Skip to main content
SpringerLink
Log in

Cannabinoids

  • Chapter
  • First Online:
Absolute Addiction Psychiatry Review

  • 990 Accesses

Abstract

As legislation and societal perception surrounding the use of cannabinoids rapidly change, addiction specialists need to be knowledgeable about cannabinoid psychopharmacology, so that they can adequately inform patients, other healthcare providers, and policy decision-makers. This chapter provides a brief review of the effects of plant-based and synthetic cannabinoids, focusing on their time- and dose-dependent effects on mood, anxiety, perception, cognition, and psychomotor functioning. We also discuss risk factors for the progression to cannabis use disorder (CUD), and pharmacological and psychosocial treatments for CUD. Finally, the chapter covers the effects of cannabinoids on individuals with psychiatric disorders, medicinal use of cannabinoids, and potential pharmacokinetic interactions with other psychotropic medications.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 49.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 64.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Ahrnsbrak R, Bose J, Hedden S, Lipari R, Park-Lee E. Key substance use and mental health indicators in the United States: results from the 2016 National Survey on Drug Use and Health. Rockville: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration; 2017.

    Google Scholar 

  2. Johnston LD, O’Malley PM, Miech RA, Bachman JG, Schulenberg JE. Monitoring the future National Survey Results on Drug Use, 1975–2016: overview, key findings on adolescent drug use. Institute for Social Research; 2017.

    Google Scholar 

  3. Azofeifa A. National estimates of marijuana use and related indicators—National Survey on Drug Use and Health, United States, 2002–2014. MMWR Surveill Summ. 2016;65:1.

    Article  Google Scholar 

  4. Rey AA, Purrio M, Viveros MP, Lutz B. Biphasic effects of cannabinoids in anxiety responses: CB1 and GABA(B) receptors in the balance of GABAergic and glutamatergic neurotransmission. Neuropsychopharmacology. 2012;37(12):2624–34.

    Article  CAS  Google Scholar 

  5. ElSohly M, Gul W. Constituents of Cannabis sativa. In: Handbook of Cannabis, vol. 3; 2014. p. 1093.

    Google Scholar 

  6. ElSohly MA, Mehmedic Z, Foster S, Gon C, Chandra S, Church JC. Changes in Cannabis potency over the last 2 decades (1995–2014): analysis of current data in the United States. Biol Psychiatry. 2016;79:613.

    Article  CAS  Google Scholar 

  7. Ranganathan M, D’souza DC. The acute effects of cannabinoids on memory in humans: a review. Psychopharmacology. 2006;188(4):425–44.

    Article  CAS  Google Scholar 

  8. Ramaekers JG, Kauert G, Theunissen EL, Toennes SW, Moeller MR. Neurocognitive performance during acute THC intoxication in heavy and occasional cannabis users. J Psychopharmacol. 2009;23(3):266–77.

    Article  CAS  Google Scholar 

  9. Borgwardt SJ, Allen P, Bhattacharyya S, Fusar-Poli P, Crippa JA, Seal ML, et al. Neural basis of Δ-9-tetrahydrocannabinol and cannabidiol: effects during response inhibition. Biol Psychiatry. 2008;64(11):966–73.

    Article  CAS  Google Scholar 

  10. Dubois S, Mullen N, Weaver B, Bedard M. The combined effects of alcohol and cannabis on driving: impact on crash risk. Forensic Sci Int. 2015;248:94–100.

    Article  CAS  Google Scholar 

  11. Meier MH, Caspi A, Ambler A, Harrington H, Houts R, Keefe RS, et al. Persistent cannabis users show neuropsychological decline from childhood to midlife. Proc Natl Acad Sci U S A. 2012;109(40):E2657–64.

    Article  CAS  Google Scholar 

  12. Blanco C, Hasin DS, Wall MM, Flórez-Salamanca L, Hoertel N, Wang S, et al. Cannabis use and risk of psychiatric disorders: prospective evidence from a US national longitudinal study. JAMA Psychiat. 2016;73(4):388–95.

    Article  Google Scholar 

  13. Bonn-Miller MO, Harris AH, Trafton JA. Prevalence of cannabis use disorder diagnoses among veterans in 2002, 2008, and 2009. Psychol Serv. 2012;9(4):404–16.

    Article  Google Scholar 

  14. Sibley MH, Pelham WE Jr, Molina BS, Coxe S, Kipp H, Gnagy EM, et al. The role of early childhood ADHD and subsequent CD in the initiation and escalation of adolescent cigarette, alcohol, and marijuana use. J Abnorm Psychol. 2014;123(2):362.

    Article  Google Scholar 

  15. Bidwell L, Henry E, Willcutt E, Kinnear M, Ito T. Childhood and current ADHD symptom dimensions are associated with more severe cannabis outcomes in college students. Drug Alcohol Depend. 2014;135:88–94.

