Does Cannabis Cause Schizophrenia?

Is Cannabis for Everyone?

We note that the subject contained in this article represents illegal activity in certain jurisdictions. Whilst we do not condone any acts which are contrary to any such laws, we understand that readers in those jurisdictions which have decriminalised cannabis may find this article of interest.

There is no doubt that cannabis use has a realm of benefits if used correctly. With the introduction of the Farm Bill in 2018, the proverbial flood gates were opened for commercially produced hemp in the U.S and since then the stereotypes of cannabis have been broken down and replaced with a collective of products, strains, and medically assured prescriptions that boast the health benefits of cannabis; specifically casting a light on its cannabidiol (CBD) properties.

In Australia, although cannabis is not yet legal for personal use, medicinal marijuana is currently available in all states for epilepsy, anxiety and chronic pain treatment.

However, regardless of the overwhelmingly positive evidence on cannabis, there is a minority of the population that cannabis negatively affects.

With just under one percent of the general population being diagnosed with schizophrenia, regular and frequent use of cannabis has been proven to not only enhance the prevalence of its symptoms but also contradicts the effectiveness of antipsychotic drugs (APD's), increasing relapse and burden of care. The issue lies within the cannabis compound Tetrahydrocannabinol (THC) which has been linked to increased feelings of paranoia and how it reacts with our endocannabinoid system. This begs the question as to how cannabis could have such a significant impact on these disorders. To answer the question, however, we need to better understand how cannabis interacts with the body and mind.

The Endocannabinoid System

The Endocannabinoid system (ECS) is an internal system consisting of CB1 and CB2 receptors that help regulate homeostasis (which is just a fancy word for balance) in the body. Whenever the body is injured or impaired, homeostasis is thrown out and the ECS receptors assist with getting everything back on track. The ECS is responsible for regulating mood, sleeping patterns, appetite, and inflammatory symptoms. Subsequently, when we consume cannabis with THC, cannabis reacts with our endocannabinoid system, stimulates our CB1 and CB2 receptors and essentially dictates our movement, mood, sleep, and appetite.

It's important to reiterate that the effects of schizophrenia are dependent on the THC levels within marijuana due to its psychoactive properties. Here, we'll be focusing on how and why marijuana affects the symptoms of schizophrenia differently than those who do not have the disorder.

What Is Schizophrenia?

cannabis schizophrenia paranoia

Many stereotypes surround what schizophrenia is, what it looks like and how it's developed; in layman's terms, it's a neuro-cognitive disorder affecting one percent of the population. The disorder is brought on by a combination of factors that may include environmental, psychological and a genetic predisposition. Most commonly, schizophrenia is linked to a hereditary gene, meaning that if it runs in your family then you're more at risk of developing it yourself.

Both men and women can inherit it however, men are more likely to develop it earlier in life during adolescence and early adulthood (this is important to remember).

Symptoms of schizophrenia include "delusions, hallucinations, disorganised speech and behaviour and social dysfunction" and though schizophrenia cannot be cured, it's treated through a combination of cognitive and behavioural therapy with antipsychotic drugs (APD's).

How Do The Symptoms Occur?

The delusionary and paranoia-related symptoms of schizophrenia begin and end with the dopamine system. Whenever our body experiences gratification through eating, pleasure or mood, levels of dopamine are released, allowing us to feel good and satisfied. However, individuals with schizophrenia already have excessive levels of dopamine in their body which kicks their dopamine levels into over-drive, causing disruptions into how they think, feel and perceive meaning.

Because schizophrenia is a neuro-cognitive disorder, the gene that carries it also leaves discrepancies within the brain structure that disrupt the connectivity between different regions of the brain. These discrepancies are commonly associated with memory and emotional processing and react with the excessive dopamine levels to cause the symptoms.

What Does Cannabis Have To Do With It?

Research into the link between cannabis and schizophrenia has been ongoing for decades. There are several reasons why cannabis and schizophrenia aren't necessarily a good fit and the ties between the two have an extensive log of psychological research behind what exactly is going on.

cannabis schizophrenia paranoia

As we mentioned earlier, cannabis use has been linked to developing schizophrenia within vulnerable individuals.

