Aims: Koro, an acute panic reaction related to the perception of penile retraction, was once considered limited to specific cultures. The disorder has appeared as part of a panic response to cannabis, but only in citizens of India. This study looked for cannabis-induced Koro in Americans.
Design: Given the relative rarity of cannabis-induced Koro, this work focused on individual case studies.
Participants: Over 70 men responded by phone to report negative reactions to cannabis. Three of them (Caucasians aged 22-26 with years of experience with cannabis) spontaneously mentioned experiencing symptoms of Koro after smoking marijuana.
Findings: All three cases occurred after participants had heard about cannabis-induced Koro and used the drug in a novel setting or atypical way. Two of the men had body dysmorphia, which may have contributed to symptoms. All three decreased their cannabis consumption after the Koro experience.
Conclusions: Koro, particularly cannabis-induced Koro, is not limited to Eastern cultures. Several factors may interact to create symptoms. These include previous knowledge of cannabis-induced Koro, the use of marijuana in a way that might heighten a panic reaction, and poor body image. In addition, these cases confirm previous work that shows that negative reactions to drugs can attenuate their use.