Of all the Schedule-I drugs abused with impunity in the US, cannabis or marijuana occupies the number one spot. There are enough statistics and reports to establish that an increasing number of teenagers and young adults in the US are taking cannabis illicitly with every passing day. As consumption of cannabis by the general populace spikes continuously, indications that the drug’s overuse could cause mental health issues are emerging.
Several in-depth types of research and studies have overwhelmingly indicated a strong correlation between cannabis intake and a range of psychiatric disorders. Trials and investigations conducted in the recent past have time and again pointed towards a perceptible association between weed and cannabis-induced psychosis (CIP), the drug’s alleged health benefits notwithstanding. Because the majority of US states have legalized therapeutic and recreational use of cannabis to varying degrees, timely diagnosis and treatment of CIP are crucial.
It is the younger generation that is more vulnerable to health risks associated with cannabis ingestion compared to the adult population. Misapprehensions and misinterpretations about its purported curative effects, together with ignorance regarding its harmful effects, hugely contribute towards cannabis’s impending disastrous fallout on the youth.
Differentiating Mainstream Psychosis From Cannabis-Induced Psychosis
Epidemiology
Some numerous reports and accounts reflect an astounding augmentation in visits to EDs and ERs in the past few years that could be linked with cannabis. The Drug Abuse Warning Network (DAWN) and Substance Abuse and the Mental Health Service Administration (SAMHSA) reported in 2011 that out of an estimated 1.25 million illegal substance-associated visits to EDs throughout the US, about 457,000 were cannabis-related. About four years later, the Washington Poison Center published the ‘Toxic Trends Report’, which revealed that marijuana-linked ED visits had ballooned considerably recently.
Visits to emergency rooms connected with illegal cannabis use had registered a sharp increase in both states that had authorized medical marijuana and states where cannabis use was still illicit.
CIP Neurobiology
Medical researches and investigations have convincingly demonstrated that long-term and heavy marijuana use exacerbates the potential threat of adverse effects. In other words, the longer you consume cannabis, the higher your risks of suffering from psychotic episodes. Someone who has been consuming the drug orally, topically, or intravenously in high doses for several years is at a greater risk of experiencing psychotic episodes.
It is delta9-THC, the chief psychoactive compound in cannabis that is mainly responsible for stimulating psychosis. When a stoner inhales or ingests cannabis copiously, the drug acts as a reuptake inhibitor (RI). In this respect, marijuana functions like selective serotonin reuptake inhibitors (SSRIs) such as antidepressants.
Evaluating CIP
The fifth edition of ‘Diagnostic and Statistical Manual of Mental Disorders’, a diagnostic and taxonomic tool published by the American Psychiatric Association (APA) has classified CIP as a psychiatric disorder, stimulated by substance abuse. Nevertheless, CIP has some unique attributes and traits that help in differentiating it from other psychiatric conditions like delusional disorder, schizophrenia, and paraphrenia.
Some distinguishing characteristics of CIP include the abrupt occurrence of paranoid symptoms and severe mood swings and unexpected changes in feelings. The correct diagnosis of CIP should not take into account the usual symptoms of typical psychosis. On the other hand, the user or the patient must demonstrate symptoms associated with excessive consumption as well as withdrawal effects. The patient’s medical history also should be taken into consideration while evaluating for CIP.
Whether the psychotic symptoms have a close correlation to marijuana intoxication and withdrawal effects is strongly influenced by the last time the patient ingested cannabis. A patient who exhibits psychotic symptoms that is noticeably different from those linked with aftereffects of intoxication and withdrawal is said to be suffering from CIP.
Dealing With CIP Through Pharmacotherapeutic Remedies
The most effective way of dealing with CIP to prevent the recurrence of psychotic episodes is to stop taking cannabis completely. However, abstaining from cannabis consumption suddenly could cause violent withdrawal episodes that could endanger the patient’s life. So, the best way out is to reduce intake slowly and steadily on the one hand and initiate pharmacotherapeutic interventions on the other.
Pharmacotherapeutic remedies involve the intake of 2nd generation antipsychotic drugs like Aristada, Asenapine, Haloperidol, and Valproate Sodium. Though these antipsychotic drugs could help treat CIP, the psychiatrist should also take note of the adverse side effects of these medicines.
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