Recommendations for Reducing the Risk of Cannabis Use-Related Adverse Psychosis Outcomes: A Public Mental Health-Oriented Evidence Review
Benedikt Fischer, W. Hall, T. Fidalgo, E. Hoch, B. Foll, M. Medina-Mora, J. Reimer, Philip G. Tibbo, Didier Jutras-Aswad
Journal of dual diagnosis July 3, 2023 DOI: 10.1080/15504263.2023.2226588 (opens in new tab) via Semantic Scholar
Summary
AI-generated from the abstractCannabis 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.
Study at a glance
| Characteristics | Review Peer reviewed |
|---|---|
| Keywords | Medicine Psychology |
| Key finding | Genetic risks, mental health and substance use histories, early age of onset, high frequency of use, high THC potency, mode of use, and co-use of other substances all influence psychosis risks; the protective effects of CBD are uncertain. |
Abstract
Abstract Objective: Cannabis use is increasingly normalized; psychosis is a major adverse health outcome. We reviewed evidence on cannabis use-related risk factors for psychosis outcomes at different stages toward recommendations for risk reduction by individuals involved in cannabis use. Methods: We searched primary databases for pertinent literature/data 2016 onward, principally relying on reviews and high-quality studies which were narratively summarized and quality-graded; recommendations were developed by international expert consensus. Results: Genetic risks, and mental health/substance use problem histories elevate the risks for cannabis-related psychosis. Early age-of-use-onset, frequency-of-use, product composition (i.e., THC potency), use mode and other substance co-use all influence psychosis risks; the protective effects of CBD are uncertain. Continuous cannabis use may adversely affect psychosis-related treatment and medication effects. Risk factor combinations further amplify the odds of adverse psychosis outcomes. Conclusions: Reductions in the identified cannabis-related risks factors—short of abstinence—may decrease risks of related adverse psychosis outcomes, and thereby protect cannabis users’ health.