Street drugs

August 2010

FocusStreet drugs

Cannabis and mental health

Management in primary care

Volume 39, No.8, August 2010 Pages 554-557

Dan I Lubman

Amanda Baker

Background

Cannabis is the most widely used illicit drug in Australia. Regular use has been associated with increased risk for a range of harms, including the development and exacerbation of mental disorders.

Objective/s

This article reviews current evidence relating to the neuropharmacology of cannabis and its impact on mental health, as well as strategies related to the assessment and management of cannabis and co-occurring mental disorders within the primary care setting.

Discussion

Early and heavy use of cannabis has been associated with the onset of psychosis and depression, while chronic use results in poorer treatment outcomes among those with co-occurring mental disorders. Effective management involves the development of therapeutic engagement and an ongoing relationship, with monitoring of cannabis use and mental health problems. Standard pharmacotherapeutic treatment of the mental disorder may be associated with a reduction in cannabis use, although adjunctive psychological intervention is also likely to be required.

Cannabis, derived from the plant Cannabis sativa, is the most widely used illicit drug in Australia.1 Approximately one-third of the population have reported cannabis use at some time in their life, with around 9% reporting use in the past 12 months.1 Over the past few decades, the proportion of young people who have used cannabis has steadily increased while the age of first use has declined.2 An earlier onset of use increases the risk for subsequent dependence, while regular use during adolescence predicts later use of other illicit drugs, underperformance in school and mental health problems.3

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Correspondence afp@racgp.org.au

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