I lost my sweet son to marijuana. It devastated him (2024)

My son Nick was an adorable, sweet child. He was always mistaken for Justin Bieber and loved skateboarding. He excelled at any sport he tried, so he never stayed with one for very long, except basketball. As a teenager, he loved his clothes and sneakers collection.

Nick's father and I divorced when he was three years old. He and his brother lived with me on Cape Cod until middle school, when they moved to Cambridge, Massachusetts, with their dad.

I didn't know Nick's exposure to cannabis would be so easy. It isn't something we would have condoned, but kids find ways to smoke with each other, and it's legal in Massachusetts.

He admitted to me in his senior year of high school that he smoked marijuana with his friends instead of going to train for one of his most important sports matches in October. A month later, he argued with his father about not doing his homework and ran away from home.

When I called around to the parents of his friends, they told me Nick should not smoke marijuana. He was living in a stairwell eating one hamburger a day. They said he acted "strange" when he was "high" on marijuana and said bizarre things.

Nick confided in me that he might commit suicide that December, so he was hospitalized for a month.

He turned 18 while inside the hospital, so Nick was released without them informing us of his diagnosis because the law prohibited us from knowing anything medical without his permission.

Then COVID hit.

Nick finished high school with a COVID-safe "Zoom graduation", and he was supposed to attend a construction supervisor course at MIT, but it was canceled because of the pandemic.

He never went to a college class, nor kept any of his jobs for more than a month. He began isolating himself and taking eight-hour walks alone in the city.

Nick ran away again on April 12, 2022, which triggered a missing and endangered case, including search dogs and hundreds of interviews. No one knew where he went, nor the circ*mstances around his disappearance.

When he returned in July 2022, he was 20lbs thinner and spoke about electronics inside our phones and remotes that control our minds.

He was convinced the lawyers and judges in his case were bigger than the FBI. I asked him if he meant the CIA or DEA and he shook his head no and said "bigger".

I knew he was not able to tell reality from delusion; he spoke with strange head and body movements, invading people's personal space, sometimes erupting with extreme mood swings, and others with a monotone voice and no expression. He would speak like a robot and swivel his head strangely. We found out later why he did this.

His family was in shock and were unprepared for this new Nick who was not the same person. He told us he went to climb trees and hills without clothes on that winter to hear the voices in his head more clearly. They told him what to do. He woke me up scared of an entity in his room making him feel like he would do bad things.

Looking back on it, the turning point was December of his senior year in high school. I'll never forget the moment I first heard him speaking in psychosis. It was in the car and he said "you're not real. I'm not a real. Nothing is real. Nothing exists. I can not feel anything."

I was so alarmed. He was committed to his first hospitalization a few days later, so I thought he would be taken care of. I was disappointed, and still am today that they did not put him on any medication. Nick did not believe he was ill and convinced staff there that he was fine.

The second time was a few weeks after he returned home from being missing for three months. We were coming back from a long beach walk in late July 2022 when he said to me: "You know I can speak to aliens? If I turn my head without my brain telling me to, I could see and hear this alien in the passenger seat next to me in the car I was living in last winter at my friend's house."

Then he demonstrated the head swivel movement. I saw him do this many times in his videos he posted in psychosis on YouTube.

In the 17 months following his return home, our nightmare grew as five criminal charges appeared against him on his previously clean police record.

Nick's alleged crimes were thefts, but the final one was an assault that almost ended his father's life during a moment of what the psychiatrists say was "extreme psychosis".

Nick had been staying at a mosque for the previous two months, because no family, friends nor homeless shelters felt safe enough to house him long-term, unmedicated.

Then, the brothers of the mosque noticed him talking to himself, waking them up in the night concerned for all of humanity. He was convinced he could see and hear the devil; he did not eat or sleep for three days in a row.

The Imam called his dad to bring him home to stabilize. Nick left without a word to anyone and threw away all his belongings (again), including his sleeping bag. When his dad finally found him, Nick was trying to stay at an orthodox monastery.

We noticed Nick's voice was altered on the phone with us. He spoke fast and had a new tone of voice we had never heard before.

