From the Editor

“Should I take cannabis for my mental illness?”

Our patients ask this question – in our EDs, inpatient wards, and outpatient clinics. We shouldn’t be surprised. Cannabis is now legal, and private industry pushes the medicinal benefits of cannabis. But what does the literature say?

This week, we have three selections.

The first is a new Canadian Psychiatric Association position statement that considers cannabis and mental illness. Dr. Philip G. Tibbo (of Dalhousie University) and his co-authors systematically reviewed the literature. They found 29 RCTs, including for anxiety and psychotic disorders. “Use of cannabis or a cannabinoid product should never delay (or replace) more evidence-based forms of treatment.”

marijuana-candy-sizedMany products, little evidence?

But is there emerging evidence for cannabis? Tom P. Freeman (of the University College London) and his co-authors did a phase 2a trial using CBD to address cannabis use disorder, which is written up in The Lancet Psychiatry. “In the first randomised clinical trial of cannabidiol for cannabis use disorder, cannabidiol 400 mg and 800 mg were safe and more efficacious than placebo at reducing cannabis use.”

Finally, on a pivot, in the third selection, we consider an essay from The Globe and Mail. Rebeccah Love writes about her own experiences with psychosis and her recovery. She also considers whether police should be involved in mental health crises. “The image of a police officer – often a big white man with a gun – is interpreted as a threat, an agent of death, an oppressor.”

DG

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