More Information – Cannabis and Psychosis

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Credit to the TOX*4000 infographic group: Nekka Hislop, Jeneka Navaranjan, Rufaida Ansari, Ainsley Arreza, Catherine Groves

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An infographic with text saying "3 Cannabis Comparisons & Strains, Substances, Symptoms. ? , What is Cannabis? Cannabis is a psychoactive plant that contains over 500 different chemical components. The two main compounds that cause significant effects on marijuana users are Cannabidiol (CBD) and delta-9-tetrahydrocannabinol (THC). 1. Strains: There are two species of the cannabis plant that are commonly administered by humans: Cannabis Indica. This strain is a shorter plant with broad, dark green leaves. The cannabidiol content is higher in this strain. Cannabis Sativa. This strain is a taller plant with thinner, lighter green leaves. The THC content is higher in this strain. 2. Substances: The species of plant determines the concentration of CBD or THC. Cannabidiol: This component of cannabis has been known to oppose the effects of THC and diminish its psychoactivating effects. Strains with a higher concentration of CBD do not get you high and are preferred by users looking for a more medicinal purpose. Delta-9-cannabinol: THC is the chemical that gives the users the characteristic high of marijuana and is the main psychoactive component in cannabis. It contributes to the behavioral symptoms of cannabis administration and users look to this strain for more recreational purposes. 3. Symptoms: CBD and THC cause different and opposite side effects in users: Xerostomia [zeer-uh-stoh-mee-uh] Noun, Dryness of the mouth. Euphoria [yoo-fawr-ee-uh] Noun. An exaggerated feeling of happiness, confidence, and well-being. Antipsychotic [an-tee-sahy-kot-ik] Adjective. Treats to control psychotic symptoms such as hallucinations & delusions. Sedation [si-dey-shuhn] Noun. The calming of mental excitement. Anti-inflammatory [an-tee-in-flam-uh-tawr-ee] Adjective. Reduces swelling and pain. Conjunctival Suffusion [con-junc-ti-val-fyooz-shuhn] Adjective. Characterized by red eyes. Anxiolytic [ang-zee-uh-lit-ik] Adjective. Anxiety relieving. Appetite Stimulation [ap-i-tahyt stim-yuh-ley-shuhn] Adjective. Increase in desire for food or drink. Anti-epileptic [an-tee-ep-uh-lep-tik] Adjective. Treats epileptic symptoms. Impaired-short term memory Noun. Forgetting moments or events that occurred recently. Paranoia/ Delusions/ Conceptual disorganization/ Altering perceptions/ Feelings of Unreality. Sources. Atakan, Z. (2012). Cannabis, a complex plant: different compounds and different effects on
individuals. Therapeutic Advances in Psychopharmacology, 2(6), 241–254. doi: 10.1177/2045125312457586
Corroon, J., & Phillips, J. A. (2018). A Cross-Sectional Study of Cannabidiol Users. Cannabis and Cannabinoid
Research, 3(1), 152–161. doi: 10.1089/can.2018.0006
Cortes-Briones, J. A., Cahill, J. D., Skosnik, P. D., Mathalon, D. H., Williams, A., Sewell, R. A., … D’Souza, D. C.
(2015). The Psychosis-like Effects of Δ9-Tetrahydrocannabinol Are Associated With Increased Cortical Noise in
Healthy Humans. Biological Psychiatry, 78(11), 805–813. doi: 10.1016/j.biopsych.2015.03.023
Iffland, K., & Grotenhermen, F. (2017). An Update on Safety and Side Effects of Cannabidiol: A Review of
Clinical Data and Relevant Animal Studies. Cannabis and Cannabinoid Research, 2(1), 139–154. doi:
10.1089/can.2016.0034
Lafaye, G., Karila, L., Blecha, L., & Benyamina, A. (2017). Cannabis, cannabinoids, and health. Dialogues
Clin Neurosci, 19, 309–316.
Sharma, P., Murthy, P., & Bharath, M. M. S. (2012). Chemistry, Metabolism, and Toxicology of Cannabis: Clinical
Implications. Iran J Psychiatry, 7, 149–156.
Volkow, N. D., Baler, R. D., Compton, W. M., & Weiss, S. R. (2014). Adverse Health Effects of Marijuana Use. New
England Journal of Medicine, 370(23), 2219–2227. doi: 10.1056/nejmra1402309". Along with the text, there are decorative symbols.

