The widespread availability of potent, legal marijuana is a relatively recent phenomenon. Many people have come to rely on it for help with managing stress, insomnia and chronic pain.
Plenty of others use it purely for recreational purposes. And legal marijuana continues to provide a firehouse of tax revenue for the state — over $200 million a year since 2022.
But some medical professionals and industry observers are starting to notice a troubling trend among heavy cannabis users: marijuana-induced psychosis.
Firm statistics aren’t yet available, but doctors are reporting upticks in people developing serious mental-health conditions that seem to be associated with excessive marijuana consumption. And Josh Mozell has encountered some of these situations directly.
Mozell is a lawyer who works in the mental health field — he started his career in behavioral health as a caseworker for people with serious mental illness. Currently, he represents both hospitals and families of mental illness patients, and lately, he’s been hearing a lot of concerning cases of marijuana psychosis.
Mozell sat down with The Show to talk more about this.
JOSH MOZELL: We’re getting people that are, you know, 35, married, kids, job, normal life, and out of nowhere they’re very psychotic in an intense way that that never happens before. So I’m getting all kinds of cases of this untraditional psychosis.
AMY SILVERMAN: Can you tell us what traditional psychosis looks like in terms of when it presents and how it presents?
MOZELL: Yeah. So the traditional course is mid- to late teens. You’re in high school, you got your friends group, you’re doing well, you’re getting good grades, and all of a sudden things start to change.
You pull away from your friends group, your grades start to diminish, you start to act bizarrely, you separate from your family.
Typically these things do not come up past your mid-20s.
SILVERMAN: But often aren’t there indicators earlier that nobody picked up on or that were kind of buried?
MOZELL: There are outliers, but I think anytime that there is an outlier, you have to start to look at other things because there’s lots of things that cause psychosis. In my practice, again, I was like, these are unusual and super intense incidents of psychosis.
Like a 36-year-old Marine, served for eight years, mechanical engineer, doing super well, married, all of a sudden, out of nowhere, he believes that he’s being sexually assaulted every night. He then buys a ticket to go fight the Taliban.
And so you look back and what is he doing? He’s vaping. When people were growing up 30-40 years ago, marijuana had 2-3% THC.
Now you can vape at 80, 90% THC, and it is dangerous. It’s kind of a nuclear bomb that went off in mental health when we allowed it to be so prevalent.
And then really no governance on the amount of THC that goes into these “marijuana products.”
SAM DINGMAN: When you started to see these cases coming in of people like you were just describing, the Marine, what made you think to ask about their marijuana usage?
MOZELL: I had worked in the mental health system, so I had dealt with hundreds and hundreds of people on my caseload that have these disorders. And part of working in the system is you understand their background.
People would come in, and it’s so unusual. I mean, a few weeks ago, a 60-year-old woman, been married 28 years, she’s a CEO, she’s an executive, got kids, and all of a sudden she goes from her mansion in Paradise Valley to living in the homeless shelter.
That is so unusual. And so then you talk to the families, what’s going on? Is there a medical condition? Did she travel out of the country and get some infection?
Every time, every single time it was this connection to dabbing or vaping of marijuana. And if you look online now, five years ago, four years ago, it was kind of hard to find the links, but now it’s very discussed because it’s happening so much.
SILVERMAN: Didn’t you tell me there was a study out of Denmark?
MOZELL: Yeah, there’s a study out of Denmark that was done in the summer of 2021 that showed if you smoke marijuana and you have that paranoid feeling, that’s a low level psychosis. And so what the study said is a third of people have that feeling.
Of that cohort, if you use high concentration THC, what they said is 47% of the people that use high concentration THC are developing bipolar or schizophrenia.
And part of it is that you get super delusional, that you believe that the FBI is following you everywhere and that the CIA is after you. And so you don’t trust anybody, including your kids and your spouses, and so you don’t want treatment.
SILVERMAN: Is it dangerous to give someone the antipsychotic medication if it’s marijuana-induced psychosis?
MOZELL: When it comes to the marijuana-induced psychosis, that’s kind of the treatment course. And again, if they can get in and get that treatment and bring down the psychosis, then it works well. And I wouldn’t say that it’s dangerous. And I would say it’s probably the right thing to be doing.
The danger though, I feel like, is that you go in and you get a diagnosis of some psychotic disorder. And lots of these people get pulled into an involuntary process that then forces them for a year to receive this treatment. That’s where the danger lies, because the medication brings you down. That’s good. That’s not dangerous.
But should you be on it for 365 days? No, no. We need to do testing. We need to understand these things in between and pull somebody off of that medication if they don’t need it.
SILVERMAN: What if you’re still using the high concentrations of marijuana?
MOZELL: Oh, you got no chance. Every family I talk to, the first thing we have to do — because we can get the person pulled in, get treatment in a variety of ways — but they’re locked up in a hospital.
And what I’m pleading with the family about is we have to do everything in our power to keep them away from these substances. And if we don’t, nothing works.
We’ve had really good results getting the person in the hospital, bringing the psychosis down to get back into life. They use a little bit, and they’re just as psychotic.
DINGMAN: How common was, in the casework you’ve done on people who are in that cohort between 15 and 25, where these breaks start to present themselves, how common was THC use in those cases?
MOZELL: That group, I think there’s lots of comorbidities. There’s lots of people that are using substances to deal with their symptoms. Most of those that the families that I dealt with and when I was an SMI case manager, marijuana wasn’t the drug that they were getting to treat their symptoms. They were using other substances out on the street, other illicit substances, alcohol, lots of times meth.
DINGMAN: How similar is like a THC-induced psychosis to psilocybin or LSD or something like that?
MOZELL: That trip is pretty contained within the six to eight hours, and you come out of it and you’re done.
What I see with marijuana-induced psychosis, or THC-induced psychosis, is an intensity that, like, going from 0 to 60, like going out and spending through — I talked about the woman who had been married for 30 years and kids.
She went out and spent $200,000 within a couple of days. People’s entire lives are pulled apart.
DINGMAN: I hear what you’re saying, that if somebody does a psilocybin trip or ketamine or any of these other things, there’s a very intense effect while the drug is in the system. But once it’s out, generally speaking, it seems like the person sort of goes back to their default state.
But in the cases you’re talking about, presumably, the psychosis is extending past the point where the body has metabolized the THC.
MOZELL: It absolutely is. And what I have found is that they’re not coming down right afterwards. I mean, we send them to the hospital, and they get held at a hospital for a month, but they can still be — so clearly they’re not using the substance — but a month later, two months later, even when they come out, they have these low-level psychotic symptoms.
So there’s something else going on. My point is there is so much risk in using these things, and nobody knows it. The number of people I know that are just vaping this stuff at 70, 80, 90% THC is wild everywhere you go, and nobody knows that there’s this danger.