He had stopped smoking marijuana seven months earlier, but he was like a different person, one we had never met.

His father didn't know what to do except try to feed him dinner and let him get a good night's sleep on his couch. Nick was too scared to sleep in the living room alone, so his father moved his mattress to the floor.

Then, the attack started when Nick went to the floor to try and sleep with his dad on the mattress. His dad asked for more personal space, so Nick elbowed him in the eye almost knocking him unconscious.

The delusions made Nick think his life was in danger so he fought and bit his father so hard that none of the neighbors could stop him, despite his father's screams for help.

The police intervened and sent him to the emergency room where the staff wanted to keep him on a psychiatric hold. This began his incarceration and competency evaluation.

It is still ongoing, for seven months now, and none of his court cases have been able to proceed.

Nick has been in 56 court hearings in five separate courthouses in the last two years. He has had four court-appointed lawyers, and one lawyer provided by his parents.

He has been placed on involuntary psychiatric hold four times, with two mental hospital commitment hearings, one of which was for a six-month commitment and forced medications order from McLean, the country's leading mental health hospital. The other was for the Massachusetts state hospital for the criminally insane.

From age 17 to 22, Nick has been in nine mental health facilities.  Nick had been diagnosed ADHD in third grade, and had an active imagination, but he had no behavioral issues until he began smoking marijuana.

Nick now sits in maximum security. He was taken to the hospital after his assault during extreme psychosis on his father, and then brought to the state psychiatric hospital for a three-month psychiatric evaluation.

He was declared incompetent to stand trial by the state hospital who did a forensic evaluation report. The state hospital took Nick to court to be committed to the mental hospital, against Nick's permission, but lost the case.

The judge said: "Even though Nick is delusional, he is competent."

So, he is now in prison, unmedicated for his schizoaffective disorder, a serious mental illness. Another judge declared him a danger to society and was concerned Nick had no mental health treatment plan so offered a hospital instead of prison to go to pending the trials.

Incredibly, Nick refused the judge's option for a hospital because he believes he has no mental illness.

One of the most common symptoms of psychotic illnesses is to have no awareness of the illness, the same way many individuals with Alzheimer's don't realize they have it. Nick was so completely impaired and incapacitated by his severe mental disorder that he was incapable of making a rational decision.

Still, the judge accepted Nick's refusal to go to a hospital and sent him to prison instead.

There is a dire need for more people in the legal profession to understand severe mental illnesses and the common condition of anosognosia that is often a part of these brain illnesses, making the person unaware of their own illness and need for treatment.

I have worried since his senior year of high school that Nick's serious mental illness will get him into bigger trouble than I can imagine. It is one thing if you have a handle on reality when you make bad decisions; it's another altogether if you are judged on acts done during psychosis.

I fear that since Nick is so incapacitated by his illness that he cannot even recognize his own illness, he will continue to make poor life-altering decisions.

He will not be able to defend himself in court nor agree to take prescribed medications as long as he has these fixed false beliefs, severe hallucinations, and delusions. These acute symptoms, along with poor insight into his illness, will remain his whole life unless he gets antipsychotic treatment.

Apart from one short hospital stint, Nick has never received the antipsychotic medications necessary to treat his symptoms.

The parents of middle and high school-aged students should be educated about the risk of permanent psychosis from smoking marijuana.

There should be public service announcements, billboards, and radio shows detailing the horrors associated with cannabis-induced psychosis.

Warning labels should be on every product containing THC about the risk of permanent psychosis, treatment-resistant schizophrenia and severe bipolar disorder associated with using cannabis before the age of 30.

During one of Nick's involuntary psychiatric holds, the emergency room doctor warned us that if Nick smoked marijuana again, he risked developing "treatment-resistant bipolar disorder with psychotic features."

No one who has a psychotic manic episode from marijuana should ever smoke it. He said there are certain people who are more at risk because of genetic factors. He told us that smoking marijuana would be disastrous for Nick.

It increases the risk fivefold for schizophrenia or psychosis disorders to appear.

