Cannabinoids for the treatment of mental disorders

TY - JOUR

T1 - Cannabinoids for the treatment of mental disorders

AU - Feingold, Daniel

AU - Lev-Ran, Shaul

N1 - Funding Information: Daniel Feingold a [email protected] Shaul Lev-Ran b c a Department of Psychology, Ariel University, Ariel, Israel Department of Psychology Ariel University Ariel Israel Department of Psychology, Ariel University, Ariel, Israel b Lev Hasharon Medical Center, Netanya, Israel Lev Hasharon Medical Center Netanya Israel Lev Hasharon Medical Center, Netanya, Israel c Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel In their meta-analysis, Nicola Black and colleagues 1 point to a lack of clinical superiority in using cannabinoids for treatment of mental disorders and a significant increased risk for developing short-term adverse consequences. The authors suggest that long-term use of cannabinoids might also increase the risk of transition to a cannabis use disorder, a notion previously supported by several population-based longitudinal studies. 2 Nevertheless, as most available data concerning risk of transition to cannabis use disorders are based on recreational users, the extent of this risk among individuals who use medicinal cannabinoids is unknown. The use of oral cannabis-based medicines or inhaled cannabis strains with low tetrahydrocannabinol (THC) concentration, common in medical settings, is associated with decreased risk for developing cannabis use disorder compared with the use of inhaled cannabis strains with high THC concentration, common in recreational use. 3 However, the extent to which standard diagnostic tools and criteria for cannabis use disorder are applicable to those receiving the substance in a medical setting is unclear. Although long-term use of addictive substances (eg, prescription opioids) often leads to physical and psychological dependence, when used in a medical setting substantially lower rates of related aberrant behaviours, characteristic of addiction, are commonly observed. 4 These aberrant behaviours are part of the diagnostic criteria both in the American Psychiatric Association's Diagnostic and Statistical Manual (DSM-5) and in the WHO's International Classification of Diseases. To address this diagnostic challenge, alternative measures, such as the Opioid Related Behaviours In Treatment scale, 5 were developed and are commonly and efficiently used to assess additional aspects of problematic use of opioid pain medication. Unfortunately, similar scales for medicinal cannabinoid users are currently unavailable. We believe that adapting screening and diagnostic tools for cannabis use disorders in individuals using medicinal cannabinoids is critical to assessing the risk of transition to problematic substance use in this patient population. SL-R has received speaking fees, travel and research support from Reckitt Benkisser and Indivior Pharmaceuticals, consulting and speaking fees from Lundbeck, consulting and speaking fees from Pfizer, speaking fees from Janssen-Cilag and from Sanofi. DF declares no competing interests.

PY - 2020/2

Y1 - 2020/2

UR - http://www.scopus.com/inward/record.url?scp=85077988293&partnerID=8YFLogxK

U2 - 10.1016/S2215-0366(19)30523-1

DO - 10.1016/S2215-0366(19)30523-1

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C2 - 31981534

AN - SCOPUS:85077988293

SN - 2215-0366

VL - 7

SP - 126

EP - 127

JO - The Lancet Psychiatry

JF - The Lancet Psychiatry

IS - 2

ER -