Research reveals an unusual case where long-term cannabis use triggered psychosis and led a patient to consider violence against his spouse while ending their marriage. A 35-year-old man developed severe psychotic symptoms when he used Cannabis indica for eight years and caused these problems after he quit his habit. Extended cannabis abuse worsened his mental illness and prompted physical attacks on his wife which started the divorce process. Doctors discovered that Cannabis was causing the patient’s mental problems so they prescribed Olanzapine and Lorazepam. He received medical treatment and joined both a cannabis recovery program and therapy sessions with his family while understanding CBT methods. His psychotic symptoms reduced during hospital care but his trust issues and anger toward his wife stayed the same. This case shows how extended cannabis use leads to mental and social problems while showing the need for starting treatment fast and seeking long-term help with full family support so people with risk of psychosis and violence due to cannabis can recover better.

• Cannabis-induced psychosis; Homicidal ideation; Domestic violence; Cannabis indica; Marital dissolution; Cognitive-behavioral therapy (CBT); Chronic cannabis use; Olanzapine; Family counseling; Psychiatric outcomes.

Azad AH, Bibi I (2025) Case Report of a Cannabis-Induced Psychosis: Homicidal Ideation and Domestic Violence Leading to Marital Dissolution. Ann Psychiatry Ment Health 13(1): 1198.

Cannabis indica gains recognition as a strong cannabis variety because of its ability to give users a high feeling. Use of cannabis daily brings harmful mental health problems and violent responses especially when the product contains high THC levels [1]. Research proves that continued use of strong cannabis products makes psychological problems worse or initiate them in people who are easy targets [2]. People undergoing cannabis-induced psychosis experience extreme feelings of paranoia along with incorrect belief systems and visual problems that create dangerous violent reactions [3]. People with mental health issues and heavy cannabis use experience stronger side effects. Studies show Cannabis indica strains tend to create violent reactions in people who use THC products at high doses [4]. Cannabis abuse causes social damage beyond mental health risks by damaging family relationships leading to domestic violence and destroying marriages [5]. Research shows that long-term cannabis users commit extreme forms of abuse in their relationships because the drug deteriorates brain control and emotional stability making them act without thinking [6]. Our study follows a patient from Ayyaz Hope Centre Islamabad who developed homicidal tendencies from by cannabis use that triggered violence at home and led to marital breakdown. Access to cannabis creates major health risks through psychosis and violence episodes. Quick diagnosis and support are essential for avoiding serious problems that impact both the person and their household unit [7]. This study shows how cannabis addiction affects domestic violence from a psychiatric and social intervention perspective.

A 35-year-old man entered Ayyaz Hope Centre Islamabad Pakistan because of his long-term cannabis use and aggressive attacks on his household. His wife filed for legal separation because he repeatedly hurt her and threatened her existence. The patient used 6 grams of Cannabis indica every day during his 7-year dependence on cannabis. After using cannabis for recreation when he was 25 years old his habit became uncontrollable as his body built up a higher tolerance. His family members saw major distinct changes in his actions during the past year. He started blaming his wife a suspected extra marital affair while presuming threats from her family members. The patient had developed hallucinations and delusions along with other psychotic elements. he became hostile to his wife and kids. The patient heard voices order him to murder his wife along with his other household members during specific hallucinations. After the patient lost his job, he became more violent and blamed ordered for his impairment. When intoxicated with Cannabis indica he repeatedly hurt his wife through physical violence. His wife noted that at peak times he acted confused and irrational through cycles of intense anger followed by silent periods. When the patient arrived at Ayyaz Hope Centre, he showed strong signs of agitation because he thought his wife was being unfaithful. He acknowledged hateful thoughts about his family but assured the evaluator he never planned to hurt them by his observation. He understood very little about how serious his drug addiction became while hurting his loved ones. His speech raced quickly without structure and showed major emotional ups and downs. Our toxicology test showed cannabinoid drug presence yet all standard laboratory results showed normal results including CBC, LFT, and RFT. Medical experts detected Cannabis-Induced Psychosis through their examination which revealed auditory hallucinations, feelings of persecution and thoughts about hurting others. Doctors confirmed no other brain conditions after finding his brain scan results normal. To handle the patient’s agitation and psychosis doctors gave him Olanzapine at 10 mg per day and Lorazepam at 2 mg per day. Besides his treatment he began a complete cannabis quitting program that combined CBT therapy with family counseling sessions. After his three-week hospital stay the patient showed better control of psychotic symptoms but his paranoid thinking was difficult to manage. Throughout the therapy the man directed his rage toward his wife and blamed her for his situation. The patient needed further outpatient care after leaving hospital but his wife ended their marriage because his dangerous actions could not be fixed (Table 1).

