Schizophrenia linked to marijuana use disorder is on the rise, study finds | Hacker News Reader

Schizophrenia linked to marijuana use disorder is on the rise, study finds

cnn.com

305 pointspseudolus428 comments

>> In 1995, 2% of schizophrenia diagnoses in the country were associated with cannabis use disorder. In 2000, it increased to around 4%. Since 2010, that figure increased to 8%, the study found.

Worded that way, causation isn't the first thing this suggests to me. If percentage of cases associated with marijuana rise, it could also be that a larger percentage of the population is smoking and admitting to smoking marijuana regularly. If cases themselves rise, it could also be increases in the percentage of cases that actually get diagnosed, etc.

It could very well be that marijuana puts you at higher risk of schizophrenia - I certainly have an acquaintance in mind for whom recreational drug usage seems to have led them to a paranoid and narcissistic personality described here in other comments - but the connection in this article feels weak. Certainly weaker than the connection we see between marijuana law enforcement and the negative fallout of that.

Anecdote: My half-sister is a diagnosed schizophrenic and life-long weed smoker. It seems to me (and her doctors agree) that the two are absolutely related.

She was likely predisposed to schizophrenia (because of her father - which we don't share) but I often wonder if it would have progressed the way it did absent the heavy smoking.

I say this also as a pot smoker myself (but only lightly in the past decade or so). I have nothing against it, and used to scoff at those who were against it.

Now... I'm absolutely convinced that marijuana use can have absolutely catastrophic mental health implications for some people. I'm also convinced it can help people with certain conditions.

At any rate, it's much less benign than I long thought.

People with schizophrenia-related disorders are likely to use substances to deal with the negative symptoms[1] of the disorders.

For example, there is a high correlation between having schizophrenia and consuming nicotine[2]:

> A strong association between schizophrenia and tobacco smoking has been shown in worldwide studies. Smoking is especially high in those diagnosed with schizophrenia, with estimates ranging from 80 to 90% being regular smokers, as compared to 20% of the general population. Those who smoke tend to smoke heavily, and additionally smoke cigarettes with high nicotine content.

I'd argue that nicotine use isn't a cause of schizophrenia, but an effect, as nicotine is reported to alleviate some people's schizophrenia symptoms.

[1] https://en.wikipedia.org/wiki/Schizophrenia#Negative_symptom...

[2] https://en.wikipedia.org/wiki/Schizophrenia#Prognosis

This is meaningless, since it conflates tobacco smoking with pure nicotine. In reality, tobacco smoke contains dozens if not hundreds of different psychoactive chemicals, and certain ones acting as monoamine oxidase inhibitors contribute heavily to tobacco dependence.

Nicotine also alleviates the (substantial) side effects from commonly used medications from what I remember. I think your point is generally true, but in the case of Marijuana I do remember as it being specifically a precipitant of an episode. Schizophrenics aren't awlays in a psychotic state in the same way manic depressives aren't always in a manic / depressive state. I believe the general perception is that pot would cause a person to become psychotic more often / earlier but not be outright causitive if that makes sense.

I am sorry to say that you are most likely right. My father is[0] a psychiatrist in big psychiatric hospital in France (1500 beds, only psychiatry, nothing else) and he told me again and again that he was against the legalisation of marijuana because of this. The problem is that once you trigger schizophrenia you need to live with it, all your life...

Note that he told me so, even if his work during the last 15 years was mainly with the very poor people or refugees without health insurance, the ones suffering a lot from the drug dealers and all the associated black market, prostitution and abuse against minorities, women and kids.

We had lively discussion because I consider that legalizing drugs would reduce violence, gangs, etc. but it is hard to argue against somebody having clear first hand experience with both sides of the problem.

[0]: was in fact, he retired 2 weeks ago.

I am pro legalization because I think people should get to make their own decisions about what they put in their own bodies, but I definitely agree that this aspect of marijuana use is somewhat downplayed by many of its advocates.

Anecdotally, I have seen several marijuana-using friends go down the tubes. One became extremely paranoid to the point he was unable to maintain relationships with the people around him (because he was worried everyone might be a spy), and several others became extremely unpleasant and irritable when they weren't high on the drug. This is perhaps the minority case and most people can partake relatively safely, but I definitely don't see it as a completely harmless substance.

Same experience with a (art) therapist in a mental hospital (less than 1500 beds). Very persistent in asserting that weed causes some people to end up there. I don't think it's a good argument against legalization. We don't ban alcohol, because there are alcoholics. I think it would be smarter to regulate the recreational drug industry and use its taxes to fund relevant education, research and mental health programmes.

So your father is for imprisoning people, gang violence, and the overall cartel drug system, because a few people will develop schizophrenia -- The question isn't marijuana or no marijuana, it's marijuana vs all the problems with prohibition.

Also, there's a fundamental right to self medicate.

> Now... I'm absolutely convinced that marijuana use can have absolutely catastrophic mental health implications for some people. I'm also convinced it can help people with certain conditions.

Absolutely. I am cutting down on weed after seeing it wreck a friend. They were really bright and down to Earth, but they use weed to deal with anxiety and now need to smoke before hanging out with friends. Now they are fully dependent on weed.

It has turned them into an unbearable person with no motivation. My friend is now totally unaware of how much of an asshole they are and no one wants to deal with them.

Weed can be an awesome relatively safe drug but please look for the warning signs of dependence and know that r/leaves exists.

Is weed legal and culturally accepted where you live?

correlation != causation

OP was commenting on why there may not necessarily be a causation, and you commented on how the doctors tend to think there's a correlation. It just as well could be that schizophrenia tends to lead to increased marijuana consumption as people are self medicating. I'm no expert, so I don't have any strong beliefs around causation, but I do think both lines of thought (marijuana causing schizophrenia, or vice versa) seem pretty logical to me.

It's pretty widely believed that there is a correlation between the two, but the reason behind the link is where there's a lot of debate.

When you think about it, it's bizzarre to expect weed to be benign in the long-term, when it's not benign in the short-term (as in, perceptibly alters many biological and psychological processes).

Similar story. I was a heavy smoker for ~10 years and was all for it, but I've since quit and realized how destructive it can be at high doses for long periods of time.

The discourse around how destructive it is encourages this thinking, similarly to how Americans struggle with alcoholism while Italians do not, despite the latter's culture of continuous exposure at young ages.

Same. I've smoked more than fair share of weed over the years and while I turned out ok (I think), two of my friends from back then have had their lives ruined due to mental health issues. There's no doubt that them smoking cannabis didn't help.

> Worded that way, causation isn't the first thing this suggests to me. If percentage of cases associated with marijuana rise, it could also be that a larger percentage of the population is smoking and admitting to smoking marijuana regularly. If cases themselves rise, it could also be increases in the percentage of cases that actually get diagnosed, etc.

I think this is a good explanation. It's also important to acknowledge that norms around marijuana use and the perception of schizophrenia and its symptoms have changed drastically in the last 25 years. So have schizophrenia treatments.

Older neuroleptics have severe side effects that cause permanent Parkinson's-like movement disorders and are responsible for lowering patients' life expectancies. It wasn't until the mid-to-late 1990's that the atypical antipsychotics were approved by the FDA, which had significantly less side effects than older drugs. And then it wasn't until the mid-to-late 2000's that those drugs had affordable generics. Several new antipsychotics were approved in the 2000's that have less side effects, as well.

I should also note that mental healthcare, in the past, was something insurance companies would fight their policyholders over, and many policies didn't cover it at all. The ACA and earlier legislation are responsible for increasing access to mental healthcare[1] for Americans, as they forced insurers to cover it.

So in the past, if you couldn't see a doctor, you couldn't get a schizophrenia diagnosis even if you had it.

[1] https://www.commonwealthfund.org/blog/2020/aca-10-how-has-it...

To me it's about as strong as the correlation between schizophrenia and _any_ use of psychedelics. THC's effects have more in common with a psychedelic than they do an analgesic or stimulant. It's not a body drug, even if it sometimes makes you feel that way. If we legalized psilocybin nationwide, I would bet money that these kinds of studies would show "correlations" in schizophrenia use among those who have taken mushrooms as well. And they would probably be the similar, if not follow the same exact curve, as what we see for MJ.

Yes indeed.

I used to think cannabis was relaxing.

Then I started wearing a watch which doubles as a heart-rate monitor.

Since we are in anecdotal territory, let me state that I’ve been a heavy smoker since I was 13, and I’m 46 now. I find it difficult to concentrate on coding without weed. I have a very low resting heart rate and enjoy hill climbs on my bicycle and am quite fit, motivated, and not lazy, etc.

I generally suffer exclusively the singular negative effect of others finger wagging and disapproval of a rather pleasurable funcional vice or medication or whatever you wish to call it.

I’ve quit a few times for up to a year and always decided consciously to go back. One of the times I left tobacco behind. Countless studies will only ever have access to what users are willing to divulge, to the degree that it’s not an open regulated or at least informed market.

There is an interesting singular fact. Not one single overdose death has ever been conclusively linked to cannabis. The LD50 is something crazy like 15kg in the span of 15 minutes for a 75kg human.

To be fair, that could be just normal paranoia from smoking too much, or perhaps your body doesn't agree with that strain.

I have what's called a paradoxical reaction to whatever they use to put you under anesthesia. I wake up in a rage, they have to take me out very slowly.

I have a friend like this with marijuana. She finds indicas make her euphoric and energized and creative, when she should be couch-locked with a body high. Until she swapped types she kept getting super anxious and it led her to bad trips. But the benefits outweighed the downsides for her (she was able to eat and sleep normally).

Also- coughing (which you almost certainly will), will raise your heart rate.

So how do we know what is a bad effect of the plant in general? This is worrying to me, and as a marijuana smoker I would really love more studies to be done on it.

I've always found that psychedelics are a far far different experience than THC, do you have anything to back this up other than "they both make you sorta hallucinate"?

OP made none of the claims you stated. Only that THC/psilocybin had more in common with each other than THC/stimulants.

The psychedelic effects of pot usually come from using edibles or smoking high potency preparations like hash.

The effects also vary from person to person, and even in the same person at different stages of their life.

When this kind of thing has come up before ("pot causes mental illness"), IIRC it turns out more that people with schizoid disorders are self-medicating with pot before getting diagnosed, rather than having taken harder drugs, alcohol, etc. The classic reversed-arrow of causation.

Worse, the "classic" studies that claim to show the connection between use and schizoid disorders claim to adjust for this, but use a method that is completely wrong, and would be expected to show the same effect for any disease where diagnosis reliability at the start is less than 100%

I don't remember the exact details anymore, but more or less they claim to address causation by 1) starting with a non-schizophrenic population, 2) segmenting by marijuana use, and 3) evaluating schizophrenic status N years later. The theory is that by limiting 1) to non-schizophrenics, they've factored out the possibility that schizophrenia drives drug use rather than the other way around.

Of course, most schizophrenics are not actually diagnosed until waaaay past the point where they are showing symptoms, and if you've ever known a schizophrenic who was diagnosed in college, for instance, you know that that diagnosis usually comes at the end of a long chain of subtle and not so subtle mental issues, shrink appointments, and life problems that start much earlier but don't present as full blown schizophrenia. So the whole supposed filter in 1) is complete trash, and they're probably including a lot of people who are already symptomatic, just not to a clinically diagnosable degree.

That could be a part of it, but there is a documented effect of marijuana "triggering" mental illness in those who are susceptible to mental illness. For a certain portion of the population marijuana use will directly lead to the onset of mental illness

But aren't the scare quotes necessary to the statement? Ie. it can appear that a "trigger" is actuated, because we do not know what is happening and reach for metaphor?

This is the correct answer here in the same way that the prevalence of ADHD is about 2x as likely in the population of meth addicts as the general population.

There's a relationship between smoking cigarettes and schizophrenia too. I think this may be a case of people trying to self medicate for their conditions.

> "There has been emerging evidence of an association between tobacco smoking and schizophrenia spectrum disorders (SSD). Two meta-analyses have reported that people who smoke tobacco have an ~2-fold increased risk of incident schizophrenia or psychosis, even after adjusting for confounding factors."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6255982/#:~:tex....

I agree 100%, I believe schizophrenics with symptoms seek out marijuana, just like they do with tobacco.

> It could very well be that marijuana puts you at higher risk of schizophrenia

More likely, marijuana use accelerates the development of schizophrenia among people already at risk.

> it could also be increases in the percentage of cases that actually get diagnosed, etc.

This is generally a valid stock response to these sorts of studies. But it strikes me as a bit unlikely that there was previously a large amount of undiagnosed schizophrenia.

(Unless we have broadened the definition recently).

> But it strikes me as a bit unlikely that there was previously a large amount of undiagnosed schizophrenia.

As another commenter pointed out, US health insurance did not typically cover mental insurance until relatively recently, making diagnosis impossible for many.

I think the increase in cases is more likely to be explained by a number of factors:

1. THC concentrations have increased which usually means there is less CBD. 2. Legalization probably increased casual use. 3. People who suffer from schizophrenia are simply more likely to be diagnosed for whatever reason.

