Risks of Cannabis Use in Bipolar Disorder
Psychiatric Risks
- High doses of THC are particularly associated with psychotic symptoms, which can exacerbate bipolar psychosis 1
- Early onset of cannabis use, especially weekly or daily use, strongly predicts future dependence and worse bipolar outcomes 1
Risk of Developing Cannabis Use Disorder
- Approximately 10% of adults with chronic cannabis use may develop cannabis use disorder, characterized by clinically significant impairment or distress 2, 1
- Long-term daily cannabis users may experience withdrawal symptoms after cessation, including irritability, insomnia, headaches, sleep disturbances, appetite changes, and abdominal pain 3, 1
- These withdrawal symptoms typically occur within 3 days after cessation and may last up to 14 days, potentially triggering mood instability 1
Physical Health Risks
- Cardiovascular side effects may include arrhythmias and orthostatic hypotension, which can interact with medications commonly used for bipolar disorder 2, 1
- Long-standing cannabis use can lead to cannabinoid hyperemesis syndrome, characterized by cyclical emetic episodes that are relieved by hot showers 2
- Cannabis smoking affects lung function and is associated with conditions like chronic bronchitis and chronic obstructive pulmonary disease 4, 1
- The increasing potency of cannabis products (average THC concentration almost doubling from 9% in 2008 to 17% in 2017) elevates all health risks 4, 1
Safety Concerns
- Cannabis users are at higher risk of motor vehicle accidents, with drivers who test positive for cannabis being more than twice as likely to be involved in crashes 2
- The percentage of fatal motor vehicle accidents involving cannabis alone increased from 9.0% in 2000 to 21.5% in 2018 2
- Cannabis impairs one's ability to drive because it affects reaction time and coordination 3
- This safety risk is particularly concerning for bipolar patients who may already have impaired judgment during mood episodes 2