenia at a later date – although causation and correlation are still in question. On the other hand, the people most likely to receive a diagnosis are those who qualify as heavy users, or who smoke on average once or more per day.
  • Genetics – Genetics are still the most important trigger in a schizophrenia diagnosis. For example, individuals with the gene expression AKT 1 C/C are 7 times more likely to receive a schizophrenia diagnosis after heavy cannabis usage than those without the gene expression, even with comparable cannabis consumption. However, if you have the AKT 1 C/C gene expression, you’re more likely than a non-C/C expression person to receive a schizophrenia diagnosis, even if you don’t smoke cannabis. So, the gene is a risk and cannabis is only a trigger. This is also true with other genes, most notably COMT, which regulates how neurotransmitters like dopamine and serotonin are reabsorbed back into the brain.

It’s widely agreed that cannabis and schizophrenia interact a great deal. However, if you have a family history of schizophrenia, it’s significantly more likely to be the case.

So, what are the Risks?

If you have a family history of schizophrenia, it’s normally better to avoid psychosis-inducing drugs altogether. While they won’t “cause” schizophrenia, they can trigger it, bringing formerly dormant symptoms to the surface. Multiple studies indicate that cannabis can play a role in activating schizophrenia, meaning that you will be more likely to develop symptoms and to need a diagnosis. Therefore, it’s always a good idea to assess your medical history for the risk of schizophrenia before smoking. However, it’s also important to keep in mind that schizophrenia increases your risk of drug use and using cannabis to cope with symptoms. If you’re using, it’s a good idea to stop and evaluate why and to seek support and treatment for those symptoms.

In almost every case, there is a complex interplay between risks, factors, and triggers. You won’t develop schizophrenia because you smoked once. However, cannabis can and does contribute to an increase in psychosis, even if it seems mild. If you start experiencing paranoia, it’s a good first warning sign and a good reason to stop smoking and look for treatment.

Of course, most drugs are relatively safe in moderation. Still, many of us are “high risk”, meaning we take on extra risks of complications, triggering underlying problems, and even addiction when we use them. If that is you, it’s better to avoid smoking or using altogether.

Take the first step towards reclaiming control of your life by seeking help for cannabis addiction today. Contact our addiction treatment team today, we are here to support you on your journey to recovery.

The Link Between Hallucinogens and Suicide Risk

The Link Between Hallucinogens and Suicide Risk

Hallucinogens or psychedelics have a long history of being known for exacerbating mental health problems and increasing suicide risk. Today that’s come under question, especially as multiple studies show that hallucinogens may actually reduce risk of suicide in (previously) suicidal persons.

However, in both cases, we still need more data and a better understanding of how hallucinogens work on an individual level in order to make safe judgement calls.

In 2022, an estimated 49,449 Americans died of suicide. In 2012, 12.3 million adults seriously thought about suicide and 3.5 million adults made a plan to do so. Suicide dramatically impacts every aspect of our lives – so it’s important to understand the risks before you start taking drugs of any kind. Hallucinogens are no worse than any other drug, however, it is still critical that you be aware of the risks and that you have the information to use or make decisions safely.

Do Hallucinogens Increase Risk of Suicide?

The short answer is, there is no statistically significant data showing an increase in risk of suicide for persons who take hallucinogens. The long answer is that hallucinogens interact with the brain in complex ways and on an individual level, may be extremely harmful to mental health and stability, which may exacerbate or worsen existing mental health problems.

However, for the general population, hallucinogens show no direct correlation to an increase in risk of suicide. For example, a study profiling the hallucinogen usage of persons taking ayahuasca, a psychedelic drug used in religious rituals in the Amazon Rainforest, found no significant differences in mental health or mindset between persons who took the drug regularly for rituals. In fact, there were also no statistically significant differences between persons who started the study having used just once and those who had used 5+ times – and the study followed up on a yearly basis for two years. Instead, the only statistically significant differences were regular ayahuasca users were less likely to avoid dangerous or potentially harmful activities because they were less likely to worry about the results of those activities, were less likely to experience shyness, and were more likely to be dependent on getting to feel good out of an interaction or activity. With over 200 people profiled, there were no significant changes in mental health or in suicidal ideation or depression.

A similar study tracking the results of peyote on Native populations showed that 70,000 individuals using the drug were unlikely to experience statisticially different mental health norms than control groups not using the drugs.

