Psychotically Sheltered

Psychotic Indian man wearing glasses sticking tongue out

Three Blunts Later

Many psychotic patients have lost everything or never had much to begin with. Their home is the shelter or a psychiatric supportive house where they spend their days doing whatever they want. Many don’t have any requirements; they can sleep all day, create music, go to work . . . it’s up to them. Many continue to abuse drugs on the streets: popular ones in New York City are crack, cocaine and heroin; don’t count out marijuana.

But this is the problem with these shelters: they don’t drug test and even if they did, would they just kick out psychotic residents? They would all just turn homeless and nothing productive would be accomplished. So they continue to abuse drugs and take advantage of the free room and board. The problem with psychotic patients is that drugs impair their judgment and insight.

In the moment while they’re getting high, they’ll report to you that they feel better and that their symptoms have calmed down, depending on which drug they are using. If it’s crack or meth, their symptoms tend to get worse: they become paranoid, start hearing voices commanding them to commit violent acts and may even start experiencing visual hallucinations.

If it’s marijuana, many psychotic patients will report that the weed relaxes them and clears their mind. It may very well do that, but marijuana is prone to cause and worsen psychosis, especially the highly potent strains going around these days. Three blunts later and many of these patients start hallucinating, experiencing disorganized thoughts and behavior and freaking out.

Keep in mind that many psychotic patients are noncompliant with medications because they believe that they don’t have a mental illness. Add three blunts a day on top of poor insight and it turns into a recipe for a mental health disaster. It’s not usually the patient that brings himself into the hospital; it’s the residents or staff at the shelter that escalate the process due to their disruptive and dysregulated behavior.

There is no psychotic patient or mental health patient who I have met that benefited from drug use, including marijuana. They may tell me that they like weed and it calms them down, but then why are they in the hospital in the first place? What’s surprising is that many schizophrenic patients inform me that they’ll probably go back to using marijuana despite being hospitalized.

This is how powerful drugs are and we must continue to spread awareness for drug addiction and advocate for more resources devoted to the treatment and healing of drug addicts. But first we must continue to call on all the drug addicts to come out of the shadows and provide them with a safe and supportive environment and this platform is known as The DSM Ready Community.

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Weedhead Gone Psychotic

Young man with tattoo on neck smoking marijuana joint

When Weed Plants Psychotic Seeds

It’s just weed! It doesn’t harm you and it’s better than alcohol! Alcohol gets you into fights and makes you do stupid things. Weed just makes you sit on the couch and watch Harold and Kumar! What people usually think about weed right? It’s time to snap out of this mentality because weed can cause psychosis in many users, especially those who are genetically vulnerable or those who smoke a ton. Marijuana enjoys planting seeds within your mind. Oftentimes, these seeds won’t sprout, but when they do, they can turn into psychosis.

The thing about marijuana is that the THC potency is much greater than it was 10-20 years ago. Growers are interbreeding various types of marijuana plants such as indicas and sativas, resulting in more potent strains. As with any drug, a user gains confidence based on his or her past tolerance, ending up smoking more of the drug until an unexpected adverse reaction develops.

In the case of cannabis, this adverse mental reaction is oftentimes paranoia or psychosis. The problem is that you can’t just turn off a paranoid or psychotic state of mind once it kicks in; the high has to dissipate before the paranoia subsides. If the paranoia kicks in within the first 15 minutes, the user has another 45-60 minutes to go before the marijuana calls it quits on his or her mental journey.

With psychosis however, this state can last even 1-2 weeks after the marijuana high is gone. It just depends on the person and how psychotic he or she has become during the high. For instance, imagine eating an edible at 7 pm and then experiencing no high by 7:45 pm. Many users who are inexperienced will indulge in a second edible, thinking that a second dose will do the trick.

By 8: 15 pm, the high from the first edible will start to kick in. The user will think, “I knew I just needed two doses!” But around 8:40 pm, the second edible will also start to kick in and the high will intensify during the whole night. At this point, a user is very vulnerable to becoming psychotic if they have ingested a very large dose of THC.

