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Cannabis use, cannabis use disorder, and comorbid psychiatric illness: a narrative review

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Hasin, Deborah, Walsh, Claire·2020·Journal of Clinical Medicine
DOI 10.3390/jcm10010015PMC PMC7793504
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Abstract

Background: The landscape of attitudes, legal status and patterns of use of cannabis is rapidly changing in the United States and elsewhere. Therefore, the primary aim of this narrative review is to provide a concise overview of the literature on the comorbidity of cannabis use and cannabis use disorder (CUD) with other substance use and psychiatric disorders, and to use this information to accurately guide future directions for the field. Methods: A literature review of PubMed was conducted for studies relating to cannabis use, CUD, and a co-occurring psychiatric disorder. To provide an overview of representative data, the literature review focused on national-level, population-based work from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) and National Survey on Drug Use and Health (NSDUH) surveys. Considering rapidly changing cannabis laws, recent (past five-year) studies were addressed. Results: A strong body of literature shows associations between cannabis use and CUD with other drug use, psychosis, mood disorders, anxiety disorders, and personality disorders. The strongest evidence of a potential causal relationship exists between cannabis use and psychotic disorders. While some evidence shows potential directionality between cannabis use and mood and anxiety disorders, results are inconsistent. Studies have established higher rates of CUD among those with personality disorders, but little about the specifics of this relationship is understood. Conclusions: Although the general population in the United States increasingly perceives cannabis to be a harmless substance, empirical evidence shows that cannabis use is associated both with CUD and comorbid psychiatric illness. However, there is mixed evidence regarding the role of cannabis in the etiology, course, and prognosis of a co-occurring disorder across all categories of psychiatric disorders. Future research should expand on the existing body of literature with representative, longitudinal data, in order to better understand the acute and long-term effects of cannabis on comorbid psychiatric illness.

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  • Respondents aged 18-34 or non-Hispanic multiracial may be at heightened risk for using other substances and/or developing psychiatric comorbidity.

    “These respondents may be at heightened risk for using other substances and/or developing psychiatric comorbidity (Connor et al., 2021, Hasin, 2018, Hasin and Walsh, 2020, National Academies of Sciences, Engineering, and Medicine, 2017, Rabiee et al., 2020).”

    From Prevalence of and trends in current cannabis use among US youth and adults, 2013–2022 (2024) · cites this paper as Hasin and Walsh, 2020

    The Methods section identifies youth as a group at elevated risk of comorbid psychiatric illness, and Results §3.1 reports an association between adolescent cannabis use and later use of other drugs. The review does not establish the claim specifically for respondents aged 18–34 or non-Hispanic multiracial respondents (searched: “18–34” and “multiracial”). No page numbers were available in our copy. (LLM, conf=0.84)

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Cited by

Sorted by citations

Authors
Hasin, D., & Walsh, C.
Affiliations
  • Columbia University Irving Medical Center (US)
  • New York State Psychiatric Institute (US)
Corresponding author
Hasin, Deborah
ORCID
Venue
Journal of Clinical Medicine
Publisher
MDPI AG
Published
2020-12-23
Volume
10
Issue
1
Pages
15
ISSN
2077-0383 (ISSN-L)
DOI
10.3390/jcm10010015
PMC
PMC7793504
OpenAlex
W3115315782
Cited by
142
References
13
Citations by year
2026: 29 · 2025: 31 · 2024: 25 · 2023: 25 · 2022: 24 · 2021: 8
FWCI
1.87
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Clinical Medicine (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, other-oa)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Pharmacology › Cannabis and Cannabinoid Research
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords
cannabis use, cannabis use disorder, psychiatric comorbidity, substance use comorbidity, psychosis, mood disorders, anxiety disorders, personality disorders, cannabis legalization, NESARC

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