This article was originally published on Leafly and appears here with permission.
Few feelings are as unpleasant as being convinced that someone is out to get you. Of the cascade of effects that cannabis can kick off, paranoia is definitely one of the least desirable. As it turns out, THC, the major intoxicating compound in cannabis, can be responsible for triggering paranoid thoughts in some individuals when they smoke weed.
While not everyone who consumes weed will experience paranoia, it can be a common adverse effect. What’s more, some individuals are more susceptible to paranoia than others. Understanding why paranoid thoughts occur and how to avoid or manage them when consuming cannabis can empower you, rather than leave you feeling fearful.
What is paranoia?
Paranoia is a state of mind or feeling when an individual has unfounded beliefs that others intend to cause them harm. Paranoia represents a central experience of paranoid personality disorder (PDD), which is characterized by consistent mistrust and suspicion of others. Paranoia is also a common feature of psychosis and psychotic illnesses, such as schizophrenia, but it isn’t always a feature of mental illness.
Symptoms of paranoia include:
- Inability to trust other people
- Inability to relax
- Feeling that outcomes are being controlled by external forces
- Finding hidden meaning in others’ behavior
- Hypervigilance
From time to time, it’s normal to experience the occasional paranoid thought. Certain populations are also likely to be more prone to paranoid thinking than others: individuals who live in conditions of poverty, isolation or exploitation, and those who have low self-esteem, poor physical health, or have experienced trauma can often have an increased tendency toward paranoia.
Certain substances can also trigger paranoia, with cannabis one of the best known examples. Cannabis-induced paranoia can show up in a bunch of different ways. Examples include feeling fearful or self-conscious about what people think, or feeling threatened because someone or something is out to get you.
Those of us who have experienced paranoia after consuming weed will likely attest that in the grips of paranoia, there’s a strong desire to be alone, antisocial, hide out in a dark room, or even become catatonic.
How can weed cause paranoia?
In 2014, a landmark study of cannabis and paranoia confirmed what had long been suspected: THC can trigger paranoia. The study included 121 volunteers who were either given intravenous THC (the equivalent of a strong joint) or a placebo.
The results clearly showed that THC can trigger paranoia in individuals who are more inclined toward paranoid thinking: Fifty percent of the volunteers given THC experienced paranoia, compared to 30% of the volunteers who received placebo.
The study also offered other fascinating insights into how THC influences paranoid thinking.
Abnormal brain processing
THC appears to impair the way the brain processes random events, a phenomenon called abnormal salience. In simple terms, individuals are more likely to give extra importance to random events and misinterpret them after taking cannabis. Other studies have shown that the likelihood of attributing significance, or salience, is further increased when the individual is exposed to negative emotions such as fear and anger.
In other words, someone who has just smoked weed is primed to freak out over an angry facial expression and misconstrue its meaning more than someone who hasn’t consumed cannabis. However, abnormal salience processing seems transitory, occurring only while the individual is high.
There’s currently no evidence to suggest that long-term cannabis use can permanently impair salience processing.
Overstimulating the brain
THC can also induce paranoid thinking through other means. The cannabinoid can activate endocannabinoid receptors throughout the brain, including in the amygdala. The amygdala plays a critical role in regulating fear-related responses, such as anxiety, stress, and paranoia.
Large doses of THC can overstimulate the amygdala, leading to an onslaught of fear or anxiety-based responses. This over-activation of negative emotions can kick off paranoia.
CBD strains may ease paranoia
Additional evidence indicates that THC can amp up fear responses and paranoid thinking. In one study, individuals were given 10 milligrams of THC then exposed to fearful faces. These individuals experienced greater amygdala activation than those who were given CBD. The CBD cohort of the study actually saw amygdala activity decrease.
It’s both fascinating and ironic that two distinct compounds housed within the same plant can exacerbate and ease paranoia.
Another recent study comparing the effects of CBD and THC-dominant cannabis cultivars found that the CBD-dominant cultivars triggered an instant reduction in tension and anxiety. On the other hand, the THC-dominant strains saw paranoia spike in users immediately following consumption, with the effects only subsiding after one hour.