Depending on their state of mind, the psychosis may intensify during the night, causing their mind to fall deeper down the rabbit hole, sometimes to the point of no return. Now that is something scary to think about! In the field of psychiatry, we see many people who become psychotic from marijuana.

Please stop thinking that this drug is innocent; comparing it to alcohol does not make you sound any smarter! Every drug has its pitfalls. Period.

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Cannabis Holiday

Clear jar of marijuana buds on table next to pencil and notebooks

The World Celebrates 4/20

April 20th marks the international cannabis celebration day where people all over the world light up to appreciate the substance known as marijuana. 4/20 is based on the the story of five California high school students who would meet at 4:20 pm to consume marijuana back in 1971. Ever since then, 4/20 has been code for “smoking weed” in the cannabis culture. Marijuana is unique because no other drug involves such a worldwide appreciation for everything related to a substance.

I guess if you consider St. Patty’s day a worldwide appreciation for alcohol, but it’s still not the same as marijuana. Marijuana is unique because it’s just starting to become legalized. Part of the allure with marijuana has been its consumption while still classified as a schedule I drug under U.S. federal law. This makes smoking the drug and partaking in activities surrounding it much more exciting and stimulating than alcohol.

What also makes marijuana exciting is that the celebration of 4/20 is unique because people are cheering for its liberation; they want to be able to be in that intoxicated state of mind without worrying about “the cops” busting them. Marijuana is known for providing a very relaxing high that is not often associated with violence or indecent behavior; people want to prove a point on 4/20 that marijuana should be legalized and consumed in peace.

While there are many consequences to getting involved with marijuana as a teenager and even as an adult, that’s not the point of 4/20. This holiday is more about appreciating the substance and the culture surrounding it. Marijuana is associated with humor and fun activities because the high makes the user interpret many ordinary events as funny; hence, why many who smoke it end up giggling and laughing out loud.

There are many positive things related to marijuana:

  • It makes spending time with friends fun and enjoyable
  • It makes activities more fun and enjoyable
  • It enhances the senses making food taste better, music sound better and sexual activities feel better
  • It increases introspection, allowing you to go deeper within yourself
  • It enhances sleep and appetite
  • It makes you think outside the box and appreciate newfound knowledge

. . . and the list goes on. I am not here to promote the use of marijuana as I know very well that there are many potential mental adverse effects, but I do appreciate the positives associated with it, such as the points provided in the list above as well as the culture associated with marijuana. Every person is different regarding their relationship with substances and each individual should come up with their own conclusion as to whether they should indulge.

What are your thoughts on marijuana and 4/20?

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Mind Stolen By Marijuana

Teenage boy wearing black hoodie smoking marijuana joint

Marijuana Turned Me Into A Schizophrenic

In the field of psychiatry, you see it all when it comes to mental illness and the various factors that contribute to it. Marijuana affecting mental health should be no surprise, despite the media not really talking much about it. Why is that? Because there’s an agenda to legalize it. I am not against legalization but it’s important that humanity is educated on the influence of marijuana on mental health.

Many teens and young adults have experienced their mind stolen by marijuana. What does this mean? Some of the stories you’ll hear is that they started smoking weed in high school and fell in love with it; their usage escalated beyond smoking joints on social occasions to smoking bowls multiple times a day by themselves at home.

Some of these patients identified as being introverted in high school to begin with. They are not afraid to admit that once they started using marijuana, they became more introverted, spending more time by themselves in isolation, lost in the internal world that marijuana dug out for them.

At some point in time, whether under the influence or not, they slowly began to feel different in regards to the way they thought and interpreted the world. Their families would clearly notice a change in behavior, eventually calling EMS to take them to the emergency room. Not all patients can pinpoint the details of the changes brought upon by marijuana.

But some of the changes noticed by family and friends is amotivation, apathy, odd beliefs, self-isolation and even responding to internal stimuli. What once was a fairly normal kid attending science class was now a socially awkward, disheveled kid who struggled to express himself; it’s very sad!

It’s not known whether the high concentration of THC in modern strains of marijuana causes schizophrenia or just helps accelerate it in predisposed individuals with a family history and genetic loading. Even if a user doesn’t become schizophrenic, transient psychosis is quite common with modern day strains; people either consume an edible or smoke too much and cannot handle the high for those 2-3 hours, eventually losing their mind in the process.

