Facts & Safety – Cannabis and Psychosis

CANNABIS USE: JUST THE FAQs

What is a good starting dose?

Currently, there is no established dosing guideline for vaping, smoking or ingesting cannabis. Dosing is highly dependent on one’s personal experience. Before using cannabis, it is important to know the short and long term effects.

Best practices?

Start low and go slow

Start with a low dose of Cannabis and reassess every few minutes. For Edibles, it can take up to an hour to feel the effects so pace yourself.

More CBD less THC

Find a low THC, high CBD cannabis strain and then ease your way into THC- dominant strains. The paranoid side effects that users experience are associated with THC. Unlike THC, CBD has more relaxing properties.

Can you get addicted to cannabis?

Yes, although the risk of addiction is less than other substances such as tobacco, opioids and alcohol.

It’s a natural plant so it can’t be harmful, right?

Natural does not mean safe. Research shows an increased risk of early-onset psychosis in adolescents.

What is greening out?

Greening out is the most common consequence of too much THC. It can also occur when mixed with other drugs and alcohol. Although the mechanism of THC toxicity isn’t fully known, some clinically observed symptoms include:

Paranoia
Anxiety
Confusion/disorientation
Rapid heart rate
Nausea
Vomiting

Typically, these symptoms are not fatal and do not result in permanent damage. However, individuals with a history of psychosis/cardiovascular illness should be cautious. Greening out can amplify psychiatric events or heart failure.

Is it safe to drive while high?

It is not safe or legal to drive while high. Drugs like cannabis affect your judgment and ability to drive. It increases your chances of being or causing a crash. Do not drive while high and do not get into a car with an impaired driver.

You have safer options:

Call a taxi
Call a friend or loved one
Rideshare
Use public transit
Stay over

“Your life can change in an instant. Don’t drive high”
A message from the Government of Canada.

More Safety information

Credit to the TOX*4000 white paper group: Michael Woods, Thomas Watt, Claire Vandeneynde, Sarah Rahimi, Priyanka Pirabakaran

To learn about some of the current regulations regarding cannabis consumption in the form of edibles, read the policy paper below prepared by fellow members of Dr. Khokar’s Medical Toxicology class.

White paper – Cannabis and Psychosis Download

There are many reputable resources available to further explore safety guidelines and recommendations. It is important to remember that everybody is different and individual tolerances and effects can vary. Use caution when consuming cannabis in any form.

canadas lower risk guidelines cannabis cover image — https://www.safecannabisuse.com/

An infographic saying "10 ways to Reduce Risks to Your Health When Using Cannabis. Cannabis and Health. Using cannabis is a personal choice, but it can have short- and long-term effects on your health. Cannabis can affect your thinking, physical co-ordination and control, and increase your risk of accidents, injuries, reproductive issues and mental health problems, including dependence. Smoking cannabis can increase your chances of having lung problems. Cannabis Use and Others. Remember that cannabis use can also harm those around you. Be considerate of other people's health and preferences if you choose to use cannabis. If Your Develop Problems. Some people who use cannabis develop problems and may become dependent. Don't hesitate to seek support if you think you need help controlling your cannabis use, if you experience withdrawal symptoms or if your use is affecting your work, school or social and family life. You can find help online, or through a doctor or other health professional. Endorsements. The LRCUG have been endorsed by the following organizations: Canadian Mental Health Association, Canadian Public Health Association, Canadian Medical Association, Council of Chief Medical Officers of Health, Mental Health Commission of Canada, Canadian Nurses Association, Canadian Society of Addictive Medicine, Canadian Centre of Substance Use and Addiction. Acknowledgement. The Lower-Risk Cannabis Use Guidelines (LRCUG) are an evidence-based intervention project by the Canadian Research Initiative in Substance Misuse (CRISM), funded by the Canadian Institutes of Health Research (CIHR). Canada's Lower-Risk Cannabis Use Guidelines (LRCUG). Revised 2018. Reference. Fischer, B., Russell, C., Sabioni, P., van den Brink, W., Le Foll, B., Hall, W., Rehm, J. & Room, R. (2017). Lower-Risk Cannabis Use Guidelines (LRCUG): An evidence based update. American Journal of Public Health, 107(8). DOI: 10, 2105/AJPH.2017.303818. Canadian Research Initiative in Substance Misuse.

An infographic saying "The following 10 Recommendations suggest ways to use cannabis more safely, based on the best available scientific evidence. 1. Remember that every form of cannabis poses risks to your health. The only way to completely avoid these risks is by choosing not to use cannabis. If you decide to use cannabis, follow these recommendations to lower risks to your health. 2. The earlier in your life you begin using cannabis, the higher your risk of serious health problems. Teenagers, particularly those younger than 16, should delay using cannabis for as long as possible. You'll lower your risk of cannabis-related health problems if you choose to start using cannabis later in life. 3. Higher strength or more powerful cannabis products are worse for your health. If you use products with high tetrahydrocannabinol (THC) content, the main mind-altering ingredient in cannabis, you're more likely to develop severe problems, such as dependence or mental health problems. Cannabidiol (CBD), another cannabis ingredient, can counteract some of THC's psychoactive effects. If you use, choose low-strength products, such as those with a lower THC content or a higher ratio of CBD to THC. 4. Don't use synthetic cannabis products. Compared with natural cannabis products, most synthetic cannabis products are stronger and more dangerous. K2 and Spice are some examples of synthetic cannabis products. Using these can lead to severe health problems, such as seizures, irregular heartbeat, hallucinations and in rare cases, death. 5. Smoking cannabis (for example, smoking a joint) is the most harmful way of using cannabis because it directly affects your lungs. There are safer, non-smoking options like vaping or taking edibles that are better for your lungs. Keep in mind that these alternatives aren't risk-free either. 6. If you choose to smoke cannabis, avoid inhaling deeply or holding your breath. These practices increase the amount of toxins absorbed by your lungs and the rest of your body, and can lead to lung problems. 7. The more frequently you use cannabis, the more likely you are to develop health problems, especially if you use on a daily or near-daily basis. Limiting your cannabis use to occasional use at most, such as only using once a week or on weekends, is a good way to reduce your health risks. Try to limit your use as much as possible. 8. Cannabis use impairs your ability to drive a car or operate other machinery. Don't engage in these activities after using cannabis, or while you still feel affected by cannabis in any way. These effects typically last at least six hours, but could be longer, depending on the person and the product used. Using cannabis and alcohol together further increases your impairment. Avoid this combination before driving or operating machinery. 9. Some people are more likely to develop problems from cannabis use. Specifically, people with a personal of family history of psychosis or substance use problems, and pregnant women should not use cannabis at all. 10. Avoid combining any of the risky behaviors described above. The more risks you take, the greater the chances of harming your health as a result of cannabis use. Please note: These recommendations are aimed mainly at non-medical cannabis use. — https://www.camh.ca/-/media/files/pdfs—reports-and-books—research/canadas-lower-risk-guidelines-cannabis-pdf.pdf