People with Psychotic Disorders Experience Far More Negative Effects from Cannabis

Cannabis users with psychotic disorders reported significantly more adverse events — including nausea/vomiting, cardiovascular problems, fainting, and CHS — than users with other mental health conditions or none.

Carlini, Beatriz H et al.·Community mental health journal·2026·Moderate EvidenceCross-Sectional
RTHC-08151Cross SectionalModerate Evidence2026RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Cross-Sectional
Evidence
Moderate Evidence
Sample
Not reported

What This Study Found

People with psychotic disorders were more likely than those with other MH or no MH diagnoses to report adverse events from cannabis (p<.001), including nausea/vomiting, heart/blood pressure problems, fainting, acute psychosis, flashbacks, CHS, and high-risk cannabis use screening positive.

Key Numbers

4,144 Washington State cannabis consumers; ages 16-65; 2020-2023; psychotic disorder group significantly more likely to report adverse events and seek medical attention (p<.001) across multiple outcome categories.

How They Did This

Cross-sectional analysis of 4,144 past-year cannabis consumers in Washington State from the International Cannabis Policy Study (2020-2023), comparing adverse events across psychotic disorder, other MH, and no MH diagnosis groups.

Why This Research Matters

Cannabis harm isn't equally distributed — people with psychotic disorders are disproportionately vulnerable, experiencing more adverse events even beyond the expected psychiatric worsening.

The Bigger Picture

The finding that psychotic disorder patients experience more non-psychiatric adverse events (cardiovascular, GI) from cannabis suggests broader physiological vulnerability, not just psychiatric exacerbation.

What This Study Doesn't Tell Us

Self-reported diagnoses and adverse events; cross-sectional design; Washington State only; cannot determine if adverse events are caused by cannabis or reflect underlying disorder severity.

Questions This Raises

  • ?Should cannabis dispensaries screen for psychotic disorders?
  • ?Is there a safe way for people with psychotic disorders to use cannabis, or should it be contraindicated?

Trust & Context

Key Stat:
Evidence Grade:
Multi-year population study with appropriate comparison groups, but self-reported data and cross-sectional design limit causal inference.
Study Age:
Published in 2026 with 2020-2023 data from a mature legal cannabis market.
Original Title:
People with psychotic disorders are the most vulnerable to cannabis adverse health outcomes: a study in WA State, USA.
Published In:
Community mental health journal (2026)
Database ID:
RTHC-08151

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

A snapshot of a population at one point in time.

What do these levels mean? →

Frequently Asked Questions

Is cannabis more dangerous for people with psychosis?

Yes — this study found people with psychotic disorders reported significantly more adverse events from cannabis across multiple categories, including physical symptoms like cardiovascular problems and fainting.

What adverse events do people with psychotic disorders experience from cannabis?

Beyond expected psychiatric effects, they reported more nausea/vomiting, heart/blood pressure problems, fainting, CHS, and flashbacks compared to users without psychotic disorders.

Read More on RethinkTHC

Cite This Study

RTHC-08151·https://rethinkthc.com/research/RTHC-08151

APA

Carlini, Beatriz H; Williams, Jason R; Garrett, Sharon B; Hammond, David. (2026). People with psychotic disorders are the most vulnerable to cannabis adverse health outcomes: a study in WA State, USA.. Community mental health journal. https://doi.org/10.1007/s10597-025-01579-1

MLA

Carlini, Beatriz H, et al. "People with psychotic disorders are the most vulnerable to cannabis adverse health outcomes: a study in WA State, USA.." Community mental health journal, 2026. https://doi.org/10.1007/s10597-025-01579-1

RethinkTHC

RethinkTHC Research Database. "People with psychotic disorders are the most vulnerable to c..." RTHC-08151. Retrieved from https://rethinkthc.com/research/carlini-2026-people-with-psychotic-disorders

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.