Some return back to reality after they come back down from the high and after receiving a dose of an antipsychotic, while some have permanently become schizophrenic. For those who have become schizophrenic, their lives have now entirely changed just because they chose to consume marijuana. It’s very important to find out if you have a family history of mental illness before you try marijuana.

As a psychiatrist, I want my patients to be as physically and mentally healthy as possible and this involves no consumption of marijuana or other drugs. Even drinking is dangerous and should be done in moderation! At the end of the day, education is important and remember that just because you’re witnessing legalization of marijuana in a lot of states and around the world, does not mean that it can’t harm your mental health!

If you enjoyed this article, please share it with your family and friends!

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The Gateway Drug

Person passing marijuana joint to another person's hand near outdoor trees

From Marijuana To Other Drugs

When people hear marijuana being the gateway drug, they are quick to become offended and dismiss the saying right away. But what they fail to admit is how marijuana increases one’s curiosity to either get higher or try a new substance that will provide a new effect. The gateway theory is not as farfetched as many would like you to believe.

Marijuana does an amazing job at enhancing your senses, making you think outside the box and helping you escape reality. Your perception while high is significantly altered: movies become more interesting, Netflix becomes your best friend, iTunes glows louder than ever before, hooking up feels better than ever before, etc.

Guess what happens when one starts coming down from a high, especially after having a good time? They want to get right back up. And that’s what they often do. The reinforcer is all the pleasurable activities that are enhanced by marijuana itself. But many eventually give up on marijuana, and not for a good reason.

They give up on it because they have lost their taste buds for the substance. They want something more potent that will take them to Pluto instead of Saturn (even though Saturn might be more safe and fun). And so that’s when marijuana users become influenced by others around them, “Hey man, have you ever tripped on acid before?”

In general, the use of marijuana can lead to an interest in recreational psychedelic use. Because high doses of marijuana itself can be a little trippy, it’s not unusual for many users to be attracted by the allure of tripping on magic mushrooms (psilocybin), LSD or even DMT.

But tripping is not done very often; nobody dedicates every weekend to using hallucinogens. So now the user scratches his or her head and thinks of a new drug to try. That’s when they become influenced by others around them again, “Hey man, there’s a party this weekend. Have you ever tried coke?”

In conclusion, that is what is meant by the gateway drug. People might wrongfully believe that “one hit of marijuana means hit one of something else”, but that’s incorrect. The gateway theory is based on the idea that regular use of marijuana can slowly spark one’s curiosity to alter his or her mind with a more powerful substance, or a substance that provides a different effect in general; not necessarily a stronger high.

That’s the gateway theory.

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Marijuana For Anxiety

Person holding marijuana joint in front of tree and body of water

Can Marijuana Help With Anxiety?

Marijuana is an interesting drug due to its intoxicating effect on the human mind. Many people swear by the fact that marijuana alleviates their anxiety by relaxing and calming them down. But others would argue otherwise, claiming that marijuana exacerbates their anxiety to the point of inducing panic-like symptoms.

But without randomized-controlled trials, we cannot assume that marijuana is efficacious for anxiety disorders. But that does not mean that we should discount the many user reports circulating around about marijuana’s positive effect on anxiety. If marijuana does alleviate anxiety, how does it do that?

We know that THC, the intoxicating chemical found in marijuana, binds to CB1 receptors in the brain and CB2 receptors in the periphery. We also know that there are two strains of marijuana: indica which produces more of a body high and sativa which produces more of a head high.

Which strain alleviates anxiety more depends on the user. Many would attest that indica highs do a better job at alleviating anxiety, because the high is more directed towards the body. This results in a lesser head high and potentially less anxious symptoms. On the other hand, sativa may exacerbate anxiety in users because it mainly provides a head high.

What is a typical user experience on marijuana that leads to less anxiety? If you’re feeling on edge, worried and anxious, within the first 5 minutes of inhaling marijuana, the user will feel their state of consciousness slowly being altered. The feeling is a sense of mental relaxation with the perception of slowed time.

