Try out PMC Labs and tell us what you think. Learn More.
Introduction: Cannabis has been historically classified as a hallucinogen. However, subjective cannabis effects do not typically include hallucinogen-like effects.
Ratings on the Hallucinogen Rating Scale HRS following the case dose are compared with HRS ratings obtained from the participant after other doses of cannabis and with archival HRS data from laboratory studies involving acute doses of cannabis, psilocybin, dextromethorphan DXMand salvinorin A. : Scores on the Volition subscale of the HRS were greater for the case dose than for the maximum dose administered in any other comparison study.
Scores on the Intensity and Perception subscales were greater for the case dose than for the maximum dose of cannabis, psilocybin, or salvinorin A. Scores on the Somaesthesia subscale were greater for the case dose than for the maximum dose of DXM, salvinorin A, or cannabis. Scores on the Affect and Cognition subscales for the case dose were ificantly lower than for the maximum doses of psilocybin and DXM.
Conclusion: Acute cannabis exposure in a healthy adult male resulted in self-reported hallucinations that rated high in magnitude on several subscales of the HRS. However, the hallucinatory experience in this case was qualitatively different than that typically experienced by Can weed cause hallucinations receiving classic and atypical hallucinogens, suggesting that the hallucinatory effects of cannabis may have a unique pharmacological mechanism of action.
Elsewhere on the weed wide web
This type of adverse event needs to be considered in the clinical use of cannabis. Early case reports that documented the subjective effects of cannabis 12 included experiences of anxiety, physiological distress, spiritual or mystical effects, and alterations to perception, awareness, and insight.
These case reports provided support for characterizing cannabis as a hallucinogen. Hallucinations may be elicited by a variety of psychoactive drugs, with variable pharmacology. That said, hallucinations are consistently observed, and, arguably, the defining feature of a subset of drugs. The primary subjective effects of classic hallucinogens e. Most case reports describing hallucinations following acute cannabis exposure involve individuals with current psychosis or a family history of psychosis, populations that are known to have an atypical response to cannabis.
Peer-reviewed reports that do detail hallucinogen-like experiences in healthy adults predominantly come from research studies involving the administration of purified THC 16 or case reports of individuals who experience adverse reactions following use of synthetic cannabinoids often full CB1 agonists with Can weed cause hallucinations potency than THC19 rather than whole plant cannabis. This distinction is worth noting as it points to exogenous CB1 receptor agonism as a potential mechanism for inducing hallucinations, and also because it has been postulated that phytocannabinoids such as cannabidiol CBD 20 or terpenoids 11 that are present Can weed cause hallucinations the cannabis plant may mitigate some of the deleterious effects of THC.
To qualitatively investigate the phenomenology of this hallucinogen-like experience, we conducted cross-sectional comparisons of data from this case with archival data obtained from controlled behavioral pharmacology studies of cannabis, the classic hallucinogen psilocybin, and the atypical hallucinogens DXM and salvinorin A. Ratings of subjective drug effects provided by H.
Across investigations, research participants were enrolled if they were medically healthy adults who screened negative for current Axis I psychiatric disorders, denied a personal or family history of psychosis i. Urine drug tests verified abstinence from drugs of abuse before all experimental sessions. Dried cannabis was weighed and dispensed in a quantity that was calculated to contain the target dose of THC e.
Participants endorsed a history of cannabis use and denied use of cannabis for at least 30 days before study enrollment. Participants were not dependent on or seeking treatment for cannabis or other psychoactive drugs. A minimum of 1 week separated each dose condition to allow for a full washout of doses, and washout was biochemically verified with quantitative urine and blood toxicology tests.
Eight healthy adults with lifetime use of a classic hallucinogen and at least one instance of salvia divinorum use in the past 5 years inhaled up to 16 ascending doses of vaporized salvinorin A 0.
Data from placebo, 9, 15, and Subscale scores were calculated as the average rating on all items that load onto each subscale. Average scores from the HRS were computed for each drug condition in each study, and plotted along with the HRS scores from responses for each dose and route of administration reported by H.
He denied a history of ificant health and psychiatric conditions and denied a family history of psychosis.
He endorsed prior cannabis use, denied a history of any ificant adverse effects associated with prior use, and he disclosed that 6 years had passed since he last used cannabis. He endorsed use of over-the-counter medication as needed for seasonal allergies.
What is psychosis?
Dose-related subjective drug effects, cardiovascular effects, and impairment on cognitive performance assessments were observed as expected. On the fourth experimental session as with other experimental sessionsbaseline assessments were within normal limits and urine drug screening for common drugs of abuse and breath alcohol tests were negative. He had difficulty responding to staff inquiries, was unable to complete self-report questionnaires, had difficulty keeping his head up, and appeared to periodically fall asleep or lose consciousness despite encouragement by research staff to stay awake and continue.
He was unable to maintain a balanced, steady gait when he walked.
New on the leaf
The volunteer had difficulty maintaining consciousness and, at times, would not respond to verbal inquiries by study staff. He was under direct supervision of Can weed cause hallucinations staff and neither his vital s nor his behavior required medical intervention.
When he did speak, he reported feeling faint, dizzy, nauseated and that he was experiencing tingling sensations in his arms and legs and pain at the base of his neck. Three hours after drug administration, his symptoms began to decrease in severity. He indicated that he had experienced a dissociative state and altered perceptions of auditory and visual stimuli at the time of peak drug effect.
Who is at risk?
He reported a hypersensitivity to voices at that time, which he described as if he was more aware of conversations around him, but was unable to hear or understand distinct words. He described visual distortions in the form of the environment and floor sinking away and the appearance of patterns moving on the carpet and chairs in the room.
