Psychosocial and pharmacological treatments for cannabis use disorder and mental health comorbidities: a narrative review

2021 ◽  
pp. 1-12
Author(s):  
Rachel Lees ◽  
Lindsey A. Hines ◽  
Deepak Cyril D'Souza ◽  
George Stothart ◽  
Marta Di Forti ◽  
...  
Keyword(s):  
Mental Health ◽  
Clinical Decision Making ◽  
Treatment Compliance ◽  
Narrative Review ◽  
Cannabis Use ◽  
Psychotic Symptoms ◽  
Motivational Enhancement Therapy ◽  
Cannabis Use Disorder ◽  
Pharmacological Treatments ◽  
Health Comorbidities

Abstract Cannabis is the most widely used illicit drug worldwide, and it is estimated that up to 30% of people who use cannabis will develop a cannabis use disorder (CUD). Demand for treatment of CUD is increasing in almost every region of the world and cannabis use is highly comorbid with mental disorders, where sustained use can reduce treatment compliance and increase risk of relapse. In this narrative review, we outline evidence for psychosocial and pharmacological treatment strategies for CUD, both alone and when comorbid with psychosis, anxiety or depression. Psychosocial treatments such as cognitive behavioural therapy, motivational enhancement therapy and contingency management are currently the most effective strategy for treating CUD but are of limited benefit when comorbid with psychosis. Pharmacological treatments targeting the endocannabinoid system have the potential to reduce cannabis withdrawal and cannabis use in CUD. Mental health comorbidities including anxiety, depression and psychosis hinder effective treatment and should be addressed in treatment provision and clinical decision making to reduce the global burden of CUDs. Antipsychotic medication may decrease cannabis use and cannabis craving as well as psychotic symptoms in patients with CUD and psychosis. Targeted treatments for anxiety and depression when comorbid with CUD are feasible.

Longitudinal course of mental health symptoms among veterans with and without cannabis use disorder.

2021 ◽  
Author(s):  
Nicholas A. Livingston ◽  
Stacey L. Farmer ◽  
Colin T. Mahoney ◽  
Brian P. Marx ◽  
Terence M. Keane
Keyword(s):  
Mental Health ◽  
Cannabis Use ◽  
Cannabis Use Disorder ◽  
Mental Health Symptoms ◽  
Health Symptoms ◽  
Longitudinal Course

An adolescent with new-onset inattention

2021 ◽  
pp. 221-228
Author(s):  
Samantha M. Taylor ◽  
David L. Beckmann
Keyword(s):  
Behavioral Therapy ◽  
Contingency Management ◽  
Cannabis Use ◽  
Motivational Enhancement Therapy ◽  
Cannabis Use Disorder ◽  
Psychoactive Substance ◽  
Cognitive Domains ◽  
Problematic Use ◽  
High Concentrations ◽  
Family Based

Cannabis use disorder is defined as a pattern of use that includes at least two signs or symptoms of problematic use. Cannabis is the second most commonly used psychoactive substance by adolescents. Cannabis use is associated with significant impairments in multiple cognitive domains, although even one week of abstinence can result in improved cognitive functioning. Cannabis use, particularly of products containing high concentrations of tetrahydrocannabinol (THC), increases the likelihood of developing schizophrenia. N-acetylcysteine (NAC) may be helpful for decreasing cravings and the risk of relapse. The most effective therapy modalities for cannabis use disorder are motivational enhancement therapy, contingency management, cognitive behavioral therapy (CBT), and family-based therapy.

scholarly journals Psychosocial and pharmacological interventions for the treatment of cannabis use disorder

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 173 ◽  
Author(s):  
Pamela Sabioni ◽  
Bernard Le Foll
Keyword(s):  
Behavioral Therapy ◽  
Contingency Management ◽  
Psychosocial Interventions ◽  
Cannabis Use ◽  
Public Health Issue ◽  
Management Approach ◽  
Motivational Enhancement Therapy ◽  
Cannabis Use Disorder ◽  
Pharmacological Interventions ◽  
Positive Effects

Cannabis use has been continuously increasing, and cannabis use disorder (CUD) has become a public health issue. Some psychosocial interventions have demonstrated the ability to reduce cannabis use; however, there are no pharmacotherapies approved for the treatment of CUD. Some drugs have shown limited positive effects on use and withdrawal symptoms, but no controlled studies have been able to show strong and persistent effects on clinically meaningful outcomes. The aim of this review is to synthesize the evidence from the available literature regarding the effectiveness of psychosocial and pharmacological treatments for CUD among adults (that is, 18 years old or older). An analysis of the evidence shows that the current best psychosocial intervention to reduce cannabis use is the combination of motivational enhancement therapy and cognitive-behavioral therapy, preferably accompanied by a contingency management approach. In regard to pharmacological interventions, there are mostly unclear findings. Some drugs, such as CB1 agonists, gabapentin, and N-acetylcysteine, have been shown to produce improvements in some symptoms of CUD in single studies, but these have not been replicated. Other classes of medications, including antidepressants and antipsychotics, have been unsuccessful in producing such effects. There is an imminent need for more clinical trials to develop more effective treatments for CUD.

scholarly journals Mental Health Comorbidities in Pediatric Chronic Pain: A Narrative Review of Epidemiology, Models, Neurobiological Mechanisms and Treatment

Children ◽  
2016 ◽  
Vol 3 (4) ◽  
pp. 40 ◽  
Author(s):  
Jillian Vinall ◽  
Maria Pavlova ◽  
Gordon Asmundson ◽  
Nivez Rasic ◽  
Melanie Noel
Keyword(s):  
Mental Health ◽  
Chronic Pain ◽  
Narrative Review ◽  
Pediatric Chronic Pain ◽  
Health Comorbidities

