Książki na temat „Cannabis use disorder”

Recreational cannabis use is widespread, with estimates of 2.8% to 4.5% of the world population having used in the past year, and many more having used over their lifetimes. While most occasional users do not suffer any consequences, among persons who have ever used cannabis, approximately 9% will develop a cannabis-use disorder at some point in their lives, and 1.8% will meet diagnostic criteria for cannabis-use disorder within the past year. Several interventions are available to treat cannabis-use disorder. Psychotherapy, delivered individually as well as in groups, is the most well-established treatment approach. Several medications may offer benefit, though evidence supporting their role is weak. Integrative treatment approaches also show promise, notwithstanding a paucity of evidence. This chapter reviews the current understanding of cannabis-use disorder, including diagnosis, epidemiology, neurobiology, and treatment. Psychotherapeutic, medication, and integrative interventions are reviewed, with a particular focus on integrative approaches.

Epidemiology can help us understand who is at risk for developing a disorder, what may happen to them, and perhaps even why people get the disorder to begin with. In this chapter, we will review the incidence and prevalence of schizophrenia and related psychotic disorders, as well as factors affecting such rates. Risk factors for psychosis include socio-demographics (e.g., gender, age, migrant status, class), predisposing factors (e.g., season of birth, perinatal trauma), and precipitating factors (e.g., substance use, psychosocial stress). We will highlight controversial issues such as traumatic life events, prenatal infection, and cannabis use, considering how epidemiological factors can shed light on the pathogenesis of schizophrenia and related illnesses.

Cannabis research is flourishing despite the difficulties that scientists have in accessing high-quality cannabis. However, many questions remain: Can new medicines be discovered and developed based on the current knowledge of the biosynthesis, actions, and inactivation of endocannabinoids? Can genetic screening identify people who are particularly susceptible to cannabis use disorder and possibly to psychosis? Can researchers pinpoint in more detail how endocannabinoids modulate neural activity and how they change on exposure to stress? Scientific research will tackle all these questions and more in the coming decades. This chapter presents a broad view of the case for medical cannabis, along with some cautions. The case for the legalization of cannabis as a recreational drug is also presented.

Individual differences in personality have long been linked to the use and misuse of alcohol, tobacco, cannabis, and other drugs. Broadly, personality characteristics of high neuroticism and behavioral undercontrol/impulsivity appear to robustly relate to several substance use disorders (SUDs), although other traits have also been linked to SUDs. Much of the genetic basis of SUDs appears to be mediated by personality traits, which may relate to SUDs through a variety of non-mutually exclusive mechanisms that may work additively and synergistically, are indexed by various motivations associated with reward seeking and regulating negative emotion, and also relate to self-control and environment selection. Considerable change occurs in personality over the life course, and recent data show that the course of substance use and SUDs is associated with personality change. Although much progress has been made, several lines of future research could be pursued to further our understanding of the personality–SUD relation.

Marijuana is the most commonly used illicit drug in the United States; currently, 29 states either allow medical and/or recreational use of the drug. As policy shifts toward medicalization and legalization of marijuana, it is reasonable to expect that prevalence rates and resulting health consequences will increase. But overall the research field regarding marijuana’s possible negative health effects and potential as medicine is still relatively young. Use of marijuana has been linked to negative deleterious effects, but the evidence varies as a function of the age of the user, whether use is recreational or regular, and health domain. This science is stronger for some areas (e.g., mental health) than others (e.g., lung functioning). The issue that marijuana may have medicinal properties has emboldened proponents of marijuana legalization to further push for recreational liberalization of the drug. The words “medical marijuana” suggest that the whole marijuana plant is safe medicine established by rigorous research. Yet the marijuana plant consists of hundreds of components; some are not linked to any medical value and some have different effects on different disorders and ailments. The aim of this edited book is to highlight new and meaningful theory and empirical pertaining to studies on marijuana use trends, the drug’s impact on cognitive and neurological functioning, its medical effects, and treatment approaches for those with a cannabis use disorder.