An infographic saying "Cannabis-induced psychosis. Looking at the effects of cannabis in the brain and it's dose dependent relationship with the development of psychosis. Cannabis in the brain. Your brain produces a chemical that looks like marijuana to regulate mood, sleep and coordination and perception. In the brain, THC over activates the endo-cannabinoid system leading to addiction and behavioral changes. CB1 and CB2 are G-protein coupled, when a key enzyme is stopped in the brain, these receptors are activated stopping the release of some of the brain's chemicals, which help to regulate your mood and behaviour. THC binds to cannabinoid receptors (CB1 and CB2) to change your mood and behavior which can ultimately cause... Psychosis. Did you know? In developing countries, people with severe mental disorders are more likely to use and become dependant on cannabis. Chronic use. The symptoms presented in chronic users of cannabis. 61-69% of cannabis users experience irritability, anxiety, craving and disrupted sleep during abstinence. Psychotic symptoms from cannabis: Hallucinations, paranoia, delusions. People with pre-existing bipolar disease report higher rates of manic episodes. People with pre-existing schizophrenia report higher rates of psychotic episodes. Did you know? 30-50mg orally or 8-30mg smoked cannabis is all you need to experience mania-like psychosis. Level of cannabis use & psychosis. A dose-dependent relationship between cannabis use and psychosis. Have you ever used cannabis? If yes... There is a 2X increased risk for YOU to develop psychosis. AND... Heavy users of cannabis are at an even higher risk for developing psychosis! 4X increased risk. Shockingly, Studies show that cannabis use before the age of 18 lead to a 2X increased risk of developing psychosis compared to non-users of cannabis. But let's not forget... Frequency of Cannabis use Daily users have a 3x risk of being diagnosed with psychosis. Potency of the Cannabis Strain. Strains with high levels of THC experience more severe symptoms of psychosis. Good news... Psychosis and it's associated symptoms can be managed by: Reducing daily cannabis use OR stopping use of Cannabis. Sources: 1. Di Forti M, Marconi A, Carra E, Fraietta S, Trotta A, Bonomo M, Bianconi F, Gardner-Sood P, O'Connor J, Russo M, et al. Proportion of patients in south london with first-episode psychosis attributable to use of high
potency cannabis: A case-control study. Lancet Psychiatry 2015 Mar;2(3):233-8
2. Moore TH, Zammit S, Lingford-Hughes A, Barnes TR, Jones PB, Burke M, Lewis G. Cannabis use and risk of psychotic or affective mental health outcomes: A systematic review. Lancet 2007 07/28;370(1474-547;
9584):319-28.
3. Hall W, Degenhardt L. Cannabis use and the risk of developing a psychotic disorder. World Psychiatry 2008 Jun; 7(2), 68-71.
4. Oberbarnscheidt T, Miller NS (2016) Pharmacology of Marijuana. J Addict Res Ther S11:012. doi:10.4172/2155-6105.1000S11-012
5. Sharma, P., Murthy, P., & Bharath, M. M. (2012). Chemistry, metabolism, and toxicology of cannabis: clinical implications. Iranian journal of psychiatry, 7(4), 149–156
6.National Institute on Drug Abuse. (n.d.). How does marijuana produce its effects? Retrieved November 18, 2019, from https://www.drugabuse.gov/publications/research-reports/marijuana/how-does-marijuanaproduce-its-effects
7.The Facts. (n.d.). Retrieved from https://cannabisandpsychosis.ca/facts/