We had never heard this before and were in shock no one warned us this could happen. We had been led to believe marijuana was "natural" and harmless. Nick told us he had quit smoking marijuana by July 2023, but his paranoid delusions worsened throughout the remainder of 2023 into 2024.

Assisted Outpatient Treatment (AOT), also known as court-ordered outpatient treatment needs to be made into a federal law once it is approved in all 50 states (currently Massachusetts and Connecticut are the only ones without this life-saving law).

Once it is federal, then access to this life-saving treatment won't depend upon where you live. We need these programs nationwide, in every state and county.

It is crucial for the most serious mental illness cases to help people to adhere to an outpatient treatment plan for six months to a year, and to keep the treatment providers involved in the care of people with the most severe mental illnesses.

If a person who meets the strict criteria on an AOT order stops their medications, or they don't show up to appointments, this triggers an evaluation to consider whether there is a need for a higher level of care, perhaps another hospital stay. It is common sense.

AOT programs do not force the medication—a person usually still has the right to refuse but the treatment team works with them to help understand why they should take it.

If they choose not to take it, then they usually end up hospitalized as they deteriorate and meet inpatient commitment standards. If a person is in outpatient treatment for 12 to 18 months, approximately 90 percent make the connection between taking their medications and being able to stay out of the hospital and to stay healthy (according to Daniel Garza, MD, AOT seminar, Treatment Advocacy Center seminar, 2020).

Currently, in Massachusetts, when individuals leave the hospital there is no "safety net" for individuals with psychosis disorders. Upon discharge, there is no requirement for a person to adhere to treatment in the state of Massachusetts and Connecticut.

All but these two states have AOT laws. However, some states execute their AOT programs better than others. In some states, civil rights groups have limited the ability of the programs to re-hospitalize individuals for non-compliance to their AOT order. These programs are not as effective and have worse outcomes.

These acute psychiatric situations where the AOT law applies are rare. Until you have seen what acute psychosis can do to a person, you don't understand.

Had there been an AOT order in place when Nick was released from the second forced hospitalization, he would have had support to continue his medications and psychiatric visits. Instead, upon discharge Nick was scheduled for one visit with a psychiatrist one month after his release.

Of course, Nick never made it to that appointment because he never once believed he had a mental illness.

Nick kept thinking he could survive outside in a tent eating berries in the woods. He said he didn't need food to exist. He threw all his possessions away on three separate occasions. Because he was over 18, there was nothing we could do.

What Nick needed was a team of knowledgeable professionals, skilled doctors, intensive case management, peer support, accountability, and wraparound services. Because Massachusetts has no such AOT programs, Nick never had a chance.

Everyone who knows and loves Nick has had to grieve the loss of him even though he is not gone, physically. His mind has been devastated by his untreated serious mental illness.

His closest friends were confused and hurt by his behavior. The friend he had been staying with in 2022 checked himself into a psychiatric hospital a few days after Nick went missing.

Nick's brother had to start and stop his college semesters two times in order to grieve. His father was almost killed and is valiantly trying to work through fear of his son to go visit him in prison. I take beta blockers regularly for the moments of overwhelming anxiety and had to quit my art business.

Will James has a podcast called The Lost Patients which highlights families like ours. One mother described it perfectly as a slow emergency over a long period of time. A fire alarm bell has been ringing in the back of my thoughts for years now.

Until Nick is on a consistent dose of antipsychotic medication, he will not be able to regulate his thoughts. I feel like the parent in the perpetual waiting room, waiting for the surgeon to come out and tell me if my son survived. Or the mother of an infant crying, waiting for professionals to tell me what is wrong with him.

Until then, I take his daily phone calls from his isolation cell wondering which Nick will be on the other end of the line. I get phone calls from his dad and wonder what shocking news will be coming. Mostly I'm just there to listen and love him.

I've gone from devastating sadness to ferocious advocacy. The civil rights lawyers and advocates who say psychotic patients should be able to "die with their rights on" are misguided and unaware of what anosognosia from psychosis looks like, the pain it puts families through, and the danger it poses to society.

Laura Balboni Craciun is the Massachusetts policy director of the National Shattering Silence Coalition, which advocates for people with serious brain disorders.

All views expressed are the author's own.

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