High Anxiety: The Cannabis Conundrum

On marijuana and free thinking

If there is one issue in the psychedelic community that gets people fired up more than anything, it’s cannabis. Perhaps it's the plant's ubiquitous nature or its long history of both recreational and medicinal use, but discussions about cannabis evoke strong emotions.

Right from the start, I want to be clear about my stance. I fully support the decriminalization of cannabis. The war on drugs has been a failure, and my concerns about marijuana should not be mistaken for an argument for making it illegal. I will return to the issue of decriminalization versus legalization later in the piece.

Cannabis is a powerful plant with numerous benefits that we are only beginning to understand. However, like any potent substance, it comes with both positive and negative aspects that must be considered. All that being said, individuals should have the freedom to use cannabis in whatever way they choose.

Marijuana was the first psychoactive plant I experimented with. Having gone to a private school on the East Coast, it was prevalent and unavoidable. It was also fun at the beginning, but I quickly realized the plant’s power. It would pull deeply at my anxiety, leaving me with a sense of dread and paranoia. Before I understood anything about working with plant medicine, marijuana felt like it had its own energy that I could do little more than respect and keep at an arm’s length.

As I grew up and eventually left the United States for good, I continued to encounter friends with deep addictions to marijuana. The nature of these personalities ranged from the classic stoner type to deeply anxious people for whom marijuana was an escape. With the latter types, there was always something off for me about the connection between their anxiety and their dope smoking.

The plant seemed to make their symptoms worse, and yet they couldn’t get beyond its reach. Raise even gentle questions about this situation and the response is almost immediately dismissive. Why is it so hard to have an honest conversation about cannabis? I am even hesitant about publishing this post due to the probable backlash.

New Perspectives

I recently sat with Alex Berenson’s controversial book, Tell Your Children: The Truth About Marijuana, Mental Illness, and Violence. Berenson, a former reporter for the New York Times, argues that marijuana is far from the benign substance it’s often portrayed to be. He highlights a growing body of research linking marijuana use to an increased risk of psychosis, schizophrenia, and violent behavior. However, several established doctors and scientists have called Berenson’s argument “pure alarmism.”

One of the book's most startling claims (beyond the violence issue) is that the public narrative around marijuana has been carefully crafted to downplay its potential dangers, with advocacy groups and the legal cannabis industry pushing an overly sanitized view. This narrative, he argues, is often fueled by financial interests and a desire to undo the harms of the war on drugs, leading to a reluctance to acknowledge the potential downsides of cannabis use.

Berenson addresses these critics by citing numerous studies showing that heavy marijuana use, particularly in adolescents and young adults, can exacerbate or even trigger latent mental health conditions. He writes, "In states that have legalized marijuana, hospitalizations for psychosis have soared. Cannabis-induced psychosis is now a well-documented and rising phenomenon that we cannot afford to ignore."

In places like Colorado, there has been a noticeable uptick in emergency room visits related to cannabis-induced psychosis, highlighting the overlooked public health risks. This data is further supported by a 2019 study published in The Lancet Psychiatry, which found that daily cannabis use was associated with a threefold increase in the risk of psychosis.

The Long Arm of Paranoia

“Marijuana causes paranoia and psychosis,” Berenson writes. “That fact is now beyond dispute. Even scientists who aren’t sure if marijuana can cause permanent psychosis agree that it can cause temporary paranoia and psychotic episodes. The risk is so obvious that marijuana dispensaries advertise certain strains as less likely to cause paranoia.”

While I think Berenson’s claims that marijuana usage is causing a spike in violent behavior is indeed overblown, I appreciate his perspective on the silencing of debate about marijuana’s profound effect on society. The desire to undo the harms of the war on drugs has, in many ways, led to an oversimplified narrative that cannabis is entirely safe and beneficial. This has left little room for nuanced discussions about its potential risks, particularly for individuals predisposed to mental health challenges or that are suffering from common challenges like anxiety. However, it's important to acknowledge that not everyone who uses cannabis will experience negative consequences. Factors such as frequency of use, potency of the product, individual predisposition, and the presence of underlying mental health conditions can all play a role in determining the risks.

The normalization of daily marijuana use, especially in high-potency forms such as dabs and edibles, can deepen anxiety and depression, making it harder for users to function without it. This dependency is rarely acknowledged in mainstream conversations about cannabis, despite mounting evidence that it can have severe consequences.

It’s easy to dismiss marijuana as a harmless indulgence, but for many people, it becomes a dangerous crutch that exacerbates their underlying struggles. Berenson states, "The link between heavy marijuana use and severe mental illness is stronger than the public has been led to believe. We need to rethink our approach before it's too late ... Marijuana use was more likely to be linked with the death of children than almost any other factor, including domestic violence or mental illness. Once again, researchers who weren’t looking for evidence that cannabis was linked to violence found it anyway.”

This claim, based on research connecting marijuana use and violence, is subject to significant debate in the scientific community. We should not mistake Berenson’s conviction with it being settled fact but we should consider the evidence he presents. Critics of Berenson’s work argue that correlation does not equal causation—that individuals predisposed to mental illness may be more likely to use cannabis as a form of self-medication. While this is a valid point, the volume of studies linking heavy cannabis use to psychosis and other mental health issues shouldn’t be ignored.

On Legalization

The issue of legalization is where the real challenge lies. Berenson argues that while decriminalization is the right path forward, full legalization is dangerous because it “signals that marijuana is not harmful and encourages teen use.” He also contends that the economic benefits of legalization are “vastly overstated.” My concerns about legalization are more practical.

Our society is simply not prepared for the widespread legalization of most psychedelics, including cannabis. In the past, I’ve written about our collective lack of responsibility in using these substances with the reverence they deserve. While I strongly support decriminalization—believing the government should not stand in the way of people learning to work with these medicines—that is a far cry from full legalization.

I’ve heard firsthand accounts from people who have traveled deep into the Amazon to work with traditional shamans and plant medicines like ayahuasca. Time and again, they’ve shared how shamans treat marijuana with great caution, recognizing its power and spirit. As a society, we lack that same reverence and, more importantly, the willingness to truly understand how to engage with this plant responsibly. Just as we wouldn’t hand a child the keys to a car, we have a lot of maturing to do before we’re ready for legalization.

Writing about this issue isn’t a way of pointing fingers. Rather, I feel that the lack of debate about the potential dangers of these substances is doing a disservice to users and the larger conversation about psychedelics in society. We are so early in the process of incorporating plant medicines into our lives that we must think critically about the genuine effects of these substances on people with profound psychological challenges.

Marijuana serves in many ways as a cautionary tale of what can go wrong when legalization efforts outpace public education and healthy discussion. We need to recognize that marijuana, like any substance, is not without its dangers and that a more balanced conversation is essential to our overall societal relationship to plant medicines. As we navigate the evolving landscape of cannabis legalization, we must ask ourselves: Are we prioritizing public health over profit? Are we equipping individuals with the knowledge to use this powerful plant responsibly? The answers to these questions will shape not only our relationship with cannabis but also the future of psychedelics in society.