Cannabis (Cannabis sativa / indica) is currently one of the most discussed psychoactive plants—sometimes seen as a “natural” alternative, and other times as a potential threat to mental health. The truth, as is often the case, lies somewhere in the middle (WHO, 2023).
1. The “New” Cannabis — Potency and Composition
In recent years, the composition of cannabis has changed dramatically: THC (tetrahydrocannabinol) concentrations have increased significantly, while CBD (cannabidiol), which can counteract some of THC’s effects, is often found in smaller percentages (Health Canada, 2023; Link Springer, 2024). Methods of use (smoking, oils, edibles, vaping) also differentiate the absorption, duration, and intensity of effects (Mayo Clinic, 2023).
2. Risks and Consequences of Use
Frequent THC use is associated with poorer memory, attention, and concentration (Canada.ca, 2023). The use of high-potency cannabis increases the likelihood of psychotic episodes by up to five times, particularly in vulnerable individuals (Di Forti et al., 2022). Furthermore, early use in adolescence is linked to an increased risk of depression and anxiety disorders (Stylianakis et al., 2024). Long-term use is associated with respiratory problems and increased cardiovascular risk (The Cardiology Advisor, 2024; ACC, 2025).
3. Dependence and Social Impacts
Cannabis can cause Cannabis Use Disorder, characterized by tolerance, withdrawal syndrome, and loss of control over use (NIDA, 2024). Its use is often associated with reduced academic and professional performance and an increased risk of traffic accidents (SAMHSA, 2023; CDC, 2023).
4. Potential Benefits and Therapeutic Uses
Science does not overlook the potential therapeutic properties of cannabis, primarily through CBD, which appears to help with chronic pain, nausea, and sleep disorders (Health.com, 2023). In Greece, studies show an improvement in the quality of life for patients receiving medical cannabis, but also deficiencies in guidance and protocols (Releaf UK, 2024; Stylianakis et al., 2024).
5. Critique of the Literature
Most studies on cannabis are observational rather than randomized clinical trials, thus showing correlations rather than causal relationships (The Lancet Psychiatry, 2024). Many do not adequately differentiate between THC and CBD, and there are also publication biases, with negative or neutral results appearing less frequently (Link Springer, 2024).
6. The Greek Reality
According to the EPIPSY survey (2019), approximately 8.2% of students aged 16–18 have used cannabis, while 50% consider its use harmless (Damianakis & colleagues, 2019). Greek healthcare professionals recognize the potential of medical cannabis but call for more data and regulation (Stylianakis et al., 2024).
7. Psychotherapeutic Approach and Deeper Understanding
During the therapeutic process, the goal is not merely to cease use, but to explore the ‘why’. Cannabis use is often a symptom—not the root of the problem. According to the Self-Medication Theory, substance use can function as a way to manage internal pain, traumatic experiences, or emotional distress (Khantzian, 1997). For others, use may represent an escape from a difficult reality or a response to broader psychosocial and cultural pressures—impoverishment, racism, social injustices, or the loneliness of modern life. Therefore, essential therapy is not limited to detoxification but seeks a deeper understanding of the meaning behind the use.
“As a therapist, I often wonder not only when and how much someone uses cannabis, but primarily why. What story does its use serve? What void does it try to fill? Every person I meet carries their own narrative—sometimes filled with loss, sometimes disappointment, sometimes silent resistance against a reality that does not accommodate them. For some, cannabis acts as a way to “numb” unbearable feelings; for others, as a temporary bridge to the calm they lack. If we view use through this lens, it ceases to be merely a symptom to be eliminated and becomes a message—an attempt by the individual to care for themselves in the best way they know at that moment. Our job then is not to remove the symptom, but to listen to the story that created it, to illuminate it, and to help the person compose a new narrative—a narrative where care does not come through use, but through connection, meaning-making, and freedom of choice. “
Conclusions
Cannabis is neither innocent nor absolutely dangerous. The essence of intervention lies in information, prevention, and a therapeutic approach that recognizes the person behind the use. Knowledge—not fear—is the basis of prevention.
References (APA 7th Edition)
Canada.ca. (2023). Health effects of cannabis. Government of Canada. https://www.canada.ca/en/services/health/campaigns/cannabis/health-effects.html
Centers for Disease Control and Prevention (CDC). (2023). Health effects of marijuana use. https://www.cdc.gov/cannabis/health-effects/index.html
Di Forti, M., et al. (2022). The contribution of cannabis use to variation in the incidence of psychotic disorder across Europe (EU-GEI). The Lancet Public Health, 7(6), e427–e436.
Health.com. (2023). Marijuana: Benefits and risks. https://www.health.com/condition/chronic-pain/marijuana-benefits-risks
Khantzian, E. J. (1997). The self-medication hypothesis of substance use disorders: A reconsideration and recent applications. Harvard Review of Psychiatry, 4(5), 231–244.
Mayo Clinic. (2023). Medical marijuana. https://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/medical-marijuana/art-20137855
NIDA. (2024). Cannabis (Marijuana) Research Report. National Institute on Drug Abuse.
Releaf UK. (2024). Greek study: Medical cannabis boosts patient quality of life. https://releaf.co.uk/blog/greek-study-medical-cannabis-boosts-patient-quality-of-life
SAMHSA. (2023). Risks of marijuana use. Substance Abuse and Mental Health Services Administration.
Stylianakis, A., et al. (2024). Assessing the market readiness for medical cannabis in Greece: A qualitative study of patient perspectives. ResearchGate.
The Cardiology Advisor. (2024). Cannabis use and cardiovascular risk.
The Lancet Psychiatry. (2024). High-potency cannabis and mental health: A review.
World Health Organization (WHO). (2023). Cannabis: Health and social effects of nonmedical use. Geneva: WHO.
Damianakis, P., & colleagues. (2019). Epidemiology of cannabis use among adolescents in Greece (EPIPSY Study). Drugs and Alcohol in History Journal, 6(1), 43–52.
