Marijuana and Schizophrenia: Does Weed Help or Hurt?

In recent years, scientific evidence has linked marijuana with several health benefits, ranging from mitigating chronic pain to treating PTSD. However, cannabis is not a panacea, and in the case of some mental health conditions, such as schizophrenia, it can make symptoms worse.

While the extent of these worsening symptoms is difficult to determine, experts recommend that those with schizophrenia should avoid using marijuana, instead opting for pure or high-CBD products.

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What Is Schizophrenia?

Schizophrenia is a rare, chronic mental disorder that affects less than 1% of people in the United States. There is no known cause, though studies suggest a mix of genetic, environmental, physical, and psychological factors combine to make a person more likely to develop the condition. Schizophrenia tends to run in families, but identifying specific genes and genetic mutations that cause schizophrenia has proven elusive. Some hypothesize that dopamine, serotonin, glutamate, GABA, and acetylcholine alterations are involved in the pathology of schizophrenia.

A diagnosis occurs after two of the following schizophrenia symptoms persist for more than six or more months, including:

• Trouble thinking
• Lack of motivation
• Delusions
• Hallucinations
• Disorganized speaking, behavior, or thoughts

There is no cure for schizophrenia, but research has produced safe and innovative treatments to improve the likelihood of psychotic symptoms. Recent studies have unearthed some insights into the origins of the disease by examining genetics, brain imaging techniques, and behavioral studies.

Due to the disease’s complexity, many people misunderstand aspects of schizophrenia. Studies have shown that it occurs equally in both men and women but often has an earlier onset in males. Additionally, people with this condition do not have multiple personalities and are no more dangerous than the average person.

Is Schizophrenia a Qualifying Condition for Medical Marijuana?

Existing evidence points to marijuana as a causal factor in developing schizophrenia in those susceptible to the condition. A systematic review of several studies found several records of marijuana — specifically THC — exacerbated negative symptoms of the disease, while others reported that it sped up the age of onset. The discussion describes the onset of schizophrenia as on a spectrum, where cannabis use disorder’s paranoia eventually leads to more psychotic episodes of full-blown schizophrenia.

Science still lacks evidence about the exact mechanics of the relationship, but theories about genetics have emerged. Research shows that people with specific variants for different genes related to dopamine signaling or degradation are at an increased risk of developing psychotic symptoms. These individuals had a seven times higher risk for psychosis if they regularly used cannabis than those who did not.

Because of the causal link and impact on symptoms, schizophrenia is not listed as a qualifying condition for medical marijuana in any legalized state, nor is it recommended for those with a diagnosis.

Potential Benefits and Risks of Using Cannabis If You Have Schizophrenia

Potential Benefits

Interestingly, other studies have found that the ratio of THC to CBD is important in how marijuana impacts those at risk of a mental health disorder. It appears that high-CBD strains may have more therapeutic effects for those with schizophrenia and may even help treat the early phases of the disorder. This may be related to how CBD works on the body’s endocannabinoid system. It acts as an antagonist and blocks the CB1 receptors, whereas THC acts on these receptors. Some of the most common antipsychotic medications, such as dopamine receptor antagonists, work similarly. Those treated with CBD as an antipsychotic found fewer side effects than common prescriptions.

Though cannabis overall, and specifically THC, is not recommended for schizophrenic patients, it’s interesting to note CBD, other cannabinoids, and terpenes separated from the compound may produce more positive symptoms. However, much more research is needed in this vein.

Theoretically, low doses of tetrahydrocannabivarin (THCV) may be useful for managing conditions where psychosis may be an issue, as it acts through serotonin receptors to produce antipsychotic effects. However, more research is needed to determine dosing and what proportions of the population prone to psychosis it may help or hinder.

Potential Risks

People with psychotic illnesses like schizophrenia should avoid cannabis, as it can trigger cannabis use disorder and worsen their condition’s symptoms. Those using cannabis at a younger age carry a higher risk factor of developing mental health problems later in life. If you have a family history of mental disorders, the likelihood of cannabis use causing schizophrenia or bipolar disorder increases.

What to Do If You Have Schizophrenia and Need to Use Marijuana

First and foremost, medical marijuana can worsen symptoms of schizophrenia and lead to disease onset for those at increased risk. However, cannabis has many positive benefits and fewer side effects than other antipsychotic drugs, so there may be some reason to explore cannabis for these particular health conditions.

If you need to use marijuana, focus on pure or high-CBD strains or products, avoiding THC as much as possible. As mentioned above, they act on the endocannabinoid system differently than THC while offering various medical benefits. CBD’s anti-anxiety, inflammation-reducing effects may relax more negative symptoms and allow patients to resume normal function.

Other terpenes and cannabinoids may have additional therapeutic benefits, though research is sorely lacking in this field. It’s essential to speak to your physician about your specific mental health condition and understand how the cannabis plant may best address your needs.

The Bottom Line

In short, marijuana use is best avoided if you or a loved one has schizophrenia. Consuming marijuana can worsen the adverse effects of psychotic disorders and cause earlier onset in young people. If you have schizophrenia and want to explore cannabis, focus on CBD or alternative terpene options and avoid consuming cannabis products with THC.

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