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Although marijuana has been marketed as less harmful than alcohol and tobacco, increasing potency in products has some rethinking this categorization and calling for stricter regulations on the burgeoning market. Numerous studies suggest a correlation between cannabis consumption and a variety of psychiatric conditions, especially among young men.
Last month, a lawsuit was filed against the number one marijuana brand in California, Stiiizy, by a former user claiming their products caused him to suffer cannabis-induced psychosis (CIP).
“CIP is not a bad high, or a bad trip,” it claims in the lawsuit complaint. “CIP is an acute psychological event that can require years of treatment, including the use of anit-psychotic medication.”
Plaintiff John Doe was an “elite high school athlete” when he started using Stiiizy’s products to “provide him with some relief from his sports-related pain, stress, and anxiety,” and increased his consumption due to multiple sports-related injuries, according to the lawsuit.
Sarah London, lead attorney for the plaintiff, said this “led to acute psychosis, including paranoia, hallucinations and delusional behavior, which required multiple hospitalizations. This totally derailed his life.”
In 2022, the complaint states, Doe told a police officer, who found him shirtless and soaking wet after jumping in a pool, that a girl from his class was practicing witchcraft and put a curse on him. Doe further said the girl possessed him and his parents, inspired suicidal thoughts and lived inside his mind.
In another 2023 episode, Doe said their dog died and came back to life, gestured to an empty space when asking his parents if he could introduce them to a girl and locked his mother in her bedroom, according to the lawsuit.
After multiple evaluations, treatment centers and medication to manage psychotic symptoms, Doe remains on medication and continues to suffer from ongoing mental health challenges.
“This case is to seek justice for our client and to raise public awareness of the harms associated with these high-potency cannabis vape products that have been marketed in ways that make them seem healthy and safe, when in fact they can cause serious mental health harms,” said London.
The plaintiff alleges that Stiiizy, knowing of the dangers of their product, omits warning labels and actively markets the product to youth as medicine, with colorful packaging, fruity flavors and celebrity endorsements.
“There are mountains of studies, research and publications on how to avoid appealing to kids with a dangerous product,” said London. “And it’s like Stiiizy took all of that and ran it as a playbook.”
The lawsuit alleges negligence, fraud, strict products liability and breach of implied warranty, and seeks unspecified compensatory and punitive damages, as well as injunctive relief.
Not Your Parent’s Weed
“These products are not the typical cannabis or marijuana that most people are familiar with,” said London. “These products are different in potency, substantially more potent than the kinds of products many people are familiar with from the 70s, 80s, or in the past.”
Delta-9 tetrahydrocannabinol (THC) is the main psychoactive ingredient in cannabis. According to data from the National Institute on Drug Abuse, the average THC content in cannabis seized by the Drug Enforcement Agency more than tripled in the past 25 years, from 4% in 1995 to 15% in 2021.
Now users are not only smoking “flower,” the natural form of marijuana, but it’s increasingly becoming popular to use vaporizers, “vapes,” to ingest high-concentrated cannabis oils. Vaping allows users to consume more potent products in more discrete ways.
A presentation by Libby Stuyt, MD addiction psychiatrist, for the Colorado Substance Abuse Trend and Response Task Force, pointed out that while the average THC content for cannabis flower currently is around 25%, and it can reach up to 95% for concentrated cannabis products like oil and wax.
Although brands like Stiiizy market stronger and more potent products as better, studies suggest that the opposite may be true.
Numerous studies have correlated higher concentrated THC products with psychotic disorders such as CIP. A 2020 consensus paper from the World Federation of Societies of Biological Psychiatry (WFSOBP) suggests that people who use cannabis are four times more likely to develop chronic psychosis, and frequent users or those who use higher potency products are up to six times more likely.
“The greater the dose, and the earlier the age of exposure, the greater the risk,” claims the WFSOBP paper. However, “cannabis is neither necessary nor sufficient to cause psychosis,” meaning one may need to be predisposed to psychosis to develop CIP or other psychotic disorders.
Although there is a correlation between cannabis use and CIP, it is disputed whether CIP is an early manifestation of schizophrenia or a catalyst for it. This can make a lawsuit such as the one against Stiiizy difficult to argue. Unlike the direct links between cancer and tobacco products, proving causation for mental health conditions can be much more difficult.
Can a Lawsuit Change the Cannabis Industry?
“Now that we are in a post-legalization world, the industry has to follow the same rules as every other company,” said London. “That’s only fair and appropriate, and right for public health.”
Californians voted to legalize marijuana in 2016, and the industry now generates over a billion dollars a year in state tax revenue.
“Ultimately the industry, just like with the tobacco industry before it, has to be held accountable for what choices they make in a largely unregulated space,” said London. “And it’s very difficult, typically, for any government agency to keep up with the speed of and talent and innovation within these companies, which we’ve seen, of course, with the tobacco industry as well.”
It’s unclear whether Doe’s lawsuit, if won, could change the industry and prevent future CIP cases. That may require a regulatory change in California. But, as London points out, regulations can be slower to enact.
Other states that have legalized marijuana, including Colorado, Oregon and New York, have implemented some stricter warning label requirements for cannabis retailers.
Doctors and lawmakers in California have been advocating for cannabis producers to warn consumers of health risks and to have clear labeling in their packaging and advertising, similar to requirements for cigarettes.
A 2022 proposed Senate Bill (SB 1097), the Cannabis Right to Know Act, suggested stricter warning labels, including for contributing to mental health disorders, to be required for California cannabis retailers. However, the legislation was put on hold the same year.
London hopes the lawsuit will help hold companies accountable, push forward regulations and aid public health research by making information more accessible.
“A big part of any lawsuit is the opportunity to discover what Stiiizy knows,” said London, adding that it took decades for tobacco companies to reveal what the industry knew regarding its product and public health.
“Our hope with a lawsuit like this is that we can not wait for an entire half-century to learn what these [cannabis] companies know,” said London. “[And to] help scientists and public health authorities make policy decisions that are informed by, not only what scientists are discovering from outside the industry, but from what the industry knows as well.”
“}]] Although marijuana has been marketed as less harmful than alcohol and tobacco, increasing potency in products has some rethinking this categorization and calling for stricter regulations on the burgeoning market. Read More