While far from conclusive, these findings strongly suggest that THC can set off paranoia, while CBD can help ease it.
Are some more vulnerable to paranoia when consuming weed than others?
We know that paranoia can be a fairly common experience for cannabis consumers. As many as 51.4% of cannabis users have had paranoid thoughts when using cannabis. However, it appears that certain factors can make some individuals more vulnerable to paranoia than others.
Knowing THC causes paranoia doesn’t help
In the largest study on paranoia and cannabis conducted to date, researchers told participants that THC could spark paranoid thoughts. The researchers hypothesized that by making participants aware that THC could trigger such an effect, they would be less likely to misinterpret random events—a precursor to paranoid thinking.
However, this revelation appeared to do the opposite, exacerbating paranoia in those who had been told. In other words, cultivating an expectation that cannabis use can be accompanied by paranoia seems to create a self-fulfilling prophecy.
There’s other evidence that also demonstrates that when people are led to associate cannabis with paranoia, they are more likely to identify a connection. Surveys on cannabis and paranoia have shown that people are significantly more likely to report paranoia when prompted to define it in a fixed way. On the other hand, when individuals are asked open-ended questions about their experiences with cannabis, as few as 6% report experiences with paranoia.
Genetic predispositions
There’s also recent evidence that genetics may influence the likelihood of cannabis causing paranoia. In an extensive study that included 109,308 participants, researchers found that those with a genetic predisposition towards psychotic illnesses were more likely to experience paranoia following cannabis use.
However, it’s important to remember that experiencing paranoia doesn’t necessarily imply a psychotic illness—lots of people experience mild paranoia at some point in their lives.
Sex can determine adverse effects
Curiously, sex may also figure as a factor. A 2019 study of human participants found that women experience the effects of THC at a lower dose than men. While the research didn’t specifically probe whether women are more likely to experience paranoia, it did suggest that women have an increased likelihood of experiencing acute adverse effects following THC use, of which paranoia is an example.
Another study also found that women are significantly more likely to experience acute anxiety-inducing effects from cannabis and should therefore start with lower doses than men.
Tips for stopping weed paranoia
When it comes to paranoia, there is an array of tools available that may help lower the likelihood of paranoid thoughts occurring.
Start low and go slow
First and foremost, “start low and go slow.” If you’re inexperienced with cannabis, it’s always advisable to start with a low dose—even a microdose—and wait for the effects to kick in before consuming more.
As you become familiar with how the plant interacts with your body, you can start to adjust your dose, increasing slowly until you hit your personal sweet spot. The sweet spot represents the dose that delivers the desired outcome you want without unwanted effects, such as paranoia.
Cultivate a positive set and setting
Another method that may help reduce the chances of paranoia is paying attention to set and setting. In recent years, research has underscored the importance of cultivating a helpful mindset and safe setting to experience substances like cannabis.
As discussed earlier, paranoia tends to arise when there’s an abundance of negative emotion present. Anxiety, for example, can rapidly lead to feelings of being threatened or vulnerable to harm. Therefore, consuming weed in a setting where you feel safe and at ease, and with a relaxed, open state of mind, may help to diminish the chance of paranoia occurring.
Ride it out
However, if you do all the right things and paranoia still strikes, all is not lost. Although stoned paranoia can feel intense and overwhelming, it’s usually short-lived, subsiding after an hour or two. The following techniques may ease the intensity of the experience, and help to pass the time.
Some cannabis consumers swear by straightforward fixes such as deep breathing, relaxing activities like yin yoga, getting wrapped up in a blanket and waiting for the paranoia to fizzle out, or getting horizontal and chilling in bed.
Herbs, spices, and CBD strains
There are also anecdotes about inhaling or consuming freshly ground black pepper or lemon juice. The aromatic terpenes present in these plants may help induce relaxation or feelings of grounding, similar to the effects of aromatherapy.
Lastly, try CBD. Smoking a CBD strain or chewing CBD gummies can usher in feelings of calm, counteracting anxiety or negative feelings, helping to ease weed paranoia.
