Pot puts youth at higher risk of psychosis: expert

Warnings about the danger pot poses to youth are coming from the Schizophrenia Society of Ontario as legalization of the drug in Canada on Oct. 17 fast approaches.

“With legalization, a lot of youth are under the misperception that means it is safe for them to use,” said Hamilton’s Dr. Suzanne Archie, scientific adviser of the society.

But, in fact, there is an increased risk of psychosis among youth smoking marijuana, particularly for those with a family history of serious mental illness like schizophrenia and bipolar disorder.

“The younger the person is when they start using marijuana, the greater the risk,” said Archie, who is also clinical director of the Cleghorn Early Intervention in Psychosis Program at St. Joseph’s Healthcare. “The frequency of use makes a difference ... so people under the age of 16 who are using three times a week or more tend to be at greater risk.”

It’s significant considering cannabisinduced psychosis lasts up to one month after drug use has stopped and takes about six months for a full recovery.

“The marijuana changes the brain’s receptors and it takes a bit of time for their brain to heal and go back to normal,” she said. “The greater the genetic vulnerability for schizophrenia or serious mental illness, the greater the changes.”

Archie says more than one-third of patients later convert to a diagnosis of schizophrenia or bipolar disorder.

“It’s really important to understand the risk,” she said. “Most youth are not aware that they have serious mental illness in the family. Serious mental illness is more common than people think.”

The society is sounding the alarm about cannabis-induced psychosis as its Peace of Minds Walk takes place Saturday at 10:30 a.m. at Bayfront Park to raise awareness and funds for those living with schizophrenia and psychosis.

One of the speakers will be 24-year-old Ilyas Khamis, who had his first episode of psychosis four years ago when he was a university student. It’s a common age for mental health issues to arise, with most first episodes occurring between the ages of 18 to 24.

“I did a lot of pot before I was hospitalized,” he said. “My experience with drugs was mainly as a coping mechanism. I learned I could soothe my emotions, get positive feelings or become more balanced. Obviously, there was a limit to that ending in my psychosis.”

Khamis tried to get help, making an appointment for a mental health assessment at a university clinic. But the fourmonth wait was too long as his mental health rapidly declined.

“I knew there was something wrong and something had changed,” he said. “Eventually, I got the point where I couldn’t trust my own thoughts.”

He called his mother when he started thinking about suicide and she took him to hospital where he started a long road to recovery. Along the way, he was diagnosed with schizoaffective disorder, which includes both schizophrenia and mood disorder symptoms.

He’s now back in his hometown of Oakville, graduated from college and has started a job at St. Joseph’s West 5th Campus as a peer support worker.

“I did stop using pot and harder drugs after I realized it wasn’t too good for me.”

A lot of confusion around the relationship between cannabis and mental health stems from two of the active chemicals found in it, cannabidiol (CBD) and tetrahydrocannabinol (THC).

CBD is thought to have antipsychotic and anti-anxiety properties and is being studied for medicinal use.

“But the proportion of CBD in the marijuana that is sold on the streets today, is still at two per cent,” said Archie. “It’s quite low.”

“The marijuana sold on the streets can be anywhere from 15 per cent to 30 per cent THC,” she said. “It’s a lot stronger than it was.”

THC has the opposite effect on mental health than CBD, making the ratio between the two crucially important.

“The stronger the THC, the higher the risk of addiction and psychosis among youth,” Archie said.

She has created a video game to show youth what it’s like to experience the disturbance in perception that is psychosis.

“The language isn’t very good at explaining what psychosis is, but the video game technology can make it obvious what it means to experience a visual hallucination or an auditory hallucination,” she said. “The parts of the brain that are processing sounds or vision is misperceiving it and misinterpreting it, so it feels like it’s coming from the outside world but actually it is coming from within their brain.”

The Back to Reality game, which she hopes will one day be in doctor’s offices, schools and youth programs, maps out mental health and addictions services available in Hamilton.

Grants from the Canadian Institutes of Health Research, CARSTAR, AMS healthcare, the St. Joseph’s Healthcare Foundation and the Ontario Trillium Foundation paid for the development of the game. Now, Archie is looking to test its ability to educate youth about the risks of cannabis.

“People are under the belief that it doesn’t have serious mental health effects,” Archie said. “The scientific community has not established safe levels of marijuana use even though the majority of adults can use marijuana and not experience harms.”