An infographic saying "Cannabis & Psychosis: the risks your teen might face. Does cannabis really cause psychosis? Maybe! What is psychosis? Psychosis is the loss of contact with reality, specifically, changes in thinking, believing, perceiving, and behaving. It is characterized by positive and negative symptoms. Positive symptoms are exaggerations & distortions of normal thinking, including hallucinations. Negative symptoms are the absence of normal thinking, including blank looks, monotone or monosyllabic speech and lack of interest. 80% experience negative symptoms, 30% diagnosed with psychosis. Cannabis may cause psychosis. Research suggests that cannabis use may have an association with the onset of psychosis. The psychosis symptoms are often caused by the component THC found in cannabis. Cannabis has been associated with more severe symptoms or worsened function, regardless of single use or continued use. Want to know some specific data on cannabis use and psychosis? In the first 3 years of cannabis use, there is a 46% association with the onset of psychosis. Cannabis use under the age of 15 is at the greatest risk of developing psychosis. One-time use is associated with 24% of the initial onset of psychotic symptoms. 46% association in 3 years. 24% association single use. Cannabis use: Cannabis use is a psychoactive drug with CBD & THC. Cannabis can be consumed via smoke, oils or by edibles. Individuals 28% primarily use cannabis via vaping. 34% primary cannabis use is through edibles. 94% smoking is the main method of use. Signs your teen is using Cannabis: Red bloodshot eyes, very tired, may be paranoid or anxious, may be excessively hungry. Source: NICE Clinical Guidelines (2014)
Canadian Centre on Substance Use and Addiction (2018)
National Alliance on Mental Illness (n.d.)

Does Cannabis really cause Psychosis? Learn more about your risk of developing psychosis. Risk Factors: Individuals with a family history of psychosis, schizophrenia, and bipolar disorder (BPD) can have an increased genetic vulnerability and should be wary of cannabis use (CU), (SHarma et al, 2012). How does cannabis use change your risk for psychosis? An individual can be genetically predisposed for or against psychosis. The onset of symptoms generally occur in one's early 20s. Early use or chronic CU may affect whether or not an individual will experience psychosis. CU may cause an individual with normal brain development to experience psychotic symptoms. CU may cause an individual with disrupted brain development to experience psychosis, but is not necessary. Stopping CU may improve outcomes of psychosis. (Burns et al. 2013). Relevant Stats: 24% if initial onset of psychotic symptoms may associated with high potency cannabis use (Di Forti et al. 2015;
Radhakrishnan et al. 2014). 18% of the general population over the age of 15 in Canada has used cannabis (Statistics Canada 2019). 2-10x the risk genetically predisposed individuals have of developing psychosis WITH cannabis use, compared to those with no family history of psychosis (Radhakrishnan et al. 2014). 5 years. This is the amount of time individuals who have had at least one episode of psychosis will spend smoking cannabis, compared to others (Di Forti et al. 2009). Sources. Burns, J. K. (2013). Pathways from Cannabis to Psychosis: A Review of the Evidence. Frontiers in Psychiatry, 4(October), 1–12. https://doi.org/10.3389/fpsyt.2013.00128
Di Forti, M., Marconi, A., Carra, E., Fraietta, S., Trotta, A., Bonomo, M., … Murray, R. M. (2015). Proportion of patients in south London with first-episode psychosis
attributable to use of high potency cannabis: A case-control study. The Lancet Psychiatry. https://doi.org/10.1016/S2215-0366(14)00117-5
Di Forti, M., Morgan, C., Dazzan, P., Pariante, C., Mondelli, V., Marques, T. R., … Murray, R. M. (2009). High-potency cannabis and the risk of psychosis. British Journal of
Psychiatry. https://doi.org/10.1192/bjp.bp.109.064220
Radhakrishnan, R., Wilkinson, S. T., & D’Souza, D. C. (2014). Gone to pot-a review of the association between cannabis and psychosis. Frontiers in Psychiatry.
https://doi.org/10.3389/fpsyt.2014.00054
Sharma, P., Murthy, P., & Bharath, M. M. S. (2012). Chemistry, metabolism, and toxicology of cannabis: Clinical implications. Iranian Journal of Psychiatry.
Statistics Canada. (2019). National Cannabis Survey, first quarter 201. The Daily, 2019, 32098. https://doi.org/https://www150.statcan.gc.ca/n1/en/dailyquotidien/190502/dq190502a-eng.pdf?st=odG3aEbr