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Marijuana Paranoia: What It Is and Why It Happens

Marijuana-induced paranoia unleashes feelings of fear and anxiety, sometimes accompanied by delusions and unpleasant dreams. Not everyone will experience feelings of paranoia after cannabis use, but it is a troubling side effect for some people, especially those new to cannabis.

Learn more about why marijuana can make you feel paranoid, what you can do to prevent it, and how you can feel better if you’re experiencing it.

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What Is Marijuana Paranoia?

The irony of being on the receiving end of a medical marijuana anxiety attack is that many medical marijuana cardholders primarily use cannabis for anxiety relief. Marijuana-induced anxiety and the soothing effects medical cannabis can have on anxiety are both results of activating the human endocannabinoid system (ECS).

The endocannabinoid system is a network of cannabinoid receptors arranged throughout the human body. When activated, the ECS triggers physiological processes involving appetite, pain sensation, mood, and memory.

The two dominant psychoactive molecules in medical cannabis products, THC and CBD, both influence the CB1 receptors of the endocannabinoid system in different ways. CB1 receptors in the brain, according to a detailed breakdown of the cannabis-anxiety connection in the Spring 2020 issue of CRx Magazine, are involved in modulating cognition, mood functions, emotional processing, and anxiety regulation.

CRx author Bonnie Johnson, director of science at Goodfeeding, addresses the question, “Does medical marijuana increase or decrease anxiety?” Johnson arrives at an answer of “yes” to both increase and decrease.

The crux of the marijuana and anxiety balance hinges on the degree of stimulation the brain’s CB1 receptors receive:

  • Mild signaling from THC molecules that have attached to CB1 receptors induces anxiolytic-like (anxiety-reducing) effects.
  • A jarring signaling from a higher concentration of THC molecules attaching to the CB1 receptors induces anxiogenic (anxiety-amplifying) effects.


  • Low doses of THC are more likely to reduce anxiety.
  • High doses of THC are more likely to amplify anxiety.

CBD does not bind to CB1 receptors in the way THC does. Rather, CBD modulates CB1 receptors, making them less receptive to THC and anandamide. This is why CBD blunts THC’s psychoactivity — it sits in the CB1 receptor’s metaphorical pocket and sends a signal to zip up the rest of the jacket. CBD, in a way, competes with THC at CB1 receptor sites. CBD also reduces anxiety in a similar manner to antidepressants: modulation of serotonin receptors, which regulates mood.

CBD is generally more well-tolerated than THC, but that doesn’t mean you don’t need to pay attention to dosage. Lower doses of CBD (e.g., 5 mg to 10 mg) can have energizing effects, whereas higher doses (50 mg+) can have sedative effects. You will also need to keep an eye on CBD dosage if you are using it to replace sedatives like clobazam (Frisum, Urbanol) or alprazolam (Xanax), as you will have to reduce sedative use as you increase your CBD dosage in order to reduce negative side-effects (e.g., over-sedation, overdose).

CRx Magazine’s scientific explanation of whether your endocannabinoid system will dole out emotional calm or lash you with psychic chaos when you swarm its CB1 receptors with THC proves the wisdom of an age-old adage to cannabis newcomers: Go low and slow.


The biggest cause of marijuana paranoia is improper dosing. People who are inexperienced with cannabis may consume THC-heavy edibles in a short span of time and consequently experience unpleasant side effects.

Some other causes of marijuana paranoia and anxiety include:

  • Body weight — People with lower body mass indexes (BMIs) may feel the effects of marijuana more strongly.
  • History of anxiety and mood disorders.
  • Highly energizing strains often miscategorized as sativas — Varieties with lots of tetrahydrocannabivarin (THCV), cannabigerol (CBG), and limonene may be more likely to have an energizing effect.

Consult with your doctor before consuming marijuana, especially if you have a history of anxiety or other mood or psychiatric disorders.

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What To Do When You Feel Paranoid

“The best thing to do if it gets too intense,” doctor of nursing practice James Lathrop at Seattle’s Cannabis City dispensary tells Lifehacker, “is to lay down, and hopefully to lay down in a familiar situation.”

Holistic doctor of cannabis medicine Joe Cohen, who runs Holos Health in Denver, Colorado, offers another cannabis life hack: “The best reversal for the unpleasant side effects of too much THC is CBD.”

Cohen admits that taking CBD doesn’t always work for everyone grappling with too much THC. Taking a shower, however, is often effective in restoring a sense of physical comfort and orderly reality. Eating a sandwich, a piece of fruit, or other snacks is also known to level and slow the endocannabinoid tilt-a-whirl.