The user also becomes more aware of their bodily sensations and their surroundings; everything becomes more alive and interesting to the senses. Because of this, it may take away the user’s focus on their anxiety symptoms; their attention becomes redirected to other activities which become more interesting, such as music and movies.

But what about a user’s experience with marijuana exacerbating anxiety? The anxious symptoms can escalate within a few minutes of inhaling or later on in the journey. The anxious symptoms can be quite severe, to the point of inducing a panic state or the thought of “losing one’s mind.”

An example of anxiety while on marijuana may include something of this sort: you’re standing in your kitchen high and eating a delicious delicacy. Your taste buds are on fire while you slowly allow your masticatory muscles to chew away your small piece of heaven. But all of a sudden, out of no where, your perception of you standing in place and eating becomes magnified and blown out of proportion!

There is way too much unnecessary focus by your mind on your current situation: your posture, your chewing, your bodily sensations such as your heart rate and breathing, and your thoughts. The next thing you know, you’re starting to experience anxious thoughts: “oh my god, I’m freaking out! I feel uncomfortable. Something bad is going to happen! I wish I could end this high!”

And that’s how one potentially experiences a panic attack while under the influence of marijuana. Therefore, we do not yet know if marijuana is a good medicine for anxiety. For some people it works wonders, while for others, it wreaks havoc! Until we have conclusive RCT results, we can only go by user reports.

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Planet Covered In Marijuana

Field of tall green marijuana plants during daytime

Recreational Marijuana For Relaxation

The debate continues as to whether marijuana is a good tool for relaxation. As a whole, it seems like were driven by a motor running on coffee, stimulated by nicotine when stepping out for a breath of fresh air, and turned on by alcohol when in the company of others. But does marijuana play a role in our lives as well?

Not everything that grows naturally is good for the human body and brain. Cocaine comes from the coca plant, yet people become addicted, develop nasal perforations, stroke out and even die of cardiac vasoconstriction. Tobacco comes from a plant and is the most addicting substance known to man!

And here comes in marijuana . . . a plant that provides beautiful flowers that humans can ingest and feel relaxed as well as high. The question is whether marijuana can be safely used by the masses for relaxation purposes, without bringing in all of the baggage that alcohol and tobacco have brought in.

Marijuana is not simply a pretty plant that smells great and provides sticky fat buds to roll up with. Along with the beauty comes the hidden dangers: the increased risk of developing psychosis; a lack of motivation; dullness of the mind; anxiety; social isolation and even violence in some!

But we have been trained by NORML and other organizations to believe that marijuana does not cause violence. If you are in the mental health field, you know very well that psychosis and violence go together like peanut butter and jelly! How do we know who is predisposed to developing schizophrenia before they take that first hit of Banana Kush?

On the other hand, marijuana and relaxation go together like milk and cereal: your body melts into the couch; your mind absorbs your iTunes; your eyes relax upon something beautiful; the touch of another human being feels silky smooth; your creativity sparks up a notch or two and sleep pulls you in like a black hole.

It’s important to keep in mind that this extreme relaxation that is provided by marijuana can be easily abused; after all, it is a drug. It can be abused because one may find less temptation to relax naturally, especially after experiencing the amazing effects that marijuana has on the mind. But marijuana should never be a replacement for natural happiness.

As governments around the world legalize the green skunk, we have to remind ourselves that it’s still our responsibility to use this tool appropriately, responsibly and maturely. The governments always have their own agenda and so we can not always rely on them.

The planet is covered in marijuana. Are you?

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The Health Benefits Of Cannabidiol

Cannabidiol from cannabis sativa plant

Will CBD Be The Next Wonder Drug?

Cannabidiol (CBD) is a non-psychoactive chemical compound found in marijuana; meaning, that it does not get you high. As more research is being done on the chemical compounds found in marijuana, CBD is gaining a lot of attention from the medical community for its potential to treat many conditions.

