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Is there a specific ‘cannabis psychosis’?

Wayne Hall, Louisa Degenhardt

Cambridge University Press eBooks May 27, 2004 DOI: 10.1017/cbo9780511543630.008 (opens in new tab)

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AI-extracted from the abstract
Characteristics Theoretical or philosophical paper Peer reviewed
Topics Cannabis
Citations 27
Key points Argues that establishing cannabis as a cause of a specific 'cannabis psychosis' requires evidence of association, temporal precedence, and exclusion of alternatives, and that this hypothesis remains unproven.

Abstract

There are good reasons to be concerned about the possibility that cannabis use may be a cause of psychotic disorders. Psychoses are serious and disabling disorders (Bromet et al. , 1995). Cannabis is widely used during late adolescence in many developed societies (Hall et al. , 1999), and high doses of tetrahydrocannabinol (THC) – the psychoactive substance in cannabis – have been reported to produce psychotic symptoms such as visual and auditory hallucinations, delusional ideas and thought disorder in normal volunteers (Hall et al. , 2001; and see Chapter 5). There are a number of hypotheses about the relationship between cannabis use and psychosis that need to be distinguished (Thornicroft, 1990). The strongest hypothesis in causal terms is that heavy cannabis use causes a specific ‘cannabis psychosis’. It assumes that these psychoses would not occur in the absence of cannabis use, and that the causal role of cannabis can be inferred from the symptoms and their relationship to cannabis use; that is, they are preceded by heavy cannabis use and remit after abstinence. It also assumes that cannabis psychoses are qualitatively different from other psychotic disorders. This hypothesis is the subject of this chapter. The potential role of cannabis as a causal agent for schizophrenia per se is the subject of Chapter 7. Making causal inferences In order to infer that cannabis use is a cause of a specific psychotic disorder, we need evidence: that there is an association between cannabis use and psychosis; that chance is an unlikely explanation of the association; that cannabis use preceded the psychosis; and that plausible alternative explanations of the association can be excluded (Hall, 1987).

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Out of Harm's Way?: Illicit Drug Use, Medicalization and the Law 2003 Theoretical or philosophical paper
[The political uses of prohibitionist "science:" The case of cannabis and psychedelics]. 2020 Theoretical or philosophical paper

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