    Article  CAS  Google Scholar 

  16. Schierenbeck T, Riemann D, Berger M, Hornyak M. Effect of illicit recreational drugs upon sleep: cocaine, ecstasy and marijuana. Sleep Med Rev. 2008;12(5):381–9.

    Article  Google Scholar 

  17. D'Souza DC, Cortes-Briones J, Creatura G, Bluez G, Thurnauer H, Deaso E, et al. Efficacy and safety of a fatty acid amide hydrolase inhibitor (PF-04457845) in the treatment of cannabis withdrawal and dependence in men: a double-blind, placebo-controlled, parallel group, phase 2a single-site randomised controlled trial. Lancet Psychiatry. 2019;6(1):35–45.

    Article  Google Scholar 

  18. Compton MT, editor. Marijuana and mental health: American Psychiatric Publishing; 2016.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA

    Joao P. De Aquino & Bachaar Arnaout

Authors
  1. Joao P. De Aquino
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bachaar Arnaout
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Joao P. De Aquino .

Editor information

Editors and Affiliations

  1. University of California, San Diego, La Jolla, CA, USA

    Carla Marienfeld

Review Questions

Review Questions

  1. 1.

    A 21-year-old man started using cannabis at age 15 and found himself escalating his daily use at age 17 to achieve the same desired effect. He feels “jittery” and “depressed,” and cannot sleep when he stops using cannabis. He was an above-average student in junior high school, but his performance and grades subsequently fell and he often felt unmotivated. Despite wanting to pursue a college education, he missed several application deadlines. He took a job at a local coffee shop, because the short work shifts allowed more time to use cannabis alone at home. Which of the following diagnoses best describes this presentation?

    1. A.

      Cannabis hyperemesis syndrome

    2. B.

      Cannabis withdrawal syndrome

    3. C.

      Chronic cannabis syndrome

    4. D.

      Cannabis use disorder

    Answer D.

    Explanation: This individual has symptoms of tolerance, withdrawal, difficulty with major role obligations in school and work, which are diagnostic criteria for cannabis use disorder. He does not present with the persistent nausea or vomiting of hyperemesis syndrome, or with the irritability after cannabis cessation of withdrawal. Chronic cannabis syndrome is not a DSM-5 diagnosis.

  2. 2.

    A 20-year-old woman has smoked hashish daily for the past 12 months. She was stopped by the police for driving while intoxicated and held in custody over the weekend until her court hearing on Monday. While unable to use hashish, which of the following sets of symptoms is she most likely to experience?

    1. A.

      Muscle twitches, lacrimation, rhinorrhea, and diarrhea

    2. B.

      Nausea, headache, irritability, vomiting, and insomnia

    3. C.

      Hallucinations, tachycardia, and hypertension

    4. D.

      Slurred speech, vomiting, ataxia, and hypotension

    Answer: B.

    Explanation: This person is likely to experience cannabis withdrawal syndrome. Muscle twitches, lacrimation, rhinorrhea, and diarrhea tend to occur with opioid withdrawal. Hallucinations, tachycardia, and hypertension are common with severe alcohol withdrawal. Slurred speech, ataxia, vomiting, and hypotension occur during opioid intoxication.

  3. 3.

    A 22-year-old man develops paranoid delusions and dissociative symptoms over seven months, until he is hospitalized for an episode of behavioral dysregulation. He reports smoking five joints of cannabis daily since the age of 13. He is diagnosed with unspecified psychotic disorder and started on an antipsychotic medication. Which of the following best describes the current scientific consensus regarding the relationship between cannabis use and psychotic disorders?

    1. A.

      Schizophrenia is caused by early cannabis use

    2. B.

      Prodromal psychotic symptoms are temporarily relieved by cannabis

    3. C.

      The development of a psychotic disorder is independent of cannabis use

    4. D.

      Though the relationship between psychosis and cannabis use is complex, cannabis does appear to be a risk factor for the development of psychosis

    Answer: D.

    Explanation: Cannabis use is a risk factor for psychosis; however, it is neither sufficient to cause it, as answer A suggests it, nor necessary. In this clinical scenario, it is likely that prolonged and heavy cannabis use contributed to the onset of the psychotic disorder. There is no evidence to suggest prodromal symptoms of psychosis are relieved by cannabis.

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

De Aquino, J.P., Arnaout, B. (2020). Cannabinoids. In: Marienfeld, C. (eds) Absolute Addiction Psychiatry Review. Springer, Cham. https://doi.org/10.1007/978-3-030-33404-8_10

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-33404-8_10

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-33403-1

  • Online ISBN: 978-3-030-33404-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation