A Little Dab Will Do: A Case of Cannabis-Induced Psychosis
Garrett Rossi, Melanie Beck
Cureus September 8, 2020 DOI: 10.7759/cureus.10311 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | A single patient presenting to the emergency department with recent-onset paranoid behavior and heavy cannabis use |
| Topics | Cannabis |
| Citations | 4 |
| Key findings | The authors describe a patient whose psychotic symptoms worsened after he began using highly concentrated cannabis "dabs" with THC content up to 80%, leading to a diagnosis of cannabis-induced psychosis with severe cannabis use disorder. They argue that rising THC concentrations in cannabis products warrant clinical awareness and caution, particularly for susceptible individuals. |
Abstract
A patient presented to the emergency department with his brother due to recent onset of paranoid behavior that escalated over the past month. The patient endorsed paranoid delusions of people watching him and following him in a black truck. The patient admitted to being unable to sleep for the past two weeks and to having hypervigilant behavior whenever he leaves the house. Due to the patient's presentation, the differential diagnosis included schizophrenia, substance-induced psychotic disorder, psychotic disorder due to another medical condition, bipolar disorder, and major depressive disorder with mood incongruent psychotic features. Upon interview, the patient stated he was using marijuana to decrease his self-reported anxiety and other social stressors since the age of 13 years. Over the past month, the patient says he has been "dabbing," which is a highly concentrated form of cannabis mainly consumed by experienced users. These "dabs" have an extremely high tetrahydrocannabinol (THC) content (up to 80%), which is the main psychoactive component in cannabis products. Since the patient began using this potent form of cannabis, he has had increasing difficulty functioning at work and worsening symptoms of psychosis. After eliciting this information and noting the patient had a positive urine drug screen for cannabis, a diagnosis of cannabis-induced psychosis along with severe cannabis use disorder was made. There is a trend towards increasing THC concentrations in cannabis products. This case highlights the importance of being aware of these highly potent cannabis products and their potential harms. Patients should approach these products with caution, as they are not only more dangerous to manufacture but also have the potential to induce psychosis in susceptible populations.
Comparable studies
Other case reports and case series on cannabis, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Psychotic Reactions Following Cannabis Use in East Indians Patients at an Indian drug addiction clinic who developed acute cannabis-related psychosis | 1974 | Descriptive report (case series of clinical observations) | n = 200 |
| Psychiatric effects of cannabis use Swedish cases of cannabis psychosis | 1985 | Case series | n = 70 |
| Forty-Six Cases of Psychosis in Cannabis Abusers Gunila Bernhardson Habitual cannabis users treated for psychosis at Swedish psychiatric clinics and mental... | 1972 | Case series (retrospective survey of psychiatric records) | n = 46 |
| Hallucinogen persisting perception disorder after psilocybin consumption: a case study 18-year-old man with HPPD after mixed psilocybin and cannabis intoxication | 2005 | Case study | n = 1 |
| Cannabis‐induced Koro in Americans American men aged 22-26 with years of cannabis experience who reported negative... | 2001 | Case series | n = 3 |