Seven cannabis-related disorders are detailed in a review article, along with the toxic effects of long-term cannabis use. “Cannabis use disorder and heavy or long-term cannabis use have adverse effects on physical and psychological health,” the authors conclude. “Research on the endocannabinoid system is needed to better elucidate the pathophysiology of these effects and to develop better treatments. Psychosocial methods are the mainstay of treatment for cannabis use disorder. No medication is shown to be broadly effective.”
After reviewing the epidemiology, burden of illness, pathophysiology, and pharmacology associated with cannabis use, the authors examine cannabis intoxication, the subacute effects of cannabis, cannabis use disorder, cannabis withdrawal, and adverse effects of long-term cannabis use. “Cannabis is one of the most commonly used psychoactive substances globally, trailing only caffeine, alcohol, and tobacco (nicotine),” write the authors. “Worldwide, an estimated 209 million persons 15 to 64 years of age used cannabis in 2020, representing about 4% of the global population in that age group. In the United States, an estimated 52.4 million persons 12 years of age or older used cannabis in 2021, representing 18.7% of the community-dwelling population in that age group, and 16.2 million persons met the diagnostic criteria for cannabis use disorder, which has as its core feature the use of cannabis despite adverse consequences. Cannabis use disorder occurs in all age groups but is primarily a disease of young adults. The median age at onset is 22 years (interquartile range, 19 to 29). In the United States, the percentage of 18-to-25-year-old persons with current (past-year) cannabis use disorder in 2021 was 14.4%. Younger age at initiation of cannabis use is associated with faster development of cannabis use disorder and more severe cannabis use disorder.”