The sum of these three things could easily account for a significant increase in diagnosis.

Sometimes increases in diagnosis correlate with better detection. Sometimes they correlate with incentives to diagnose people. I’m not even suggesting a nefarious connection. Sometimes incentives with the best intentions can have a big impact.

The high THC and lack of CBD in today's strains is concerning (to me) honestly. I'm worried that a lot of the data we've seen in the past about chronic cannabis use being relatively safe may not apply when THC/CBD ratios approach 50:1, since CBD and other cannabinoids counter act some of THCs effects.

also it's 2% "of diagnosis" connected to marijuana use. So the difference would be if marijuana use is more commonly known/reported, regardless of whether they have 100 or 10000 diagnosis

Might be broadened by the overlap of symptoms. Schizophrenia in particular is a broad classification of different kinds of similarly presenting thought disorders. A person exhibiting textbook symptoms but with the cause more directly attributable to use and social disruptions might have a vastly different prognosis and course of treatment than a more genetic or organic case.

> But it strikes me as a bit unlikely that there was previously a large amount of undiagnosed schizophrenia.

Why would that be unlikely?

Yea, this is a very bizarre framing. I understand that researchers hypothesize that a Marijuana-driven causal link is possible, but theres a well-established, strong causal effect in the other direction that first needs to be controlled for. In that light, the statistic is framed very dishonestly in the article.

(Though perhaps dishonesty isn't the correct word to use here: I don't have a high prior on the journalist even understanding this complaint)

I have literally seen an article before that said prodromal(pre/early onset) schizophrenia leads to Marijuana use, and I remember wondering at the time how they knew which way the causation went.

I'm also not sure if it's journalists wanting to push one narrative over the other, or just a lack of understanding.

I wouldn't be terribly surprised if it was both. What's dishonest/incompetent is the framing of changes like the statistic as if the causal direction is clear, without addressing the (to my mind more plausible) opposite causal direction.

Cigarette smoking also has a heavy association with schizophrenia, but the biases we have about it don't lend themselves to the kind of sloppy causality that you see with marijuana. I know you can legitimize biases by calling them priors, but then you need to show your work: those priors themselves should be based in harder data and explicitly referenced.

Otherwise, sloppy science (and reporting) become indistinguishable from considered priors.

I agree, there's just too many variables here.

The drug itself also changed over the years with current breeds having way more active ingredients than the ones used decades ago.

This part is easy to overstate.

It's mostly true for the United States, although even back in the day there were strains (Maui was famous for this) which had nice crystals and were grown without males around to spoil the product.

In Europe, hashish was the normal form of cannabis, and it's hard to make hash more potent than it already is. It varies in quality and strength like any natural product, but over a range that is higher than a flower can achieve, pretty much by definition.

Hard-core concentrates and pure THC products are new, sure, but hashish gets you most of the way there.

According to studies, cannabis potency has indeed increasedi n Europe in the last few decades. See An overview of cannabis potency in Europe (https://www.emcdda.europa.eu/publications/insights/cannabis-...) and Increasing potency and price of cannabis in Europe, 2006–16 (https://onlinelibrary.wiley.com/doi/10.1111/add.14525). From the abstract of the latter study:

"Resin potency increased from a mean [95% confidence interval (CI)] of 8.14% THC (6.89, 9.49) in 2006 to 17.22 (15.23, 19.25) in 2016. Resin price increased from 8.21 euros/g (7.54, 8.97) to 12.27 (10.62, 14.16). Resin increased in value, from 11.00 mg THC per euro (8.60, 13.62) to 16.39 (13.68, 19.05). Quadratic time trends for resin potency and value indicated minimal change from 2006 to 2011, followed by marked increases from 2011 to 2016. Herbal cannabis potency increased from 5.00% THC (3.91, 6.23) to 10.22 (9.01, 11.47). Herbal price increased from 7.36 euros/g (6.22, 8.53) to 12.22 (10.59, 14.03). The value of herbal cannabis did not change from 12.65 mg of THC per euro (10.18, 15.34) to 12.72 (10.73, 14.73). All price trends persisted after adjusting for inflation.

Conclusions European cannabis resin and herbal cannabis increased in potency and price from 2006 to 2016. Cannabis resin (but not herbal cannabis) increased in the quantity of Δ9-tetrahydrocannabinol per euro spent. Marked increases in resin potency and value from 2011 to 2016 are consistent with the emergence of new resin production techniques in European and neighbouring drug markets."

Certainly, the potency is much higher than it was in the 1960's and 1970's.

I don’t think it’s overstating it.

You explain it well enough yourself. The was a wide gap of difference hash in Europe in the 90’s vs your average weed in the US. All too often the stuff in the US would barely get you high whereas a few tokes of hash would be pretty intense.

Sure, you always had special strains, but they were the exception. Now the strains and derived products is competitive with hash and you have to be careful.

I don't worry about the increased concentration of cannabinoids, but I do worry about the trend towards extremely high THC content while other cannabinoids like CBD are barely present.

Could you go into detail about "paranoid and narcissistic personality" specifically the narcissistic personality - I have not heard of that.

Narcissism probably isn't the right word for me to be using here. It was on my mind because of this comment, where there happens to be more discussion of it: https://news.ycombinator.com/item?id=27920152. And it happened to fit the case I was thinking of at the time. But it probably shouldn't be part of my original comment. Specifically what I'm referring to is an integral part of paranoia: someone thinking that, while long-term unemployed and living with their parents in their 40s, they are so "in the loop" as to be aware of conspiracies and such a threat to those conspiracies that they're a target. I have a hard time not equating that attitude with a little bit of narcissism, though again - probably not the right word to have used when discussing specific disorders.

This is known as "delusion of reference" and is common during states of psychosis or mania: https://en.wikipedia.org/wiki/Ideas_and_delusions_of_referen...

>It is "the notion that everything one perceives in the world relates to one's own destiny", usually in a negative and hostile manner.

I would imagine this is not a medical assessment but a more liberal, laymen use of the words paranoid and narcissistic.

After all, MJ does alter the mind and broadens the worldview so to say, which could be called paranoid through a certain lens, and also dulls the senses and makes more tolerant for micro signs and non-verbal communication, which could be called, with some exaggeration, more narcisstic.

The study is also highly sensitive to the way drug use disorders are classified by behavioral health professionals, particularly due to the changing criteria of various DSM editions. I’d want to look at the underlying dataset to see if they’ve properly accounted for exogenous effects like that.

Additionally if you use these recreational drugs, you are constantly hiding from law enforcement or are at least weary of it. You also try to hide it and it become a permanent secret you carry around. I think this could certainly influence paranoia.

To my knowledge schizophrenia is hearing voices and similar hallucinations, which are beyond trust issues.

But from experience with weed smokers, I certainly have the impression that there might be some truth to the story.

I get schizophrenia from smoking pot. But I also know people who get it who've never been pot heads.

Something about THC is at the center of this. And also something about age.

I used to be able to smoke as much as I wanted and just enjoy it, then one day it started making me crazy.. and I kept smoking for a few years and truly lost my mind.

I've heard this story countless times... something (usually around age 20) just snaps, and suddenly THC == paranoia.

Anecdotal. Causation isn't that simple to establish. What drives people to smoke pot may very well be a factor that Will lead to paranoia or other form of mental instability.

Also to note, psycho active drugs are as they are called: psycho active. With prolonged use, tolerance increase, with further use some imbalance occurs especially when not under the influence of that substance. Re establishing that balance takes time. We are very poorly educated when it comes to mental stability, and pharmaceutical treatment is the de facto answer by medical corps.

I do hope you get better, just don't forget substance use has an impact on the brain subtle chemistry, that's in a way what makes them attractive in the first place, and this impact doesn't disappear after a day like a hangover. Take some time off stimilant and psychedelics, you will slowly regain your normal self.

That is about the age when schizophrenia hits, even in people who have never smoked.

"I've heard this story countless times... something (usually around age 20) just snaps, and suddenly THC == paranoia."

It's common for people to smoke more and more cannabis as their tolerance grows, and higher doses of cannabis can easily lead to paranoia and other adverse mental effects.

If these people took a long break and then tried the smallest amount of the weakest pot they could get, they might find that they can enjoy it again without getting paranoid.

Did your symptoms disappear when you stopped using it?

It took a while, but yes. And they come back if I smoke again.

Is the paranoia thing schizophrenia? I have similar issue where around 27 no longer could smoke without getting super paranoid. Typically I have found if I am not living right in some way weed will bring the fear of it right out. However are you saying anything along the lines that this paranoia thing is related to schizo?

~18-25 IIRC is the normal age for prodromal schizophrenia to occur(the early phase where symptoms begin to manifest) so that makes sense. If you don't get it by that age it's extremely unlikely to start experiencing symptoms at an older age, there are younger children with schizophrenia but it's still much less common than people first noticing it around their early 20s.

And in your first sentence, do you mean you get psychosis or hallucinations from smoking pot? Or literal schizophrenia? Interestingly, around 19-22 years old when I smoked a lot, I had some psychosis-like symptoms, mostly auditory hallucinations. They weren't very disruptive or paranoid-feeling though, it was always the sound of a group of people at a party or backyard barbecue or something standing around laughing & talking, and I could only actually make out like 1/5 words. It felt very real though, I looked out my window countless times to see if my neighbors were having a 2am party in their back yard.

Did you have these when you were high, not high, or both? How old are you now and what has become of them?

Early adulthood is often when schizophrenia disorders start manifesting FWIW.

I know someone who went through the same thing... Now alcoholic and homeless.. Also around 20...

Either way, it’s not really a risk I want to take

Sorry, but the suggestion that marijuanna use leads to narcissistic personality disorder is absurd.

There is this: "Cannabis use is associated with 2–4 times the likelihood of developing psychosis in healthy individuals:

That sure seems causative.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7255842/

I can only speak from personal experience, which is of course limited. I smoked occasionally in my 20s, but not since (I'm middle-aged now). I've been friends and acquaintances with many people that smoke a lot. I see a trend among these people - not necessarily schizophrenia (I'm not a psychologist and probably wouldn't even notice a mild case) - but instead a consistent arrogance and self-importance. It's peculiar - they may be contributing very little to society (or maybe a lot), but regardless there's a sense of superiority that seems to crop up among them all. Maybe even narcissism?

I could be completely wrong. I don't express this to assert it, but rather to ask if anyone else has noticed anything similar.

It is entirely possible that this is a misunderstanding of their true feelings or intents. To quote Kat Williams "Weed has a chemical in it called F*k it..."

Maybe when they use they are not having the same anxious feeling that the general public feels and they do not react to others who otherwise might be perceived as "more important" than them. This would appear to the person who typically views themselves as "more important" as arrogance or self importance...when in reality they are just mildly happy and don't care at that moment about the typical societal norms and ranking.

More than likely they are just going about their own business and not paying attention to how you are reacting to it. Every life has value...every person is equal.

Daily toker and edible eater; I’m high now. Hit the bong and a cartridge multiple times.

I’ve also successfully upgraded large chunks of my employers infra code; tests green, deploys green.

It’s no different than coffee to me at this point; I figured out working with those jitters and anxiety. I even saw shimmering with caffeine I’ve never seen on THC.

I’m pretty sure a whole lot of the behavior is just subculture stereotypes that become something like a truism; correct at any speed of light; which become hard to shake for most people (even smart ones).

Personal experience is the science of human existence. The anxiety of non-smokers isn’t an anxiety I have to take on myself.

I have a co-worker who I would described as mildly happy at all times and doesn't care about societal norms/ranking, but I never interpreted them to consider themselves superior to me. This doesn't jive with my understanding of mildly happy people.

> consistent arrogance and self-importance

Unfortunately, these words are vague and will only facilitate people projecting their own definitions onto them in order to either support or deny your claim.

If there is a CEO making 500% more than some engineer, and some engineer complains about that, then someone may say, "Hey that person is just some engineer, how self-important and arrogant to complain to the CEO like that", but for me it's self-important and arrogant for the CEO to think the pay is proportional, and brave and commendable for the engineer to speak up.

I have known many assholes. Some were teetotalers and some used cannabis.

Be careful to let your own self-importance and arrogance allow you to think you can or should outright label someone else, or explain another's behavior, especially by pointing at only one facet of their life that you happen to be privvy to.

That just sounds like people in their 20s in general, even without weed. Marijuana might make it seem worse because stupid ideas sound much more profound when we're high

I could certainly be accused of haughtiness when someone made a snide remark about me using marijuana. This is because I got fed up with arrogant people shitting on me when they found out I use it.

In my experience it is those who love to flout their sense of superiority by shitting on users who are arrogant. But shit can flow both ways and when I'd point out that they too use "drugs" they'd get very defensive.

Back in the 80s my cocaine using friends loved shitting on weed users. "It makes you dumb" was one of their favorite cut downs.

My alcohol drinking friends who didn't smoke weed loved to cast the aspersion that weed smokers were "drug users". When I started pointing out that alcohol was a drug too they all very loudly denied it because couldn't stand the idea that they were "drug users" too.

