Marijuana, SMI, and Violence: Practical Guidance for Practitioners-View Presentation Slides

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The webinar reviews cannabis use, serious mental illness (SMI), psychosis, and violence, with practical implications for clinicians. Cannabis use has increased in the United States, while products have become more potent. Concentrates, dabbing, vaping, and edible products can deliver very high THC doses; edibles may have delayed effects and increase the risk of excessive use. Synthetic cannabinoids are distinct from cannabis, can be far more potent, and may cause severe medical and psychiatric effects.<br /><br />Evidence presented links cannabis use—particularly early, frequent, or heavy use and higher-potency products—to increased risk of psychosis. Cannabis-related psychosis may precede schizophrenia or bipolar disorder, with younger age and self-harm identified as concerning predictors. Synthetic cannabinoids can also trigger agitation, hallucinations, psychosis, and other serious symptoms.<br /><br />The presentation also describes associations between cannabis use and violence, including among people with SMI. Persistent heavy use and cannabis misuse show stronger associations, although the direction and mechanisms are not fully established and further research is needed. Risk factors highlighted include SMI, younger age, high-potency or frequent use, combining cannabis with other substances, and violence involving an intimate partner.<br /><br />Clinicians are encouraged to ask about cannabis use, age at first use, frequency, product type and THC/CBD content, adverse effects, and other substance use. The central message is to assess cannabis exposure carefully—especially in patients with psychosis or SMI—and consider potency, patterns of use, and co-occurring risks when evaluating safety.

Keywords

cannabis use

serious mental illness

psychosis

violence risk

THC potency

synthetic cannabinoids

dabbing

edibles

clinician assessment

substance use