This article was originally published Letters and appears here with permission.
Few feelings are as unpleasant as the conviction that someone is out to get you. Of the cascade of cannabis-induced effects, paranoia is definitely one of the least desirable. As it turns out, THC, the main intoxicating compound in cannabis, may be responsible for triggering paranoid thoughts in some individuals when they smoke weed.
While not everyone who uses weed experiences paranoia, it can be a common adverse effect. What’s more, some individuals are more prone to paranoia than others. Understanding why paranoid thoughts occur and how to avoid or manage them while using cannabis can empower you instead of fear you.
What is paranoia?
Paranoia is a state of mind or feeling where an individual has an unfounded belief that others are out to harm them. Paranoia is a central experience of paranoid personality disorder (PDD), which is characterized by consistent distrust and suspicion of others. Paranoia is a common feature of psychosis and psychotic illnesses such as schizophrenia, but is not always a feature of mental illness.
Symptoms of paranoia include:
- Inability to trust other people
- Inability to relax
- You feel that the results are controlled by external forces
- Finding hidden meaning in other people’s behavior
- Hypervigilance
It is normal to experience occasional paranoid thoughts from time to time. Some populations are likely to be more prone to paranoid thinking than others: those living in poverty, isolation, or exploitation, as well as individuals with low self-esteem, poor physical health, or trauma are often more prone. towards paranoia.
Certain substances can also trigger paranoia, cannabis being one of the most well-known examples. Cannabis-induced paranoia can manifest itself in many ways. Examples include fear or self-consciousness about what people think, or feeling threatened because someone or something is out to get you.
Those of us who have experienced paranoia after consuming weed will likely attest to the strong desire to be alone, antisocial, hide in a dark room, or even catatonic in the grip of paranoia.
How can weed cause paranoia?
In 2014, a landmark study on cannabis and paranoia confirmed what had long been suspected: THC can cause paranoia. The study involved 121 volunteers who received either intravenous THC (the equivalent of a strong joint) or a placebo.
The results clearly showed that THC can induce paranoia in individuals who are more prone to paranoid thinking: 50% of volunteers who received THC experienced paranoia, compared to 30% of volunteers who received a placebo.
The study also offered other fascinating insights into how THC affects paranoid thinking.
Abnormal brain processing
THC appears to impair the way the brain processes random events, a phenomenon known as abnormal salience. Simply put, individuals are more likely to attribute greater importance to and misinterpret random events after consuming cannabis. Other studies have shown that the likelihood of attributing significance or salience further increases when an individual is exposed to negative emotions such as fear and anger.
In other words, someone who has just smoked weed is more frightened by an angry facial expression and more likely to misunderstand its meaning than someone who has not used cannabis. However, the abnormal salience processing appears to be transient and only occurs when the individual is high.
There is currently no evidence that long-term cannabis use can permanently impair salience processing.
Overstimulation of the brain
THC can also induce paranoid thinking in other ways. The cannabinoid can activate endocannabinoid receptors in the brain, including the amygdala. The amygdala plays a critical role in regulating fear-related responses such as anxiety, stress, and paranoia.
High doses of THC can overstimulate the amygdala, leading to fear or anxiety-based reactions. Excessive activation of negative emotions can trigger paranoia.
CBD strains can alleviate paranoia
Additional evidence suggests that THC can amplify fear responses and paranoid thinking. In one study, individuals were given 10 milligrams of THC and then exposed to fearful faces. These individuals experienced greater amygdala activation than those who received CBD. Indeed, amygdala activity was reduced in the study’s CBD cohort.
It is both fascinating and ironic that two different compounds found in the same plant can both aggravate and alleviate paranoia.
Another recent study comparing the effects of CBD and THC-dominant strains of cannabis found that CBD-dominant strains produced an immediate reduction in tension and anxiety. On the other hand, THC-dominant strains have been seen to cause paranoid spikes in users immediately after consumption, and the effects only subside after an hour.
Although far from conclusive, these results strongly suggest that THC may initiate paranoia, while CBD may help alleviate it.
Are some people more vulnerable to paranoia when using weed than others?
We know that paranoia can be a fairly common experience for cannabis users. 51.4% of cannabis users had paranoid thoughts while using cannabis. However, it appears that certain factors may make certain individuals more vulnerable to paranoia than others.
Knowing that THC causes paranoia doesn’t help
In the largest study to date on paranoia and cannabis, researchers told participants that THC could induce paranoid thoughts. The researchers hypothesized that if participants were made aware that THC could produce such an effect, they would be less likely to misinterpret random events—a precursor to paranoid thinking.
However, this revelation seemed to do the opposite and increase the paranoia of those it was told to. In other words, expecting cannabis use to be accompanied by paranoia creates a self-fulfilling prophecy.
There is other evidence that when people are prompted to associate cannabis with paranoia, they are more likely to make the association. Surveys on cannabis and paranoia have shown that people are significantly more likely to report paranoia when asked to define it in a fixed way. On the other hand, when individuals are asked open-ended questions about their experiences with cannabis, only 6% report experiences with paranoia.
Genetic tendencies
There is also recent evidence that genetics may influence the likelihood that cannabis will cause paranoia. In a large study of 109,308 participants, researchers found that those with a genetic predisposition to psychotic illnesses were more likely to experience paranoia after using cannabis.
However, it is important to remember that paranoia is not necessarily a psychotic illness – many people experience mild paranoia at some point in their lives.
Sex can determine adverse effects
Interestingly, sex can also play a role. A 2019 study of human participants found that women experience the effects of THC at lower doses than men. Although the research did not specifically examine whether women were more likely to experience paranoia, it did suggest that women are more likely to experience acute adverse effects following THC use, such as paranoia.
Another study also found that women are significantly more likely to experience acute anxiety-inducing effects from cannabis, and therefore need to start with a lower dose than men.
Tips to stop weed paranoia
When it comes to paranoia, there are many tools available to help reduce the likelihood of paranoid thoughts occurring.
Start low and go slow
First and foremost, “Start low and go slow.” If you are new to cannabis, it is always advisable to start with a low dose – even a micro dose – and wait for the effects to kick in before consuming more.
Once you get to know how the herb interacts with your body, you can begin to adjust your dose and slowly increase it until you hit your personal sweet spot. The sweet spot is the dose that provides the desired results without unwanted effects such as paranoia.
Creating a positive set and setup
Another method that can help reduce the chance of paranoia is paying attention to setup and setup. In recent years, research has highlighted the importance of a helpful mindset and creating a safe environment for learning about substances like cannabis.
As discussed earlier, paranoia usually develops when there are a lot of negative emotions present. For example, anxiety can quickly lead to feelings of being threatened or vulnerable to harm. Therefore, consuming weed in an environment where you feel safe and calm and in a calm, open state of mind can help reduce the chance of paranoia occurring.
Ride it out
However, if you do all the right things and the paranoia still sets in, all is not lost. Although stone paranoia can feel intense and overwhelming, it is usually short-lived and subsides after an hour or two. The following techniques can ease the intensity of the experience and help pass the time.
Some cannabis users swear by simple solutions such as deep breathing, relaxing activities such as yin yoga, wrapping up in blankets and waiting for the paranoia to pass, or floating in water and chilling in bed.
Herbs, spices and CBD strains
There are also anecdotes about inhaling or consuming freshly ground black pepper or lemon juice. The aromatic terpenes present in these plants can promote relaxation or a sense of grounding, similar to the effects of aromatherapy.
Finally, try CBD. Smoking a CBD strain or chewing CBD gum can induce a sense of calm, counteract anxiety or negative feelings, and help alleviate weed paranoia.
