Some people smoke weed their entire lives, and never get paranoid.
Others experience crippling anxiety and paranoid thoughts the first time they smoke up.
For most, it may happen only once in a great while.
That’s a small consolation when you start sweating, your heart starts racing, your mind starts playing games on you — and you’re freaking out.
Anxiety and paranoia aren’t common side effects of smoking marijuana. But they can happen, sometimes when you least expect them.
Why do only some people get paranoid when smoking weed? How do you keep it from happening? And what should you do if you’re unlucky enough to experience it?
Why Weed Can Cause Anxiety And Paranoia
Paranoia doesn’t only affect weed smokers, of course. However, they’re apparently more likely to feel it. One British study reported that pot smokers were between three and five times more likely than non-smokers to think that someone wanted to harm them.
What’s the connection? It’s something you’ve probably heard about: the endocannabinoid system (ECS), which serves as a massive signaling system between the brain and most of the body’s important systems.
The psychoactive cannabinoid in marijuana, THC, is extremely similar to some of the neurotransmitters the ECS uses to send and receive messages. When you consume cannabis, that similarity allows THC to bind with endocannabinoid receptors throughout the body and alter their communications.
There are a lot of those receptors in the part of the brain known as the amygdala, which is responsible for regulating fear, stress, anxiety, and even paranoia. So it’s not surprising that an overload of THC could make the amygdala go “tilt” — and cause the amygdala’s owner to feel anxious and paranoid.
That doesn’t answer two of the big questions, though. Why doesn’t that happen to everyone, and why does it happen to others only occasionally?
Not All Weed — Or Weed Smokers — Are The Same
There are several reasons why one person might get paranoid when smoking weed, while another one would blissfully enjoy the experience.
It’s no secret that some strains of cannabis are more potent than others. In fact, samples of the same strains may have different potency levels.
However, there’s been a constant increase in marijuana’s average THC content over the last 25 years. As customers demand more potency, growers now have the tools and knowledge to provide them with high-THC weed. The result is obvious. The average smoker is more likely than ever to pound their amygdala with high amounts of the cannabinoid, and research implies that higher levels of THC are associated with higher levels of anxiety and paranoia.
In short, the more potent your weed and the more you smoke, the greater the chances that you’ll get paranoid. Edibles often hit harder than smoking or vaping, too, so that can play a role.
We’ve all known someone who gets completely wasted after just a couple of tokes, and another who barely gets stoned at all after smoking up. That demonstrates the way THC tolerance works; the cannabinoid affects everyone differently.
There are a number of factors that determine someone’s tolerance of weed’s effects, including genetics, body size and weight, age, sex (higher estrogen levels appear to lower tolerance), and how frequently the person smokes. But someone who has a high tolerance is less likely to experience anxiety and paranoia when they ingest cannabis.
One other surprising factor: different areas of the brain can apparently have different levels of THC tolerance. A study performed with animal subjects indicated that when the cannabinoid primarily stimulates the front of the brain, THC can boost relaxation (and reduce anxiety). If it has more of an effect on the back of the brain (and the amygdala is toward the back), it may increase anxiety.
Existing Mental State
This is a simple one. If you’re already feeling stressed or anxious, weed is likely to make the situation worse. That’s why you’ll commonly hear (and probably know from first-hand experience) that getting high is more enjoyable if you’re in a comfortable place with good friends when you smoke up.
How To Avoid Paranoia When Smoking Weed
Some people may simply be susceptible to the anxiety-creating potential of cannabis. For everyone else, it makes sense to take precautions ahead of time.
The last point we discussed is a good one to start with here. Even if you haven’t been diagnosed with stress or anxiety, you shouldn’t invite it. If you’re smoking somewhere where you’re afraid of getting caught, or you’re smoking in an environment that seems sketchy, or you don’t know the people you’re with (and they’re not particularly welcoming) — your chances of getting anxious and paranoid are already high. THC can make them worse.
A good setting, good company, good music, and whatever else puts you in a good mood will enhance your experience, and lower the chance that you’ll have to deal with anxiety or paranoia.
