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A new review article out of the University of Maryland School of Medicine (UMSOM) urges medical professionals to screen patients with suspected or diagnosed Cannabis use disorder (CUD) for psychiatric conditions.
David Gorelick, MD, PhD, UMSOM professor of psychiatry and editor-in-chief of the Journal of Cannabis Research, felt the need to conduct the review as Cannabis use, the diagnosis of CUD, and Cannabis-linked psychiatric disorders are all on the rise.
As the legalization of Marijuana is a continued discussion, with 24 states allowing recreational use, Gorelick warns that people are often too quick to write it off as a harmless drug.
“There is a lot of misinformation in the public sphere about Cannabis and its effects on psychological health, with many assuming that this drug is safe to use with no side effects,” he states, continuing, “It is important for physicians and the public to understand that Cannabis can have addictive effects and to recognize signs and symptoms in order to get properly diagnosed and treated.”
Marijuana is one of the most widely used substances in the US, with 48.2 million Americans reporting using it at least once in the past year.
The Centers for Disease Control and Prevention (CDC) found that 3 in 10 people who recreationally use Marijuana have a Cannabis use disorder, with 16 million meeting the outline criteria.
The primary risk factor for a Cannabis use disorder is the frequency and duration of Cannabis use, with the disorder being more prevalent in people who use the drug four or more times a week. The following signs are indicators that someone may have a Cannabis use disorder:
Though exhibiting these signs does not guarantee a person has a Cannabis use disorder, they are good indicators that some substance misuse is taking place.
Another main contributing factor of Cannabis use disorder is not only the increasing legalization of Marijuana but also its increased potency. Studies have found that the manufactured forms found in dispensaries are becoming stronger and more potent, with the average THC levels found to be 22%. This is a striking number, as the averages in 2008 were 9% and in 2017 were 17%.
As the strength rises, so does the danger and risks for Cannabis use disorder and its linked mental conditions.
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Gorelick found that almost 50% of people who are diagnosed with Cannabis use disorder have a comorbid psychiatric condition, such as depression or generalized anxiety disorder. Cannabis use has also been linked to other mental conditions such as schizophrenia, bipolar disorder, and post-traumatic stress disorder (PTSD).
Dr. Ryan Sultan, psychiatrist and assistant professor of clinical psychiatry at Columbia Irving Medical Center, has conducted his own research on teenage Cannabis use and its link to psychiatric disorders, spurred by the many young patients he would see with comorbidities.
Studies have found that the young adult population is disproportionality affected by Cannabis use, which is rising across all demographics but particularly among those aged 19-30. The risk of developing a Cannabis use disorder is greater in those who start using Marijuana before the age of 18. In the same population, one in ten reported daily Cannabis use.
Sultan found that teens who use Marijuana recreationally “are two to four times more likely to develop psychiatric disorders, including depression and suicidality” when compared to teens who do not use the drug at all.
“Of all the people I’ve diagnosed with a psychotic disorder, I can’t think of a single one who wasn’t also positive for Cannabis,” he told NBC News.
Still, some researchers are more hesitant to confirm a direct correlation between Marijuana use and mental conditions, as they say more research is needed. However, the National Institute on Drug Abuse confirms that there is a link between Cannabis use and psychotic disorders (particularly schizophrenia) in people who are already genetically pre-disposed for psychotic disorders.
As a deeper connection is revealed, the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) now formally recognizes seven Cannabis-linked disorders, including:
Gorelick warns that the symptoms for these disorders closely resemble their non-Cannabis-related counterparts, so it is important to screen for CUD use specifically.
As the number of people using Cannabis is expected to grow, focus on treatment becomes more paramount. Gorelick encourages those in the medical field to be more informed and diligent when screening for psychiatric disorders in those with Cannabis use disorder and encourages those using the drug to be mindful of the risks.
While there are no current FDA-approved medications for the treatment of Cannabis use disorder, behavioral therapies, like cognitive interactive therapy and motivational enhancement therapy, have been shown to help manage symptoms and help reduce and stop Cannabis use altogether.
If your life has been negatively affected by Cannabis use and you are looking to get help, contact a treatment provider today to explore your treatment options.
Jessica Sherer earned her B.A. in English from Ashford University and has over eight years of copyediting experience in healthcare education. Dedicated to providing clear and useful information, she hopes her work will help to support those affected by addiction.