Journal Article

Suicide attempt and paranoia persisting for 28 days following heavy delta‐9‐tetrahydrocannabinolic acid and tetrahydrocannabinol use: A case report

Greer, Daniel, Dey, Prithula, Kulig, Caitlin E.

2026

Overview

Background Cannabis contains various cannabinoids, with Δ9‐tetrahydrocannabinol (Δ9‐THC) being the primary psychoactive compound. A non‐psychoactive precursor called Δ9‐tetrahydrocannabinolic acid (THC‐A) is converted to Δ9‐THC slowly over time or rapidly when heated. Cannabis use is linked to psychotic outcomes, with increased risk associated with heavier or earlier use. Additionally, Δ9‐THC's lipophilic nature leads to prolonged detection following heavy use. These factors highlight the need for a better understanding of cannabis formulations, dosing, and their psychiatric and pharmacokinetic implications. Case Presentation This case report describes a patient who attempted suicide after developing paranoia induced by cannabis use. The patient experienced paranoid thoughts following daily consumption of 15–30 mg Δ9‐THC gummies and THC‐A in dried plant form. He reported being unfamiliar with the dosing and effects of THC‐A, which contributed to his excessive and prolonged use. Conclusion This case highlights the potential risks of consumers being unaware of the differences in cannabinoids and dosing, which can result in adverse outcomes. THC‐A, often labeled as non‐psychoactive, becomes psychoactive when heated, which can confuse users. Improved product labeling is essential to help prevent poor patient outcomes.

• Publisher: John Wiley & Sons, Inc,Wiley
• Subject: Case Report / Case reports / Descriptive labeling / Disease control / Marijuana / Paranoia / Patients / Psychosis / substance use / suicidality / Suicides & suicide attempts / Tetrahydrocannabinol / tetrahydrocannabinolic acid / THC / THC‐A / Toxicology