People say “it’s just weed” the same way they say “it’s just a few drinks” or “it’s just stress.” It is a sentence designed to end the conversation, not tell the truth. In South Africa, cannabis has become normalised in a way that makes families hesitate to speak up, because they do not want to sound old fashioned, dramatic, or uninformed. The problem is that normal does not mean safe for everyone, and harmless is not the same thing as low risk.
If you have never seen someone slide into paranoia, panic, or psychosis, it is easy to treat cannabis like a lifestyle choice. If you have watched a son, partner, or friend turn into someone you do not recognise, it stops being a debate about politics and starts being a question of safety.
This article is not about moralising. It is about the real consequences families are seeing, the warning signs people dismiss, and what to do when the person you love is no longer thinking clearly.
The myth of harmless, and why it sticks
Cannabis has a reputation as the soft option, the “natural” alternative, the thing that helps people relax. Many users genuinely feel calmer when they smoke, at least at first. That early relief becomes the proof they use to defend the habit. They say it helps them sleep, helps them eat, helps them feel normal. Family members see a person who is less irritable after smoking and assume it is working.
The trap is that short term relief can hide longer term harm. Cannabis can reduce tension in the moment, but it can also change how a person responds to stress over time. People start needing it to unwind, then to sleep, then to face social situations, then to get through a day without feeling raw. That shift is subtle, and because it is socially accepted, it flies under the radar longer than alcohol or harder drugs.
Another reason the myth sticks is comparison. People compare cannabis to meth, heroin, or crack and say, at least it is not that. The comparison is pointless. A substance does not have to be the worst substance to cause serious harm. If someone is sliding into panic, paranoia, or psychosis, it does not matter that their cousin uses the same strain and feels fine.
Anxiety that is being fuelled
A lot of cannabis use is self prescribed treatment for anxiety. People feel stressed, wired, tense, and overwhelmed, and cannabis switches the volume down. The problem is that anxiety is not only a feeling, it is a system in the body. When you rely on cannabis to manage it, you often stop learning how to regulate stress without a chemical shortcut.
Over time, some people notice their baseline anxiety gets worse. They feel edgy when they are not high. They become impatient, restless, and irritable. Their sleep becomes dependent on smoking. Their appetite becomes dependent on smoking. Their ability to sit with normal discomfort becomes weaker.
In that state, they smoke again, not to relax, but to stop the discomfort of being sober. That is not relief. That is dependency dressed up as coping. Families often miss this because the person will still insist it is helping, and they will have a hundred online posts to back them up.
Anxiety also shows up differently across people. Some become withdrawn and quiet. Others become angry and defensive. If you are living with someone like that, you can end up in constant tension without understanding why every small request turns into an argument. Cannabis can be part of that pattern, because it changes mood, motivation, and emotional reactivity in ways people do not always admit.
The slow slide into unstable behaviour
Not everyone who uses cannabis experiences paranoia or psychosis. That is true. The problem is that when it happens, families often do not connect the dots, especially if the person has been using for a long time.
Paranoia can start small. A person becomes suspicious. They start reading meaning into tone, into glances, into ordinary events. They believe people are judging them, plotting against them, or talking behind their back. They become controlling, checking phones, questioning family members, accusing partners. They start isolating because they do not feel safe, then they smoke more because isolation feels heavy.
Delusions can creep in next. They may develop fixed beliefs that do not respond to reassurance, like the neighbours are spying, the family is poisoning them, the police are watching, the employer is setting them up. They may become obsessed with conspiracy content online, not because they are curious, but because it matches their internal fear.
When cannabis is involved, families often mistake these symptoms for personality issues, stress, or “being dramatic.” They argue, they try to reason, they demand proof. That usually escalates things, because a person who is slipping into psychosis does not need more debate, they need assessment and stabilisation.
Mixing cannabis with alcohol and pills
Cannabis rarely travels alone. Many people mix it with alcohol, sleeping tablets, pain pills, or anxiety medication. The mix is where things can turn dangerous, because each substance alters judgement, impulse control, and emotional regulation.
Alcohol can lower inhibitions and increase aggression. Cannabis can amplify fear and distort perception. Combine them and you can get emotional volatility that feels out of character. People can become reckless, paranoid, and impulsive, then have little memory of how intense they were. Families then find themselves living with someone who apologises the next day but repeats the behaviour the next weekend.
Mixing cannabis with prescription medication is also a problem because people self adjust doses. They skip meds when they want to feel more high, or they double down on cannabis when medication makes them feel flat. Some people stop taking prescribed medication entirely and replace it with cannabis, especially if they dislike side effects or do not accept their diagnosis. That substitution can become the start of a rapid decline.
What to do when someone is spiralling
If you suspect cannabis is contributing to a mental health spiral, the first rule is simple, stop trying to win the argument. You are not dealing with a rational debate about personal freedom, you are dealing with risk.
If the person is paranoid, aggressive, suicidal, hallucinating, or making threats, treat it as a safety issue. Make the environment safer. Remove access to weapons. Avoid cornering them. Keep your voice calm. Do not mock their beliefs, even if they sound ridiculous, because humiliation can escalate aggression. If you feel unsafe, get support immediately, from family, from emergency services, or from professional crisis care.
If the risk is not acute but the pattern is obvious, pick your timing. Do not confront someone when they are high or coming down. Speak when they are sober and relatively calm. Use specific examples, not general statements. Say what you have seen, how often it happens, and what it is doing to the household.
Most importantly, push for a professional assessment. Families often try to solve this at home because they fear the stigma of psychiatric care. That fear costs people months and sometimes years. A proper assessment can identify whether the person is experiencing cannabis induced anxiety, cannabis induced psychosis, an underlying psychiatric condition that cannabis is aggravating, or a combination of issues.
Treatment approach and stabilisation
If someone is spiralling, the priority is stabilisation, sleep, safety, and reduction of symptoms. This is where families often get trapped, because the person may refuse to admit cannabis is part of the problem. They will say it is the only thing that helps. They will claim professionals are biased. They will promise to cut down and then continue.
Treatment that works starts with honesty. If a person is using cannabis daily, it must be included in the assessment. If they are mixing substances, it must be included. If they have a history of trauma, depression, bipolar symptoms, or psychotic episodes, it must be included. Without that, any treatment plan is built on fantasy.
For some people, the answer is straightforward, stop using cannabis and symptoms reduce. For others, stopping use can initially make them more anxious and irritable, because their body and mind have been relying on it. That discomfort does not prove cannabis was helping, it proves they have become dependent on it to regulate their state.
In more severe cases, a person may need inpatient psychiatric care, especially if they cannot sleep, cannot think coherently, or are a risk to themselves or others. Families often resist this step because it feels extreme, but psychosis is not a self help problem. It is a clinical emergency when it escalates.