And along with and within those two groups are those who do prescription drugs. It was pretty strange to be accused of being a "drug user" by people taking codeine and Xanax and Quaaludes, ect.

When I pointed out the serious side effects of alcohol, both personal and to our society at large as compared to weed smokers they started shutting up about that when talking to me.

Since Colorado legalized it those kinds of encounters have been far less common, and I've certainly appreciated it. And because of that I'd probably be far less likely to be accused of being arrogant nowadays.

My experience is the exact opposite:

1) I would not suggest that marijuana use correlates with any particular behavior very much.

2) The only thing I have noticed in common among some heavy users was stereotypical stoner behavior, primarily forgetfulness and absent-mindedness. They are usually aware of this, which means it does not present as anything remotely like arrogance.

> they may be contributing very little to society (or maybe a lot), but regardless there's a sense of superiority

A sober individual's brain is operating on standard (often societally installed) reward mechanism, including "succeeding" on certain self-evaluated measures like "contributions to society"

It's commonly said that weed makes you "OK with being bored". i.e. standard reward mechanisms mentioned above don't really matter much when you're high.

It has nothing to do with narcissism or sense of superiority as you call it, just that their reward mechanism doesn't include things like "how much am I contributing to society". Apathy is a better word for it.

There is the persistent question: does this attract people who are a certain way or does it transform some people into being that way. But let's be clear, schizophrenia is not a personality trait.

That's just society these days...

Actually I think you have a point and it probably stems from the way in which MJ modifies your dopamine system.

In any case, the reason I ultimately gave up smoking it is it makes my overall psychological health worse. I take a more cynical and negative view of things, even if it makes me mellower and temporarily happy. It affects my memory and my motivation, even as it increases my interest in things(so it slightly helps with ADHD, but effective net benefit to my job is zero). It also costs a hell of a lot of money unless you can grow it yourself these days(thanks, legal weed).

Smoked for 16 years constantly, quit for 2, resumed a couple times to help with various issues in mid life, but at the end of the day I quit because it's just not in line with my goals for my life. Weed helped me stay in bad life situations and compromised my ability to plan an effective way of changing my circumstances. It works for some people, I get it. My friend is a paraplegic and loves it for pain. I love the benefits to joint pain and general mid-life aches. That pain relief is what led me to never really dealing with my back problems until now though.

Same observation. I also smoked weed in my teens and early twenties and I remember it making some of the most banal horse shit ideas seem profound, or like I really understand how the universe clicked together. I bet hanging out with a bunch of stoners steeping in my own bullshit for another decade would make me a(n even more) pompous ass too.

My experience is opposite.

My experience with cannabis use using a simple activity.

Sober, I can clean my office without much thinking and if I had to repeatedly do it, I’d probably do it the same fashion every time.

On cannabis, I’m able to see what I believe to be the more or most efficient way of cleaning my office, garage and rooms. I could probably come up with a few ways or road maps for doing so.

I don’t know what it is. Maybe there’s a higher level of dopamine from using cannabis that influenced me to have so much attention and focus on such a menial task.

I have been told that I’m usually not there mentally and never arrogant; and my friends are pretty outspoken.

I think part of that isn't the symptoms of the drug but the culture surrounding it. In most places its illegal or at the very least frowned upon, so being one who does this regularly makes you perceived by some parts of society as some sort of black sheep. People wear the black sheep badge proudly and can be arrogant and in your face about it. Just look at how techies act online. Smoking pot, like knowing stuff about technology, makes you 'in the know' relative to the rest of society, and can make you feel superior that you are taking part in something that most people will never or might outright refuse to experience.

Even in parts of the US where its been legal to smoke pot for some time like California, the social stigma of meeting up for drinks at a bar regularly and meeting up to smoke pot regularly are not equivalent. Your employer might even drug test you still.

Honestly I've noticed the opposite. The pot smokers I've known (which there have been many) have been some of the coolest people. They've been very friendly and giving, and definitely not arrogant or self-important. Maybe it depends on the area you live in and types of social circles you're in?

> there's a sense of superiority that seems to crop up among them all

As a Canadian where weed is legal, I can say I've not had this experience at all. A lot of folks here use it, at all ages and all personality types. Very unusual for me to meet someone who uses it and for them to strike me as any different than the average Canadian.

Reading this article made me recall an incident back in art college. A mature student asked if I smoked cannabis, I said I do. There was another mature student in the room with us. Upon hearing my confession she stared at me with a very serious expression, then lunged forward at me and pushed her face into mine. I was so taken aback I nearly fell off my chair. I had never met this woman before, we were never introduced and I haven't seen her since.

I would argue this woman was sufficiently arrogant that she thought it was socially acceptable to invade my personal space because I was a stoner. Perhaps I myself was more arrogant when I was younger, in the spirit that user warent mentioned below. On the other hand, I'm not the type to spontaneously invade the space of others.

Yes, I've noticed something simila, although way I phrase it is I noticed among high marijauna users from teens to twenties was what is a sense of delayed maturity. This overlaps with the attributes you described but it also felt like they weren't able to accept the increasing responsibility to themselves and others that comes with growth out of adolesence. I accept this is just one lived experience and there are other possible confounding factors, but I've definiutely noticed it.

My experience with the substance is similar to yours. I’ve started again occasionally and see that the experience differs depending on the strain. I do get paranoia that wears off; there were times where I’ve experience schizophrenia like symptoms; where reality seems off or my perception of it changes temporarily until it wears off. Hopefully I don’t have early onset of the disorder.

Regarding your friends, is it possible that the behavior you are seeing is when they are under the influence and not during sober?

I can only provide a single data point, but I used to smoke a lot of weed for a pretty long time, then stopped about 12 years ago, and one of the changes I noticed was that I became much more able to accept responsibility for my mistakes instead of blaming everything wrong with my life on others.

After I stopped smoking, I talked about this a friend who also quit weed around that time, and he said it was the same for him. (Okay, so it's two data points.)

Make of that what you want, but there is a correlation. That doesn't mean weed turns people into assholes necessarily, but it can certainly amplify preexisting tendencies in that direction. I'm pretty sure the same goes for various other drugs as well - I never spent time around cocaine or methamphetamine enthusiasts, but I've been told, some people have a tendency to become real assholes on cocaine. And of course there's alcohol, which definitely helps all kinds of unpleasant personality traits to float to the surface.

I'm not a psychologist, but I think narcissism and self-importance simply stem from a small world view.

If your main hobby/recreational activity in life is smoking weed (certainly not judging anyone) then you'll likely only associate with people who enjoy the same things, if anyone at all.

This leads to a very narrow world-view where you're the center of that world. Going out and meeting people, doing different activities, taking on new jobs and roles, going to school and getting an education all really help to humble people and make people realize that most of us are all very similar in our pursuit of happiness.

I've had my weed phase between 16 and 19 and I dont know. There is a sort of arrogance that comes with ignorance in general that subsides as you learn the vastness of what you'll never know.

I suppose the intersection of ignorance, criminality and drug consumption may make you think that because they smoke, they exhibit the other traits, but it could be the contrary.

You need a bit of arrogance to think cannabis is on your side and you can dominate it, as I witnessed myself when I started stumbling as a teenager.

What an elaborate way if saying weed smokers are lazy bums.

Have you considered you attract a certain type? The long time smokers I know live remarkably normal lives. Kids, jobs, etc

I noticed the opposite. In my 30s now and most of the people I know who smoke a lot are pretty relaxed and the complete opposite of a narcissist.

> there's a sense of superiority that seems to crop up among them

the directionality could be the inverse: e.g. insecurity driving people to social overcompensation as well as cannabis as a reprieve or escape from their anxieties

I think what you describe is pretty common in humans, weed or not.

What I've seen in weed users (myself included when I was in my 20s) is a tendency towards magical thinking and enjoying/accepting fantasies.

I take the position that it’s your biochemistry reacting to them.

What words you label it as feeling like are subjective.

I notice people from all walks of life can feel entitled, and narcissistic. I’m sure some have been stoners.

You've hit the nail on the head with my experience. I have noticed this with a brother who smoke daily.. I never really put it down to the marijuana use entirely, but more of an aversion to any kind of confrontation/disagreement that might make him second guess himself etc.

Personally I can't smoke it anymore, I get super anxious now and nervous. I don't enjoy it, but I can see why some people who enjoy it would rather avoid any kind of mental doubt/disagreements.

Ask yourself why people smoke weed in the first place. It isn't because they're temperate and psychically/spiritually/morally in order. Weed stupefies and dulls a person to certain unwanted feelings, like guilt or anxiety. That isn't any more medicinal than alcoholism.

In line with that, if what you write is true, it would be consistent with the idea that they have vices which cause them suffering which they then proceed to numb instead of dealing with the vices. So if they suffer from envy and pride, this will make them miserable people, so they smoke to numb the suffering. It's basically a way of coping with the consequences of denial about those vices: an intentional disintegration of the intellect to prevent conscious realization of one's vices because they can bear down on one's conscience. The only true way out is moral reform, but if you don't want to repent and face the consequences of repentance, if you are a slave to your pride and to your passions, then you will look for something else to kill the guilt and the pain.

As usual, a sensational headline averring a research article's causal hypothesis, of which the PI even calls for reproducibility. Reading such paltry science articles makes me really appreciate papers like Quanta, whose reporters seem to actually have a semblance of domain knowledge.

Indeed, no discussion of the existing link between schizophrenia and tobacco smoking, in conjunction with the increased availability of marijuana?

> of which the PI even calls for reproducibility

You mean like every study I've ever read? I can't recall the last time the conclusion didn't say something like, "In our study X appears to be associated with Y, but more research is needed to understand the relationship."

You're right, though, that this article leaves many questions unasked. We know that people who are schizophrenic are far more likely to smoke cigarettes, but there is evidence to suggest they're more likely to smoke before their first episode as well. So is tobacco causal? Probably not. Instead, there are probably precursor symptoms to diagnosable schizophrenia that drive tobacco use: anxiety being the main one. Anxiety and marijuana has already been studied with conflicting results, probably because it's hard to determine out whether people with anxiety are drawn to marijuana (or heavier usage) or whether heavy usage causes anxiety.

There are reasons to think marijuana use can cause schizophrenic episodes - sometimes a first episode - but that use may not increase the risk of developing the disorder when viewed in a 20-year window. In other words, it happens sooner. So according to the article the number of schizophrenia cases linked to cannabis use disorder increased by 4x. I'd like to know whether schizophrenia diagnoses overall changed significantly.

I am not saying there are no risks. But I am agreeing that the article does a bad job of analyzing the science.

The population level prevalence is where we should see this. If cannabis really did cause SCZ, as opposed to merely being self-medication, general drug use dysfunctionality, or possibly just accelerating SCZ onset but not increasing total cases, we should see incredibly high rates in recreational legalizing jurisdictions where prevalence is now a large fraction of the population. Instead, buried at the end, we get

"The findings could help explain the "general increase in the incidence of schizophrenia that has been observed in recent years" and provides some support that the "long-observed association between cannabis and schizophrenia is likely partially causal in nature," the study said."

OK then...

> If cannabis really did cause SCZ, as opposed to merely being self-medication, general drug use dysfunctionality, or possibly just accelerating SCZ onset but not increasing total cases, we should see incredibly high rates in recreational legalizing jurisdictions where prevalence is now a large fraction of the population

So basically, let's keep watching Canada's national legalization and Switzerland's targeted trials to see what the population level impact is.

not in necesity: maybe heavy users are using with or without law, maybe law mostly causing casual users to use it but not many more heavy ones. If then only heavy use is cause schizofrenia, we maybe are not seeing a great growth of rates.

All PIs always call for more research. Its another way of saying I need more funds.

I have some experience with this. My first wife was diagnosed with schizophrenia after birthing a stillborn baby. This was about 14 month after we had our first child. One of her doctors insisted the cause was marijuana, but she really did smoke much at all. I did most everyday though and one of the first questions he asked was if we used it.

I told him I thought it was caused by losing the baby and he insisted that had nothing at all to do with it. I knew for sure he was wrong, but he refused to even consider it. But there was more to it than that.

Her grandmother was clearly schizophrenic, and her mother was probably was too. Just a few months before this her mother told me she "hated" our first child because "she looks like you" (it was me she was referring to).

This was in 1986. 15 years later, in 2001, a woman name Andrea Yates murdered her five children and that was when psychiatrist first diagnosed severe "Post Partum Depression" as the cause of what led her to do that.

During those years in between I had pointed out that connection many times to psychiatrists and everyone of them told me I was wrong and they all loved to make the point that I didn't have the credentials to offer a diagnoses of cause. But what I did have that none of them had was real life experience watching my wife slide into schizophrenia.

Schizophrenia is genetic and stress is a trigger. It often doesn't show up until one is an adult. By that time almost anyone will have taken a puff of weed and if a doctor asks them "have you ever used marijuana" and they say "yes", in my experience it doesn't matter how often, using it just once, even years prior, is enough for them to associate cause and effect.

