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  • Print publication year: 2004
  • Online publication date: December 2009

12 - Addressing cannabis abuse in people with psychosis

Summary

As outlined in Chapter 8, cannabis use is common amongst people with schizophrenia and regular use, even at relatively low levels, can have a negative impact on illness course (Hall and Degenhardt, 2000). The effective management of this clinical problem is increasingly the focus of psychiatric practice and research. This chapter reviews a number of important areas that deserve consideration when developing an effective response. Aspects such as screening, assessment and models of service delivery are covered. The chapter concludes by outlining a number of psychosocial treatment interventions available for addressing cannabis use in schizophrenia and related disorders.

It must be acknowledged from the outset that there is a paucity of research evidence in terms of treatment interventions solely for cannabis use amongst people with schizophrenia. Thus, studies that have considered other drugs, and not just cannabis, are included in this review.

Screening

An awareness of any ongoing drug abuse is essential when determining psychiatric diagnosis, deciding on appropriate treatment interventions and planning future care (Zeidonis and Fisher, 1994). If undetected, drugs such as cannabis can confound the interpretation of important signs and symptoms of psychosis, possibly lead to overmanagement with psychotropic medications, as well as rendering other psychosocial treatments less effective for people with schizophrenia (Drake et al., 1993b).

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