Cited by 567Cannabis and Cannabinoid ResearchSchizophrenia research and treatmentForensic Toxicology and Drug Analysis

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High-potency cannabis and the risk of psychosis

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Di Forti, Marta, Morgan, Craig, Dazzan, Paola, Pariante, Carmine, Mondelli, Valeria, Marques, Tiago Reis, Handley, Rowena, Luzi, Sonija, Russo, Manuela, Paparelli, Alessandra, Butt, Alexander, Stilo, Simona A., Wiffen, Ben, Powell, John, Murray, Robin M.·2009·British Journal of Psychiatry

DOI 10.1192/bjp.bp.109.064220PMC PMC2801827

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Abstract

Background: People who use cannabis have an increased risk of psychosis an effect attributed to the active ingredient δ9-tetrahydrocannabinol (Δ9-THC). There has recently been concern over an increase in the concentration of Δ9-THC in the cannabis available in many countries. Aims: To investigate whether people with a first episode of psychosis were particularly likely to use high-potency cannabis. Method: We collected information on cannabis use from 280 cases presenting with a first episode of psychosis to the South London & Maudsley National Health Service (NHS) Foundation Trust, and from 174 healthy controls recruited from the local population. Results: There was no significant difference between cases and controls in whether they had ever taken cannabis, or age at first use. However, those in the cases group were more likely to be current daily users (OR = 6.4) and to have smoked cannabis for more than 5 years (OR = 2.1). Among those who used cannabis, 78% of the cases group used high-potency cannabis (sinsemilla, ‘skunk’) compared with 37% of the control group (OR 6.8). Conclusions: The finding that people with a first episode of psychosis had smoked higher-potency cannabis, for longer and with greater frequency, than a healthy control group is consistent with the hypothesis that Δ9-THC is the active ingredient increasing risk of psychosis. This has important public health implications, given the increased availability and use of high-potency cannabis.

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Authors: Di Forti, M., Morgan, C., Dazzan, P., Pariante, C., Mondelli, V., Marques, T. R., Handley, R., Luzi, S., Russo, M., Paparelli, A., Butt, A., Stilo, S. A., Wiffen, B., Powell, J., & Murray, R. M.
Affiliations: Springfield University Hospital (GB)
ORCID: Morgan, Craig
Dazzan, Paola
Pariante, Carmine
Mondelli, Valeria
Marques, Tiago Reis
Luzi, Sonija
Russo, Manuela
Powell, John
Murray, Robin M.
Venue: British Journal of Psychiatry
Publisher: Royal College of Psychiatrists
Published: 2009-12
Volume: 195
Issue: 6
Pages: 488-491
ISSN: 0007-1250 (ISSN-L)
1472-1465
DOI: 10.1192/bjp.bp.109.064220
PMC: PMC2801827
OpenAlex: W2104532446
Cited by: 567
References: 15
Citations by year: 2026: 10 · 2025: 11 · 2024: 25 · 2023: 30 · 2022: 38 · 2021: 41 · 2020: 54 · 2019: 31 · 2018: 35 · 2017: 38 · 2016: 46 · 2015: 36 · 2014: 28 · 2013: 36 · 2012: 29
FWCI: 25.87
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.cambridge.org/core/terms (unspecified, 2954 d)
Locations: The British Journal of Psychiatry (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Research Portal (King's College London) (submittedVersion)
Funders: King's College London
Topics: Health Sciences › Medicine › Pharmacology (medical) › Cannabis and Cannabinoid Research
Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Forensic Toxicology and Drug Analysis
Keywords: high-potency cannabis, psychosis, first-episode psychosis, delta-9-tetrahydrocannabinol, cannabis use, daily cannabis use, public health implications
MeSH terms: Adolescent, Adult, Age Factors, Aged, Cannabis, Female, Humans, London, Male, Marijuana Smoking, Middle Aged, Psychoses, Substance-Induced, Risk Factors, Dronabinol, Case-Control Studies, Young Adult

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High-potency cannabis and the risk of psychosis

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