Truth is you can learn something from anyone if you listen to them. If you don't, you won't. What I learned is psychiatry is still pretty much bullshit and the medical profession still doesn't understand the causes or how to treat schizophrenia effectively. They manage it by giving those suffering with it drugs that are akin to turning their patients into slobbering "zombies" so they can manage them.

> "One of her doctors insisted the cause was marijuana..."

Anecdotally, this seems to be a common viewpoint among doctors. As soon as you admit to using marijuana, in any amount, then suddenly any health issues are caused by marijuana. Asthma? Caused by weed. Trouble focusing? Caused by weed. You vomited? Must be cannabinoid hyperemesis syndrome.

Thank you for sharing your experience and I'm sorry for your losses.

I'm taken away by your story and would like to connect, please. I have a similar experience and I'm working on a research project in AI that is related to this. Please drop me a note me aee at berkeley edu I couldn't find your contact info in your profile.

"One of her doctors insisted the cause was marijuana..."

"I knew for sure he was wrong, but he refused to even consider it... [even with family history]."

I have seen stuff like this a few times, and it is usually the sign of a bad doctor. If there isn't a positive test for something and you're ignoring other evidence, how can you say it absolutely is one thing or the other. This is extremely common with vaccines when providers say it is completely safe and write off adverse events as unrelated without any evidence to support the claim. Vaccines are generally safe, but adverse reactions can occur. If you have doctors underreporting to the VAERS system, then the system will not catch the rare events because the data is too incomplete to show significance.

Edit: why downvote? Here's a paper acknowledging limitations like under reporting. https://pubmed.ncbi.nlm.nih.gov/15071280/

I agree with what you're saying.

It's kind of hard to excuse not taking the time to know the risks though. And in this case (covid) I've noticed a very interesting common line of thought. Over and over I've been told on FB "There a 99.5% chance you'll survive" by those who've refused to get vaxxed. (I live near the nation's latest hot spot, Branson, MO).

It's really been closer to a 98% survival rate here and if you frame that same subject differently by saying "You have a one in fifty chance of dying" it "feels" a lot different.

Still, the risk of vaccines has been both downplayed and exaggerated and it's kind of saddening to see how sides have been taken by our popular news media sources here in the U.S. and the divisiveness that's caused.

I think we've all had the opportunity to fully understand the risks with the corona virus vaccines if we wanted to look into it. But if our sources were only and any of the Big TV News Corporations we got a very tilted view. Much the same as I got from my first wife's doctors.

All that said, I think Fauci has done a very good job of telling us where we stand. The media has used him like a ping-pong ball and that's pretty sad.

"It's really been closer to a 98% survival rate here"

I thought this varies widely by age group, sex, and comorbidities? For example, a 30 year old man has a 99.97% chance of survival. And this doesn't even account for comorbidities. Now 3 in 10k is still a relatively large risk, but nowhere near 1 in 50. So the value proposition varies greatly by age group and risk factors, including lifestyle risk factors like WFH v in the office.

For example, I was invited to diner at a restaurant by my in-laws. We had eaten outside there before, so I assumed that was happening again (or I would have declined). Instead they got there first and got an indoor seat for some unknown reason. The vaccine is about 95% effective at preventing serious infection and death. My father in law is in an age group with mortality rates about 4% (and be has multiple comorbidities). He started lecturing me about how I need a vaccine NOW when his risk of dying even with the vaccine was multiple times higher than mine (5%x4%=.2% v .03%).

Now that was months ago, and I planned on getting my vaccination later when more data was available right before going back to the office (in the process now), where I would essentially be guaranteed to contract the virus if I didn't. My strategy seems to have worked for me since we are now learning the J&J vaccine might not be as effective as the others against delta and I was also able to view the VAERS data, as shoddy as it may be, for specific events in my age group to select the vaccine with lower rates (Pfizer).

"Still, the risk of vaccines has been both downplayed and exaggerated and it's kind of saddening to see how sides have been taken by our popular news media sources here in the U.S. and the divisiveness that's caused."

I completely agree.

"I think we've all had the opportunity to fully understand the risks with the corona virus vaccines if we wanted to look into it."

I agree on short term risks. There is one area that I couldn't find much info on - autoimmune conditions. My concern is that these conditions can take years to show up in many cases. We are using our own cells to grow the spike, so what happens if our immune system keys off other proteins that still exist on the cell in addition to the spike protein? It appears that severe covid infection generates higher numbers of autoimmune antibodies than the general population, so there is some risk of that even if one is not vaccinated. There just really isn't much info out there on this.

https://www.acsh.org/news/2020/11/18/covid-infection-fatalit...

This would not surprise me at all. But I'm curious to know if they got the causation backwards. Maybe people with schizophrenia just have a higher likelihood of smoking marijuana

I have long thought this for not just mental disorders...but also the long standing view that Marijuana use causes laziness or "makes you stupid". Perhaps these people have other issues they are self medicating for or have a higher probability of using illicit substances...for whatever reason they may be using it makes it easy to skew numbers to make it seem like the substance use is the cause, but to the user it may feel like the solution.

”Lazy and stupid” is a common outsider generalization of people with ADHD’s primarily inattentive variant.

Untreated neuro-divergent people tend to use recreational drugs for medicinal purposes. And psychoactive drug usage is directly linked with the early onset of otherwise dormant schizophrenia, as well as a myriad of other mental disorders.

There is no science to state that psychoactives cause these mental disorders. In fact, current medical science states the opposite, that psychoactives do NOT cause, but exacerbate, certain mental disorders.

Considering that both psychoative drug use and mental disorder rates are on the rise (some would argue due to improved screening, treatments, etc) I'm not sure how anyone could draw a conclusion from this.

If they want to prove that psychoactive use can cause mental disorder, they should approach it from a bio-chemical perspective.

To be clear, there is science that is compatible with THC increasing the risk of psychosis (and perhaps that CBD is protective). I would agree that some are self medicating, but the data also shows that dosage, THC/CBD mixture, and age of use each elevate psychosis risk over random controls [1][2].

It would be great to do double blinded experiments to test this more definitely, but we don't due to unethical reasons. I think the differential legalization will provide useful data along those lines, though it will take some years.

I also think it's important to distinguish between THC "exacerbating" an existing mental illness and triggering psychosis in otherwise healthy people who have a predisposition, due to genes and early life experience. We still don't have a clear idea exactly how to say who's predisposed. Plenty of reasons to take caution, in my opinion.

[1] https://www.nap.edu/catalog/24625/the-health-effects-of-cann... [2] https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0...

I'm not trying to form a distinction between exacerbating and triggering psychosis in people who have a predisposition. But I think it's unfair to call them "otherwise healthy" as their psychosis, BPD, bi-polar, etc can manifest at any point in their life.

It's fair to say that it triggers the early onset of a "dormant" mental disorder.

My point being to say that it "causes" anything other than that trigger is currently unsupported.

> And psychoactive drug usage is directly linked with the early onset of otherwise dormant schizophrenia, as well as a myriad of other mental disorders.

Citation please. Drug usage tends to begun around the same age schizophrenia is typically diagnosed.

https://childmind.org/article/marijuana-and-psychosis/

Presented for your consideration without comment:

https://adai.uw.edu/pubs/pdf/2017mjbipolar.pdf

I find it somewhat funny that this is written by Susan A. Stoner, PhD, Research Consultant.

Pretty standard study that showing two things are correlated. The THC/CBD chart is misleading because none of the data is actually used to form the conclusions.

The interesting thing is the "Use of Marijuana to Self-Medicate BD" study is useless. Monitoring a small number of bipolar people for 6 days will give you completely random results. It's too short a period to remove moods from the equation.

I don't have links but read a lot on this years ago. There were multiple UK studies that connected genetic predisposition to mental health issues to increased drug use. They're just self medicating until it doesn't work anymore. IDK why it would be dramatically different for non-genetically predisposed victims.

IMO, drug use is a symptom and not the cause. That said, we didn't have 75% THC vape back in the day and now everyone is doing CBD with wonderful new Delta-8 and there's not a shred of research on it.

One of my high school friends developed severe schizophrenia in his 30s. Given hindsight it's clear to all of us that know him that some elements of it must have started all the way back at middle school. He was very into hallucinogens and doing his art, the themes of which are directly in line with his current delusions.

I'm curious about alcohol and tobacco usage as well. Tobacco usage in mentally ill has generally been higher. It could simply reflect over all trends in substance choices depending on availability. So many variables unaccounted for.

I've heard it on good authority that schizophrenics find nicotine/tobacco significantly ameliorates their symptoms - it can be a lesser evil for some.

Plus, if you're going to self-medicate by building a psychological addiction, there are worse substances to do it with than nicotine. I know many alcoholics, for example, who picked up tobacco in rehab. It might not be healthy, but it can be a bit less self-destructive to your personal life.

Well, tobacco smoke is full of MAO inhibitors. I would not be surprised if it was daily abuse of tobacco and coffee that were causing mental illness.

I think it’s an acetylcholine agonist or something like that.

I have a disorder that affects perception (fortunately nothing as serious!) and nicotine absolutely helps with sensory gating. I quit smoking last year and my focus has really suffered for it.

Or maybe both are happening.

Some people like the high from THC, which might make someone go in the direction of psychosis, it can be very stimulating.

For people whith a background of psychosis, they might like the CBD part, which makes them relax and feel less stimulated and aroused.

I think any research about cannabis that fails to distinguish thc/cbd and other important phenotypical traits of the plant will ultimately go nowhere. Thc and cbd have diametrically opposing effects. Marijuana is not one substance it is many.

CBD with Delta-8 THC is all the unregulated rage now.

Like cigarettes. It seems like it could be both self medication, but also have negative side effects too. Benzodiazepines are my favorite analogy.

Can you share that analogy? I take Benzodiazepam from time to time but never more than once every 3-4 months. Keen to learn a bit more. :)

Not OP, but benzo's can be problematic because they can exacerbate the condition they're meant to treat. I.e. they are often prescribed for anxiety, but one of the symptoms of benzo withdrawal is heightened anxiety. It creates a feedback loop where the medication builds an addiction, and the only way out of that addiction is to suffer a worse version of the symptoms you were trying to self-medicate away in the first place.

I believe research has said similar of opiates. Heightened sensitivity to pain is one of the symptoms of opiate withdrawal.

It stands in contrast to other medications where withdrawal isn't counter-indicated by the underlying condition. I.e. amphetamine withdrawal doesn't really exacerbate ADHD. It's not a pleasant thing, but stopping the medication only sends your ADHD back to baseline, not below.

Another similarity to cigarettes and opiates is that they don't cure anything, they merely treat symptoms.

Not a doctor, but I don't think you're at risk of those problems if you take them every 3-4 months. They're great for acute symptoms like that because of how effective they are. They're not good for chronic symptoms, though, because of that feedback loop.

Can I ask a follow up question; how would a study similar to eones like this one rule out getting their causation backwards?

Yeah this is often the debate. Many schizophrenic people self-medicate with drugs and alcohol before they've been diagnosed, so it's very hard to get a clear picture.

The "component cause" makes sense... marijuana and other psychedelics don't necessarily cause schizophrenia in most people, but for some people it may serve as a trigger. There's some evidence that trauma in childhood may have a similar impact.

I think it's too common a sentiment that psychoactive substances like cannabis and psilocybin are harmless and in fact are good for mental health. I've had adverse mental reactions to both and I would caution people with family history of anxiety.

Maybe the people I've discussed this with are not representative, but it seems to me it's widely known that weed can lead to an anxiety event, and psychedelics are sometimes a frightening experience.

Usually you'll be back to normal the next day, but will have had a memorable experience, and sometimes mushrooms produce long-term relief from depression.

I'm definitely not an expert with this, but it seems to me it is often a good idea to take a chance with some carefully chosen drugs.

You're not always back to normal the next day with the more intense hallucinogens. I think bad experiences (or good, but intense experiences) and the longer term psychological recovery from them is often underrepresented online, but it does exist. The risk can be high.

I think a bad trip can be a traumatic experience like any other experience.

Just as a counter-anecdote. There's depression and anxiety in my family tree, and it has caught up to me too in the last year. Among other remedies, I've experimented with small doses of edibles (they are legal where I live). I don't particularly enjoy the high, but for me it does take the edge off the worst times, without side effects. It lets me at least relax/sleep. (It kind of takes the edge off everything, which is why I don't like it and don't do it recreationally.)

I think this is very much a YMMV situation. I certainly don't recommend it as the only solution. It has been useful to me as a medicine, though, in the same way I might take a cough suppressant during a serious cold.

This is a touchy subject to discuss on HN, but I’d caution you that much of the scientific literature on the topic of depression and cannabis is not positive. Obviously there is some possibility of bidirectional causation (cannabis worsens depression, depression increases cannabis consumption) but even the most “both sides” papers on the subject still lean toward cannabis worsening depression over time. This paper is a decent “both sides” overview if you can get the full text: https://pubmed.ncbi.nlm.nih.gov/33332004/

Note that the negative effects of cannabis on depression aren’t immediately obvious, as the drug itself makes users temporarily feel better. As such, people tend to associate cannabis with an immediate improvement of symptoms, yet can’t quite pinpoint the long-term downward trend in their depressive symptoms that occurs due to long-term changes of repeated consumption. There is also some concerning evidence to suggest that traditional depression treatments are less effective when someone is consuming cannabis.

