A Hypothesis on the Role of Olfactory Dysfunction in Cannabis-Associated Neuropsychiatric Effects

Abstract Cannabis use is associated with anxiety, paranoia, and psychotic symptoms in a subset of individuals, yet the mechanisms responsible for this vulnerability remain incompletely understood. Existing explanations have largely emphasized cannabinoid receptor signaling, dopaminergic modulation, and large-scale changes in neural network dynamics. This paper advances the hypothesis that disruption of olfactory processing may represent an important and previously underrecognized contributor to these neuropsychiatric effects. The central proposal is that impairment of olfactory function reduces the continuity and reliability of environmental sensory information, increasing perceptual uncertainty and promoting greater reliance on internally generated interpretations. In susceptible individuals, this shift may increase the likelihood of anxiety, paranoid ideation, and related cognitive disturbances. The hypothesis generates specific, falsifiable predictions regarding the relationship between objective measures of olfactory performance and the severity of cannabis-associated psychiatric symptoms. To facilitate independent evaluation, the accompanying article compiles and organizes the relevant biomedical literature concerning cannabis, olfactory function, and neuropsychiatric outcomes. By making this body of evidence readily accessible, the present work aims to provide both a clear statement of the hypothesis and a foundation for future experimental testing. Confirmation or refutation of this proposal will require prospective studies directly measuring olfactory function alongside psychiatric outcomes during controlled cannabinoid exposure.