I’m considering using concentrates and edibles to help alleviate pain. I have no history of psychoses in my family. Should I be worried about developing psychoses if I use cannabis concentrates or extracts?

Lately there have been articles stating that cannabis use can cause psychosis and even schizophrenia. For example, the New York Times recently published an op-ed by Alex Berenson, who recently wrote the book Tell Your Children: The Truth About Marijuana, Mental Illness and Violence. Berenson posits that, because cannabis use can cause paranoia — and paranoia can contribute to an increase in psychosis and, subsequently, violent crime — an increase in cannabis use will lead to an increase in psychosis and violent crime.

Berenson references the National Academy of Science’s report, The Health Effects of Cannabis and Cannabinoids, which stated that there exists substantial evidence of a statistical correlation between frequent cannabis use and developing schizophrenia and/or other psychoses. The committee report did not state that cannabis use causes schizophrenia or psychosis. It is important to remember that correlation does not equal causation. And, the question remains whether frequent, heavy cannabis use affects incidence of psychosis.

In May 2019, the Lancet Psychiatry published a study that suggested high THC use was associated with an increased risk of developing a psychotic disorder. The study reported that daily use of high-potency cannabis increased the odds of developing psychosis five fold. High-potency THC was defined as 10 per cent or more, although the potency values used in this study were not measured directly (researchers used data self-reported by study participants and data that measured THC levels in cannabis that had been seized).

High-potency cannabis products are becoming more widely available in legal markets. Those who are looking to use cannabis to alleviate pain, insomnia, anxiety, or other symptoms might not require a high-potency product. For example, high-potency concentrates and edibles might produce more adverse effects than benefits.

It is important to start low and slow and keep a journal to help identify the dose and frequency that works best for your particular ailment. Even without a family history of psychosis, it is best to consult a health care practitioner who is knowledgeable in cannabis and who can perform a thorough health history to determine if cannabis use is appropriate. A healthcare professional can also monitor for possible adverse effects during cannabis use.