Cannabis-related adverse mental health events that precipitate presentations to the Emergency Department (DE) may include anxiety, suicidal thoughts, attenuated psychotic or psychotic symptoms, and may account for 25 to 30% of cannabis-related emergency department visits (3). All but one of these studies suggest that marijuana use is associated with schizophrenia. Sir Robin Murray, a psychiatrist at King's College London, says the tests changed his mind about marijuana. Even I, 20 years ago, used to tell patients that cannabis is safe.
Only after seeing all the patients who become psychotic do you realize that it's not so safe. With the legalization of cannabis in several jurisdictions, a research approach is emerging in understanding who (for example, it is not clear if anxiety symptoms severe enough to warrant emergency care) will eventually develop into an anxiety disorder on a continuum similar to postulate) cannabis and psychosis. It's not uncommon for cannabis-induced psychosis to be misdiagnosed as schizophrenia, since the symptoms are similar. While it did not focus on their cannabis use, this study found that 7 years after being admitted to the emergency room, 53% reported using cannabis last year and 87% reported using cannabis for life.
It is strongly recommended that you arrange to see a health professional who is specifically familiar with drug-induced symptoms, such as cannabis-induced psychosis. Cannabis-related adverse mental health events that precipitate presentations from the Emergency Department (DE) or Emergency Medical Services may include anxiety, suicidal thoughts, attenuated psychotic or psychotic symptoms, and may account for 25 to 30% of emergency department visits related to cannabis. Measuring the presentation of anxiety symptoms in the emergency department may underestimate the number of cases associated with cannabis poisoning. A 5-year follow-up review of patients who completely abstained after a first episode of cannabis-induced psychosis found that they never relapsed again.
A similar comparison could be made with suicide victims; however, in both situations, victims cannot self-report cannabis use, and the pharmacokinetics of cannabis are such that detectable levels of THC or THC-COOH can be found for 30 days after the last use in chronic daily users. (70). In the absence of a clear understanding of the risk factors for adverse mental health effects related to cannabis use, it may be instructive to examine what characteristics are observed in new presentations of mental illness in both emergency services (ED) and intervention services early for mental illness. Unfortunately, this is an exercise in reflection, since even less literature focuses on what the route of care may be, if any, for people who come to the emergency department with a cannabis-related mental health problem, especially if it is an index mental health presentation.
Cannabis smokers are also more likely to use other drugs, including those known to induce brief psychotic episodes. Clinical effects of synthetic cannabinoid receptor agonists compared to marijuana in emergency department patients with acute drug overdose.
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