A Thai man cut off his penis with a pair of scissors during a frightening cannabis-induced psychotic episode.
The life-changing injury occurred after the unidentified 23-year-old smoked 2g of marijuana – the equivalent of six joints – in two bong rips.
Prior to his self-amputation, the man had quit using cannabis use for three months after being a frequent user for two years.
Two hours after smoking the drug for the first time in months, he began to have a painful erection unrelated to any sexual stimulation, which can be a side-effect of smoking cannabis.
During his hallucination, the man grew paranoid that the head of his penis looked ‘distorted’ while examining himself to identify the source of the pain.
In an attempt to eradicate the problem, the man decided to use a pair of scissors to ‘trim’ the skin of his penis before amputating it completely, leaving a 2cm stump and a 5cm laceration in his scrotum.
Incredibly, the man then waited two hours before seeking attention from medics at a hospital in the city of Chiang Mai, after the bleeding failed to stop.
Doctors briefly considered reattaching the man’s penis, but it was found to be too fragile and contaminated with ants.
And the psychosis was so intense he experienced visual and auditory hallucinations for about two weeks during his recovery.
The harrowing tale was revealed in a medical case report by the doctors who treated him.
It comes just weeks after Thailand effectively decriminalised cannabis.
The 23-year-old-man suffered psychosis after smoking 2g of cannabis from a bong. After experiencing a painful erection the man started ‘trimming’ the skin of his penis with a pair of scissors eventually amputating it entirely and leaving a 2cm stump
What is cannabis-induced psychosis?
Psychosis is a mental health condition where people lose some contact with reality.
This might involve seeing or hearing things that other people can’t and believing things that are not untrue.
Cannabis is one of the drugs that can induce such a state, others include speed, meth, cocaine, LSD and ecstasy.
People experiencing psychosis are at higher risk of self-harm and/or suicide.
While there isn’t an exact figure on the risk of developing a psychotic illness from using cannabis certain factors are known ton increase the risk.
- Starting to use cannabis at a young age
- Smoking stronger types, such as skunk
- Smoking regularly, and for a long period of time
- Those who have a family history of schizophrenia
Detailing the case in the Journal of Medical Case Reports, Dr Theerapon Tangsuwanaruk said medics briefly considered reattaching the severed penis.
However, he said the man’s penis was too severely damaged and a possible infection risk for this to go ahead.
‘The distal penis was deemed too dirty and fragile for reconstruction,’ he said.
‘The amputated distal part of the penis was contaminated with ants and had fragile dorsal veins.’
After surgery to clean the wound and stop the bleeding, the man was interviewed by a psychiatrist.
Urine tests taken from the man confirmed the presence of THC, the psychoactive chemical in cannabis responsible for giving people the sensation of feeling ‘high’.
The psychiatrist found the man was suffering from both visual and auditory hallucinations, such as seeing shadows move and hearing animal noises like birds chirping and insects buzzing.
He was also found to be coherent but, delusional, with a restricted emotional range.
However, professionals deemed that he was not suicidal and diagnosed him as having suffered from substance-induced psychotic disorder.
After a two-week stay in hospital the man was able to urinate while seated and reported that the hallucinations had ceased.
Dr Tangsuwanaruk said a planned surgery to extend the length of the man’s remaining penis did not go ahead as the patient had moved away.
The original source of man’s erection pain remains a mystery but, Dr Tangsuwanaruk said it may have been a case of priapism, a painful erection lasting longer than four hours.
However, Dr Tangsuwanaruk said an official diagnosis for priapism in this patient’s case is impossible due to the self-amputation before the four-hour mark.
The NHS advises anyone with an erection lasting longer than two hours to call 999 or go to A&E as it can cause permanent damage to the penis.
Cannabis-induced psychosis is a known potential side effect of using the drug, though self-genital mutilation as result is rare.
Smoking cannabis can cause mild hallucinations generally, as well as sense of anxiety but this is normally not psychosis.
The authors of the most recent case reported said that while the true prevalence is unknown, there have been about 100 cases of substance-induced psychosis resulting in self-genital-mutilation within the past 20 years.
However, they added that the severity of psychosis people can experience after using cannabis depends on the amount of THC consumed.
Skunk — which makes up most of the cannabis sold on Britain’s streets — contains more THC than traditional strains.
It is purposely created by dealers aiming to make the most potent strain of the drug possible in order to maximise their profits.
While the medics did not detail exactly when the case occurred, Thailand is currently undergoing a cannabis revolution.
Last week it became the first country in Asia to decriminalise marijuana though its use as a recreational product is still a grey area.
It followed Thailand removing cannabis, the plant species to which both marijuana and hemp belong, from the list of illegal drugs under Thailand´s narcotics laws in December 2021.