5 ms·

I’ve wondered how much of our homelessness crisis is due to psychotic breaks from marijuana. It’s a small fraction of users which have psychotic breaks, but our

by jmpman 4y ago

I’ve wondered how much of our homelessness crisis is due to psychotic breaks from marijuana. It’s a small fraction of users which have psychotic breaks, but our homelessness population is similarly small.

draw_down 4y ago
[dead]
devmor 4y ago
Is there any study or relevant data point that would lead you to believe this is happening? Or is it just a completely wild thought?
- brandall10 4y ago
  https://nida.nih.gov/publications/research-reports/marijuana/there-link-between-marijuana-use-psychiatric-disorders https://nida.nih.gov/publications/research-reports/marijuana...
  - deleted 4y ago
    [deleted]
  - devmor 4y ago
    I meant on whether or not it has a significant representation in the homeless community - not that it exists.
    - jmpman 4y ago
      Would be interesting to see the homelessness rates in countries with very restricted marijuana access, like Japan, versus countries where it’s widely used. Or some other way to determine if marijuana usage increases homelessness.
jrsj 4y ago
Happens a lot more with stimulants, meth being the worst. Amphetamine psychosis can be permanent & irreversible with heavy enough use.
wahnfrieden 4y ago
You think homeless people have only themselves and their own actions to blame?
giraffe_lady 4y ago
Very little of it. The causes of homelessness are pretty well understood and it's basically poverty, high housing costs, low wages, lack of access to affordable medical care. Being homeless also does a number on your mental health and my intuition says a lot of those "psychotic breaks" were experiences of homelessness, not causes.
- jmpman 4y ago
  I had a friend who experienced a psychotic break following marijuana use. He was a moderate user, weekends only, for a dozen years prior. If he didn’t have such excellent support structure around him, I’d expect him to be homeless now.
phren0logy 4y ago
I'm a psychiatrist who works with lots of people who are homeless and mentally ill. My experience faces a strong selection bias in that I don't see the homeless people who don't have marked symptoms of mental illness. The ones who come to my attention usually have delusions and hallucinations. Beyond anecdotes, there's some reasonable and ongoing research on the topic. Methamphetamine remains far more strongly associated with psychosis than cannabis, but both anecdotes and research support that THC extracts are considerably more likely to cause psychosis than whole flowers. There also seems to be something protective about CBD, so THC extract (dabs/oil) products appear to carry more risk due to both their high THC content and the absence of CBD. People who use cannabis heavily in adolescence also have an increased risk of developing a psychotic disorder.
- mrosett 4y ago
  Interesting response. Subjectively, do you THC-linked psychosis regularly?
  - phren0logy 4y ago
    Again, strong selection bias, but yes. THC stays in your system for a long time. It can take a while to figure out if the issue is a primary psychotic disorder, like Schizophrenia, that has been exacerbated by THC or if it's only drug-induced. I occasionally see cases that appear to be completely accounted for by THC, but at a far lower rate than meth-induced psychosis.
    - tarotuser 4y ago
      I'm also curious, since you work in psychiatry.... Have you seen any cases of scromiting, or "Cannabinoid hyperemesis syndrome"? These articles showed up in a big online hit in mid-2022, and never seemingly referenced again. My pessimism indicated that it was likely a hit piece against cannabis, but I'd rather ask for sure than just assume some conspiracy.
      - phren0logy 4y ago
RajT88 4y ago
I'd look to alcohol first. It's been legal for much more of the modern age, and certainly also carries with it the risk of psychosis. And as the other commenter points out, "Whither Meth?" Probably all of these things are contributing factors, in some form.
w______roy 4y ago
Having a psychotic break doesn't suddenly make you homeless. You would need a psychotic break + lack of healthcare + lack of family/friends/support network + lack of money + lack of social programs + lack of affordable housing. The idea that people just one day lose their minds and wander out into the street is not supported by my experiences working with and interacting with unhoused people.

by jmpman 4y ago

draw_down 4y ago

[dead]

devmor 4y ago

Is there any study or relevant data point that would lead you to believe this is happening? Or is it just a completely wild thought?

brandall10 4y ago
https://nida.nih.gov/publications/research-reports/marijuana/there-link-between-marijuana-use-psychiatric-disorders https://nida.nih.gov/publications/research-reports/marijuana...
- deleted 4y ago
  [deleted]
- devmor 4y ago
  I meant on whether or not it has a significant representation in the homeless community - not that it exists.
  - jmpman 4y ago
    Would be interesting to see the homelessness rates in countries with very restricted marijuana access, like Japan, versus countries where it’s widely used. Or some other way to determine if marijuana usage increases homelessness.

jrsj 4y ago

Happens a lot more with stimulants, meth being the worst. Amphetamine psychosis can be permanent & irreversible with heavy enough use.

wahnfrieden 4y ago

You think homeless people have only themselves and their own actions to blame?

giraffe_lady 4y ago

Very little of it. The causes of homelessness are pretty well understood and it's basically poverty, high housing costs, low wages, lack of access to affordable medical care. Being homeless also does a number on your mental health and my intuition says a lot of those "psychotic breaks" were experiences of homelessness, not causes.

jmpman 4y ago
I had a friend who experienced a psychotic break following marijuana use. He was a moderate user, weekends only, for a dozen years prior. If he didn’t have such excellent support structure around him, I’d expect him to be homeless now.

phren0logy 4y ago

I'm a psychiatrist who works with lots of people who are homeless and mentally ill. My experience faces a strong selection bias in that I don't see the homeless people who don't have marked symptoms of mental illness. The ones who come to my attention usually have delusions and hallucinations. Beyond anecdotes, there's some reasonable and ongoing research on the topic. Methamphetamine remains far more strongly associated with psychosis than cannabis, but both anecdotes and research support that THC extracts are considerably more likely to cause psychosis than whole flowers. There also seems to be something protective about CBD, so THC extract (dabs/oil) products appear to carry more risk due to both their high THC content and the absence of CBD. People who use cannabis heavily in adolescence also have an increased risk of developing a psychotic disorder.

mrosett 4y ago
Interesting response. Subjectively, do you THC-linked psychosis regularly?
- phren0logy 4y ago
  Again, strong selection bias, but yes. THC stays in your system for a long time. It can take a while to figure out if the issue is a primary psychotic disorder, like Schizophrenia, that has been exacerbated by THC or if it's only drug-induced. I occasionally see cases that appear to be completely accounted for by THC, but at a far lower rate than meth-induced psychosis.
  - tarotuser 4y ago
    I'm also curious, since you work in psychiatry.... Have you seen any cases of scromiting, or "Cannabinoid hyperemesis syndrome"? These articles showed up in a big online hit in mid-2022, and never seemingly referenced again. My pessimism indicated that it was likely a hit piece against cannabis, but I'd rather ask for sure than just assume some conspiracy.
    - phren0logy 4y ago

RajT88 4y ago

I'd look to alcohol first. It's been legal for much more of the modern age, and certainly also carries with it the risk of psychosis. And as the other commenter points out, "Whither Meth?" Probably all of these things are contributing factors, in some form.

w______roy 4y ago

Having a psychotic break doesn't suddenly make you homeless. You would need a psychotic break + lack of healthcare + lack of family/friends/support network + lack of money + lack of social programs + lack of affordable housing. The idea that people just one day lose their minds and wander out into the street is not supported by my experiences working with and interacting with unhoused people.