One of my good friends is a professional therapist who is very open about her own personal cannabis use. However, she says she spends much of her professional time convincing depression patients to stop consuming cannabis, with positive results for those who can follow through.

Thats kind of a funny analogy - most cough suppressant drugs are either opiates or disassociative - either of which have history of recreational use as well.

That's true, interesting point. :) For me they're both strictly medicine though.

A past colleague of mine told me a shocking story. He was a heavy weed smoker (multiple times a day) and one evening couldn't find his weed and as he was searching for it, became increasingly furious.

Eventually, he was so angry that he blanked out. He told me he found himself in a hyper lucid state, but in absolute darkness and in a state of pure dread.

He felt the presense of millions of dead egos that were "roaming" like zombies in this strange environment. Some were screaming like their skin was being pulled from their body, some were tormenting others. A total nighmarish trip.

He was so shocked by this experience that he stop smoking pot that very evening and never touched it again.

I suffer from chronic anxiety and the tales of weed just relaxing you sounded like a magic pill. It was one of the most intense anxiety inducing experiences I’ve ever had. Very unfortunate, but some people seem to manage it well.

If you can barely manage anxiety on your own, weed is is a force multiplier for your fears.

However, I’d be willing to try again in the future as it becomes more available in vape form and try micro dosing it. The smallest hits to see if I can get a modest calmness.

> I suffer from chronic anxiety and the tales of weed just relaxing you sounded like a magic pill. It was one of the most intense anxiety inducing experiences I’ve ever had. Very unfortunate, but some people seem to manage it well.

Low doses (5mg of edible or under, for me) have been amazing for my sleep and (very relatedly) anxiety.

The effect of 10mg of same (yes, I know, that's lightweight amounts still) on an empty stomach were... very different. I can definitely see how that would induce anxiety. The disconnectedness and extreme short-term-memory forgetfulness was certainly alarming. I felt about as impaired as when I've been pretty damn drunk, but with a much stronger memory-related effect.

Luckily, just going to sleep much earlier than I'd intended solved the problem. Unlike with alcohol, I woke up the next day feeling great, and had, surprisingly, excellent recall of the sequence of events the night before, despite in-the-moment having great difficulty remembering why I was where I was, even.

YMMV, obviously, but now I know to treat an evening with higher doses (should I try that again) as rather less medicinal than a low-dose evening.

> The effect of 10mg of same (yes, I know, that's lightweight amounts still) on an empty stomach were... very different.

That's a really good point. I commented elsewhere in this thread, similar experience to you with small doses. I always make sure to take the stuff with food.

A lot of marijuana smokers like to pretend weed smoke is somehow less harmful than any other smoke. It's still CO whether it comes from the tobacco or hemp plant. It's still bad and creates a tar residue in your lungs. Any time I bring that up, somehow I become anti-pot even though it's a genuine concern.

Edit: Carbon Monoxide, not Carbon Dioxide. And some additions since this is a tad controversial.

Here is one source - https://pubmed.ncbi.nlm.nih.gov/3340105/

Marijuana inhaled is bad for your body. End of story. Let's not pretend like it's some panacea that the government doesn't want us to know about. It shouldn't be illegal, but a lot of people on here lie to themselves that somehow the harmful effects of CO aren't bad just because it's marijuana. I feel like there is some major cognitive dissonance among pot smokers equivalent to religious people that get upset when you say there is no god.

I won't say it's harmless, but there are material differences. Weed is an expectorant. That's why it makes you cough. So it also tends to promote the lung functions that help clean the gunk out, at least partially. Nicotine and the additives in cigarettes on the other hand suppresses these same functions. And lastly, pot smokers don't smoke nearly the same volume as tobacco smokers.

So no, it's not harmless, but it is in fact less harmful, which is why people keep telling you that.

Also, there's plenty of other options for ingesting THC these days.

Also more transparency and a more limited toxic ingredient list in a typical joint than a cigarette. But yes, smoking weed isn't harmless.

I don't think anyone who's serious doesn't think the act of burning organic matter and inhaling it is bad.

That being said, pot simply has a lot less stuff in it than tobacco smoke. Also, almost no one is smoking a pack of day of joints.

Fortunately there are other alternatives too, like sugar free candies.

You hit the nail on the head. Most people I know will smoke like half a joint in an evening and be done. Maybe take a couple bong rips. You don't sit there and smoke all night long. You'd be passed out long before you'd get through a 20 pack of joints.

Meanwhile, it's super easy to pick up a pack of cigarettes and suck down 5-10 of them in an evening.

Sometimes it feels like people who don't smoke really have to justify it hard. All these justifications they come up with which really aren't even an issue. Maybe they're afraid of it, and don't want to admit it... If you don't wanna smoke it, don't smoke it. There's nothing wrong with that. But some of the reasons I read to not smoke weed are ridiculous.

And that is why engineers created the vaporizer.

Eh, there's also popcorn lung to worry about. Think the research is still out on this one.

I mean, if we want to ignore the additives and difference in typical consumption then sure they are just as bad.

I think you'd get a similar reaction if you said "bikes and motorcycles both have two wheels, thus riding one has all the same risks and dangers as the other". Obviously you'd be right, you can split your skull on either, but you don't go 70+MPH on both.

It is definitely still bad, but I think there is some truth there because tobacco tobacco is especially, extremely harmful.

There's an abundance of ways to use it that don't involve smoking nowadays

Weed actually contains anti-inflammatory and anti-carcinogenic components, that's why people say it is healthier then other plants when inhaled. I'm not making this up, please look for it yourself if you care for the full picture and are genuinely interested as to why people say that.

This literally reads like a stoner in denial

CO also in weed smoke is a hell of a lot more harmful than CO2.

I think the evidence of the amount of replies arguing against my comment above goes to show the amount of people that still think weed smoke vs tobacco smoke is still a legitimate argument against "weed smoke is bad for your lungs." It's really funny to see these universally come out of the woodwork every single time this gets brought up.

one word: edibles

nah. it’s not a common sentiment.

people talk about set and setting + harm reduction over and over again.

If you’re gonna do a drug and be reckless you’re gonna have a bad time.

I have enjoyed smoking Cannabis for decades, but a recent bought of financial difficulty coupled with a desire to get programming last week has shown some teeth on the cute little bubbly image of Cannabis in my mind.

I started smoking more (due to stress) and trying to complete a new project (financial difficulty) and it was just a nightmare.

It's noticeably more difficult to concentrate and retain new information when I am ingesting regularly.

Learning a new programming language, even having just had a few joints the night before, is so much more difficult that it would be without the Cannabis. I honestly felt like I was losing my mind.

I'm not even talking about being high while learning/working... just having the cannabinoids in your system from a few days ago really soaks and coats the mind.

So I've cut it out, for now.

That makes a lot of sense and is smart. Very introspective. I want to provide my anecdotal evidence as a counterpoint, with the understanding that weed can trigger anxiety in a really damaging way and it affects everyone differently.

I’m not in a financially stressful situation, but have been under a lot of performance stress in recent jobs. I found the best routine for myself was meetings during the day + whatever coding I could fit.

Where it gets interesting is at night, I would have a Coke Zero for a small caffeine kick and vape a bit of weed - not a lot - and put on some tunes. Then I’d be totally in the zone and code several day’s worth of work in a night. Sometimes even more.

I was praised for high productivity, and got a lot of work done. I don’t do it as often now, trying to maximize my sleep and my current work has more inter-team tension... but overall I get less work done now.

It definitely was a cheat code to enter the zone for a good 4-6 hours at night, and helped me perform at a higher level than I normally would.

Worth noting I wasn’t avoiding anything or using it as a tool for comfort. I think that can blur the line into an addiction or avoidance mechanism that can be harmful.

Interesting that you say that.

I have noticed great programming ability on Cannabis in the evenings... that's how I raised myself in a nutshell.

I think the productivity is directly related to the sheer lack of stimulation the night-time environment affords you. No light, no sounds, nobody awake, nothing else to do. You can code or sleep, that's it.

I used to stay up all night, getting very high, and programming very well... but society wouldn't stand for it.

Sometimes when I do smoke my joint to go to sleep, I get crazy good ideas and motivation and code great for a few hours.

But then I am forced to wake up at "a decent hour" (society) and the next day is pure shambles/no-work.

Math problems become more difficult after smoking cannabis. This has been replicated in many psychological studies. It seems we cannot smoke joints and program well all night in the same way we can smoke cigarettes and program well all night.

That being said it is much easier to program in the morning after a night of smoking cannabis than a night of drinking.

My quest to find the best combination of drugs for programming has been long. Just vaping nicotine and drinking strong tea seems to be near the pinnacle. Sometimes we miss the simple solutions right in front of our eyes.

>My quest to find the best combination of drugs for programming has been long. Just vaping nicotine and drinking strong tea seems to be near the pinnacle. Sometimes we miss the simple solutions right in front of our eyes.

I tried that a decade ago... ended up in the Cardiologist with a heart monitor for a week because I was blacking out just stepping out of my programming chair.

After they took a look at the data, they just told me to cut down on caffeine and nicotine.

Stimulants are not always the simple solution for everybody.

Just to give another perspective. I vape pretty much every evening. It's just a small amount and it's also is heavy on CBD. After all my work is done.

I can't say i perform any worse in any regard than i did before (didn't use to partake a few years ago). But i also eat clean, sleep enough, exercise and so on. I also keep my tolerance in check. The latter may be because of the CBD, that should in theory also prevent some of long term effects of THC.

Bottom line, i think it's is highly individual to the person and also what product is used. Cannabis is a highly complex substance, unlike say alcohol (IMHO). You may have to try out a few combinations before you find one that suits you and your chemistry/biology.

In my case is different. I tend to focus and learn better with cannabis, but that might be that it relaxes me to some degree that I can take existence better and concentrate stimulating my mind.

In fact I believe weed changed me for the better. May sound cliche but now I'm deeply interested in philosophy and technical concepts and aptitudes (like programming), and actually my whole attitude towards life got really bright and mature, with myself and with others.

I'm not saying weed alone made that, but definitely helped me. As I said, at least for me concentration, in this case facilitated by weed, is life changing.

I have noticed that a very small dose of cannabis can help in work motivation and concentration... but for myself at least, it's a slippery slope.

After a few hours of coding well I start thinking about another very small dose of Cannabis... which won't work because you just ingested a few hours ago and you need to up the dosage... rinse and repeat.

A few joints per night? That's a whole lot, isn't it?

They're pretty darned small... ~0.2g a piece maybe.. And by a few I meant 1 or 2 max.

And I only smoked them right before bed to help with sleep. I don't enjoy "being high" typically.

I would like to see a study exploring the decline (if any) of problems from alcohol abuse in states where marijuana became legal. I am fairly certain that if I could have smoked marijuana when I was in the military then I wouldn't have developed an alcohol habit that has caused me so many problems over the years up until the time I quit.

Who doesn't know someone who went crazy from drinking? It's normalized, especially in the military it seems. A major difference between the long term negative effects of the two drugs is that alcoholics seem to mostly recover after some years of sobriety, but former cannabis users can receive incurable disorders like schizophrenia. More simply, the mental disorders of alcohol abuse resist being pathologized, we assign them sociocultural explanations like "he's going through a rough time." Meanwhile, he's clinically depressed, anxious, has mood swings, all direct results of long term alcohol consumption.

My official diagnosis is Substance Use Disorder.

The DSM 5 recognizes substance-related disorders resulting from the use of 10 separate classes of drugs: alcohol; caffeine; cannabis; hallucinogens (phencyclidine or similarly acting arylcyclohexylamines, and other hallucinogens, such as LSD); inhalants; opioids; sedatives, hypnotics, or anxiolytics; stimulants (including amphetamine-type substances, cocaine, and other stimulants); tobacco; and other or unknown substances.

https://www.verywellmind.com/dsm-5-criteria-for-substance-us...

>>but former cannabis users can receive incurable disorders like schizophrenia.

No. This is the problem with pieces like the original article. "Schizophrenia link to marijuana use disorder" sounds VERY similar to what you just said. But they mean completely different things.

1- This study is specifically noting a correlation (note not causal relation) between 2 disorders, Schizophrenia and marijuana use disorder. Not everyone who drinks is an alcoholic, and not everyone who smokes weed has a disordered relationship with it. The article about the study even points out the methodology shouldn't be translated to the population at large of pot smokers who don't seek treatment for their usage. 2- The study specifically notes that their results have not been replicated. Their results aren't even really anything other than "we crunched some numbers and found a relationship between 2 things". There are all sorts of great graphs here: https://www.tylervigen.com/spurious-correlations that show exactly how "useful" this information might be.

tl;dr- This study is not saying Schizophrenia can be caused by smoking any amount of weed, but too many people will think it says exactly that.

