The number of patients admitted to hospitals with psychotic episodes after consuming marijuana in Germany has tripled since 2000, from 3,392 then to 11,708 in 2013. More than half were younger than age 25.

Andreas Bechdolf, chief of medicine for psychiatry and psychotherapy at the Berlin Urban Hospital, heads the Center for Early Intervention and Therapy, which focuses on adolescents. “The truly awful thing is that it often takes years before young adults with psychoses receive treatment, and many feel stigmatized,” he says. “It often takes another year from the point they start hearing voices before they finally take the step to open up to a doctor.”

His center works with several hundred patients ages 18 to 25 and the vast majority—from 80% to 90%—smoked marijuana regularly before their treatment began. Most were addicted.

Adolescents who smoke marijuana on a regular basis before age 15 are six time more likely to suffer from psychosis in later years. At first, they are unable to concentrate or put thoughts together. The meaning of once-familiar words is obscured. “Perceptions begin to change. Colors become more intense. A car that is 10 meters away might seem to be right in front of you.”

These early symptoms develop over three or four years, Bechdolf says. Then “acoustic hallucinations” appear, voices that unveil secrets or continuously comment on a person’s shortcomings. They feel they are being followed or spied on.

“Those who stop smoking pot have a very good chance of being healed,” Bechdolf says. But continued therapy on an outpatient basis after release from the hospital is key, he points out.

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