Cannabis and Schizophrenia: A Complex Connection

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The question “can cannabis cause schizophrenia?” is among the most hotly debated in mental health research. As legalization of cannabis continues globally, understanding this relationship is increasingly important for both healthcare providers and the public.

Statistical Association Between Cannabis Use and Schizophrenia

Regular cannabis users, especially those who started using it in adolescence, have nearly twice the chance of developing psychotic-type disorders compared to those who do not use it. However, this association alone does not demonstrate causation, and researchers study associations and the various factors that may underlie these relationships.

Vulnerability at Critical Periods of Brain Development

The vulnerability is especially strong during critical periods of brain development. Adolescent brains are particularly sensitive to the effects of cannabis on the brain,as the neural pathways continue to mature until the mid-twenties. Cannabis use is likely affecting the normal neurodevelopment of the brain and causing psychotic symptoms in those who are genetically prone to psychotic disorders. The endogenous cannabinoid system has important roles in brain development; the exogenous cannabinoids from marijuana will alter the natural activity of this endogenous system.

Сannabis schizophrenia: Meta-Analysis on Cannabis Use and Psychosis Risk

A significant body of work was published in 2019 that summarized results from 36 studies with over 66,000 subjects. This meta-analysis concluded that while there is an increased risk of psychosis related to cannabis use, the absolute risk is low. Notably, this meta-analysis indicated people who use high-potency cannabis products with a high amount of THC have greater risks than those who use lower-potency products.

The Role of THC among Risk Factors

Modern cannabis products have THC amounts 15-25%, compared to only a few percent in the past. High-THC products cause a greater psychoactive effect and are more strongly associated with psychotic symptoms. CBD, another major cannabinoid in cannabis and, unlike THC, is not an intoxicating substance, may offer some protection against psychosis; this might explain some of the different risks related to the range of THC-CBD balanced products.

Cannabis Use as a Trigger or Accelerator of Schizophrenia

Cannabis use may precipitate schizophrenia in people who are genetically vulnerable and might eventually have developed the disorder in a matter of time. Alternatively, cannabis use might simply induce symptoms more quickly or accelerate the timing of developing the condition or increase its severity in a vulnerable person.

Exploring Cannabis for Schizophrenia Treatment

Ironically, some researchers are exploring cannabis as a treatment for schizophrenia, particularly because of the potential therapeutic benefits of CBD with respect to psychosis. CBD has shown antipsychotic properties in laboratory studies and is shown to help with particular symptoms in some people living with schizophrenia.

Can cause schizophrenia: Individual Factors

Current evidence suggests cannabis use increases the risk of schizophrenia-related psychosis in vulnerable populations, but this likely occurs in a dose-dependent manner and is age-sensitive. Specifically, cannabis use is most perilous for adolescent users when compared to all other users. Cannabis use alone is rarely enough to result in an individual with a genetic or environmental risk factor developing schizophrenia.

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