Since we’re here I would like to see a study linking sugar to the increase of health problems (including mental health). Other drugs are small change compared to sugar.

I recently gave up sugar when I realized I suffered sugar highs/withdrawal depressions and reached for it when I felt anxious, just like a drug.

https://www.medicalnewstoday.com/articles/318818

Food As A Machine Gun (Official Lyric Video) - Enemy Radio, Public Enemy

https://www.google.com/search?gs_ssp=eJzj4tVP1zc0TCtJMra0yDY...

No understood method that marijuana could possibly cause the condition check. Trivially comprehensible in terms of increasing usage or increasing admission of usage check.

> our findings will have to be replicated elsewhere

Check

> "long-observed association between cannabis and schizophrenia is likely partially causal in nature,"

Weasel words.

If they had printed their article on toilet paper at least it would be good for something.

Sneering at the article doesn't really make your case more convincing. Instead it just seems like it provoked an overly-defensive reaction.

The article is so bad it actually denigrates the publication by its existence and lends unearned weight to the degenerates criticism of CNN. I don't personally have a dog in the fight.

Rolling papers might be a better medium.

Too many people might be at risk of contentment and their own personal happiness if we let up now.

There have been other studies. Here's a summary.[1]

From the current data, we can conclude that the tetrahydrocannabinol (THC) component of cannabis can be the main culprit causing psychosis and schizophrenia in the at-risk population. THC can also be the one exacerbating symptoms and causing an adverse prognosis in already diagnosed patients. Even though CBD shows therapeutic effects and THC opposing effects, the data is minimal and low safety and efficacy warrants more research. The relation between cannabis and schizophrenia needs further investigation. We need more case-control studies and clinical trials with a larger population to get conclusive data.

So, something seems to be going on, but there's not enough data yet.

Years from now, the cannabis industry may face the product liability problems the tobacco industry did in the past, and the vaping industry is facing now.[2]

[1] https://pubmed.ncbi.nlm.nih.gov/32839678/

[2] https://www.cand.uscourts.gov/judges/orrick-william-h-who/in...

Purely anecdotal, but a long time ago I read a book by Mark Vonnegut, Kurt Vonnegut's son. He explained how he was diagnosed with schizophrenia, and warned that for him, marijuana made his condition much, much worse, and he learned early on to strictly avoid it. From that one could argue that maybe pot aggravates borderline cases of schizophrenia to the point of a temporary psychotic breakdown & diagnosis. In Mr Vonnegut's case he needed long-term treatment for his schizophrenia either way, but the marijuana effect was short-term and remedied by just staying the heck away from it. Also worth noting that 30+ years ago the stuff people smoked was much weaker than some of the high-end product you can buy today.

I smoked weed the first time when I was 15 or so. A buddy of mine bought some from a friend of a friend. And we continued to smoke mostly on weekends for years. I stopped right around college in 2007 or so.

Then a year or so ago I smoked some legal weed from a dispensary. And that shit almost killed me.

I was nauseated and sweating and I vomited repeatedly for like two hours. And I couldn’t control my thoughts. They got dark very quickly. Like voices in my head telling me to kill myself…it was fucking insane…

So naturally a few months later I tried it again, assuming it was just something with that strain or whatever. And it happened again. And I’m not even talking like I smoked a whole joint. I smoked maybe four puffs from a bong.

I know that’s not evidence of any kind. It’s just my reaction. And my wife smokes daily to help with the symptoms of medication she takes. She smokes fairly heavily and the worst thing that happens to her is she gets hungry.

I don’t know what the difference is between “modern” weed and the grown-in-the-ditch North Carolina weed I smoked in my youth. But it is not the same thing.

You smoked "4 puffs from a bong" which is a _lot_ of weed for someone who is essentially cold turkey.

The whole anecdote that weed is _exceptionally_ stronger than it used to be in the past is not well proven. In the 70's people were alleging weed is 20x stronger than in the 60s, in the 80s alleging it was 7x stronger than in the 70s. In the 90's alleging it was 40x stronger than the 80s. And so on. People repeat it because someone goes from cold turkey to sucking down a huge toke from a vape pen in 2021 and get high as balls, not taking into account they probably vaped the equivalent of a whole joint in one action.

Its a trope that's never been born out by any real data.

>I don’t know what the difference is between “modern” weed and the grown-in-the-ditch North Carolina weed I smoked in my youth.

Several differences.

You know if the street stuff was an indica, sativa or hybrid? Some people react much, much worse to specific strain types than others. I'm one of those. I can't smoke strong indicas or I basically have panic attacks.

Modern strains can have upwards of FOUR+ TIMES the thc content... I've seen cheap strains in dispensaries that were above 30%. Old cheap street skunk was maybe 6 to 8% if you were lucky.

You smoked like you smoked before, ignoring the differences in potency, so you gave yourself a much higher dose right off the bat... with no tolerance from being a regular smoker.

Someone who isn't an alcoholic isn't going to be able to drink a bottle of Jack like a habitual drinker is.

Tolerance makes a big difference. If you haven't smoked in a long time, you'll be sensitive to even small amounts of marijuana and it doesn't take much to be too much.

I suspect that cannabinoids and the cannabinoid system act somewhat like the opioid system, where the brain will react differently to the substances depending on tolerance. In the latter system, chronic opioid usage changes the sedative effects associated with that class of drugs to stimulant-like effects.

Similarly, people with no THC tolerance who consume it get anxiety as a side effect, but for chronic users, they get anxiolytic responses from it.

> I don’t know what the difference is between “modern” weed and the grown-in-the-ditch North Carolina weed I smoked in my youth. But it is not the same thing.

Doctors in Canada are well versed in this actually. The standing advice I have gotten from every doctor I've seen is to ensure some CBD content in the cannabis at all times to reduce the impact of the substance. That said, there's a push to have higher and higher concentrations of THC as a cost-saving measure, which is not generally considered a good thing.

I've seen someone have a textbook psychotic break while consuming a lot of cannabis. Radio was sending them secret messages, coworkers were government spies, believed they were Jesus (and normally they'd been a confirmed atheist).

As soon as the cannabis consumption stopped, the psychosis stopped. They started smoking again, symptoms came back.

I'd also done some googling to try to understand why some people have panic attacks, and there seems to be a link to cannabis and hypoglycemia for some people. Hypoglycemia can cause: psychosis and panic attacks.

Interestingly, it's sometimes recommended to quickly consume a lot of highly sugary foods if you feel panic/anxiety from cannabis. (And I've found that this has worked for me. Plus you get the bonus of them tasting especially delicious.)

It would be interesting to know more about the hypoglycemia link. I contracted type one diabetes as an adult, somehow, and was hesitant to try anything for the first time after that including alcohol or cannabis. I wear a continuous glucose monitor and as far as I can tell, cannabis has no effect on my blood glucose.

There's this study published in Diabetes Care[1], "Efficacy and Safety of Cannabidiol and Tetrahydrocannabivarin on Glycemic and Lipid Parameters in Patients With Type 2 Diabetes: A Randomized, Double-Blind, Placebo-Controlled, Parallel Group Pilot Study".

> RESULTS Compared with placebo, THCV significantly decreased fasting plasma glucose (estimated treatment difference [ETD] = −1.2 mmol/L; P < 0.05) and improved pancreatic β-cell function (HOMA2 β-cell function [ETD = −44.51 points; P < 0.01]), adiponectin (ETD = −5.9 × 106 pg/mL; P < 0.01), and apolipoprotein A (ETD = −6.02 μmol/L; P < 0.05), although plasma HDL was unaffected. Compared with baseline (but not placebo), CBD decreased resistin (−898 pg/ml; P < 0.05) and increased glucose-dependent insulinotropic peptide (21.9 pg/ml; P < 0.05). None of the combination treatments had a significant impact on end points. CBD and THCV were well tolerated.

[1] https://care.diabetesjournals.org/content/39/10/1777.long

I've known a few people that this happens to. Not sure it's the same as long-term schizophrenia but there's definitely similarities.

It could be a stimulant drug and situational interaction

Whatever underlying mental state you have running in the background will come to surface when you use psychedelics. Marijuana is a mild psychedelic. Many people seem to be under the impression we should live free from scary thoughts, dark thoughts, things that make us worry or anxious. This is all part of the human condition though and as long as these states are transitory and lead to positive change they're not "bad". Recognize there's a time and place for everything. If bringing these things to the surface helps you grow and deal with things in your life, even if it's scary, good. If not, then stop ingesting / smoking it. Really simple. People seem to want things to be good or bad when in fact the state of isness really just is. It's not good or bad. It just is. What you make of it, how you live your life is what matters. If you smoke weed and it helps your back pain, or if it helps you think about your feelings and deal with something you've been putting off, that can be "good". If you smoke it and have heart palpitations and freak out about taxes that can be "bad" but the weed hasn't changed, it's just brought something to the surface. Our minds are complicated. Especially now, in a culture where we're overloaded with information, entertainment, manufactured outrage, and expectations about what we should or shouldn't be, all compared to thousands of other things. How can anyone, smoking weed or not, expect to be sane or live a simple life that doesn't lead to mental health problems?

I’m a big proponent of marijuana. I recommend it to others almost as a rite of passage and I’m eager to see a world where marijuana use trumps alcohol consumption. But I admit that it’s not without risk.

I like to think I am of stable mind. I have never had a drug experience that had overwhelmed my sense of self or being. I have a couple times felt overwhelmed physically, to the point of exhaustion, but my mind kept pace and knew how to navigate the experience. But I’ve also experienced moments where I sensed a certain line was on the verge of being crossed, where the sense of self/being would not be my ultimate experience. Again, I don’t feel as though I’ve crossed that border myself but I have a rather high tolerance.

I recognize these moments to be quite dangerous to those less grounded in their sense of self. I would not be surprised that such an experience could lead to psychosis.

The potency of commercially available strains now are on a completely level to the ones I consumed during college. This research is absolutely necessary.

Alcohol consumption is not without risk. It literally kills your brain cells and has many negative side effects associated with it. Alcohol is widely produced, distributed and consumed. To me this comes down to having the choice. Do the research, document the possible side effect, give me the choice is I want to drink/do the drug. Also, anecdotally based on my own life experience, I think overall marijuana is less harmful than alcohol.

This doesn't even take into account the damage it does to your body's insulin resistance and blood sugar levels. Alcohol is damaging on a systemic level that most people never consider.

I completely agree.

How do you develop a stronger sense of self?

I can’t answer that. I don’t think I did anything to be this way. As far as I know I was born with it.

I don't know about schizophrenia and marijuana use, but a ER Dr. friend of mine always complains about the amount of people she sees that have a condition where their body can't handle the weed they regularly smoke. The symptoms are always the same, extremely belligerent, violently sick(constant vomiting), and very nauseous. She says that sometimes its the same people as they just don't get that weed is making them really sick(stopping smoking makes the symptoms go away). For some reason the media never reports on this but if you know someone in the medical field(ER etc) ask them and they will tell you the same thing. I found this medical paper about the issue: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5330965/

Hyperemesis is definitely real, and eventually affects 1/3 of heavy weed smokers. A lover of mine had to self-diagnose because their doctor wasn’t aware.

The crazy part is as that smoking weed ameliorated the symptoms in the short term, so there is a strong psychological reinforcement to keep smoking even though it is actually causing the background symptoms.

This was discussed a lot in the cannabis community a few years ago though the topic seems to have died down. The consensus among people heavily involved in cannabis is that it is related to overuse of neem oil, an organic pesticide. Some growers had been using neem very liberally without keeping in mind that the active ingredients are toxic to humans. The toxicity of neem seems to be in line with the effects of cyclical vomiting/hypermesis. So, it has been a thing to shun and shame people using that pesticide for a few years.

Anecdotal however cannabis has many compounds, The two main ones are: THC and CBD.

If your using a strain that has high THC and not much in CBD. CBD being the compound to safe-guard, governor the effects of THC you end up in a trip that can spiral out of control causing negative effects.

If you add a CBD strain to the mix. Which are high in CBD and contain trace amounts of THC to your normal method usage, these tend to level out the percentages.

My take is this: If your not mentally fit, high THC can cause you to go off the edge compared to strains with lower amounts. The same can be said for Wine and the alcohol volume.

And I talk from personal experience from being in a psychosis episode caused by cannabis.

-- Edit: I have my own downvote brigade. Yay - Just seems odd that every post I post on HN gets down-voted.

Don’t forget the terpenes! Terpenes play a big role in cannabis effects as well, accounting for the differences between sativa and indica strains.

Pinine and terpinaline for example are more likely than other terpenes to cause anxiety and paranoia at higher concentrations, meaning >1%. I don’t know if they contribute psychotic episodes though.

>-- Edit: I have my own downvote brigade. Yay - Just seems odd that every post I post on HN gets down-voted.

Respectfully, I think it may largely be because your post has many odd grammar and spelling errors, and a confusing sentence and paragraph structure. As a result, the post is difficult and awkward to read.

