Paranoia. You’re being watched. The people on the street are not who they seem; they’re following you. You’re sure you’ve seen that man before, he must be a spy. It might sound like James Bond’s inner monologue, but these are some of the sensations you can feel while intoxicated after smoking cannabis. They’re also some of the symptoms of psychosis, a disorder of the mind which has been linked to cannabis use. Feeling paranoid when you’re high is not the same as developing a condition like psychosis. The effects of intoxication are gone after a few hours; psychosis as a disorder can involve episodes like this lasting for days, or longer. Currently the government believes that cannabis use as a teenager increases a person’s risk of developing psychosis, but the scientific evidence is not so clear cut.
Although cannabis is illegal, it is a widely used drug. A 2004 report from the European Monitoring Centre for Drugs and Drug Addiction found that two in five 15 year olds in the UK had tried cannabis, and one in ten had done so more than 50 times the previous year. Because of this, you might expect there to be lot of youngsters with psychosis, but it’s a very rare disorder. David Nutt, the ex-government drug advisor, has pointed out that although the use of cannabis has increased dramatically over the last few decades, the number of people with psychosis over the same time period has not increased at the same rate. If there was a direct link between cannabis use and likelihood to develop psychosis, you would expect to see both either increase or decrease together. If there is a link between cannabis use and psychosis it is likely to be complicated, and it is still not clear in which direction an effect occurs. It may be that the link is seen because people with psychosis find that smoking cannabis alleviates some psychotic symptoms, such as social anxiety, so they self medicate.