Journal Watch Psychiatry
Patients with mental illness accounted for 83% of all U.S. cannabis consumption.
Cannabis seems to be used by many of our patients, who often say that it helps with anxiety and depression. But do they use cannabis more often than individuals in the general population? To find out, investigators compared cannabis use in the previous 12 months in more than 43,000 adults with or without 12-month mental illness who participated in the National Epidemiologic Survey on Alcohol and Related Conditions from 2001 to 2002.
Respondents with 12-month mental illness (excluding substance-induced psychiatric disorders) had higher 12-month prevalence of cannabis use (9.9% vs. 4.0% in those without mental illness) and cannabis-use disorders (1.6% vs. 0.4%). People with mental illness accounted for 72% of all cannabis users and 82% of all individuals with cannabis-use disorders. Weekly usage rates and daily doses of cannabis were higher in individuals with mental illness. The likelihood of using cannabis was higher in respondents with mental illness across all age groups (odds ratios, 5.8–8.2), except in those 65 and older; prevalence in these older individuals was low (0.04%). Prevalence of cannabis use was particularly elevated in respondents with multiple diagnoses and in those with bipolar disorder and histrionic or antisocial personality disorder. Respondents with mental illness accounted for 83% of all cannabis use in the U.S.
Comment: This study provides an additional perspective on our patients who tell us they use cannabis for “therapeutic” reasons. It does not provide data about whether cannabis helps or exacerbates symptoms. However, the striking finding that almost all cannabis use is among those with mental illness gives us another reason to question the legalization of cannabis as well as discuss our patients’ rationalizations for continued use.
— Jonathan Silver, MD
Published in Journal Watch Psychiatry February 25, 2013
Lev-Ran S et al. Cannabis use and cannabis use disorders among individuals with mental illness. Compr Psychiatry 2013 Jan 30; [e-pub ahead of print]. (http://dx.doi.org/10.1016/j.comppsych.2012.12.021)