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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)

Study at a glance

AI-extracted from the abstract
Characteristics Review Peer reviewed
Topics Cannabis
Key findings 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.