Dan I Lubman
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
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.
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.
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.
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