He reported having had a similar experience when administered ketamine before surgery for a broken leg. Four hours after drug administration, and after eating lunch, H. Five hours after drug administration, he appeared more alert and was able to complete all study-related tasks. At the Can weed cause hallucinations of the experimental session, H.
He reported feeling overwhelmed that it was an uncomfortable, scary, and unpleasant experience akin to what he would expect an overdose or anxiety attack may feel like, and he indicated he never wanted to have the experience again. The study medical team determined that there was no ificant health risk with continued study participation and H. Volition scores Fig. Intensity scores Fig. The score on the Perception subscale Fig. HRS scores for the Somaesthesia subscale Fig.
Comparison of HRS scores across studies. Each A—F compares the scores for the indicated scale of the HRS ordinate at each of four dose conditions for each drug abscissa for each of the studies identified within the legend.
Smoked cannabis and vaporized cannabis studies are not yet published. The Affect score Fig. The Cognition score Fig. The legalization of cannabis for medicinal and nonmedicinal use is rapidly expanding. The development of novel Can weed cause hallucinations of administration and technologies for delivering cannabis raises concerns about the adequacy of available data to inform dosing recommendations and complete disclosure of potential adverse consequences.
In a controlled research study, a year-old healthy male research participant H. These effects are not typical in controlled laboratory studies of healthy adults who do not report prior adverse reactions to cannabis or family history of psychosis. He reported large changes on the Intensity, Somaesthesia, Perception, and Volition subscales of the HRS, domains associated with classical hallucinogen drug effects, but relatively low ratings on the Affect and Cognition subscales compared with HRS ratings obtained in controlled laboratory studies of other hallucinogenic drugs.
The case dose was greater in Intensity and Perception subscales of the HRS compared with mean scores obtained following administration of high doses of psilocybin and salvinorin A, but was comparable to Perception scores following the maximum tolerated dose of DXM.
Scores on the Affect Can weed cause hallucinations Cognition subscales of the HRS for the case dose were low, consistent with scores provided by other participants in acute cannabis dosing studies, and were not consistent with the most intense reported experiences with psilocybin, DXM, or salvinorin A. Given that changes in affect and cognition are core features of experience with classic hallucinogens, 3 it is difficult to attribute the reported case as an experience similar to that of a true classic hallucinogen.
Can medical cannabis cause hallucinations?
Curiously, Intensity Can weed cause hallucinations for the case dose were equal to the Intensity score for H. Also, scores on the Volition subscale for all vaporized drug conditions, including placebo, were greater than for sessions involving smoked cannabis for H. A of case reports have been recently published that indicate psychotic or hallucinogen-like effects after ingestion of synthetic cannabinoids in both adults 193031 and adolescents.
These factors may contribute to a greater likelihood compared with cannabis of negative and hallucinogen-like effects after consumption of synthetic cannabinoids, and may suggest that CB1 agonism Can weed cause hallucinations underlie hallucinogen-like effects of cannabinoids. Although the subjective effects that H.
Thus, it appears that the hallucinatory effects of cannabis, taken as a whole, may be qualitatively different than those of other hallucinogens, which suggests that the hallucinatory effects of cannabis may have a unique pharmacological mechanism of action. Multiple preclinical studies have demonstrated an impact of exogenous cannabinoid administration on 5-HT receptor expression and function3.
CBD has been shown to alter psychological response to ketamine, 35 and subchronic administration of PCP an NMDA antagonist has been shown to change the effects of exogenous cannabinoids on prefrontal brain function. Similarly, blood cannabinoid levels measured for H. This is consistent with suggests that H. Given H. Additional research is needed to help understand the neurobiological underpinnings of hallucinations that are sometimes occasioned following high-dose cannabis administration.
For example, there may be genetic differences between individuals who experience and those who do not experience rare and atypical effects of cannabinoids that for these effects. Although we did not sample and cannot address the genetic profile of H. In addition, individual differences in sensitivity to CB1 agonists potentially mediated by the CNR1 gene may predict individual differences in response to exogenous cannabinoids. As mentioned ly, there are hypotheses that cannabis constituents other than THC e.
While an extreme ratio of THC to these minor phytocannabinoids may increase the likelihood of adverse events such as the hallucinations observed in this report, there is insufficient empirical data on the interaction between Can weed cause hallucinations and other constituents of the plant to confidently draw that conclusion at this point.
It is also important to note that most research evaluating the cannabinoid profile of commercial cannabis and related products indicate that very high THC and very low CBD products are predominant in the current retail market.
The current report describes perceptual alterations and dissociative symptoms of a type that have been sparsely described ly as resulting from acute cannabis exposure.
Medical cannabis for chronic pain treatment in fairborn, ohio
There is a substantial literature pointing to cannabinoid-induced psychosis in those with a personal or family history of psychosis. This particular susceptibility to psychosis was nominally ruled out in the case of Can weed cause hallucinations. The current article is also limited in that cross-study comparisons with respect to the qualitative and quantitative characteristics of hallucinations across drug types was conducted with archival data across subjects rather than prospective evaluation within the same individuals.
Additional research on the comparative effects of these drugs, especially those that incorporate genetic and neuroimaging components, is needed to extend the present observations. In this article, we highlighted a rare but clinically ificant response to acute cannabis dosing. It is unclear how frequently this type of reaction occurs in healthy adults without a family history of psychosis. This case also demonstrates the importance of considering dose and route of administration in decision making regarding cannabis use as this individual did not exhibit similar effects at lower vaporized doses or smoking the same dose of cannabis.
In addition, N. All other authors have no conflicts of interest to report. National Center for Biotechnology InformationU. Journal List Cannabis Cannabinoid Res v.