Liz Kirkaldie鈥檚 grandson was near the top of his class in high school and a talented jazz bassist when he started smoking pot. The more serious he got about music, the more serious he got about pot.
And the more serious he got about pot, the more paranoid, even psychotic, he became. He started hearing voices.
鈥淭hey were going to kill him and there were people coming to eat his brain. Weird, weird stuff,鈥� Kirkaldie said. 鈥淚 woke up one morning, and no Kory anywhere. Well, it turns out, he鈥檇 been running down Villa Lane here totally naked.鈥�
Kory went to live with his grandmother for a couple of years in Napa, California. She thought maybe she could help. Now, she says that was naive.
Kory was diagnosed with schizophrenia. Kirkaldie blames the pot.
鈥淭he drug use activated the psychosis, is what I really think,鈥� she said.
Indeed, have linked marijuana use to an increased risk of developing psychiatric disorders, including schizophrenia. The risk is more than for people who use high-potency marijuana daily than for those who have never used, according published in The Lancet Psychiatry in 2019. One study found eliminating marijuana use in adolescents could reduce global rates of schizophrenia .
Doctors and lawmakers in California want cannabis producers to warn consumers of this and other health risks on their packaging labels and in advertising, similar to requirements for cigarettes. They also want sellers to distribute health brochures to first-time customers outlining the risks cannabis poses to youths, drivers, and those who are pregnant, especially for pot that has high concentrations of THC, the chemical primarily responsible for marijuana鈥檚 mental effects.
鈥淭oday鈥檚 turbocharged products are turbocharging the harms associated with cannabis,鈥� said Dr. Lynn Silver with the , a nonprofit sponsoring the proposed labeling legislation, , the Cannabis Right to Know Act.
Californians voted to legalize recreational pot in 2016. Three years later, emergency room visits for cannabis-induced psychosis went up 54% across the state, from 682 to 1,053, according to state hospital data. For people who already have a psychotic disorder, cannabis makes things worse 鈥� leading to more ER visits, more hospitalizations, and more legal troubles, said , a psychiatry professor at Yale University School of Medicine who also serves on the for Connecticut鈥檚 medical marijuana program.
But D鈥橲ouza faces great difficulty convincing his patients of the dangers, especially as have legalized recreational marijuana.
鈥淢y patients with schizophrenia and also adolescents hear very conflicting messages that it鈥檚 legal; in fact, there may be medical uses for it,鈥� he said. 鈥淚f there are medical uses, how can we say there鈥檚 anything wrong with it?鈥�
Legalization is not the problem, he said; rather, it鈥檚 the commercialization of cannabis 鈥� the heavy marketing, which can be geared toward attracting young people to become customers for life, and from 4% on average up to between 20% and 35% in today鈥檚 varieties.
Limiting the amount of THC in pot products and putting health warnings on labels could help reduce the health harms associated with cannabis use, D鈥橲ouza said, the same way those methods worked for cigarettes.
He credits warning labels, education campaigns, and marketing restrictions for the sharp drop in in the past decade.
鈥淲e know how to message them,鈥� D鈥橲ouza said. 鈥淏ut I don鈥檛 think we have the will or the resources, as yet.鈥�
Some states, including Colorado, Oregon, and New York, have dabbled with cannabis warning-label requirements. California鈥檚 proposed rules are modeled after comprehensive protocols established in Canada: Rotating health warnings would be set against a bright-yellow background, use black 12-point type, and take up a third of the package front. The bill suggests language for 10 distinct warnings.
Opponents of the proposed labels say the requirements are excessive and expensive, especially since marketing to children is already prohibited in California and people must be 21 to buy.
鈥淭his bill is really duplicative and puts unnecessary burdens on the legal cannabis industry, as we already have incredibly restrictive packaging and advertising requirements,鈥� said Lindsay Robinson, executive director of the .
The state should focus more on combating the illicit pot market rather than further regulating the legal one, she said. Legal dispensaries are already struggling to keep up with existing rules and taxes 鈥� the state鈥檚 1,500 licensed pot retailers generated last year. Adding more requirements makes it harder for them to compete with the illicit market, she said, and more likely to go out of business.
鈥淭he only real option if they fail out of the legal system is to shutter their businesses altogether or to operate underground. And I don鈥檛 think the state of California, with the tax revenue, wants either of those to happen,鈥� Robinson said. 鈥淭he heart of the issue is that there鈥檚 a massive, unregulated market in the state.鈥�
Some people are skeptical that the labels will work. Liz Kirkaldie鈥檚 grandson, Kory, is stable now, living with his dad. But she鈥檚 not sure a yellow warning would鈥檝e stopped him when he was a teen.
鈥淭hey鈥檙e just not going to pay attention,鈥� she said. 鈥淏ut if it helps even one person? Great.鈥�
Scientists still do not know what causes schizophrenia, but they believe multiple factors are at play, including genetics, family history, trauma, and other influences in a person鈥檚 environment, like smoking pot. Some scientists believe having schizophrenia in the first place . While it鈥檚 difficult to prove a direct causal link between cannabis use and schizophrenia, the associations are strong enough to warrant action, said D鈥橲ouza, and, importantly, pot use is one of the few risk factors people can control.
鈥淣ot everyone who smoked cigarettes developed lung cancer, and not everyone who has lung cancer smoked cigarettes,鈥� he said. 鈥淏ut I think we would all agree that one of the most preventable causes of lung cancer is cigarette smoking.鈥�
Applying the same health education strategies to cannabis that were used for tobacco, he said, is long overdue.
This story is part of a partnership that includes聽,听,听and KHN.