Cannabis and Psychosis: What's Changed? What Do We Know? Where Are We Going?
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The fact that not all cannabis users will develop psychosis suggests that cannabis may exert its causal role only in pre-disposed individuals. However, since the number of people who use cannabis worldwide is so high, those who will eventually develop psychosis, whilst still a minority, represent a large number. The evidence indicates that different patterns of cannabis use have a different impact on the risk of developing psychosis, with young age at first use, and a higher frequency of use of high-potency types of cannabis indicated as the most important risk factors. Nonetheless, given the complex nature of the association between cannabis use and psychosis, it is hard to determine which cannabis users will eventually develop psychosis. The link between cannabis use and schizophrenia is unlikely to be just the result of a genetic predisposition, it is more likely the result of Gene x Environment inter-play.
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Telling the difference between primary psychosis, cannabis intoxication and cannabis‐induced psychosis is challenging but important, especially now that it's known that almost 50% of cannabis‐induced psychosis precedes primary psychosis. A fictional case study reported in Paediatrics & Child Health makes these challenges come to life. But the purpose of the case study is only as an introduction to the meat of the article, which is how to differentiate between the three. The authors are psychiatrists from Canada.
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Studies indicate that cannabis (marijuana) is the most frequently used recreational substance (after tobacco and alcohol) in pregnancy despite being under-reported. The prevalence is expected to increase with the recent wave of interest in medicinal and recreational cannabis use, resulting in the reconsideration of its classification in terms of clinical and legal risks, in the backdrop of campaigns for its decriminalisation and legalisation gradually sweeping the world. This paper reviews the likely impact on the ethics of the use of cannabis in pregnancy, and implications for obstetricians, midwives, general practitioners, psychiatrists, and other clinicians managing such patients.
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Recreational use
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Effects of cannabis
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Cannabis is abused by a progressively larger and younger proportion of our population. For the clinician, this can raise the question of what the relationship between cannabis and psychosis is. For the patient who is already psychotic, this relationship is most certainly adverse; cannabis worsens the symptoms and prognosis of a psychosis. What may be of even greater concern is the growing evidence that cannabis may cause psychosis in healthy individuals. Many studies now show a robust and consistent association between cannabis consumption and the ulterior development of psychosis. Furthermore, our better understanding of cannabis biology allows the proposal of a plausible hypothetical model, based notably on possible interactions between cannabis and dopaminergic neurotransmission.
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Abstract This chapter discusses the recreational use of cannabis. Topics covered include prevalence, how cannabis is consumed and where it comes from, patterns of recreational use, the potency of illicit marijuana, whether recreational use of marijuana cases dependency, and cannabis use around the world. The recreational use of cannabis has become common in most Western countries. As of now it is an activity indulged in mainly by those under the age of 30. There are health risks associated with cannabis use, particularly with smoked marijuana, but earlier reports of the dangers of cannabis have proved to be exaggerated. There is also a genuine risk of developing dependency on cannabis.
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Many states have legalized cannabis use for treatment of certain medical conditions or have legalized cannabis for recreational use. Consequently, cannabis use prevalence has escalated, giving rise to concerns about potential health effects. Cannabis smoking remains the most prevalent route of administration and is associated with inhalation of chemical toxicants. The aim of this article is to summarize the effects of cannabis smoking on the vasculature and occurrence of cardiovascular (CV) events such as myocardial infarction (MI) and stroke.
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