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Abstract
Objective: The authors investigated the rates of conversion to schizophrenia and bipolar disorder after a substance-induced psychosis, as well as risk factors for conversion.
Method: All patient information was extracted from the Danish Civil Registration System and the Psychiatric Central Research Register. The study population included all persons who received a diagnosis of substance-induced psychosis between 1994 and 2014 (N=6,788); patients were followed until first occurrence of schizophrenia or bipolar disorder or until death, emigration, or August 2014. The Kaplan-Meier method was used to obtain cumulative probabilities for the conversion from a substance-induced psychosis to schizophrenia or bipolar disorder. Cox proportional hazards regression models were used to calculate hazard ratios for all covariates.
Results: Overall, 32.2% (95% CI=29.7-34.9) of patients with a substance-induced psychosis converted to either bipolar or schizophrenia-spectrum disorders. The highest conversion rate was found for cannabis-induced psychosis, with 47.4% (95% CI=42.7-52.3) converting to either schizophrenia or bipolar disorder. Young age was associated with a higher risk of converting to schizophrenia. Self-harm after a substance-induced psychosis was significantly linked to a higher risk of converting to both schizophrenia and bipolar disorder. Half the cases of conversion to schizophrenia occurred within 3.1 years after a substance-induced psychosis, and half the cases of conversion to bipolar disorder occurred within 4.4 years.
Conclusions: Substance-induced psychosis is strongly associated with the development of severe mental illness, and a long follow-up period is needed to identify the majority of cases.
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Highlights:
- Less than a third of youth maintained a single mode of cannabis use across legalization.
- More than three times as many participants expanded their use modes as reduced them.
- Maintenance of multiple modes was associated with other substance use and depressive symptoms
- Using cannabis in multiple ways linked to binge drinking and depressive symptoms
Conclusions: Multi-modal cannabis use increased among Canadian youth in our sample. Its association with other substance use and depressive symptoms may indicate clustering of additional harms. Screening for this use pattern may assist in identifying high-risk substance use and should be considered in the design of harm reduction programming.
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The genotoxicity of Cannabis has long been suspected, even acknowledged, be it only in part. Research over the last 5 to 10 years has confirmed the case. Much of this important research has been ‘buried’ in the deluge of ‘hopeful’ and even spectacular claims of the potential therapeutic capacity of cannabis.
Claims and promises that have persisted for well over 20 years, yet with little to nothing to show for it.
However, the harms associated with the use of this now heavily engineered plant/product are mounting, and the research is not only monitoring, but discovering these harms.
If science and health matter, then all research must be thorough and properly vetted to ensure that health is advanced, not mere ‘symptom abated’ whilst disease, disorder or other harms grow.
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Boredom, self-medication for increased depression and/or isolation, along with the various mental health issues that ramp up with a toxic combination of managing a legitimate mental health concern with a psychotropic toxin that only aids and abets mental health decline – not fix it.
The vicious cycle of very short term ‘alleviation’ with self-medication, to only exacerbate symptoms and disorder accelerating even greater ‘need’ for further alleviation. The addiction for profit industry has hit a gold-mine with their fallacious medicinal marketing and wanton misrepresentation of this far from ‘natural’ drug.
Recent research from the Australian Institute of Criminology (Statistical Bulletin 33, July 2021) uncovered what anecdotal and observation had already assumed. Demand for Cannabis went up during the pandemic
The Report
This study uses data from the Drug Use Monitoring in Australia program to examine the impact of the COVID-19 pandemic on cannabis demand and supply in Australia. It found past-month cannabis users reported using cannabis on a median of 25 days per month, significantly more often than before the pandemic. Those experiencing changes in their employment, financial or living situation or mental health or who used drugs to cope with negative emotions were more likely to increase cannabis use. Most users reported no changes in cannabis supply, but there were increasing prices and decreasing numbers of dealers in Brisbane.
Quick Points from Discussion
- This study suggests patterns of cannabis use may have been altered by COVID-19 restrictions, but that cannabis supply appears to have been resistant to the impacts of the pandemic.
- Not so much more users, but the frequency of cannabis use was significantly greater than before the pandemic. This is consistent with other research suggesting an overall increase in frequency of cannabis use during the pandemic in Australia (Peacock et al. 2020; Sutherland et al. 2020) and internationally (EMCDDA 2020).
- The National Wastewater Drug Monitoring Program also found an increase in cannabis consumption, reaching a record high in capital cities in June 2020 (ACIC 2020).
- Increases in the frequency and quantity of cannabis use were significantly more likely to occur among detainees who had experienced changes in their employment, financial or living situation; who experienced changes in their mental health; or who used drugs to cope with negative emotions.
- These results are consistent with Peacock et al.’s (2020) findings that cannabis users were likely to attribute increases in drug use to feelings of boredom (74%), an increase in available time to use the drug (38%) and greater anxiety or depression associated with COVID-19 (11%). These findings suggest it may be important to ensure support services for cannabis use are available to those who have experienced changes in their life associated with the pandemic.
- Other factors may also explain the increase in cannabis use during the pandemic. Economic changes such as increases to income support and policies such as early access to superannuation may have provided some respondents with greater income and increased demand for cannabis. Detainees may also have bought more cannabis as a substitute for methamphetamine following a rise in the price of methamphetamine (Voce, Sullivan & Doherty 2021)
- Cannabis supply appeared to remain stable during the pandemic. Most cannabis users reported no change in availability or quality compared with before the pandemic. Four out of five cannabis users also reported no change in the price of cannabis, and three out of five cannabis users reported no change in the number of dealers selling cannabis.
- 90 percent of those interviewed between June and September 2020 for the Adapting to Pandemic Threats study reported that cannabis was easy or very easy to obtain (Sutherland et al. 2020). The cannabis market may have been less disrupted during the COVID-19 pandemic than other drug markets because cannabis cultivation occurs domestically, rather than relying on drugs being produced internationally and trafficked into the country (ACIC 2020). Despite this stability, two in five detainees purchased larger quantities of cannabis than usual because they anticipated a possible decrease in supply due to the pandemic. Seventeen percent of cannabis users also reported using other drugs as a substitute for cannabis, with benzodiazepines and methamphetamine common substitutes for cannabis. These results are concerning, as the risk of drug overdose may be increased when an individual has access to a large personal supply of a drug (Dietze & Peacock 2020), uses a new substance for the first time, or uses multiple drugs simultaneously or concurrently within a brief period (Lalica et al. 2018)
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ABSTRACT
Background and Aims The idea that cannabis is a ‘gateway drug’ to more harmful substances such as opioids is highly controversial, yet has substantially impacted policy, education and how we conceptualize substance use. Given a rise in access to cannabis products and opioid-related harm, the current study aimed to conduct the first systematic review and meta-analysis on the likelihood of transitioning from cannabis use to subsequent first-time opioid use, opioid use disorders (OUD), dependence or abuse.
Conclusion A systematic review and meta-analysis found that while people who use cannabis are disproportionately more likely to initiate opioid use and engage in problematic patterns of use than people who do not use cannabis, the low quality of the evidence must be considered when interpreting these findings.
- High potency weed linked to psychotic episodes, mysterious vomiting illness in young users
- Pediatric cannabis intoxication trends in the pre and post-legalization era
- Associations of Suicidality Trends With Cannabis Use as a Function of Sex and Depression Status
- Association of Cannabis Use During Adolescence With Neurodevelopment