In conjunction with alcohol, cannabis, nicotine, and stimulants are the substances most commonly used by older adults. Little is known about the specific characteristics of older adults who use these substances and how best to screen, identify, and treat these disorders in this population. As we reach the population peak for aging baby boomers, increasing percentages of older adults are using these substances, and developing substance-use disorders is anticipated. Concomitant factors are policy and social changes toward drugs of abuse in the United States. Evidence presented in this chapter represents what is currently known about cannabis, nicotine, and stimulant use and its impact on older adults. However, the use of these substances in older adults is under-studied, and much of the current information is extrapolated from studies of younger and middle-aged adults. This practice represents a large gap in our understanding and a significant opportunity for future research endeavors.

There are many herbal and botanical substances that are currently used by patients with psychiatric disorders such as anxiety or depression. Because each botanical derives from a different source, contains different active components, and has a different application, each must be studied thoroughly and used carefully. The use of herbal medicines differs from that of chemical pharmaceuticals, which are usually tested, packaged, and administered as single agents in defined dosages. Clinical evidence of effectiveness and toxicity of natural agents varies greatly as do methods for assessing their efficacy. The regulation, legality, standards, and control of the use of botanicals also vary greatly throughout the world. An account of the most frequently used phytopsychopharmaceuticals with their biologic effects, indications, side effects, and interactions can be useful to the clinician and are described in this chapter. Some ingredients covered include St. John’s wort, panax ginseng, kava, valerian, cannabis, and lavender.

The use of non-prescription drugs is widespread and has a major impact on the health of the individual user and society. In 2006, the British Crime Survey reported that 10% of adults had used one or more illicit drugs in the preceding year, with 3% reporting using a Class A drug. Over 11 million people in the UK are estimated to have used an illicit drug at least once in their lifetime (35%). Drugs abused vary in their intrinsic potential to cause addiction and, with it, more regular and harmful use. Drug users are influenced by trends and fashions, adopting new compounds such as crack cocaine and experimenting with routes of ingestion. Some drugs may become less popular over time, such as LSD, while others, such as cannabis, experience a revival as more potent strains (e.g. Skunk) are developed. A problem drug user is best defined as a person whose drug taking is no longer controlled or undertaken for recreational purposes and where drugs have become a more essential element of the individual’s life. The true economic and social cost of drug use is likely to be substantially greater than the published figures, which are derived from a variety of health and crime surveys which may overlook vulnerable groups such as the homeless. The majority of non-prescription drugs used in the UK are illegal and covered by the Misuse of Drugs Act 1971. The drugs most commonly abused gave rise in 2003–4 to an estimated financial cost in England and Wales of 15.4 billion pounds to the economy, with Class A drugs such as heroin and cocaine accounting for the majority of this. Some 90% of the cost is due to drug-related crime, with only 3% (£488 million) due to health service expenditure, which is mainly spent on inpatient care episodes. This still represents a major health pressure, which in 2006–7 amounted to 38 000 admissions, in England, for primary and secondary drug-related mental or behavioural problems, and over 10 000 admissions recorded for drug poisoning. Clinicians in all specialities can expect to encounter harmful drug use, especially those working in primary care, A & E, and psychiatric services. Presenting problems are protean, ranging from mood disorders, delirium, and psychosis to sepsis, malnutrition, and hepatitis. Blood-borne infections such as hepatitis C and HIV are widespread, as contaminated needles and syringes are shared by up to a quarter of problem drug users. Even smoking drugs such as crack cocaine can lead to increased transmission of hepatitis C through oral ulceration and contact with hot contaminated smoking pipes. Amongst the UK population, over half of IV drug users have hepatitis C, a quarter have antibodies to hepatitis B, and, by 2006, 4662 had been diagnosed with HIV. Non-prescription drug abuse is a leading cause of death and morbidity amongst the young adult population (those aged 16–35). In 2006 there were 1573 deaths where the underlying cause was poisoning, drug abuse, or dependence on substances controlled under the Misuse of Drugs Act. The vast majority (79%) were male. Young men, in particular, are at greater risk of violent death through associated criminal activity such as drug supplying and from deliberate and accidental overdose. The male-to-female ratio for deaths associated with mental and behavioural disorder is 6:1.