I don't think the downvotes have much to do with the actual content of the post. The content of everything you said is obviously 100% correct. It's just - again, with all due respect - written in an especially peculiar and very grammatically incorrect way.

Many of your posts seem to be like this, and I think that's probably mainly why you seem to get downvoted often. It's not what you're saying, but how you're saying it. (If English isn't your first language, I understand that it's unfair, but that's just how people seem to react.)

The additional parts that I could comprehend as strange would be the part where spiral off to and explain what CBD is. "CBD is the governor.." I did that for users who may not be familiar with cannabis. and a "," and a stray capital letter after a comma and a few words. Drat, I see them now. I can see that now. I am always happy to correct my mistakes and I do normally double check, edit, reconstruct.

However if that is truly reason of down-votes and, I will admit some of my comments have been lack-luster contain down-votes, understandably. I do have a learning-disability in English then that's act of discrimination in a way. I can't call upon on those who do and so if the down-votes are truly "I can't read your text and I am not going to bother to put effort in to trying to understand, I am down-voting." is very petty of the user.

However I do not think it's grammatical errors at all. It feels too coincidental, but you could be correct and if that is, then I'll work on it. Thank you for the input.

This matches my experience as someone who struggles with severe anxiety and intrusive/delusional thoughts. THC makes for a very bad time for me, but a high CBD edible calms down my mind and helps me temper those thoughts.

I’m upvoting this.

I believe your explanation on the strains are on point.

When using the vapor method, very high in thc, sometimes I do experience psychosis or schizophrenic symptoms. My perception of reality does change a bit during peak affect but disappears after wearing off.

When smoking raw cannabis the regular way, I experience a more calming affect; emotionally tolerable and focused mindset.

Editing your post to whine about the downvotes will surely get people to stop downvoting you. Well played.

No discussion on this thread yet of the role of AKT1 gene, which I find surprising after 300 comments.

If you have a C/C pair at AKT1, your risk of developing schizophrenia jumps from slightly-below-average if you don't smoke marijuana, to over 7x average if you smoke every day [0].

If you've done 23andMe, you can check your own genotype for this risk.

[0]: https://www.drugabuse.gov/publications/research-reports/mari...

I think part of the problem is that people are using the wrong stuff. My personal preference is for milder balanced strains that are about 50% CBD, or CBD-only strains. The THC-only strains tend to have been bred to be strong and if you are not careful, many will trigger anxiety etc. CBD modulates or stops this effect. Often you can repair a problematic THC-only strain by mixing it 1:1 or 1:2 with CBD.

If you live in a legal jurisdiction, please do try a balanced and/or cbd-only strain if you are someone who has had problems with anxiety from many thc-only strains.

Original paper: "Development Over Time of the Population-Attributable Risk Fraction for Cannabis Use Disorder in Schizophrenia in Denmark" (https://jamanetwork.com/journals/jamapsychiatry/article-abst...)

"Question Has the population-attributable risk fraction for cannabis use disorder in schizophrenia increased over time, as would be expected with increasing use and potency of cannabis?

"Findings In this Danish nationwide, register-based cohort study, the population-attributable risk fraction for cannabis use disorder in schizophrenia increased from approximately 2% in the period to 1995 to approximately 6% to 8% since 2010.

"Meaning These findings may indicate that cannabis use disorders are associated with an increase in the proportion of cases of schizophrenia.

"* The results from these longitudinal analyses show the proportion of cases of schizophrenia associated with cannabis use disorder has increased 3- to 4-fold during the past 2 decades, which is expected given previously described increases in the use and potency of cannabis. This finding has important ramifications regarding legalization and control of use of cannabis.*"

We should all consider what kinds of delusions we’ve conditioned into our brains, and how that might affect our attitudes and opinions. Maybe be a little less certain that the right way to think just so happens to be the only way that is accessible to us personally.

Prevalence of smoking tobacco is also dramatically higher among schizophrenic people [0]. Before marijuana use is demonized for causing schizophrenia, it would be worthwhile to more robustly prove these results.

[0] https://pubmed.ncbi.nlm.nih.gov/19794359/

Nicotine modulating the hyperactive dopaminergic activity of schizophrenics I recall being one hypothesis for this remarkable connection. 90% of schizophrenics smoked tobacco compared to 20% of non-schizophrenics in 2006![0]

[0] https://en.wikipedia.org/wiki/Schizophrenia_and_tobacco_smok...

One of my main goals is for real research to occur.

People have been saying or alluding to any psychedelics triggering schizophrenia for a long time.

Like, its almost dismissive and toxic, people want their psychedelics to be safe so bad that they'll tell people "you should have known that your were predisposed to schizophrenia before you took this, therefore your experience is invalid, its safe ya'll!"

Instead of these binary approaches to advocate for legality or illegality, I would just like normal clinical trials done and side effects listed in tiny print at the bottom of the bottle. This shouldn't be that hard of an ask, many approved drugs have "you may get suicidal thoughts and also might randomly die without doing the suicide" as a side effect, which seems worse than schizophrenia and these aren't scheduled drugs at all! Just do the studies and let us know!

Obvious I hope, but this doesn’t prove anything other than marijuana use has increased.

If the population, independent of other conditions, has an increase in marijuana use disorder, then that same increase would be present in the subset of the population that are diagnosed with schizophrenia or related disorders.

I suffer from severe restless legs, largely treatment resistant unless I acquiesce to opioids. MJ is the only substance that provides me relief during the worst times - and it takes a LOT to get the effect. Weighing the risks, I am firmly on the side of MJ - at least my 'rescue drug'.

So, more schizophrenic people are self-medicating with marijuana now that it's more readily available?

I'm speaking as a medical student. And I can't speak for what it's like in the US - only Sweden. Here it's not uncommon for schizofrenic patients to self medicate with marijuana. I guess it increases their quality of life until they have just a little too much and end up having a psychosis. That said, at least among Swedish psychiatrists, it's well know that marijuana can trigger schizophrenia in people that are ~16 years old.

By what pathway is the schizophrenia triggered?

And is the trigger causal or catalytic?

I had a girlfriend with a brother he was schizophrenic. He had a classic break with Ronald Reagan directly addressing him through the television and all that. Like most patients, he did not like the side effects of anti-psychotics. He tended to drink light beer all day. At some point he started smoking cannabis and said it was the only thing that had made the voices go away for him. However, this effect seem to go away with tolerance, which isn’t surprising. He also ended up hanging out with a different crowd and starting to smoke crack about six months later, which probably is related to how one was forced to access illegal markets that also sell other drugs to obtain cannabis at that time. Not surprisingly, crack was not good for his schizophrenia. Cannabis, however, seems promising. The way he described it is similar to my experience with pain relief from cannabinoids, which is the unpleasant sensation is still there but you don’t pay any attention to it.

Nice to make an illiterate sounding typo in the first sentence. Of course I meant “who was schizophrenic.”

Most obvious schizophrenics i have come across were not drug users and were just frightened supicious people who couldnt navigate a social interaction including but not limited to food deliveries, drug deliveries, buying batteries etc. I think the uptick in noticed drug user psychosis is Related to something Big Bill Orielly warned us about: the confluence of drugs and technology, esp social media, implying not taking care of sleep hygiene at the least, but at the most you are seeing what can only be described as “cyber torture” in which subjects are persuaded by those without hands to become retarded. Thats what this weapon is

Can you provide a link to oriellys talk on that

Really getting sick of voluntary behavior being labeled as a "disease" or "disorder". That's the mainstream, PC way of presenting it, and while a number of doctors do support that labeling, it's by no means a universal consensus. Plenty of doctors push back against this, but most of them just avoid picking a fight you can't win against the rabid faction that wants to remove any vestige of personal responsibility. And I say this as someone who's (ab)used his fair share of substances.

Psychiatrist (and addiction psychiatrist in training) here. I agree that calling substance use disorders a disease is highly problematic. However, I think that while the majority of people who use substances don't have a problem, there are many people who use substances in a maladaptive (or disordered) way that dramatically impacts their ability to function, and we need a name to describe that. Substance use disorder is a pretty neutral term, and much better than the older "abuse" and "dependence" terminology for a number of reasons. The wording isn't intended to suggest that personal responsibility isn't required--and any treating clinician would quash that idea right away. It's a way to describe patterns and determine what might be helpful for an individual. It's certainly imperfect, but a much better description than past nomenclature.

Thanks for replying. I agree with what you've said, and agree that it's helpful to have a term for use that dramatically impacts a person's ability to function. "Use disorder" here does seem to be a reasonable, neutral term for differentiating between normal (or even heavy) use that doesn't cause significant problems and use (at any level) that does cause significant problems (physical, mental, financial, or social).

I have a knee-jerk reaction to calling problematic drug use a "disease". "Disorder", as you've described it, does seem like a reasonable term.

Agreed. This paper https://www.nejm.org/doi/10.1056/NEJMra1602872 (which isn't available open access, unfortunately) argues that the brain changes in substance use are more likely normal learning associated with very strong stimuli than actual disease processes. I find this to be a more helpful, optimistic, and accurate interpretation of the data than the disease model. (And it really complements the other evidence-based interventions for substance use disorders we have!)

Seems like we are leaving the cultural moment that presented Marijuana as a glorious panacea which would open your third eye if only you let go of your fear. Our culture was so scared of the stuff before, maybe we needed to paint an unrealistically bright picture to find the courage to leave the cave.

To the unfamiliar it can be a thrilling adventure, to others it can serve as inspiration. It feels like it has mental costs though. Being wary of regular recreational use seems warranted.

No reason to be wary of recreational use. No more so than you might of caffeine.

Not everything is for everyone and that’s 100% ok.

If you look at it from a cultural perspective, many African American boys/men in extremely dangerous and poor areas use marijuana as a way to NOT develop mental issues. Considering how little mental help or even how little routine healthcare these men/boys receive, it makes sense to find SOMETHING to cope. Dependence on alcohol has clear bad-examples of the "wino", or street drunk. Same with the use of crack cocaine (the "crack" head/ the "fiend"). So many black men smoke lots of marijuana, but don't drink and don't do any other drugs.

Also, the environments they need to navigate requires understanding tattoos, colors, signs and tons of other subtle social cues in order to not become a target or deemed to be weak. There may be an under-reporting of instances of schizophrenia, but on a whole these brothers aren't showing signs of schizophrenia due to over use of marijuana.

And really, our current laws are just used to arrest someone, who might be an overall good person, besides the social stigma of "weed smoker". I really do beg anyone who is conservative on this issue due to the POSSIBILITY of someone developing schizophrenia, to maybe consider this as magnitudes less harmful than the use of marijuana policy to target black men; specifically black boys; and putting them in jail and ruining their future. You have to understand the environments they are coming from; so just saying "stay off the dope" is very callous and uninformed. Your life experience isn't the template for everyone.

I know this is a touchy topic on HN, but I really do hope we are able to open our circle of trust to people we wouldn't normally think about.

From my personal observation of loved ones, schizophrenics self-medicate, often with what is available.

I plan to read this article to understand if they are just seeing selection bias.

They may be paranoid because marijuana amplifies paranoia. Nowadays, doctors can prescribe some highly effective tranquilizer medication that can stop schizophrenia and paranoia. Maybe if both you and another person they know simultaneously visit them, advise the same-thing, and ask inquire if getting the brand name medication would be more trust-worthy?

During brain development ~< 25, I recommend against indulging in marijuana. It is a psychoactive drug that can alter developmental growth processes with long-term consequences. Well into adulthood, expression of many of the genes regulating development are suppressed, and thus the means for structural change are more limited; thus adults tend to be more resilient to psychoactive exposures.

Last I read that an order of magnitude more outbreaks of latent schizophrenia occur with alcohol use, compared to marijuana use.

Long time lurker here. Not sure if this helps the discussion but have actual first hand experience with this. I was a heavy user of marijuana (extremely heavy I would say) from my late 20s to my early 30s. One day in those 30s (combined with significant physical effort that day and heat) smoking my umpteenth spliff of the day led to a complete blackout on a public sidewalk. From that point I began experiencing persistent auditory hallucinations and was eventually diagnosed as schizoaffective. I had no prior expression of schizophrenia and no family history that I am aware of (though there are clearly other family members with some psychological disorders). It is roughly 4 years since the last time I touched marijuana and the auditory hallucinations persist. Still in favor of legalization, but, as with overconsumption of practically anything, it should probably come with clear awareness of the risks involved.

I would take this with a grain of salt. Research on illegal substances is highly restricted.

That said, a friend of mine developed a psychosis after using Marijuana while he was still a teenager. Although there had been cases of Psychosis in his family before, not Marijuana induced though. It stopped eventually but came back years after when he took other drugs as well combined with a very stressful life situation, things went downhill afterwards.

That's already years ago, but my understanding that I got from reading articles about this topic at the time was that this activated some sort of latent psychosis. I also read about a proposal to introduce a "Cannabis driver's license" that could be made at a pharmacy. So people would be able to check before they take it. There are also people that feel positive effects of Marijuana, me included.