Table 1: Summary of Case Information

Studies show that repeated exposure to Cannabis indica strains creates a genuine form of mental illness. Through this instance the patient showed all the typical symptoms of psychosis caused by cannabis including paranoid thoughts and hallucinations while becoming violent. The main psychoactive compound THC from cannabis makes connections with brain cannabinoid receptors including zones that control behavior and mood while affecting cognitive functions [8]. Regular THC use harms the brain’s functioning most in people with genetic susceptibility to psychosis causing permanent effects [9]. Research shows that people who use cannabis become more aggressive in their conduct. When THC affects specific areas of the brain responsible for emotional control people may lose their ability to manage their impulses and become more prone to violence [10]. According to research results cannabis reduces mental functions and makes it harder for users to think clearly and make smart choices [11]. Research shows cannabis users during domestic violence cases have trouble managing anger and understanding outcome risks [12]. People who use cannabis appear more likely to become violent against their partners in personal relationships. People who use cannabis and experience job loss plus money challenges become significantly more prone to act aggressively with their partners according to research [13]. The patient’s cannabis use made his everyday relationship problems worse until he repeatedly hurt and threatened to kill his partner. Using cannabis caused suspicious thinking which worsened his mental health enough to destroy his marriage [14]. To treat cannabis-induced psychosis doctors need to combine medicine treatment with talk therapy and support programs. 

Olanzapine as an atypical antipsychotic medicine helped bring the patient’s psychotic symptoms under control. Doctors prescribe antipsychotic medications to patients with cannabis-induced psychosis because these drugs help correct the brain’s dopamine levels from continuous THC use [15]. Cognitive Behavioral Therapy helps substance users learn better ways to respond to stress while reducing their aggressive actions [16]. Individuals with cannabis disorders need family support to heal better especially after domestic violence events. During their treatment program family counseling help patients rebuild connections with family members while learning to handle their violent tendencies. The lasting harm from extended violence typically prevents the involved parties from restoring their relationship according to the study [17]. Stopping cannabis use recurrence remains a primary obstacle in helping people with cannabis-related psychotic symptoms. Maintaining patient recovery from psychosis requires doctors to monitor progress while patients engage in substance remission programs to stay clean [18]. Patients who have cannabis-induced psychosis need proper treatment to prevent relapse and subsequent violent behavior alongside mental health decline [19]. Early and ongoing support for people with cannabis problems helps them stay mentally well while keeping their families safe from danger. New studies show that the endocannabinoid system controls our emotional reactions and our actions. Research on THC’s effects on the endocannabinoid system will guide us toward better treatments for psychosis caused by cannabis. Research shows that when the brain’s endocannabinoid system does not work correctly it increases violent behavior in people who use cannabis regularly so these users need focused treatment [20].

Using Olanzapine as an atypical anti-psychotic medicine helps decrease the patient’s psychotic behaviors. Doctors prescribe antipsychotic medicine to treat dopaminergic dysfunction due to excessive THC use. People with substance use disorders gain better coping skills and control their violent behavior by treating themselves with Cognitive Behavioral Therapy according to research. The success of cannabis use disorder treatment depends heavily on family participation especially when domestic violence take place. Family counseling aimed to both revitalize the family relationship and heal the effects his aggression caused to their unit in this study. The extensive damage from violence makes normal restoration between victims and perpetrators very hard or no longer possible. Stopping cannabis use is a hard part of treating patients who develop psychotic symptoms from marijuana. Successful recovery needs patients to remain engaged with substance cessation programs and providers must monitor their progress over time to keep psychotic episodes controlled. When treatment is not provided patients with cannabis induced psychosis face a strong chance of returning to violence and psychiatric decline. Research shows that consistent support and treatment during early stages of cannabis use disorder protects users’ mental health while stopping family harm. New research findings study how the endocannabinoid system controls mood and behavior while managing aggression. The cannabis system and THC relationship teach us better ways to cure cannabis stimulated psychotic behavior. Research links abnormal activity in the brain’s endocannabinoid system to increased aggression in chronic marijuana users showing how these individuals require specific treatment.

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