Cannabis Use

Question 1

Association between cannabis and psychosis

Answer 1

Increased cannabis exposure => increased risk of psychosis

• more likely to present with positive symptoms
• MOST COMMON BEING DELUSIONS

Continual use of skunk more likely to have psychotic relapse and be readmitted

Cannot be explained purely by genes predisposing to schizophrenia

Question 2

Types of cannabis

Answer 2

Imported herbal
-THC 5-6%

Hash raisin
-THC 4-5%

Skunk - female plant with no seeds as crops are grown and not pollinated

• v distinct smell
• THC 16%
• associated with a higher risk of psychosis

Question 3

Withdrawal symptoms

Answer 3

Headache
Nausea
Anxiety
Sweating
Insomnia
Decreased appetite

Peaks at 4-6 days, falls at 1-2wks

Question 4

Effects of THC and CBD

Answer 4

The same plant can only produce high conc of one or the other

THC

• impaired attention, memory, learning
• hallucinations, paranoia
• brief psychosis

CBD

• not hallucinogenic
• anxiety relieving
• no impact on cognition
• can ameliorate THC related psychosis

Question 5

Endocannabinoid system

Answer 5

Cannabinoid receptors 1 found in brain and immune system
Cannabinoid receptor 2 found in lungs and liver

Exerts impact on appetite, memory, sleep, immune system, pain

Regulates glutamate and GABA - protective role of CNS
-downstream regulation of D

Question 6

When can we prescribe medicinal cannabis

Answer 6

Epilepsy
MS spasticity - equal amounts of CBD and THC
Intractable chemo related nausea

Doses still not completely established

Question 7

How can you screen for cannabis use

Answer 7

CUDIT score