Cannabis and Psychosis

Recently, a study conducted by Australian and European researchers, as published by Revista Fórum, analyzed 334 individuals at high risk of developing psychosis, claiming that cannabis does not have a significant relationship with psychotic outbreaks. However, this conclusion diverges from other research that supports the opposite, casting a shadow of uncertainty over the central question: 

After all, does cannabis contribute to psychotic outbreaks or not? 

To clarify this controversy, we sought the expertise of two renowned specialists, psychiatrist Dr. Wilson Lessa, who has extensive knowledge of cannabis, and pediatric neurologist and president of the Pan American Cannabinoid Medicine Association, Dr. Flávio Geraldes. 

Dr. Lessa reflects on the apparent association between cannabis use and psychotic outbreaks, especially in young people. He highlights that many cases report intense use of the substance weeks or months before the onset of psychosis. However, the doctor questions whether cannabis is the true cause of the problem or merely an observed component in the pre-psychotic period. 

“I don't think anyone would argue that cannabis is helping in this situation, or that cannabis is indicated in these scenarios, but did cannabis cause the problem?”

The specialist highlights four distinct ways to assess the situation. First, he discusses the possibility that early cannabis use increases the chances of developing schizophrenia and other psychotic disorders. Next, he explores the hypothesis that intensive self-treatment with cannabis, often associated with other substances, may be a prodromal component (a set of symptoms that precedes the manifestation or appearance of a disease) of schizophrenia.

The third approach involves the idea that specific genes are responsible for both psychosis and excessive cannabis use, creating a "shared responsibility." Finally, he highlights the view of Dr. Staci Gruber, one of the leading cannabis researchers at Harvard Medical, who argues that the association between cannabis use and psychosis may be influenced by inadequately controlled confounding variables, suggesting that the use of the plant's compounds alone is not sufficient to cause psychotic disorders.

Dr. Lessa emphasizes the need for more in-depth studies but suggests that cannabis may not be the villain in this complex relationship. 

On the other hand, Dr. Flávio Geraldes highlights important nuances, especially regarding the THC content in cannabis. He points out that high amounts of THC can be anxiogenic (capable of inducing or causing anxiety), triggering psychotic outbreaks. 

“When we talk about the smoked use of plant derivatives, we have no control over what each person is using, making it difficult to achieve an accurate diagnosis. However, when it comes to isolated cannabidiol (CBD), the chances of psychotic outbreaks are significantly lower,” warns Geraldes.

In conclusion, the relationship between cannabis and psychotic outbreaks remains a complex and evolving field of study. The opinions of experts diverge, highlighting the need for additional research to reach a conclusive verdict on the role of cannabis in this delicate context.