People With Mental Health Problems Are More Likely to Use Drugs

a woman with mental health issue being comforted by a womanWhile hallucinogens are unlikely to cause increases in risk of suicidal ideation or depression, people with suicidal ideation and depression are more likely to use drugs. This means that populations using hallucinogens are more likely to be vulnerable to suicide or suicidal ideation because they have a mental health disorder. That’s in part because many people use drugs and alcohol to self-medicate and to feel better. That’s especially true after multiple studies were picked up by the news showing that psychedelics can actually help people to relieve symptoms of suicidal ideation and decrease suicide risk. More people opt to self-medicate and then use psychedelics as a means of temporarily feeling better.

Self-medication is always dangerous because it means that people look for quick ways to feel better. This means they don’t treat underlying symptoms. Often, drug and alcohol use also exacerbates symptoms. Sometimes that’s by causing shifts in hormone and neurotransmitter production in the brain, reducing your ability to feel and process emotions properly or creating unhealthy reliance on drugs. Often, it also results in isolation and alienation from friends and family, pushing you further away from support networks and healthy coping mechanisms. That’s less true with psychedelics than with drugs like heroin or heavy alcohol use. However, hallucinogen use can still take the place of healthy coping mechanisms like exercise and eating well – resulting in reduced mental and physical health and worse coping mechanisms.

According to one study, almost 1 in 10 persons taking hallucinogens experienced major depressive episodes. However, the most significant factor contributing to those depressive episodes were significant trauma, typically before the age of 16. During the study, almost no one developed depressive episodes or suicidal ideation close enough to taking hallucinogens for the two to be linked. In fact, most people developed these episodes before taking hallucinogens with a smaller number of people developing them 3-5 years after starting hallucinogen use.

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Drugs and Alcohol Use Increase Risks of Suicide

man takings drugs with alcoholThat’s so much the case that drugs or alcohol were involved in 58.6% of all suicide deaths. Of those, alcohol is present in 22% – with severe intoxication being the number one most common factor between all people attempting suicide. That’s most likely linked to the fact that substance use and intoxication reduces inhibitions and decreases risk evaluation skills. This means people are more likely to be impulsive and less likely to be inhibited in their behavior. Therefore, if you go to drugs and alcohol while being depressed or suicidal, you’re more likely to go through with it while intoxicated. That lack of inhibition means that even a drug that doesn’t increase suicidal thoughts or behavior can increase the risk of suicide – because it means you’re less likely to weigh the negatives or to think through your decision. Drugs like hallucinogens also greatly reduce anxiety and ability to worry (although this depends on the specific drug) meaning that persons who take them score significantly lower on harm avoidance. This means that risk of suicide is higher while intoxicated, providing the individual was already experiencing suicidal ideation or depression.

Can Hallucinogens Decrease Risk of Suicide?

Multiple studies have shown that clinical hallucinogen use of either psylocibin or LSD can result in decreases in suicidal ideation in patients already showing suicide risk. However, it’s important to note that those studies are in a clinical setting with extremely controlled doses and reactions. For example, one study reviewing the efficacy of MDMA, psilocybin, and LSD in reducing suicidal thoughts and psychological distress found that MDMA and psilocybin reduced suicidal ideation by 0.01% to 10% over the course of the follow-up year. However, LSD increased risk of suicidal thoughts in that follow-up year. In addition, the study was not able to prove if results were because of hallucinogen usage or causal based on other lifestyle changes. Other studies show that LSD can also have a positive effect, although these studies are entirely clinical with controlled doses and settings.

Eventually, hallucinogens are like any other drug and should never be used to self-medicate. This means that it isn’t safe to use psychedelics of any kind to reduce suicidal ideation or depression, because you can’t guarantee what the outcome will be. Hallucinogens can increase risks of depression and psychosis in individuals, which can make your mental health problems worse. Therefore, you should never try to treat yourself with them outside of a clinical setting where you can get medical care, medical monitoring, and follow-up treatment if something goes wrong.

Hallucinogens have a reputation for increasing risk of suicide. However, that’s unlikely to be true. Instead, it’s more likely that people with a high risk of suicide are more likely to use drugs. In addition, drugs reduce inhibitions, which can increase risks of following through on suicide ideation. And, with more people now using hallucinogens to self-medicate, those risks are higher than ever. If you or a loved one is struggling with depression or thoughts of suicide, it’s important to seek out professional mental health help rather than attempting self-treatment.