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

What the researchers 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.

Why it 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 numbers in context

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 the study worked

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.

What this study cannot 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.

How to read the evidence

Moderate - large sample from a psychiatric hospital with appropriate statistical methods, but retrospective and single-site.

When this study was published

Published in 2018.

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.

Questions still open

• 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?

Common questions

Read the original research

Comorbid Cannabis and Tobacco Use Disorders in Hospitalized Patients with Psychotic-Spectrum Disorders.

Journal of dual diagnosis, 14(3), 171-180

Citation

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

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