Assessing evidence supporting cannabis harm reduction practices for adolescents at clinical high-risk for psychosis: a review and clinical implementation tool.
Psychological Medicine January 1, 2024 Simon Kapler, Laura Adery, Gil D Hoftman et al.
Cannabis use is linked to increased rates of psychotic disorders and worsening of symptoms in people with psychosis spectrum disorders, including those at Clinical High Risk for Psychosis (CHR-P). While causality remains uncertain, cannabis may be a modifiable risk factor for conversion to psychotic disorder in CHR-P individuals. Current evidence supports a harm reduction approach rather than abstinence alone: reducing frequency of use, choosing lower delta-9-tetrahydrocannabinol content or cannabidiol-only products, avoiding edibles with inconsistent potency, improving patient-provider communication about cannabis use and psychotic-like experiences, and using a collaborative, individualized therapeutic approach. Whether these interventions lower conversion risk is unknown.