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Psychotic-like experiences with cannabis use predict cannabis cessation and desire to quit: a cannabis discontinuation hypothesis

Published online by Cambridge University Press:  23 March 2018

Musa Sami
Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK South London and Maudsley NHS Foundation Trust, UK
Caitlin Notley
Norwich Medical School, University of East Anglia,Norwich, UK
Christos Kouimtsidis
Surrey and Borders Partnership NHS Foundation Trust, UK Department of Medicine, Division of Brain Sciences, Imperial College London, UK
Michael Lynskey
National Addiction Centre, Addiction Sciences Building, King's College London, UK
Sagnik Bhattacharyya*
Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK South London and Maudsley NHS Foundation Trust, UK
Author for correspondence: Sagnik Bhattacharyya, E-mail:



Evidence suggests that cannabis-induced psychotic-like experiences may be a marker of psychosis proneness. The effect of such experiences on cannabis use has not systematically been examined.


We undertook a mixed-methods online survey of 1231 cannabis users (including 926 continued users) using the Cannabis Experiences Questionnaire. We examined the effect of psychotic-like and pleasurable experiences on cessation of cannabis and intention to quit. Socio-demographic variables, cannabis use parameters and substance misuse history were included as covariates. Free-text data explored subjective reasons for changes in use.


Cessation of cannabis use was associated with greater psychotic-like experiences [p < 0.001, Exp(B) 1.262, 95% confidence interval (CI) 1.179–1.351], whilst continued cannabis users were more likely to report pleasurable experiences [p < 0.001, Exp(B) 0.717, 95% CI 0.662–0.776]. Intention to quit cannabis in continued users was associated with greater psychotic-like experiences [p < 0.003, Exp(B) 1.131, 95% CI 1.044–1.225], whilst intention to not quit was significantly associated with increased pleasurable experiences [p < 0.015, Exp(B) 0.892, 95% CI 0.814–0.978]. Whereas former users clearly ascribed cessation to negative experiences, continued users who expressed intention to quit less readily ascribed the intention to negative experiences.


Elucidation of psychotic-like experiences may form the basis of a therapeutic intervention for those who wish to quit. Cessation in those with cannabis-induced psychotomimetic experiences may offset the risk for the development of a psychotic disorder, in this higher risk group.

Original Articles
Copyright © Cambridge University Press 2018 

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