Ask Doctor Leigh: Why does cannabis make me paranoid?

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Using cannabis can have a big impact on your physical and mental health—for better, and sometimes for worse. That’s why it’s important to consult a healthcare provider before experimenting.

Here at GreenState, cannabis clinician Dr. Leigh Vinocur is here to answer your questions on healthy living with cannabis.

Editor’s Note: The answer to this question is meant to supplement, not replace, advice, diagnoses, and treatment from a healthcare provider.  Always consult a medical professional when using cannabis for medicinal purposes, and do not disregard the advice of your healthcare provider because of anything you may read in this article. 

Q: Why does cannabis make me paranoid?

A: Paranoia is defined as being suspicious without real evidence or justification. It occurs in many different mental health conditions involving psychotic disorders, characterized by intense fearful thoughts of persecution, threats, and conspiracy.

Feeling paranoid is a typical symptom along with nausea, vomiting, tachycardia, hypertension, confusion, anxiety, loss of reality seen in patients that have an overdose or acute intoxication of cannabis, especially with high doses of THC.

THC binds with our endocannabinoid receptors in different parts of the brain. One specific area is called the amygdala. This is the area that regulates and processes our emotions and responses to fearful, threatening stimuli. It helps us detect real threats and activate the appropriate fearful responses to dangers. Overstimulation of this area with THC can increase our fears and anxieties for no reason and cause paranoia. One study found that in some people 7.5mg of THC could reduce anxiety while 12.5 mg of THC had the opposite effect increasing anxiety and fear.

But not everyone experiences this. Animal studies have shown that there may be genetic reasons why these areas in the brain may be more sensitive to THC. And there may be some people more prone to anxiety and paranoia which cannabis can exacerbate.

But there are some other things you can consider. Increasing the CBD content in your cannabis, which doesn’t directly interact with our endocannabinoids in that region of the brain can help counteract these negative effects of THC. Additionally, some other animal research has shown there are sex difference in tolerance and sensitivity to THC that may also affect these feeling.

Other research shows that some terpenes, such as limonene, pinene and caryophyllene, may also be able to counteract some negative effects of THC.

But the most important thing to remember is to stay calm. This feeling will usually pass.  You should be with someone you trust in a quiet relaxing environment until that happens. But if you continue to feel that way, once the cannabis has worn off, make sure you seek medical help for further evaluation.

Got cannabis questions? Ask Doctor Leigh. Send your questions to GreenState’s Assistant Editor Elissa Esher at and keep an eye out for new answers from Dr. Leigh Vinocur every month.

Dr. Leigh Vinocur is a board-certified emergency physician who also has a cannabis consulting practice for patients and industry. She is a member of the Society of Cannabis Clinicians and a graduate of the inaugural class, with the first Master of Science in the country in Medical Cannabis Science and Therapeutics from the University of Maryland School of Pharmacy.

The response to this question was not written or edited by Hearst. The authors are solely responsible for the content.

Leigh Vinocur, MD