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Cannabis and psychosis: what do we know and what should we do?

  • Marco Colizzi (a1) and Robin Murray (a2)
Summary

It is now incontrovertible that heavy use of cannabis increases the risk of psychosis. There is a dose–response relationship and high potency preparations and synthetic cannabinoids carry the greatest risk. It would be wise to await the outcome of the different models of legalisation that are being introduced in North America, before deciding whether or not to follow suit.

Declaration of interest

None.
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Copyright
COPYRIGHT: © The Royal College of Psychiatrists 2018 
Corresponding author
Correspondence: Marco Colizzi, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK. Email: marco.v.colizzi@kcl.ac.uk
References
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1 National Academies of Sciences, Engineering, and Medicine. The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research. The National Academies Press, 2017.
2 Hasin, DS, Sarvet, AL, Cerdá, M, Keyes, KM, Stohl, M, Galea, S, et al. US adult illicit cannabis use, cannabis use disorder, and medical marijuana laws: 1991-1992 to 2012-2013. JAMA Psychiatry 2017; 74: 579–88.
3 Hall, W, Lynskey, M. Evaluating the public health impacts of legalizing recreational cannabis use in the United States. Addiction 2016; 111: 1764–73.
4 Murray, RM, Englund, A, Abi-Dargham, A, Lewis, DA, Di Forti, M, Davies, C, et al. Cannabis-associated psychosis: neural substrate and clinical impact. Neuropharmacology 2017; 124: 89–104.
5 Marconi, A, Di Forti, M, Lewis, CM, Murray, RM, Vassos, E. Meta-analysis of the association between the level of cannabis use and risk of psychosis. Schizophr Bull 2016; 42: 1262–9.
6 Colizzi, M, Iyegbe, C, Powell, J, Blasi, G, Bertolino, A, Murray, RM, et al. Interaction between DRD2 and AKT1 genetic variations on risk of psychosis in cannabis users: a case-control study. NPJ Schizophr 2015; 1: 15025.
7 Englund, A, Freeman, TP, Murray, RM, McGuire, P. Can we make cannabis safer? Lancet Psychiatry 2017; 4: 643–8.
8 Altintas, M, Inanc, L, Oruc, GA, Arpacioglu, S, Gulec, H. Clinical characteristics of synthetic cannabinoid-induced psychosis in relation to schizophrenia: a single-center cross-sectional analysis of concurrently hospitalized patients. Neuropsychiatr Dis Treat 2016; 12: 1893–900.
9 Schoeler, T, Petros, N, Di Forti, M, Klamerus, E, Foglia, E, Ajnakina, O, et al. Effects of continuation, frequency, and type of cannabis use on relapse in the first 2 years after onset of psychosis: an observational study. Lancet Psychiatry 2016; 3: 947–53.
10 Colizzi, M, Carra, E, Fraietta, S, Lally, J, Quattrone, D, Bonaccorso, S, et al. Substance use, medication adherence and outcome one year following a first episode of psychosis. Schizophr Res 2016; 170: 311–7.
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The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
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Cannabis and psychosis: what do we know and what should we do?

  • Marco Colizzi (a1) and Robin Murray (a2)
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