One study found that the use of cannabis in adolescence (specifically ages sixteen and above) have a greater risk of developing the disorder if you already have a genetic vulnerability to it.

This means that if schizophrenia runs in your family then the risk of you inheriting the disorder is already heightened (by approximately eighty percent).

So, if you're already considered vulnerable to developing the disorder and you engage in regular cannabis use in your adolescence, then your chances of developing schizophrenia are heightened yet again. This is most likely due to the effect of cannabis on brain development at a crucial time of growth. Researchers have even gone as far as to declare that by avoiding cannabis, it may lead to an 8-13% decrease in schizophrenic cases. However, let's be clear on this – this statistic has not been substantiated.

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Why can't APD's and cannabis get along?

Without getting too technical, APD's react directly with the 'excessive neurotransmission' or the drastically high levels of dopamine that is responsible for the psychosis symptoms in schizophrenics. APD's bind and block the dopamine receptors and therefore decrease the dopamine levels and compress the symptoms of the disorder. Still with me? 

When cannabis is consumed or smoked, the THC also reacts with the dopamine system (remember this is responsible for pleasurable experiences and gratification). When an individual is on APD treatment, the THC triggers the signal for higher levels of dopamine to be released, ultimately, counteracting the effect of any APD's that are in the body's system.

When a person with normal levels of dopamine engages in cannabis use, the THC would signal the dopamine and endocannabinoid system through the dopamine, CB1 and CB2 receptors. These receptors will then release dopamine and stimulate our mood, sleep, and appetite. When THC reacts with over-stimulated receptors and the discrepancies in neural connectivity then it causes an imbalance in the body's reaction.

This results in the hallucinations, paranoia and disorganized speech that schizophrenic people experience.

How does THC induce feelings of paranoia?

Paranoia is a core experience in psychosis; however, feelings of paranoia can exist outside of mental illness as well. An individual can experience paranoia through a combination of life triggers and heightened emotion. When someone is experiencing paranoia, the perception of threat is heightened if an individual is experiencing stress, anxiety, or has a psychological vulnerability to be over-stimulated.

As mentioned before, when a person consumes cannabis, THC reacts with the receptors in the ECS and dopamine system and stimulates neural activity. If a person is prone to stress and anxiety then the THC will elicit a negative reaction – causing the experience of paranoia. One study linked THC to increased feelings of anxiety via the CB1 receptors in the amygdala (which is responsible for how we experience emotions) and was also accountable for feelings of depression and worry – which are also prominent in paranoia.

Of course, there are always exceptions to the rule; paranoia symptoms come from a collective of many different social, biological, psychological and environmental factors. If you're a chronic worrier however, then chances are THC may well enhance those feelings of worry and anxiety.

So, What Do We Know?

The effects of cannabis is an intricate and fascinating topic that displays a vast spectrum of positive and negative consequences on the human body and mind. There is no doubt that cannabis use can have a profound effect on health, lifestyle, and wellness. Unfortunately, the effects of cannabis can also harm around one percent of the general population and contradict the effectiveness of APD treatment.

Through a combination of genetics, physiology, psychological and environmental factors cannabis has been causally linked to having a detrimental effect on the dopamine and endocannabinoid system in schizophrenic individuals.

Regrettably, all of the positive reactions that we can experience from cannabis use has the opposite effect on schizophrenic individuals and those who are psychologically vulnerable to paranoia.

With that being said, these effects have more to do with the individual brain anomalies than it does with the plant itself.

Further research is being undertaken to investigate the ongoing relationship between cannabis and schizophrenia. Research is also currently being focused on the development of an APD that can positively interact with the ECS without causing an imbalance.

In the meantime, cannabis use and its properties, especially CBD are continuing to flourish around the world.

So, there you have it: cannabis may not be for everyone, but we're well on the way of discovering a way to ensure everyone who does use it, can do it safely and without harm.

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Taylor Ridewood
Taylor Ridewood

Taylor is a Sydney-based writer with a background in psychology and professional writing. She has a keen interest in the benefits of medicinal cannabis and enjoys researching the multi-faceted effects of cannabis on the body and mind.

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