A comprehensive commentary found that cannabinoids produce dose-dependent effects on anxiety, mood, and cognition acutely, while chronic use increases risk of tolerance, dependence, withdrawal, and associations with anxiety, psychotic, and mood disorders.
Read this if you want a broad overview of how cannabis affects mental health from first use through chronic exposure.
Chronic cannabinoid exposure increases probability of tolerance, dependence, and withdrawal
What the researchers found
This overview examined the psychiatric effects of both plant-based and synthetic cannabinoids across different timeframes.
Acutely, cannabinoids produce multiphasic, dose-dependent effects on anxiety, mood, and perception while impairing cognition and psychomotor function. In healthy individuals, these acute negative effects tend to be milder compared to people with pre-existing psychiatric conditions.
With chronic exposure, the probability of developing tolerance and dependence increases. A problematic pattern of use can lead to clinically significant impairment, and cessation in tolerant, dependent individuals produces a withdrawal syndrome.
Long-term cannabis exposure has been linked to anxiety, psychotic, and mood disorders in the research literature. The authors noted that even with limitations in existing evidence, the plausibility of a causal relationship and the potential for long-term brain changes from regular exposure, especially in adolescents, warrant clinical attention.
Why it matters
With rising cannabis use rates and expanding legalization, clinicians and the public need a clear picture of the full spectrum of psychiatric effects, from single-use experiences through chronic exposure to withdrawal.
The numbers in context
Effects are dose-dependent and multiphasic. Chronic use increases probability of tolerance, dependence, and withdrawal. Acute effects milder in healthy individuals vs. those with pre-existing psychiatric conditions.
How the study worked
Commentary and overview synthesizing published literature on acute, chronic, and withdrawal-related psychiatric effects of plant-based and synthetic cannabinoids, with discussion of clinical implications.
What this study cannot tell us
This is a commentary synthesizing existing literature rather than conducting new analysis. The authors acknowledge limitations in the existing evidence base. The review does not quantify absolute risk levels or differentiate effects by specific cannabinoid profiles, doses, or routes of administration.
How to read the evidence
This is a comprehensive commentary drawing on established literature, providing moderate-level evidence as an overview of the field rather than a systematic analysis.
When this study was published
Published in 2018. Cannabis potency and use patterns have continued to evolve since publication.
The bigger picture
This overview frames cannabis psychiatric effects as existing on a spectrum from acute to chronic, with different risk profiles for different populations. The emphasis on adolescent vulnerability and pre-existing psychiatric conditions highlights that cannabis effects are not uniform across all users.
Questions still open
- How do psychiatric risks differ across specific cannabinoid profiles (high-THC vs. balanced THC:CBD)? What screening tools should clinicians use for patients who use cannabis? How has legalization affected psychiatric presentations in emergency settings?
Common questions
Are the psychiatric effects the same for everyone?
Does cannabis use always lead to dependence?
Read the original research
The Psychiatric Consequences of Cannabinoids.
Clinical therapeutics, 40(9), 1448-1456
Citation
De Aquino, Joao P; Sherif, Mohamed; Radhakrishnan, Rajiv; Cahill, John D; Ranganathan, Mohini; D'Souza, Deepak C. (2018). The Psychiatric Consequences of Cannabinoids.. Clinical therapeutics, 40(9), 1448-1456. https://doi.org/10.1016/j.clinthera.2018.03.013
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