San Diego ERs seeing up to 37 marijuana cases a day — mostly psychosis

Meg and Scott knew something was going on with their son Kyle when, during the pandemic, he began refusing to get out of bed to attend class online.

Up until then, Kyle had been like a dream son: tall, good-looking, strong, athletic, with a great sense of humor. He was such a good baseball player that talent scouts were checking him out, and had a decent chance of someday playing in the Major League.

“He had the world by the balls,” his dad said. (At the family’s request, The Post has used pseudonyms.)

Now, Kyle was constantly irritable and depressed and wanted to drop out of his New Jersey high school. Then, one night, he lost it completely, fantasizing that his parents wanted to kill him. 

“Zero touch with reality,” Scott recalled. The family checked Kyle into a psychiatric facility, where his delusions got worse. He thought his dad ran the mafia and had put Joe Biden in office. He demanded that his parents give him $10 million.

Meg and Scott were sure their son was messed up on some hardcore drug. But when the institution ran a drug test, Kyle came up positive only for his prescribed Attention Deficit Disorder medication and for THC — that is, marijuana.

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Kyle’s now in recovery, but his is a story that is becoming familiar to more and more American families. Someone begins showing classic signs of hardcore drug addiction. Eventually, they suffer a full psychotic break. But the only drug history is for cannabis.

“We’re now counting 37 cannabis-related diagnoses a day,” Dr. Roneet Lev, an addiction medicine doctor at Scripps Mercy Hospital in San Diego, said about emergency departments in San Diego County. “It’s been steadily increasing over the years. When I started in the 1990s, there was no such thing. Now I see 1 to 2 cases per shift. The most common symptom is psychosis.” 

“We probably see 20 THC-induced psychoses for every amphetamine-induced psychosis,” said Ben Cort, who runs a drug and alcohol treatment center in Colorado. One study showed an increase of 24% in cases of psychoses in emergency departments in Colorado in the five years following marijuana’s legalization in that state in 2012.

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Since then, legal marijuana has been transformed into a potent and unrecognizable product.

“When I speak at parent nights at schools, most adults still think it’s like the weed we smoked when we were teens in the ’80s, [which had] between 3 to 5% THC per gram of flower,” said Laura Stack, an advocate against cannabis abuse in Colorado. “We never had today’s high-potency concentrates, vapes or edibles.”

Laura’s son Johnny was driven into acute psychosis by years of high concentrate THC usage. He believed his dorm room was bugged and that the mob was after him.

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Johnny killed himself in 2019 at the age of 19 by jumping off a six-story building. “There are no caps on potency,” said Stack. “They’re cultivating higher and higher concentrates of THC. You literally can’t buy what you could get in the ’80s and ’90s; marijuana that mild isn’t around anymore.”

THC (Tetrahydrocannabinol) is the psychoactive chemical, or cannabinoid, that causes both the euphoria and the paranoia that tends to accompany marijuana highs. The strongest marijuana flower you can buy is in the range of 25% THC. 

The edibles that are sold in dispensaries are created by chemically stripping the THC from the marijuana plant and creating a concentrated THC “wax” that’s typically three times that level. These products also lack CBD, a chemical in natural marijuana that partially counteracts the THC. Even more potent than edibles are “dabs,” a form of THC that users smoke out of vape pens, which can be over 90% THC. At this level of potency, THC can trigger severe symptoms of psychosis in regular users, studies and addiction experts say.

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“Now that THC is a more readily available drug and the perception of harm is at the lowest point in recorded history, we treat more people for THC disorder than for opiate disorder right now,” said Cort. “I’d say about half of our census is THC. And the vast majority of them have THC-induced psychosis.”

“One clinical study showed that a moderate dose of pure THC causes psychotic symptoms in about 40% of people who lack a family history of psychosis. If you’re a casual user and your dosage is mild, that likely just means a touch of paranoia,” said neuroscientist Christine Miller, an expert on psychotic disorders.

Thirty-five percent of people who have experienced such symptoms, however, will go on to experience a full psychotic break, according to another study, if they continue their high risk environmental exposure by continuing to use cannabis.

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According to multiple studies, for those who have ever suffered a full cannabis-induced psychotic break, the chance that, if you still keep using, you’ll eventually develop permanent schizophrenia is almost 50 percent. That’s a higher conversion rate than amphetamines, opioids or LSD.

But what really makes THC more dangerous than those other drugs, experts say, is that so few people consider it dangerous at all. “We know fentanyl is bad. We know meth is bad,” said Dr. Libby Stuyt, a recently retired addiction psychiatrist in Colorado. “We don’t know that marijuana is bad.”

THC concentrates are highly physically addictive, experts add. “It is almost impossible for people to quit,” said Stuyt.

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But because they’re produced from marijuana, many users assume that they’re as non-addictive as an old-fashioned marijuana joint is. According to a Rasmussen Reports poll, 57% of Americans do not believe that marijuana is dangerous.

Often cannabis users believe the THC products they consume are cures for the very symptoms that are generated by their withdrawal from the drug, such as anxiety and insomnia. “People think, ‘Oh, it’s my symptoms. That’s why I need it. I’m anxious and it’s treating my anxiety,’” said Stuyt. “No: It’s the withdrawal that’s causing your anxiety.”

“Because it’s allowed to be heavily marketed and advertised as ‘medicine,’ people believe it’s safe,” Stuyt continued “It’s the industry, they keep saying it’s not addicting, it doesn’t cause psychosis. This is no different from the tobacco companies when they were saying it doesn’t cause cancer, it’s non-addicting.”

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Since marijuana has been legalized in 19 states and counting, a $13 billion industry has emerged around it that has marketed the drug as a remedy for everything from chronic pain to anxiety. The corporations that have invested most heavily in cannabis are the ones that know best how to market addictive products and manipulate public opinion into underestimating their risks: the tobacco, alcohol and pharmaceutical industries.

There are in fact only four cannabis-derived drugs that are FDA-approved: Epidiolex for seizures, Marinol and Syndros for nausea and anorexia, and Cesamet, also for nausea. They are available only by prescription, and none are sold over-the-counter at dispensaries. (Since marijuana is still a Schedule I drug, American scientists cannot legally research it. President Biden has announced plans to review that status; if the administration re-schedules it, researchers will be able to legally experiment with it and more medical applications could in time be revealed.)

Beyond those four prescription drugs, evidence for claims to the medicinal properties of marijuana are scientifically lacking. 

“This is not medicine,” Stuyt said. “This high-potency THC has not been studied as medicine.”

According to Cort, Americans underestimate the risks of THC because they conflate it with the much less harmful marijuana of the pre-legalization years. “They’re not smoking weed,” said Cort. “What’s being consumed in these concentrates is devastating for their mental health.”

“The whole world is telling them it’s safe,” said Dr. Lev of cannabis users. “People are in unbelievable denial.”