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Can Marijuana Cause HPPD? How to Address It Safely

While quite rare, it is possible to experience hallucinogen-persisting perception disorder (HPPD) due to marijuana use.

HPPD is poorly understood. If you experience it, you should stop using drugs as soon as possible and consult a doctor.

Marijuana

Marijuana is a recreational drug subject to much debate. Its recreational use is not healthy. It is capable of causing breathing problems, throat problems, and complications with pregnancy.

It is sometimes used medicinally, however. When taken medicinally in doctor-approved doses, there is growing evidence that it may treat several conditions and be a safer alternative to traditional painkillers.

HPPD

Hallucinogen-persisting perception disorder is generally associated with hallucinogens, most commonly with LSD use.  It should be noted that cannabinoids, the class of drug marijuana falls under, are generally not thought of as hallucinations except in cases where a user has a history of mental illness or takes a very high dose of the drug. 

There are two general types of HPPD. Type 1 is associated with random, brief flashbacks. Type 2 is associated with vision changes, which come and go. These flashbacks are not as intense as those associated with post-traumatic stress disorder (PTSD).

HPPD is mostly visual. While the person experiencing a flashback may see a moment in their past, it is generally just distracting and possibly frustrating since such an occurrence makes day-to-day life extremely difficult. 

Meanwhile, vision changes can be quite varied. Some examples include:

  • Halos or auras around objects
  • Trails that follow moving objects
  • Changes in color perception
  • Objects appearing to move even when still
  • Seeing patterns that are not there, such as checkerboard patterns
  • Visual snow
  • Stretched or distorted dimensions on objects

HPPD generally fades over time, although it can persist for years in some people, especially chronic drug abusers.

How Are HPPD and Marijuana Related?

Exactly how marijuana is related to hallucinogen-persisting perception disorder is a difficult question to answer, as research is scarce. Marijuana use is relatively common, and HPPD can be quite disruptive to a person’s quality of life. Even if it is only presenting in a tiny minority of people, answers should still be sought.

There seem to be two potential ways marijuana use and HPPD might be related. What remains apparent in either case is that experiencing HPPD after marijuana use, especially light marijuana use, seems extremely uncommon. This again does not mean such use is healthy; it only means that HPPD is unlikely. 

These may affect people when marijuana is taken at very high doses and/or by those with a family history of mental illness. It is possible that at these high doses, marijuana is hitting triggers that only hallucinogens like LSD usually do. In turn, this may cause HPPD to manifest.

This admittedly does not explain why some studies show HPPD manifesting in people who smoked marijuana in doses seemingly too small for such a result. Researchers Zoë Ellison-Wright and Ben Sessa report of one such case. In the report, they describe a teenage boy who seemed to develop HPPD after what would be considered light cannabis use.

The study posited two different reasons this might have occurred — one reason supporting the above and the other introducing a new element. Potentially, there are some strains of cannabis with a significantly more potent amount of THC (the chemical that causes a marijuana high) than normal. It is possible that, in such cases, smoking even a moderate amount of the drug could have an intense enough effect to cause HPPD.

The study also brought up another quite important second possibility; however: inappropriate association. It is possible that an incorrect link is being drawn between people who have taken marijuana and HPPD.

It is possible that doctors, patients, or both may be underestimating the fact marijuana is often mixed with other drugs. This is something that even the user may have been unaware of at the time they chose to smoke or otherwise consume marijuana.

If marijuana has been mixed with LSD, as seemed to be the case in Ellison-Wright and Sessa’s study, then it is not just possible but seems likely that HPPD was caused by the LSD mixed with the marijuana, not the marijuana mixed with the LSD.

There is no definitive conclusion on this link, at least not presently. It is difficult to say why a small minority of marijuana users experience HPPD without further study.

It is likely to either be related to particularly potent strains of marijuana or just intense marijuana use or erroneously thinking marijuana is to blame when it actually was the accidental or intentional consumption of a different drug with marijuana that caused HPPD.

Should Marijuana Users Worry About HPPD?

weed and hppd

Deciding how to approach whether a marijuana user should worry about HPPD is a difficult question. Recreational abuse of any drug is inadvisable, and marijuana is not fully understood.

Illicitly sold marijuana, in any form, is not regulated. Dealers may want to produce a more addictive drug with a stronger high so that they may mix marijuana with other substances, often unbeknownst to users. 

On its own, marijuana seems only to cause HPPD very rarely, if at all. While more studies should be done into the matter, it seems unlikely that even serious abusers of marijuana are likely to experience HPPD.

However, not enough studies have been done on the link between the two. It would be irresponsible to merely dismiss the cases linking marijuana to HPPD as erroneous until further research is conducted. 

If you are going to choose to abuse marijuana, which is not advisable for various other reasons, make sure to control your intake. You should understand what you are putting into your body and the danger of exposing yourself to other drugs that are often mixed with marijuana. 

Heavy marijuana use or the use of very potent marijuana may have poorly understood consequences beyond those already associated with the drug. 

Sources

(February 2019). Marijuana. MedlinePlus. Retrieved March 2019 from https://medlineplus.gov/marijuana.html

What is Hallucinogen-Persisting Perception Disorder? Healthline Media UK. Retrieved March 2019 from https://www.medicalnewstoday.com/articles/320181.php

Hallucinogen Persisting Perception Disorder (HPPD) After Marijuana Consumption: Clinical And In-vitro Evidence Of Cannabinoid (CB) Receptors In RPE Cells. Investigative Ophthalmology & Visual Science. Retrieved March 2019 from https://iovs.arvojournals.org/article.aspx?articleid=2355085

Ophthalmological Assessment of Cannabis-Induced Persisting Perception Disorder: Is There a Direct Retinal Effect? Documenta Ophthalmologica. Retrieved March 2019 from https://www.ncbi.nlm.nih.gov/pubmed/25612939

(February 2015).How Do Hallucinogens (LSD, Psilocybin, Peyote, DMT, and Ayahuasca) Affect the Brain and Body? National Institute on Drug Abuse (NIDA). Retrieved March 2019 from https://www.drugabuse.gov/publications/hallucinogens-dissociative-drugs/how-do-hallucinogens-lsd-psilocybin-peyote-dmt-ayahuasca-affect-brain-body

Cannabis. Alcohol and Drug Foundation. Retrieved March 2019 from https://adf.org.au/drug-facts/cannabis/

(February 2015). A Persisting Perception Disorder After Cannabis Use. Progress in Neurology and Psychiatry. Retrieved March 2019 from https://onlinelibrary.wiley.com/doi/pdf/10.1002/pnp.363

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