Choose Strains Wisely
The temptation is understandable. People may want to buy the strongest strain with the highest THC content they can find. That’s not always smart, particularly for those who are already prone to anxiety or have had bad experiences in the past. Strains that are lower in THC, and have a decent amount of CBD content, are less likely to produce or worsen anxiety or paranoia.
Pace yourself, especially if you’re smoking high-THC weed. Repeated, huge bong rips are much more likely to overload the amygdala and trigger paranoid feelings. Take time to savor the experience, rather than trying to get as blasted as possible as soon as possible.
And remember that edibles take quite a while to kick in — and hit harder when they do. Don’t get impatient when a brownie doesn’t get you stoned; it won’t, for a while. Start by eating half of what you’d intended, and wait to see what happens. You can always go back for a second dose.
What To Do When Paranoia Sets In
First and foremost, don’t panic. Remind yourself that it’s only temporary. Even better, have friends remind you, as they try to talk you down. If you’re smoking alone, call someone who will be able to help talk you down.
Find a comfortable spot and try to relax. Deep breathing, calming music, or a warm bath could speed the process.
Other “survival” techniques may also help you shake the paranoid and anxious feelings, and re-ground you in reality:
- Slowly sip water. Focusing on the simple act of sipping may help as much as the hydration.
- Chew on some black peppercorns, or sniff some ground pepper.
- Cut a lemon in half and smell it deeply, or make lemonade with it.
- Take ibuprofen (not Tylenol); it may help counteract the effects of THC.
- Do something you enjoy (other than smoking weed), to take your mind off the paranoid feelings.
And above all, remember the experience when you’re tempted to party with high-THC weed the next time.
How to Stop Being Paranoid When High? FAQ
Q: I thought that weed was supported to help relieve stress, not increase it.
A: That’s one of the weird paradoxes of cannabis. It helps some people, but it makes others’ anxiety worse. Experts say that most of the factors we mentioned earlier like THC tolerance, how much you smoke, and pre-existing conditions, all play a role. They also think that CBD may be the key cannabinoid in weed that eases stress and anxiety — which is why strains that are lower in THC and higher in CBD are less likely to cause anxiety and paranoia.
Q: Is it a good idea to smoke a lot, to increase THC tolerance and lower the chance of becoming paranoid?
A: Whether it’s a good idea or not isn’t for us to say. That might work in theory but remember: the higher your tolerance, the more you’ll have to smoke to get high. So there’s a decent chance you’ll keep tempting fate by overloading your brain’s cannabinoid receptors with more and more THC.
- Freeman, D., McManus, S., Brugha, T., Meltzer, H., Jenkins, R., & Bebbington, P. (2011). Concomitants of paranoia in the general population. Psychological medicine, 41(5), 923-936. 
- Phan, K. L., Angstadt, M., Golden, J., Onyewuenyi, I., Popovska, A., & de Wit, H. (2008). Cannabinoid modulation of amygdala reactivity to social signals of threat in humans. Journal of Neuroscience, 28(10), 2313-2319. 
- Sharpe, L., Sinclair, J., Kramer, A., de Manincor, M., & Sarris, J. (2020). Cannabis, a cause for anxiety? A critical appraisal of the anxiogenic and anxiolytic properties. Journal of translational medicine, 18(1), 1-21. 
- Ramikie, T. S., Nyilas, R., Bluett, R. J., Gamble-George, J. C., Hartley, N. D., Mackie, K., … & Patel, S. (2014). Multiple mechanistically distinct modes of endocannabinoid mobilization at central amygdala glutamatergic synapses. Neuron, 81(5), 1111-1125. 
- Norris, C., Szkudlarek, H. J., Pereira, B., Rushlow, W., & Laviolette, S. R. (2019). The bivalent rewarding and aversive properties of Δ 9-tetrahydrocannabinol are mediated through dissociable opioid receptor substrates and neuronal modulation mechanisms in distinct striatal sub-regions. Scientific reports, 9(1), 1-14.