Co-morbidity and cannabis use in a mental health trust in South East England

2007 ◽  
Vol 32 (10) ◽  
pp. 2164-2177
Author(s):  
Bruce Trathen ◽  
Colin O'Gara ◽  
Arghya Sarkhel ◽  
Mohammed Sessay ◽  
Harish Rao ◽  
...  
2021 ◽  
pp. 145507252098596
Author(s):  
Sinikka L. Kvamme ◽  
Michael M. Pedersen ◽  
Sagi Alagem-Iversen ◽  
Birgitte Thylstrup

Background: In Denmark the boundaries between cannabis as an illicit drug and licit medicine have shifted rapidly in recent years, affecting also policy. However, the vast majority of Danes, who use cannabis as medicine (CaM) continue to rely on the unregulated market for supply. This study explores patterns of use and motives for use of CaM in Denmark. Methods: An anonymous online survey was made available to a convenience sample of users of CaM from July 14, 2018 to November 1, 2018. Participants were recruited through patient organisations, social and public media, and the illegal open cannabis market. Results: Of the final sample ( n = 3,021), a majority were women (62.6%) and the mean age was 49 years. Most had no prescription for CaM (90.9%), a majority had no or limited previous experience with recreational cannabis use (63.9%), and had used CaM for two years or less (65.0%). The most common form of intake was oil (56.8%) followed by smoke (24.0%). CBD oil (65.0%) was used more than hash, pot or skunk (36.2%). Most frequent conditions treated were chronic pain (32.0%), sleep disturbances (27.5%), stress (23.7%), osteoarthritis (22.7%), anxiety (19.6%), and depression (19.6%). Overall, users experienced CaM to be effective in managing somatic and mental health conditions and reported relatively few side-effects. CBD oil only users were more likely to be women, older, have limited recreational experience and have initiated use recently. Conclusions: A new user group has emerged in Denmark that, for the most part, use illegally sourced CaM to treat a broad range of somatic and mental health conditions, often with experienced effect and relatively low level of side-effects. The prevalent use of low-potency CBD oil indicates an interest in effects beyond the high normally associated with cannabis use. More clinical research into the effects and side-effects of CaM is needed to draw the boundaries of the medical utility of cannabis.


2021 ◽  
pp. 135910452199463
Author(s):  
Sara Moreno-Mansilla ◽  
Jorge J Ricarte ◽  
David J Hallford

Introduction: Cannabis is the most widely used psychoactive substance among adolescents worldwide, and the age at which consumption begins to decrease. Cannabis use in adolescents is associated with a wide range of adverse consequences in adulthood including increased vulnerability to psychosis and other mental disorders, as well as suicidal ideation and attempt. The aim of this study is to extend understanding of the link between cannabis use and mental illness by examining whether cannabis use at early ages predicts transdiagnostic variables that are precursors to severe clinical diagnoses. Methods: A descriptive cross-sectional study was conducted. The sample was made up of 605 adolescents from 7th to 9th grades, with a mean age of 13.2 years ( SD = 1.0, 47% girls). The variables evaluated were: anomalous perception of reality, intolerance of uncertainty, rumination, suicide attempt, hopelessness, and symptoms of depression and anxiety. The administration of the questionnaires was carried out in groups of 20 participants under the supervision of a researcher in a unique session of 1 hour. Results: Adolescent cannabis users scored higher on all variables assessed: anomalous perception of reality (Cohen’s d = .60), rumination ( d = .48), intolerance of uncertainty ( d = .11), suicidal attempt (affirmative answer: 25.9% of users vs 7.7% of non-users), hopelessness ( d = .85), symptoms of depression ( d = .80), and anxiety ( d = .39). A binary logistic regression showed that the only variable uniquely related to cannabis use was hopelessness (Wald = 4.560, OR: 1.159, p = .033). Conclusions: Among some mental health risk factors, hopelessness appears uniquely related to cannabis use. Adolescents may use cannabis as a coping strategy for negative thoughts and emotions, or it may be a consequence of cannabis use. Future prevention programs should focus on preventing/treating modifiable factors such as hopelessness, and delaying cannabis use in specific subgroups of adolescents who experience pathologies such as depression or suicide attempts.


2021 ◽  
pp. 1-12
Author(s):  
Rachel Lees ◽  
Lindsey A. Hines ◽  
Deepak Cyril D'Souza ◽  
George Stothart ◽  
Marta Di Forti ◽  
...  

Abstract Cannabis is the most widely used illicit drug worldwide, and it is estimated that up to 30% of people who use cannabis will develop a cannabis use disorder (CUD). Demand for treatment of CUD is increasing in almost every region of the world and cannabis use is highly comorbid with mental disorders, where sustained use can reduce treatment compliance and increase risk of relapse. In this narrative review, we outline evidence for psychosocial and pharmacological treatment strategies for CUD, both alone and when comorbid with psychosis, anxiety or depression. Psychosocial treatments such as cognitive behavioural therapy, motivational enhancement therapy and contingency management are currently the most effective strategy for treating CUD but are of limited benefit when comorbid with psychosis. Pharmacological treatments targeting the endocannabinoid system have the potential to reduce cannabis withdrawal and cannabis use in CUD. Mental health comorbidities including anxiety, depression and psychosis hinder effective treatment and should be addressed in treatment provision and clinical decision making to reduce the global burden of CUDs. Antipsychotic medication may decrease cannabis use and cannabis craving as well as psychotic symptoms in patients with CUD and psychosis. Targeted treatments for anxiety and depression when comorbid with CUD are feasible.


2021 ◽  
Vol 14 ◽  
Author(s):  
Alison Bennetts

Abstract Treatment recommendations for mental health are often founded on diagnosis-specific models; however, there are high rates of co-morbidity of mental health presentations and growing recognition of the presence of ‘transdiagnostic processes’ (cognitive, emotional or behavioural features) seen across a range of mental health presentations. This model proposes a novel conceptualisation of how transdiagnostic behaviours may maintain co-morbid mental health presentations by acting as a trigger event for the cognitive biases specific to each presentation. Drawing on existing evidence, psychological theory and the author’s clinical experience, the model organises complex presentations in a theory-driven yet accessible manner for use in clinical practice. The model offers both theoretical and clinical implications for the treatment of mental health presentations using cognitive behavioural approaches, positing that transdiagnostic behaviours be the primary treatment target in co-morbid presentations. Key learning aims (1) To understand the strengths and limitations of existing transdiagnostic CBT formulation models. (2) To learn about a novel, transdiagnostic and behaviourally focused formulation for use in clinical practice. (3) To understand how to use the tool in clinical practice and future research.


Author(s):  
Megan J. Magier ◽  
Scott T. Leatherdale ◽  
Terrance J. Wade ◽  
Karen A. Patte

The objective of this study was to examine the disciplinary approaches being used in secondary schools for student violations of school cannabis policies. Survey data from 134 Canadian secondary schools participating in the Cannabis use, Obesity, Mental health, Physical activity, Alcohol use, Smoking, and Sedentary behaviour (COMPASS) study were used from the school year immediately following cannabis legalization in Canada (2018/19). Despite all schools reporting always/sometimes using a progressive discipline approach, punitive consequences (suspension, alert police) remain prevalent as first-offence options, with fewer schools indicating supportive responses (counselling, cessation/educational programs). Schools were classified into disciplinary approach styles, with most schools using Authoritarian and Authoritative approaches, followed by Neglectful and Permissive/Supportive styles. Further support for schools boards in implementing progressive discipline and supportive approaches may be of benefit.


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