There are multiple reports online of people trying cannabis for the first time, only to get “stuck in a loop” where an altered mind-state persists for days, weeks, or even months. Is there any scientifically proven reason for it? Will you have long-lasting side effects? Curious about why this happens or how often it happens?
Some users report that the subjectively positive effects of cannabis stay with them long after they would be expected to wear off. However, it is more common for individuals who experience a negative first-time cannabis experience to report persistent, unsettling, and negative after-effects.
How often do first-time cannabis users have negative, long lasting effects?
First off, it’s important to state that it appears to be only a small minority of first-time users that experience this effect. Exactly how many is not clear, as official figures do not yet exist on many cannabis-related matters. In the future, as legal cannabis becomes more widespread, a clearer picture should emerge.
Is it normal to still feel high the day after first using cannabis?
It seems to be fairly common for new users to use a lot of cannabis during a session then go to sleep at night, only to wake up the next day still feeling high. The typical duration of a cannabis high is almost invariably stated to be 2-4 hours. One would expect that a good night’s sleep would be more than enough time for the body to process the THC and for normal consciousness to resume.
It is important here to note the difference between people who experience a cannabis “hangover” the day after a session and those who state that they still feel subjectively high. The former usually report feeling “groggy”, “burnt out” and “half-asleep”.
This may well be something to do with the fact that cannabis use reduces time spent in REM sleep (an important stage of sleep in which we dream, and thereby refresh and repair various mental processes). This appears to be a different phenomenon from those who claim to still feel “high” or “stoned”.
In contrast, the people who genuinely seem to experience an extended high use descriptors like “in a daydream”, “blazed”, “afterglow”, and “delightful”—generally positive and enjoyable.
How can the positive aspects persist for days?
Most of these reports are of feeling high the next morning, but there are also reports of people who continue to feel high for several days. One individual reports feeling “blazed” for up to six days after using cannabis. Another talks about his “delightful” experience the day after his “very psychedelic” first use of cannabis.
It is not clear what causes some new users to feel subjectively high for days after using cannabis. It is possible that for some, the breakdown of THC into its metabolites in the liver (which are then secreted in the urine) occurs at a slower rate than in others. This would allow the THC to circulate in the bloodstream for longer, giving it an extended chance to reach the brain, encounter CB₁-receptors, and cause psychoactive effects.
Another possibility is the route of administration. Eating cannabis edibles often leads to a delayed peak concentration of THC in the blood, as the cannabinoids are usually dissolved in the fat used to make the edibles.
Fat releases the cannabinoids slowly into the bloodstream via the gastrointestinal tract, compared with the rapid administration achieved with smoking, vaping and sublingual sprays, which deliver cannabinoids directly to the bloodstream via the mucous membranes of the mouth. Also, since THC builds up in the adipose (fat) tissues, those with more body fat may experience a slow release effect of THC.
But what about persistent negative effects?
By far the most common negative effects reported by first-time cannabis users are anxiety, paranoia, panic, confusion, disorientation and depersonalization. Again, most of those who experience these negative effects do so in the days or weeks immediately following use of cannabis, and then find that normality quickly returns.
However, a small percentage of people state that their intense negative feelings persisted for weeks or even months. In some cases it caused such an unprecedented disturbance to normal life that psychiatric treatment was sought.
Anecdotal reports of these persistent negative effects sometimes include the experience of suicidal thoughts and a desire to self-harm. However, it is problematic to assume a causal link between cannabis use and suicide. Those who report such feelings may simply be suffering from or at risk of a separate mental illness. Some studies have associated cannabis use with an increased risk of suicide, but others have noted that in several U.S. states, suicide rates have dropped since medicinal cannabis programs were implemented.
The truth probably lies somewhere in between. Cannabis use may increase suicidal thinking in certain susceptible individuals. On the other hand, there are those who suffer from chronic pain or intractable illnesses, which is thought to be a risk factor for suicide. Since cannabis has been shown to have therapeutic benefits that alleviate chronic pain and suffering, it’s reasonable to say that cannabis use may actually reduce the risk of suicide in some cases.
Why do some people experience these negative effects?
This is a complicated question, and one that science has been trying to answer for decades. However, it’s also a question that overlaps heavily with the general study of cannabis and its effect on mental health. This makes it an area of research that is muddied by bias and politics. Thus, getting a clear answer is difficult. It’s arguable that a clear answer doesn’t even exist yet, as we are still far from having all the facts.
It is interesting to note that in a book written in 1980, High Culture: Marijuana in the Lives of Americans by William Novak, the author states “bad trips on marijuana are statistically minuscule, but they do occur—especially the first time…But the vast majority of first-time experiences are either neutral or pleasant”.
While negative first-time experiences are certainly still in the minority, the sheer number of modern reports implies that some increase in their incidence may be occurring. After all, most regular smokers today know at least one or two people who “couldn’t handle” their first time. This phenomenon may correspond to the increase in THC relative to CBD and other cannabinoids and terpenes that has been occurring in commercial cannabis varieties over the last few decades. Or it may simply be a result of residual chemicals present in poorly-grown cannabis.