Cannabis use disorder among veterans: Comorbidity and mental health treatment utilization

2020 ◽  
Vol 109 ◽  
pp. 46-49
Author(s):  
Anthony H. Ecker ◽  
Brent Lang ◽  
Julianna Hogan ◽  
Michael A. Cucciare ◽  
Jan Lindsay
Keyword(s):  
Mental Health ◽  
Mental Health Treatment ◽  
Cannabis Use ◽  
Treatment Utilization ◽  
Cannabis Use Disorder ◽  
Health Treatment

Cannabis use and the Mental Health of Young People

2006 ◽  
Vol 40 (2) ◽  
pp. 105-113 ◽  
Author(s):  
Wayne D. Hall
Keyword(s):  
Mental Health ◽  
Young People ◽  
Large Scale ◽  
Illicit Drugs ◽  
Developed Countries ◽  
Cannabis Use ◽  
Psychotic Symptoms ◽  
Cannabis Dependence ◽  
Psychosocial Consequences ◽  
Representative Samples

Objective: To review the evidence on the mental health and psychosocial consequences of rising rates of cannabis use among young people in developed countries. Method: This paper critically reviews epidemiological evidence on the following psychosocial consequences of adolescent cannabis use: cannabis dependence; the use of heroin and cocaine; educational underachievement; and psychosis. Leading electronic databases such as PubMed have been searched to identify large-scale longitudinal studies of representative samples of adolescents and young adults conducted in developed societies over the past 20 years. Results: Cannabis is a drug of dependence, the risk of which increases with decreasing age of initiation. Cannabis dependence in young people predicts increased risks of using other illicit drugs, underperforming in school, and reporting psychotic symptoms. Uncertainty remains about which of these relationships are causal although the evidence is growing that cannabis is a contributory cause of psychotic symptoms. Conclusions: We face major challenges in communicating with young people about the most probable risks of cannabis use (dependence, educational underachievement and psychosis) given uncertainties about these risks and polarized community views about the policies that should be adopted to reduce them.

scholarly journals When Cannabis Use Goes Wrong: Mental Health Side Effects of Cannabis Use That Present to Emergency Services

2021 ◽  
Vol 12 ◽  
Author(s):  
Candice E. Crocker ◽  
Alix J. E. Carter ◽  
Jason G. Emsley ◽  
Kirk Magee ◽  
Paul Atkinson ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Mental Illness ◽  
Adverse Events ◽  
Age Groups ◽  
Cannabis Use ◽  
Psychotic Symptoms ◽  
Clear Understanding ◽  
Knowledge Mobilization ◽  
The Impact

Cannabis use is a modifiable risk factor for the development and exacerbation of mental illness. The strongest evidence of risk is for the development of a psychotic disorder, associated with early and consistent use in youth and young adults. Cannabis-related mental health adverse events precipitating Emergency Department (ED) or Emergency Medical Services presentations can include anxiety, suicidal thoughts, psychotic or attenuated psychotic symptoms, and can account for 25–30% of cannabis-related ED visits. Up to 50% of patients with cannabis-related psychotic symptoms presenting to the ED requiring hospitalization will go on to develop schizophrenia. With the legalization of cannabis in various jurisdiction and the subsequent emerging focus of research in this area, our understanding of who (e.g., age groups and risk factors) are presenting with cannabis-related adverse mental health events in an emergency situation is starting to become clearer. However, for years we have heard in popular culture that cannabis use is less harmful or no more harmful than alcohol use; however, this does not appear to be the case for everyone. It is evident that these ED presentations should be considered another aspect of potentially harmful outcomes that need to be included in knowledge mobilization. In the absence of a clear understanding of the risk factors for mental health adverse events with cannabis use it can be instructive to examine what characteristics are seen with new presentations of mental illness both in emergency departments (ED) and early intervention services for mental illness. In this narrative review, we will discuss what is currently known about cannabis-related mental illness presentations to the ED, discussing risk variables and outcomes both prior to and after legalization, including our experiences following cannabis legalization in Canada. We will also discuss what is known about cannabis-related ED adverse events based on gender or biological sex. We also touch on the differences in magnitude between the impact of alcohol and cannabis on emergency mental health services to fairly present the differences in service demand with the understanding that these two recreational substances may impact different populations of individuals at risk for adverse events.

scholarly journals Canadian Guidelines on Cannabis Use Disorder Among Older Adults

2020 ◽  
Vol 23 (1) ◽  
pp. 135-142
Author(s):  
Jonathan R. Bertram ◽  
Amy Porath ◽  
Dallas Seitz ◽  
Harold Kalant ◽  
Ashok Krishnamoorthy ◽  
...  
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Substance Use ◽  
Financial Support ◽  
Cannabis Use ◽  
Cannabis Use Disorder ◽  
Full Version ◽  
Assessment And Treatment ◽  
Health Canada

BackgroundCannabis Use Disorder (CUD) is an emerging and diverse challenge among older adults.MethodsThe Canadian Coalition for Seniors’ Mental Health, with financial support from Health Canada, has produced evidencebased guidelines on the prevention, identification, assessment, and treatment of this form of substance use disorder.ConclusionsOlder adults may develop CUD in the setting of recreational and even medical use. Clinicians should remain vigilant for the detection of CUD, and they should be aware of strategies for prevention and managing its emergence and consequences The full version of these guidelines can be accessed at www.ccsmh.ca.

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