An 8-week Mindful Self-Compassion group was delivered to 26 male veterans with moral injury, PTSD, and substance use disorder. Recruitment was easy and dropout was low (30.8%). Participants reported satisfaction. Clinically meaningful improvements were observed: self-compassion increased, while PTSD symptoms, guilt, shame, and number of drinking days decreased. The open-label design and small sample prevent conclusions about efficacy, but results suggest further study is warranted.
Cannabis use is increasingly normalized, and psychosis is a major adverse health outcome. This review identifies risk factors for cannabis-related psychosis: genetic predisposition, mental health and substance use histories, early age of first use, high frequency of use, high THC potency, mode of use, and co-use of other substances. The protective effects of CBD are uncertain. Continuous cannabis use may worsen psychosis treatment and medication effects. Combinations of risk factors further amplify the odds of adverse psychosis outcomes. Reducing these risk factors, short of abstinence, may decrease the risk of psychosis and protect cannabis users' health.
Heavy use of high-potency cannabis that is high in THC and low in CBD increases the risk of psychotic disorders, with greater risk for early use and use of synthetic cannabinoids. Frequent cannabis use also raises the risk for mania and suicide, but the effect on depression is less clear and findings on anxiety are contradictory. Depression and anxiety may lead to greater cannabis consumption in some studies. THC interacts with genetic predisposition and other environmental factors, while CBD may reduce the psychotogenic effects of THC but is absent from many high-potency varieties. The evidence is strong enough to merit public health education about psychosis risk.