Increased THC levels may be responsible
The market for cannabis in the Western world has so decisively shifted from imported, outdoor-grown varieties containing relatively little THC (and few pesticides, if any) to indoor crops grown with commercial nutrients and chemicals.
With most plants, there are specific chemicals and pesticides to be used and that use is dictated by the governing body’s regulations, such as those from the Environmental Protection Agency in the USA (at a federal level). But at least in USA’s case, that doesn’t apply to cannabis since it’s still illegal on a federal level. Therefore, those growing cannabis have no clear guidance on what can or should be used and when. No such oversight likely means at least some of today’s cannabis in the Western world are more contaminated with chemical residue.
There’s also the fact that relative THC content has increased over these last few decades.
THC content has risen dramatically in more recently developed strains in much of the Western world and more and more people are getting access to these high-strength strains. We’re now hearing about strains that have up to 40 percent THC. In 1980, levels that high were unheard of with the average THC content being less than 10 percent.
Nowadays, average THC content isn’t 35 percent, but it’s certainly higher than the 1-10 percent range. In 2008, the UNODC stated that average content was approximately 10 percent. In Colorado in 2015, the average was apparently more like 18.7 percent!
THC really does seem to cause short-term psychosis
We have so much evidence connecting THC with short-term psychotic effects that it’s fatuous to ignore it. While we have little reliable evidence that it causes long-term psychiatric illness, we certainly do have evidence that acute administration of THC causes a state comparable to psychosis in the short term.
It’s likely that some of the more susceptible individuals among us (who may be more susceptible due to genetics, state of health, or various other factors) can experience a THC-induced psychosis-like state, which may persist for some time. For most of these people, this state will eventually go away. For a small subset of them, this THC-induced state may trigger an underlying mental illness.
This is not the same as THC itself causing the mental illness, as they would probably become mentally ill without any cannabis use. The cannabis use could speed up or possibly exacerbate its onset, though. So while THC shouldn’t currently be blamed for causing mental illness, its short-term psychosis-inducing effects are extremely important to study.
What’s the evidence for THC causing psychosis?
From 1972, an Iranian report on narcotics highlights a case of a policeman with no previous history of psychosis who “went into a very violent excitement with paranoid delusions, struggling to get hold of his rifle to shoot his imaginary persecutors” after “a bout of bhang drinking”. Of course, this was during a time of intense controversy on recreational use of cannabis. A time with plenty cases of wild propaganda and unfounded statements about cannabis use (ever see the movie Reefer Madness?!). So how much truth there is in this story we may never know for sure.
Then in 2005, we have two case studies of “cannabis acute psychosis”. Two “regular but occasional” users experienced “depersonalization, paranoid feelings and derealisation” after oral administration of THC. Both felt “well” the next day, with no recurrence.
Another 2005 study states “even the critics have accepted that psychotic symptoms can be induced by cannabis, and that such symptoms generally wear off quickly and with complete remission”. However, this study did find a very strong association between cannabis psychosis and later development of paranoid schizophrenia, backing up the concept that cannabis psychosis can act as a trigger for underlying conditions.
In 2009, an excellent review on the existing literature on cannabis and acute psychosis was published, which states “generally these psychotic symptoms are transitory (minutes to hours) but there have been a few reports of symptoms persisting for weeks (…) severe or persistent psychotic reactions are rare, and are more likely to occur in individuals with a pre-existing psychiatric condition”.
Should you be worried about your own usage?
Again, it is crucial to bear in mind that these persistent negative effects are unusual, and that most people have a pleasant first time using cannabis. Furthermore, even if you find yourself experiencing feelings like those described herein, it is important to try to remain calm and rationalize your experience.
Feelings of anxiety, paranoia and depersonalization in first-time cannabis users are usually temporary. They are the result of using a powerful psychoactive substance. Many people who experience these feelings immediately begin to question their own sanity. Just keep in mind that it is a natural reaction to a powerful substance. This should help reassure you that you are not insane, and you will feel more confident that normality will return imminently. Whether or not this attitude will speed the return of normality is unclear, but it can certainly make a huge difference to one’s state of panic and fear while experiencing unusual feelings.
If this altered state continues to persist beyond a few days, it may be advantageous to seek psychiatric help to help identify any possible existence of an underlying condition. Again, if this is the case, it does not necessarily imply that cannabis has caused any such illness. It is also possible that the temporary altered mind-state simply “paves the way” for its onset.
It may be possible to reduce the risk of psychotic symptoms appearing by choosing varieties of cannabis that are high in CBD, which is well-known to counteract the psychoactive effects of THC. This is perhaps the most important consideration. But it is also worth keeping in mind the importance of a relaxed environment, a full stomach, a hydrated body and a clear head, when first using cannabis.
- Disclaimer:This article is not a substitute for professional medical advice, diagnosis, or treatment. Always consult with your doctor or other licensed medical professional. Do not delay seeking medical advice or disregard medical advice due to something you have read on this website.