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• W4241076258 abstract "JACEP Open’s podcasts aim to spotlight the journal's most interesting and controversial articles. Listen to the full podcast at https://soundcloud.com/jacepopen. In this JACEP Open podcast, we discuss this month's article by Marco et al1 (https://onlinelibrary.wiley.com/doi/10.1002/emp2.12025), which evaluates the relationship between marijuana use and mental health disorders (MHD) in emergency department patients. Looking forward, 3 big questions remain unanswered when it comes to fully depicting the intersection of MHD and marijuana use. Multiple previous studies have suggested that cannabis use, specifically at a young age, may contribute to increased rates of subsequent MHD. Worldwide, ≈50% of people report using cannabis at some point.2 Independently, a similar percentage of people report being diagnosed with a MHD.3 With these baseline rates, it would be difficult to establish any clear causal relationship, and we may be dealing with a mere association between exposure to cannabis and diagnosis of a MHD. Similarly, the role that age of first exposure plays remains unclear. Coffey et al4 reported >68% patients first used marijuana between the ages of 14 and 20. Despite this early exposure, the median age for diagnosis of generalized anxiety disorder is 31, suggesting that patients may have a considerable gap between their initial exposure and the development of a potential complication.5 The complex nature of cannabis, which is thought to contain up to 400 potentially psychoactive compounds, makes it difficult to truly evaluate the potential risks and benefits of using marijuana related to MHD.6 ∆9-Tetrahydrocannabinol alone has numerous reported manifestations with variable anxiolytic or anxiogenic effects noted based upon a potential dose-dependent response.7 When it comes to the potential effects of marijuana, the commercial market has outpaced the available medical literature. Most dispensaries offer the services of a “budtender” who can extol the purported differences between various strains of plant and routes of administration.8 As the commercial approach to marijuana becomes more nuanced, future medical studies would benefit from a more detailed evaluation of the actual products that patients are consuming. To date, the focus has been largely on an association between cannabis use and potential negative mental health consequences. Data from this month's article suggests that patients often view cannabis use as having a positive impact on their mental health. Among those who cited a MHD as a motivator to consume marijuana, ≈68% reported that it offered a “great deal of help.” Ultimately, the most important question to ask a patient may be if they overall feel better or worse. Here again, the data from Marco et al1 suggest that patients may subjectively derive more benefits from marijuana use than earlier studies have shown. Even when including self-proclaimed recreational users, 62% of participants felt as if marijuana helped their overall mental health. As the legalization and commercialization of marijuana continues, we will likely see increasing numbers of patients who use marijuana and have an underlying MHD. Further study into the nuances of cannabis use will help us more accurately create a risk–benefit profile for our patients. The authors have no financial conflicts of interest to disclose." @default.
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• W4241076258 date "2020-06-01" @default.
• W4241076258 modified "2023-09-27" @default.
• W4241076258 title "Reefer madness?" @default.
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• W4241076258 doi "https://doi.org/10.1002/emp2.12160" @default.
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