One potential confounding factor is the massive drop in smoking rates, particularly among those in the prime age for schizophrenia onset.

The evidence seems to strongly indicate that nicotine is a powerful antipsychotic. When smoking was widespread it's possible that many schizophrenics were self-medicating in a basically effective way. The trend is probably particularly acute among cannabis users. 40 years, I'd expect that nearly all cannabis smokers were cigarette smokers. (Non-smoke consumption being essentially a rounding error back then.) Nowadays the sizable majority of cannabis users probably don't smoke cigarettes whatsoever.

>The evidence seems to strongly indicate that nicotine is a powerful antipsychotic.

Source? It's commonly known that there's a very high nicotine use rate among people with schizophrenia, but I haven't heard that it has antipsychotic properties. It likely temporarily helps with certain symptoms, but doesn't necessarily reduce psychosis.

I think it may generally be used as self-medication for the negative rather than the positive symptoms of schizophrenia.

As is often the case on these type of topics, Slate Star Codex had a really good roundup of the evidence:

https://slatestarcodex.com/2016/01/11/schizophrenia-no-smoki...

Anything can be a trigger, including alcohol:

"Researchers have mostly studied the effects of cannabis and nicotine on people with schizophrenia. But they’ve also found that other things that alter your nervous system and mood (called psychoactive substances), like alcohol, can trigger first-time psychosis."

Source: https://www.webmd.com/schizophrenia/features/alcohol-schizop...

IOW, if you have predisposition to schizophrenia (family history, previous psychotic episodes), you should avoid mind-altering substances.

Edit: word

That might help. Other things can trigger it, like going away to college, or a breakup with your first girl/boy friend.

Maybe not cause directly , but seems to trigger something that was laying dormant. From the smokers I know or knew , it becomes a very addictive habit, where they drift off the norm while stoned or worse, while not stoned.

They're not as annoying as coke heads or tweakers, these are more extrovert and kinda obvious, while smokers are often more silent, God knows what's going on in them.

I wouldn't associate it to weed until it's 100percent proven, to understand the human mind will take a lot more time.

I don’t buy it. In 2006, tobacco smoking rates among schizophrenics was 90% vs 20% of non-schizophrenics. [0]

Now, does tobacco cause schizophrenia or do schizophrenics seek out tobacco?

Now, s/tobacco/marijuana/g for the above sentence.

[0] https://onlinelibrary.wiley.com/doi/10.1111/j.1744-6163.2006...

Could it be that schizophrenics are more likely to partake marijuana? Since it is a mental disorder and tends to run in families, the underlying genetics may predispose such people to marijuana, or marijuana may have a stronger effect on such people. That is, a strong correlation should result in a deeper look at this connection rather than directly influence marijuana legalization.

Note that cannabis sold in the danish black market is of unknown quality. No one knows what strain they're getting even in terms of indica/sativa as well as THC/CBD mix. It is mostly illegally shipped from Marocco or Albania. Sometimes it is also dusted with synthetic cannabinoids.

That said, I would love more research on the topic as it is a wild west right now.

This devil's lettuce... I quit daily 24/7 smoking 10 days ago after 6 years of constant smoke. I smoked on 2 occasions with friends since then and I liked it...

It makes me calm but lazy and not wanting to socialize. When I'm high I want to quit but when I am not high I am quite anxious and always looking for something to ease me up...

I admit that I was thinking of some armchair diagnoses while watching this interview of Lee Scratch Perry, a man who has probably smoked more weed than most:

https://www.youtube.com/watch?v=czf9nZFBmnw

Direct link to the journal: https://jamanetwork.com/journals/jamapsychiatry/article-abst...

I recall that there is a specific biochemical pathway that is distinct in people that makes them paranoid when they partake in marijuana.

Perhaps if a test for this gene was widely available, the negative effects of the drug could be greatly limited in the community.

Schizophrenia generally manifests in your 20's, so I wish this article broke out age because I think the causal link is more obvious (vs soothing tendency) when we are talking about the developmental effects of drug use on children.

Schizophrenia is a bucket diagnosis that a large number of mentally ill people are placed into because other diagnoses do not fit or do not fit completely. Once psychiatry doesn't know what's wrong with you, and your symptoms have a certain severity, you get diagnosed with schizophrenia.

This link between marijuana use and schizophrenia will be tenuous at best. Look deeper (into an article published on the well-respected academic journal that is CNN) (a intern probably wrote your article) and you'll find nothing but unscientific hogwash, irrelevant sample sizes, questionable procedure, and just about everything else you usually find that isn't helpful when the subject being discussed is repleat with cultural bias instead of fact.

In short, this is pseudoscientific poppycock written and published to sell you ads.

There is nothing here yet. They literally said:

> Many researchers hypothesize that cannabis use may be a "component cause," which interacts with other risk factors, to cause the condition.

No shit...

anyone I know thats a heavy pot smoker tends to become unstable....

Reminds me of the opening to this article by a journalist having a casual chat with this wife (a psychiatrist at a state mental institution) one evening where she stated in passing: Of course he’d been smoking pot his whole life.

https://imprimis.hillsdale.edu/marijuana-mental-illness-viol...

I've been meaning to read further about that connection because like the author I had never heard of that idea before and everything before it was like taken to be Reefer Madness paranoia.

I know, this isn't scientific, but I met in my life at least 50 people who did all kind of drugs and two of them have problems with schizophrenia and both did smoke much more marijuana, than I could ever do or want. Most of the others stopped at some point to do drugs and are now more or less normal people in their society. I know, this says nothing, but I have become careful with marijuana and don't see it as being completely harmless. This being said, I think that alcohol and tobacco are much more dangerous than marijuana.

Instinctively skeptical of mainstream news orgs that report on scientific studies without linking to the actual study.

Don't worry, the Authors have an agenda too: https://jamanetwork.com/journals/jamapsychiatry/article-abst...

"heavy use of the drug" ... shocker! problems arise in people woth substance abuse problem's :/

People with Schizophrenia may abuse drugs (at up to an 8% rate for marijuana).

who would have thought that a mind-altering substance could permanently alter someone's mind.

The only thing I can reasonably conclude from this study is that more schizophrenics are using marijuana because marijuana is more available than it used to be. I see no evidence of an increase in the absolute number of schizophrenics relative to the availability of cannabis. Who funded this, the DEA?

Link to the study:https://jamanetwork.com/journals/jamapsychiatry/article-abst...

I love that they think that smoking weed is causal to schizophrenia...but aren't considering the opposite.

What about medicated people diagnosed with Schizophrenia that then start smoking?

Tl;dr- People who have Schizophrenia are more frequently found to also have marijuana use disorder than before.

Correlation. This is not been proven causal (which, btw why is it never phrased such that “people inclined towards schizophrenia are more inclined to abuse drugs” which seems like a pretty obvious line to me but I just work in medical publishing, I’m not the actual doctor).

Remember everyone: someone is funding all research, often times they have an agenda and a good press agent when they get some results they like. That said, this piece very specifically says “we can’t conclude a causal relationship, we need further research” (or, more specifically, funding for our research)

Anything that has an effect has side effects.

Using a throwaway account for this. It is hard to write this because of the bad memories it brings back but I hope my experience can help you without you having actually experience it. About 1 in 200 people have experienced schizophrenia at least once in their life so plausibly 1 in 200 comments you read on HN is by someone who has experienced it. My comments is one of those comments. I was in gifted classes in high-school, got a bachelors degree in college, earn a middle-class salary, and saved up enough to buy a home. Stimulant medication helped turn my ADHD from a handicap to an asset. It helped me stay focused and achieve that.

I’ve found that every single time I smoke marijuana there is a synergistic effect with the ADHD stimulant medication that is left in my system and I get the effects of Schizophrenia. It might just be serotonin syndrome but that’s just as bad. I don’t have any family history of schizophrenia whatsoever but people with ADHD are 5x more likely to develop schizophrenia. However, if it is non-reoccurring, according to the DSM-IV, it doesn’t yet count as schizophrenia.

I think my episode was triggered by all of the following things combined: “marijuana, stimulant medication synergy, fear of Covid-19 anarchy in the streets (hey! It was a valid fear for a little while!), drinking alcohol too frequently reduced the logic and judgement side of my brain, seeing the scary side of Instagram Reels shows when it knows you’re behind a VPN, not getting enough sleep due to heavy work deadlines, the scare mail I was received about various deaths, the news reports of all of the deaths in news, and a darn drone that hovered over my house for too long at the wrong time.

Fortunately there is good medication that knocks the schizophrenia out. Highly effective stuff. Both Olanzapine and Quetiapine Fumarate work excellent at stopping the schizophrenia in it’s tracks and getting your sleep back on track. However I was resistant at first to take medication or trust advice. I had experienced a total breakdown of trust in the world. The fear side of my brain had totally hijacked and overrode the logic side of my brain. My amygdala overrode my frontal cortex and I was focused on survival. I didn’t know what paranoia was legitimate and what was overblown. For one, which I mention with a heavy sigh, I didn’t know if my loved ones were agents that just looked like my friends..

I philosophize that paranoid schizophrenia is caused by fear while catatonic schizophrenia is caused by both fear and a lack of trust.

When I questioned my two loved ones independently and their stories matched up, I thought that the odds I was the crazy person was high. I was then willing to talk to a general practitioner and a psychiatrist and they gave me those prescriptions I mentioned above. Just tell them you that you’ve been paranoid, want to be lightly tranquilized, and want to catch up on your sleep.

I’m happy to say I have not had any relapses into schizophrenia since then! But I had to distanced myself away from my friends that smoked marijuana to do that because it influenced me to smoke too. I couldn’t do that though until I had made new friends in person first which hasn’t been easy… and still isn’t easy. My primary goal for 2021 is to make more close friends.

Maybe more people are borderline schizophrenic than we realize.

Cancer detection improved and people thought that meant cancer rates are up but, to my current knowledge, no one knows which is true.

I’m not going to accept this is marijuana causing schizophrenia given this. Society, their specific DNA, family life, could be, and marijuana use is merely exposing it, and enabling proper diagnosis.

Reefer Madness

Is correlation always causation?

No, but we are unlikely to find causation without initially noticing a correlation.

1) THC to CBD ratio in Cannabis has been intentionally increased in favor of THC.

2) Cannabis is more and more cut with synthetic cannabinoids which are notoriously bad for the brain and mind.

3) Long-term Cannabis use is not evenly distributed but focused on people with a certain personality open for such an experience.

4) Cannabis has been and still is illegal in most places. That alone will foster a tendency for paranoia.

5) Just as with other drugs, some people aren't able to control their consumption and that's never good for you.

6) Long-term Cannabis enjoyment in the face of prohibition will solidify the realisation that our society is inherently fascist and narrow-minded. (I can confirm that from personal experience.)

> Cannabis is more and more cut with synthetic cannabinoids which are notoriously bad for the brain and mind.

Do you have a link to support that?

that's a pretty well documented trend. Google it.

Another thing I perceived is would isolate themselves from other groups and think of themselves as the cool kids, same with the sporty folks. Then you have just the regular nerds who aren't impressed by either group. For my college class, the following turned true... Group smokers ended on social ladder at the dole or slightly above or below it. Sports group, none of them turned to Messi or Ronaldo or a new Michael Jordan, they held average jobs, did alcohol and other recreational things and created a family. Group nerd all ended up in very prestigious job segments, some with "global head of " etc titles, some of them went through nasty divorces maybe they didn't gain social competence or street wiseness while studying but at least they are economically safe.

My take away lesson was that it's too hard to recover from group 1 and move on.

That is my personal study and that's all I need to know. The scientists can figure out the rest, I don't know how much a factor drugs and alc play, there's always other factors as well.

Cool story bro!

My hometown is notoriously supportive of cannabis consumption, and one of my high-schools has a well rated jazz programme.

Of my smoking buddies, one is a multimillionaire platinum artist, several are successful and sought-after session musicians, and those are just the music geeks. In general my social cohort have had successful lives, and cannabis doesn't strike me as a relevant variable in that success.

Some of them also fell off and had a hard life. Those tended to be the ones from single-family homes, living on government assistance. Even that wasn't a universal, but in terms of correlation it really stands out.

If you want to see mental health problems, force people into social isolation for 18months, tell them strangers can kill them by not hiding their faces, food and surfaces are contaminated, there is conspiracy to eugenicize them encoded in history books and symbols, words don't mean what they think they do, truth is what you make it, their neighbours are part of a plot, reinforce the filter bubbles of the information they consume, elevate and exalt unstable personalities, debase the media of the culture they trusted, reveal that their electronics are spying on them, and wait for it - then give them access to cheap and plentiful THC concentrates on every corner. How do you think that's going to play out? It's a perfect storm.

Some of my close friends are among what I call the professionally sane (they work in mental health) and they seem as susceptable to delusion and paranoia as anyone. I don't worry about being crazy anymore, as when you see what the bar is, I only need to be be less crazy than most of everyone else. 80th percentile is sufficient for most purposes. Post pandemic, mental health isn't something you manage or exercise, it's just a poker game.

Like a fox. ;)

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