Young Psychosis Patients Kept Using Cannabis Because They Lacked Alternative Coping Strategies

Participants recognized that cannabis use conflicted with their life goals but maintained use because they perceived it as facilitating social interactions, enjoyable activities, and improved mental health. The primary barrier to quitting was having no replacement strategies to compensate for these perceived benefits.

Three online focus groups and 3 individual interviews with 16 young adults with first-episode psychosis (mean age 23.7) who had used cannabis an average of 11.8 days in the past month. Data analyzed using theory of planned behavior framework with content and thematic analysis.

No evidence-based treatment effectively addresses cannabis use disorder in first-episode psychosis. Understanding why patients keep using, despite knowing the risks, points to specific intervention targets: teaching alternative social skills, activity planning, and mood management.

This study shifts the conversation from "why won't they stop?" to "what would they need to stop?" The answer is not more warnings about risks (patients already know) but concrete alternative strategies for the functions cannabis serves in their lives.

Small qualitative sample of 16 participants from a specific clinical context. Self-reported perceptions of cannabis benefits may not reflect actual effects. The theory of planned behavior framework may not capture all relevant factors.