  • It can help reduce pain (The human body contains an endocannabinoid system which regulates pain, appetite, sleep and the immune system. Neurotransmitters bind to endocannabinoid receptors in the nervous system. It has been shown in research studies that CBD can reduce sciatic nerve pain and inflammation, pain secondary to multiple sclerosis as well as arthritic pain)
  • It can help reduce anxiety and depression (In one study involving patients with social anxiety disorder, CBD was shown to provide a reduction in anxiety, cognitive impairment and discomfort in speech as compared to placebo. It has also been shown that CBD can treat insomnia and anxiety in children with Post-traumatic stress disorder (PTSD). And as for depression, it is believed that CBD acts on the receptors that bind serotonin – the neurotransmitter responsible for mood regulation)
  • It can alleviate cancer symptoms (CBD helps reduce nausea, vomiting and pain. In one study involving cancer patients with pain not relieved by conventional pain medications, CBD and THC given together demonstrated a significant reduction in pain. Another study involving cancer patients undergoing chemotherapy, CBD and THC given together demonstrated a reduction in nausea and vomiting better than standard treatment)
  • It can help reduce acne (CBD has anti-inflammatory properties and an ability to control the overproduction of sebum from sebaceous glands. But humans studies will need to confirm this)
  • It may have neuroprotective effects (Sativex, an oral spray containing CBD and THC has been shown to reduce muscle spasticity in patients with multiple sclerosis. One study demonstrated a reduction in seizures in patients with epilepsy after they were given CBD oil. Another study demonstrated that CBD reduced childhood seizures in Dravet syndrome – an epilepsy disorder in children. And other studies have demonstrated improved quality of sleep in patients with Parkinson’s disease)
  • It may benefit the heart (One study demonstrated a reduction in high blood pressure in men given CBD. It is also thought that CBD helps prevent heart damage through its antioxidant properties and stress-reducing properties)
  • It may help reduce psychosis (CBD may help counteract psychotic symptoms and cognitive impairment associated with cannabis use and may help reduce the risk for developing psychosis related to cannabis use, mediated by the opposite effects of CBD and THC on brain regions such as the striatum, hippocampus and prefrontal cortex)
  • It may help treat substance abuse (In rat studies, CBD has been shown to reduce morphine dependence and heroin-seeking behavior)
  • It may help fight cancer (In animal studies, CBD has been shown to prevent the spread of breast, colon, lung, prostate and brain cancer cells)
  • It may help reduce diabetes (In mice studies, CBD has demonstrated a reduction in the incidence of diabetes by over 50% as well as reduced inflammation)

Even though there are many promising effects from CBD, it is important to keep in mind that every treatment comes with side effects. In the case of CBD, some people may experience diarrhea, fatigue and changes in appetite. Always talk to your doctor before starting a new treatment.

In addition, because the research studies are very young, we must give time for more clinical trials to be completed before we can conclude with certainty the health benefits discussed above.

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Will Marijuana Legalization Worsen Mental Health?

A purple, orange and green marijuana plant

THC And The Impact On Mental Health

It’s no secret that Marijuana legalization is happening all across the United States. New Jersey, New York and Pennsylvania are the northeast states looking to legalize the green herb within the next couple of years. What will be the repercussions from allowing such a move to occur?

Well, first things first: research is coming out showing brain changes in adolescents who smoke Marijuana, resulting in emotional dysregulation. During the adolescent years, teenagers identify more with their peers and less with their parents. By Marijuana interfering with the emotional circuity of the brain, teenagers will possibly be even more disconnected from their parents.

Secondly, the prefrontal lobe is not fully developed until age 24; this is why adolescents have poor judgement. By Marijuana dysregulating adolescents’ emotions with a naturally undeveloped frontal lobe, this may cause even more dangerous and unpredictable behavior from adolescents.

The truth is that the legalization movement is not addressing the mental health repercussions from legalizing Marijuana. They have an agenda to see the plant legalized, while ignoring the major negative side effects of potential psychosis, worsened anxiety and even depression in some!

Only via clinical trials and research, we will see the results of Marijuana legalization. But legalization is happening now, while research results can take many more years to deliver the conclusions. Will it be too late?

One thing is for sure: the best way to stay mentally healthy is exercising, socializing, eating healthy and being productive. Substance use should not be at the top of this list.

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