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Legalization of Cannabis – what’s the impact on mental health?

Published online by Cambridge University Press:  19 July 2023

S. Torres*
Affiliation:
Departamento de Psiquiatria e Saúde Mental, Centro Hospitalar Barreiro-Montijo, Lisbon, Portugal
T. Rocha
Affiliation:
Departamento de Psiquiatria e Saúde Mental, Centro Hospitalar Barreiro-Montijo, Lisbon, Portugal
J. Leal
Affiliation:
Departamento de Psiquiatria e Saúde Mental, Centro Hospitalar Barreiro-Montijo, Lisbon, Portugal
J. Moura
Affiliation:
Departamento de Psiquiatria e Saúde Mental, Centro Hospitalar Barreiro-Montijo, Lisbon, Portugal
A. Lopes
Affiliation:
Departamento de Psiquiatria e Saúde Mental, Centro Hospitalar Barreiro-Montijo, Lisbon, Portugal
*
*Corresponding author.

Abstract

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Introduction

With the increasing push to legalize cannabis in Western nations, there is a need to gauge the potential impact of this policy change on vulnerable populations, such as those with mental illness, including schizophrenia, mood and anxiety disorders.

Objectives

Understand the effects of cannabis in people with mental illness and the impact of policies legalizing cannabis in societies.

Methods

Literature review performed on PubMed and Google Scholar databases, using the keywords “cannabis”, “mental health”, “psychiatry”.

Results

Cannabis use is a modifiable risk factor for the development and exacerbation of mental illness. The strongest evidence of risk is for the development of a psychotic disorder, associated with early and consistent use in youth and young adults. Cannabis-related mental health adverse events precipitating Emergency Department (ED) or Emergency Medical Services presentations can include anxiety, suicidal thoughts, psychotic or attenuated psychotic symptoms, and can account for 25–30% of cannabis-related ED visits. Up to 50% of patients with cannabis-related psychotic symptoms presenting to the ED requiring hospitalization will go on to develop schizophrenia. With the legalization of cannabis in various jurisdiction and the subsequent emerging focus of research in this area, our understanding of who (e.g., age groups and risk factors) are presenting with cannabis-related adverse mental health events in an emergency situation is starting to become clearer.

Conclusions

There’s a need to provide a reconciliation of the addiction vulnerability and allostatic hypotheses to explain addiction comorbidity in mentally ill cannabis users, as well as to further aid in developing a rational framework for assessment and treatment of problematic cannabis use in these patients.

Disclosure of Interest

None Declared

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of the European Psychiatric Association
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