The Psychiatric Effects of Cannabis / 생물치료정신의학

ABSTRACT

With the recent legalization of recreational cannabis in Canada and 11 states of the U.S., the interest surrounding cannabis use is increasing. However, many people and even clinicians in Korea do not have exact knowledge about the psychiatric consequences of cannabis use. In this narrative review, the characteristics of cannabis, the endocannabinoid system, and the psychiatric consequences of cannabis use were provided. Cannabis contains more than 80 cannabinoids in the native plant. Psychotropic properties of Δ-9-tetrahydrocannabinol and cannabidiol are most well studied. The two main receptors are cannabinoid-1 receptor and cannabinoid-2 receptor. Several endocannabinoids, such as anandamide and 2-arachidonoylglycerol, act on the receptors as the endogenous ligands. Cannabis influences mood, cognitive functions, and psychomotor functions in acute phase responses, increasing the odds ratio for motor vehicle crashes. Long-term cannabis use is associated with various psychotic outcomes, including the development of schizophrenia, although there is interindividual variability. Cannabis adversely influences learning, memory, and attention. More frequent, persistent, and earlier onset cannabis use is associated with greater cognitive impairment. The chronic cognitive effects of cannabis are complex and controversial. Cannabis has addictive potential, and cannabis use disorder is common. Clinicians should have evidence-based knowledge about the consequences of cannabis use and communicate accurate information about cannabis use and its associated risks to the public.