A man in Thailand’s bong session went disastrously wrong, according to his doctors. In a new case report, they describe how he “completely amputated his penis” using scissors, apparently due to a rare episode of cannabis-induced psychosis. Though the man’s delusional symptoms faded after being admitted to the hospital and his injuries were treated, doctors weren’t able to reattach the lost appendage.
The bizarre injury was detailed in a paper published over the weekend in the Journal of Medical Case Reports by doctors from Chiang Mai University in Thailand.
The 23-year-old man had reportedly been a regular cannabis user for the past two years but had stopped for the preceding three months. He then got back into his habit by smoking two bongs of cannabis, equivalent to two grams worth, according to the paper. Two hours later, he began to experience an unwanted erection, along with a severe and persistent sharp pain in his penis; he also reported that his glans (the tip of the penis) looked “distorted” to him. In an attempt to stop the pain, he decided to grab a pair of scissors and to “trim the penile skin several times.” Eventually, he severed his penis clean off, leaving behind an inch-long stump.
Unsurprisingly, the home surgery caused the man to bleed out. He was admitted to the hospital two hours after the amputation and immediately treated with antibiotics and a tetanus booster. Emergency surgery stopped the man’s bleeding and cleaned his wounds, while he underwent a procedure to create a new opening so he could still urinate through his urethra. Unfortunately, though the penis was recovered, it was deemed too dirty and fragile to be reconstructed and reattached. By the time doctors saw the man, his amputated member had even been left crawling with ants (Yes, there are pictures of the penis and stump in the paper, but I wouldn’t recommend viewing them if you have a weak stomach).
Given the man’s behavior, he was psychologically evaluated as well. Upon admission, he reported experiencing visual and auditory hallucinations, which included seeing moving shadows and hearing birds and insects. But he was otherwise coherent, not suicidal, and denied having a family or personal history of depression, self harm, and any other issues related to his prior drug use. The man was hospitalized for two weeks and given antipsychotics. And by the time he was discharged, he no longer reported any delusional symptoms.
Because the man’s symptoms happened soon after he ingested cannabis and went away after a month of not taking the drug—along with no other likely explanation—the doctors diagnosed him with substance-induced psychotic disorder. Cases of people self-amputating their penis during a drug-induced psychosis aren’t unheard of, though they are rarely reported. Even rarer is a case seemingly brought on by cannabis-induced psychosis, they wrote.
Many studies have shown a link between cannabis use and an increased risk of acute schizophrenia-like symptoms, though it’s less clear whether cannabis actually increases the risk of schizophrenia itself. And while this risk is rare in general, possible factors include being young and ingesting cannabis high in THC, the primary ingredient responsible for making you feel high. The sharp and persistent pain in the man’s penis that prompted his amputation may have been a subjective sensation brought on by his delusion, but it also could have been the result of a genuine unwanted erection caused by the cannabis—it’s simply not possible to tell either way, the doctors concluded.
“In summary, cannabis-induced psychosis is an adverse effect of cannabis, which may lead to impaired judgement and unexpected self-harm,” they wrote.
As for the man himself, the doctors did plan to perform another surgery that would have lengthened and reconstructed his penis further. But the patient apparently relocated and they’ve since lost touch with him.