Cannabis Plus Tobacco Was the Most Complicated Substance Pattern in Hospitalized Psychosis Patients

Among 829 hospitalized psychosis patients, those with both cannabis and tobacco use disorders had the highest rates of additional alcohol and stimulant use disorders.

Reeves, Lauren E et al.·Journal of dual diagnosis·2018·Moderate EvidenceRetrospective Cohort
RTHC-01808Retrospective CohortModerate Evidence2018RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Retrospective Cohort
Evidence
Moderate Evidence
Sample
N=829

What This Study Found

Patients with both cannabis and tobacco use disorders (CUD + TUD) had significantly higher odds of also having alcohol and stimulant use disorders compared to patients with neither. Stimulant and polysubstance use disorder diagnoses were associated with tobacco use disorder. More prescribed psychotropic medications was linked to tobacco use disorder.

Key Numbers

829 patients with psychotic-spectrum disorders. Four groups: cannabis use disorder only, tobacco use disorder only, both, and neither. Age and gender varied significantly across groups.

How They Did This

Retrospective analysis of electronic medical records from 829 patients with psychotic-spectrum disorders admitted to a psychiatric hospital. Patients were categorized into four groups based on cannabis and/or tobacco use disorder. Multinomial logistic regression compared groups controlling for age and sex.

Why This Research Matters

Tobacco and cannabis are the most commonly used substances among people with psychosis. Understanding how these use patterns cluster with other substance use and clinical characteristics can help clinicians screen more effectively and tailor treatment during hospitalization.

The Bigger Picture

Substance use in psychosis is the rule rather than the exception. This study highlights that cannabis and tobacco use rarely occur in isolation - they tend to co-occur with each other and with other substance use disorders, complicating treatment.

What This Study Doesn't Tell Us

Retrospective chart review at a single hospital. Diagnoses depended on clinical documentation quality. Cross-sectional snapshot during hospitalization. Age differences between groups may account for some findings.

Questions This Raises

  • ?Does treating one substance use disorder in psychosis patients help reduce others?
  • ?Would integrated treatment for multiple substances be more effective than targeting them individually?
  • ?How do these comorbidity patterns affect treatment outcomes?

Trust & Context

Key Stat:
Alcohol and stimulant use disorder diagnoses each predicted having both cannabis and tobacco use disorders in psychosis patients.
Evidence Grade:
Moderate - large sample from a psychiatric hospital with appropriate statistical methods, but retrospective and single-site.
Study Age:
Published in 2018.
Original Title:
Comorbid Cannabis and Tobacco Use Disorders in Hospitalized Patients with Psychotic-Spectrum Disorders.
Published In:
Journal of dual diagnosis, 14(3), 171-180 (2018)
Database ID:
RTHC-01808

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-ControlFollows or compares groups over time
This study
Cross-Sectional / Observational
Case Report / Animal Study

Looks back at existing records to find patterns.

What do these levels mean? →

Frequently Asked Questions

How common is substance use in people with psychosis?

Very common. This study of 829 hospitalized psychosis patients found that cannabis and tobacco use disorders frequently co-occurred with each other and with alcohol and stimulant use disorders.

Do cannabis and tobacco use tend to go together in psychosis?

Yes. This study identified a distinct group of psychosis patients with both cannabis and tobacco use disorders who had the most complex substance use profiles, including higher rates of alcohol and stimulant problems.

Read More on RethinkTHC

Cite This Study

RTHC-01808·https://rethinkthc.com/research/RTHC-01808

APA

Reeves, Lauren E; Gaudiano, Brandon A; Metrik, Jane; Guzman Holst, Carolina; Morena, Alexandra; Sydnor, Valerie J; Weinstock, Lauren M; Epstein-Lubow, Gary. (2018). Comorbid Cannabis and Tobacco Use Disorders in Hospitalized Patients with Psychotic-Spectrum Disorders.. Journal of dual diagnosis, 14(3), 171-180. https://doi.org/10.1080/15504263.2018.1470359

MLA

Reeves, Lauren E, et al. "Comorbid Cannabis and Tobacco Use Disorders in Hospitalized Patients with Psychotic-Spectrum Disorders.." Journal of dual diagnosis, 2018. https://doi.org/10.1080/15504263.2018.1470359

RethinkTHC

RethinkTHC Research Database. "Comorbid Cannabis and Tobacco Use Disorders in Hospitalized ..." RTHC-01808. Retrieved from https://rethinkthc.com/research/reeves-2018-comorbid-cannabis-and-tobacco

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.