Try to keep in mind that the body processes THC quite readily, so you can’t overdose on cannabis alone. Most people who take huge doses of cannabis usually only feel the negative effects for a few hours or so and are often feeling better within the day, if not sooner.

Additional Tips for Handling Paranoia

  • Put yourself in an environment where you’re comfortable and at ease, and remember that it’ll all be over soon.
  • Play some soothing or enjoyable music.
  • A mug of hot herbal tea, such as chamomile, can have sedative effects that may help you feel more relaxed and at ease.
  • Black peppercorns contain the terpene-cannabinoid beta-caryophyllene. Beta-caryophyllene has anti-anxiety and painkilling effects and may also help refresh or awaken one’s senses when stuck in a paranoid or anxiety-induced thought loop.
  • Terpenes like pinene can also mitigate some of the negative effects high doses of THC may have, especially on short-term memory.
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How to Prevent Marijuana Paranoia

Everything you need to know about cannabis and anxiety starts with one fundamental fact: Newcomers to therapeutic marijuana who move too fast into high doses of cannabis products that contain high concentrations of THC put themselves at risk of a nasty panic attack.

The number one rule for avoiding a medical marijuana freakout is to not take more medical marijuana than your endocannabinoid system can handle. You may increase your tolerance to THC as you gain more exposure to different types of cannabis and cannabis products.

However, your aim shouldn’t necessarily be to take increasing levels of THC (which would be inefficient) but to get to the dosage of THC — and other cannabinoids and terpenes — that is best for you.

Some people may require more THC for their condition. Others will require less. Also, it is worth acknowledging that, even if you are an experienced cannabis vape user or smoker, your tolerance doesn’t always translate to other ingestion methods.

Particular care needs to be taken when ingesting medical cannabis edible products, which can have a much stronger effect even at lower doses of THC. This is because THC is turned into the more powerful 11-OH-THC in the liver.

Prior to ingesting marijuana edibles, consult your physician to determine the optimum, safe dose to address your health issue while maintaining your mood functions, emotional processing, and anxiety regulation.

Do not exceed your doctor’s recommended upper limit of THC concentration. If the cannabis edible seems to be doing nothing, just relax and wait. The therapeutic effects of medical cannabis on chronic conditions can be so subtle that the relief may not even be easily attributable to the medical cannabis product.

A common and avoidable mistake is succumbing to the notion that a cannabis edible has no effect and that eating another one immediately is what you need to do to make the marijuana medicine work.

Use medical marijuana responsibly with your own MMJ card. Leafwell’s physicians are available to meet with you online and help you start an application for a medical marijuana card in your home state.

Extra Paranoia-Preventing Advice

  • Start by microdosing THC — don’t go overboard with an unnecessarily high dose.
  • Be particularly careful with edibles because THC is more potent when eaten.
  • Utilize strains and products high in CBD to curb some of the discomforts of too much THC.
  • CBG, beta-caryophyllene, and pinene all have stress-busting properties and can help mitigate some of the effects of THC.
  • Cannabinol (CBN) can be useful if you’re seeking a sedative effect with less of the psychoactivity of THC.
  • When trying a new product, do so in a comfortable environment and test it out to see what sort of effect it has on you.

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Originally Published: February 2022

Last Updated: March 2024

Frequently Asked Questions

What does paranoia caused by marijuana use feel like?

You may experience delusional thinking, increased heart rate and intense feelings of anxiety during an episode of marijuana paranoia. People with conditions like schizophrenia may experience particularly severe paranoia and hallucinations, which is one of many reasons why marijuana is best consumed based on your doctor’s recommendation.

Which strain of weed makes you more paranoid?

Everyone responds to marijuana strains differently, but some people report that Jack the Ripper, Sour Diesel, Trainwreck, and other CBG- and THCV-rich cultivars trigger paranoia.

How can I reduce paranoia when I smoke weed?

Choose strains lower in THC, THCV and CBG, and higher in CBD, cannabichromene (CBC) and terpenes like myrcene & linalool.  Ingest slowly and refrain from purchasing the most potent cannabis product in the dispensary. Take a look at THCV, CBG and limonene content, and avoid these varieties if there are high concentrations of these cannabinoids & terpenes. Other things that will help include:
  • Drinking plenty of water
  • Consuming cannabis in a place that feels safe to you.
  • Utilizing cannabis products with a wide and balanced cannabinoid & terpene profile.
  • Having some healthy snacks close to hand.
  • Having something else to focus on. E.g. music, art, reading or watching a film.

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