Cannabis and Psychiatry

Medical Marijuana Use in Psychiatry

Many patients seem to find out for the first time in the psychiatrist’s office that the chronic use of marijuana could induce a psychotic episode and, based on the literature available, trigger the first episode of schizophrenia. Reportedly, 25 % of patients suffering with schizophrenia have a comorbid disorder of ‘ cannabis abuse or dependence’ . The comorbidity only makes the treatment more difficult exacerbating the exact symptoms that anti psychotic medications try to address.

The use of marijuana starts in adolescents, and at the present time is the most commonly used illicit drug by adolescents and young adults. Some studies show that cortex volume abnormalities precede cannabis use, instead of creating them, and could be used in some ways as a vulnerability markers. Parents, educators, counselors and physicians try to convey the message that the use of marijuana is not harmless, but in fact could have very serious consequences. The researchers believe that some cortical structural abnormalities preceding the chronic use of marijuana could be suggestive that these alterations are responsible for impaired decision making process that could increase the risk for an earlier use.

Parents sometimes confide that they also used marijuana in their teenage years, and their lives turned out well. What some of them are not aware of is that the THC ( tetrahydrocannabinol, the primary psychoactive component) content in marijuana could reach 20% today, compared with 1-3% in the 1960. If we add to that the fact that the adolescent brain goes through a very sensitive period of neurodevelopment that makes it more vulnerable to the effects of cannabis, we should try to make our message louder and clearer for this group age.