People often smoke pot recreationally to enjoy a relaxed and euphoric buzz. But for many people, marijuana use can provoke short-term feelings of anxiety and paranoia.
Stronger strains of marijuana and heavy use of the drug are more likely to cause panic attacks and paranoia, according to the National Institute on Drug Abuse — though these symptoms can also occur with occasional use.
In a 2014 op-ed column for The New York Times, Maureen Dowd described the uncomfortable paranoia she experienced after consuming two bites of a marijuana-infused chocolate bar in a Colorado hotel room.
For the first hour, Dowd felt no different. But then she began to feel strange.
“I was thirsty but couldn’t move to get water. Or even turn off the lights,” she wrote. “I was panting and paranoid, sure that when the room-service waiter knocked and I didn’t answer, he’d call the police and have me arrested for being unable to handle my candy.”
Dowd’s symptoms resolved within eight hours. After returning to the dispensary where she’d purchased the edible form of marijuana the day before, she learned that she’d consumed far too much in one sitting.
Dowd isn’t alone. As many states have legalized recreational and medicinal forms of pot, use of the drug is increasing. And so are emergency department visits related to unpleasant side effects of the drug.
Dr. Larry Bedard, former president of the American College of Emergency Physicians, told The Denver Post in an article from 2016 that anxiety is the most common symptom landing people in the ER after using marijuana.
Patients often feel an impending sense of doom and think they’re dying, but they may actually be having a panic attack.
“If you’re smoking a joint and suddenly you can’t breathe and your chest feels tight and you start to get numb and tingly, you start to think you’ve been poisoned,” Bedard told the paper.
In many cases, the individual is simply hyperventilating, according to Bedard. He said fast and shallow breathing changes pH levels in the blood, which can cause tingling sensations in the hands and around the mouth. People may also experience a pounding heart, lightheadedness and other symptoms.
Often, the symptoms will improve if patients slow down their breathing and relax.
Anxiety is also a common withdrawal symptom among people who use marijuana heavily.
While many perceive marijuana as a harmless drug, marijuana addiction and physical dependence on the drug are common.
Frequent use of marijuana can lead to dependence, a state where people need the substance to function normally. They feel unpleasant side effects when they stop using the drug. But not everyone who is dependent on marijuana is addicted.
Addiction is a brain disease that causes people to compulsively seek out and use a drug in spite of its negative impacts on their social life or well-being.
Marijuana withdrawal symptoms typically occur within one to three days of quitting, and they can last for one to two weeks. Other common withdrawal symptoms include irritability, nervousness, restlessness, decreased appetite and insomnia.
While there’s no doubt that marijuana use can cause acute episodes of anxiety, some research has linked marijuana use to anxiety disorders and other more persistent conditions. Young people who use marijuana appear to have a greater risk of developing anxiety disorders later in life.
A 2002 Australian study by the Murdoch Children’s Research Institute that tracked 1,601 teens for seven years found double the risk for later depression and anxiety among those who smoked weed weekly or more frequently. Girls who used weed daily were five times more likely to report a state of depression and anxiety.
No clear evidence exists proving that marijuana use directly causes anxiety disorders, but research shows that individuals with these conditions are more vulnerable to developing a dependence on marijuana.
One 2014 study analyzed 31 past studies on the association between a variety of anxiety disorders and marijuana use. The researchers discovered that people with anxiety disorders were more likely to use cannabis or have a cannabis use disorder than those without anxiety disorders. A cannabis use disorder can range in severity from harmful use to dependence to addiction.
People with social anxiety disorder, a condition in which social interactions cause an extreme fear of being watched or judged by others, are seven times more likely to develop a dependence on marijuana, according to a 2009 study in the journal Depression and Anxiety.
Some individuals may self-medicate with marijuana to alleviate the symptoms of an untreated mental illness. Other factors, including poverty, childhood trauma and genetics, may also contribute to co-occurring disorders such as anxiety disorders, marijuana abuse or addiction.
Large doses of marijuana can cause temporary psychotic episodes, characterized by delusions, hallucinations and feelings of depersonalization, or detachment from oneself.
People who use the drug may also experience other marijuana-related mental health problems, including depression. Research shows that weed use can worsen symptoms post-traumatic stress disorder and schizophrenia.
Xanax, a common prescription medication used to treat anxiety, should not be combined with marijuana.
Cannabidiol, one of the active ingredients in marijuana, blocks some of the enzymes the body uses to break down Xanax and other benzodiazepine drugs. As a result, mixing the two can increase the amount of Xanax circulating in the blood stream. This worsens the medication’s side effects and causes it to remain in your system longer.
Xanax is a potent central nervous system depressant with powerful sedative effects. Marijuana, which also causes sleepiness, may increase these effects.
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