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Marijuana and Mental Health, Here We Go Again!

Allan Schwartz, LCSW, Ph.D. Updated: Feb 17th 2011

Marijuana and Mental Health, Here We Go Again!Back on November 1, 2008 I wrote an article that continues to stir a lot of debate. The article is, "Marijuana Makes It Worse: Severe Mental Illnesses." It can be found at the following URL:


The focus of the article was on the impact that marijuana can have on those diagnosed with Bipolar Disorder. People continue to argue the pros and cons of the argument that this drug can worsen Bipolar, some insisting that it has relieved their symptoms.

You will see from the note just below that the most recent study shows that marijuana can hasten the first episode of Schizophrenia.

(A Systematic Meta-analysis

Matthew Large, BSc(Med), MBBS, FRANZCP; Swapnil Sharma, MBBS, FRANZCP; Michael T. Compton, MD, MPH; Tim Slade, PhD; Olav Nielssen, MBBS, MCrim, FRANZCP

Arch Gen Psychiatry. Published online February 7, 2011. doi:10.1001/archgenpsychiatry.2011.5)

A meta analysis refers to the fact that researchers went back and carefully reviewed the prior research on the effects that psychoactive substances have on psychotic illnesses, the age of their onset, its effects on people who do not have psychotic illnesses and the impact of alcohol abuse on mental health. More than 800 studies were carefully selected for their integrity, validity and reliability. In total, the meta analysis included 20,000 patients over several decades. The data collected was subjected to this statistical analysis called metal analysis.

Consistent with previous research, this comprehensive and exhaustive study clearly shows that those with a predisposition to psychotic illnesses, including schizophrenia, become ill two and one half years earlier than expected. This earlier onset is critically important in terms of treatment effectiveness. In general, prognosis was worse for these subjects.

Its important to emphasize four important findings in the research:

1. There is no proof that marijuana causes the psychotic illnesses.

2. Those who were free of mental illness but used marijuana did not become psychotic.

3. those users who had a predispostion had a worse prognosis than those who did not use.

4. Alcohol did not hasten or cause psychotic illnesses.

This does not imply that alcohol is safe and harmless. It is not. It has been implicated in worsening feelings of depression and it can cause some to become violent, not to mention its tragic influence on those who drink and drive.

I will repeat my earlier assertion that those with Bipolar Disorder suffer worse symptoms as a result of marijuana use. In terms of schizophrenia and the other psychoses, I have repeatedly witnessed the fact that psychotic patients decompensated and had to be hospitalized as a result of marijuana and alcohol usage.

I guess means that those who already hallucinate do not need an hallucinogenic substance like THC to further aggravate their severe mental illness.

For those readers with Bipolar Disorder who insist that marijuana helped calm them, it is true that it contains cannabinoids that have mild analgesic effects. However, there are an additional 400 other chemicals found in cannabis. Perhaps the most disturbing of all is that marjunana purchased on the street may be adulterated with unknow substances to make the supplies of the sellers last longer and increase profits.

Having said all of this, there is evidence that cannabis has medicinal qualities. That is why there are some states the permit the sale of medical marjuana. Presumably, the supplies are not adulterated and are more trustworthy. Also, a medical prescription is supposed to be necessary.

The bottom line is that if you have a family history of severe mental illness it is much safer to avoid the use of this substance.

Your comments are welcome and encouraged.

Allan N. Schwartz, PhD

Allan Schwartz, LCSW, Ph.D.

Readers who live in the Boulder, Colorado metro area, or in Southwest Florida may contact Dr. Schwartz for face-to-face consultation. He is also available for psychotherapy through Skype video for those who are not in Florida or Colorado. He can be reached via email at for details.

Reader Comments
Discuss this issue below or in our forums.

Is there a study? - - Apr 21st 2011

Is there a study that has been made about it?

My personnal guess is that some strains of cannabis like cannabis sativa makes mania worse while strains of cannabis indica (which contains more CBD antagonist of THC and even more if the CBN has the time to be oxydated) tends to act like a neuroloptic atypique.

Cannabis sativa would be good for depression and Cannabis Indica would be good for manic states.

Sorry if my English isn't perfect

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