Academic journal article Indian Journal of Psychiatry

Cannabis and Psychopathology: The Meandering Journey of the Last Decade

Academic journal article Indian Journal of Psychiatry

Cannabis and Psychopathology: The Meandering Journey of the Last Decade

Article excerpt

Byline: Abhishek. Ghosh, Debasish. Basu

Since its inception cannabis has been observed to be associated with various psycho-pathology. In this paper, the authors have reviewed the advancement made in this area over the last decade. The association between cannabis and schizophrenia has been researched more intensively. The controversy regarding the reliability, clinical utility, and the existence of a cannabis withdrawal syndrome has also been settled. Recent studies also buttressed the possibility of acute and chronic effect of cannabis on various cognitive functions. There has been a plethora of research regarding the treatment for cannabis use disorders. But the new and most interesting area of research is concentrated on the endocannabinoid system and its contribution in various psychiatric disorders.

Introduction

The use of cannabis has been known to mankind for time immemorial. As per the latest World Drug Report released by United Nations Office on Drug and Crime in June 2014, the global market for cannabis (both herb and resin) continues to expand, with two-third of the reporting countries ranking cannabis as the primary substance of abuse. [sup][1] In 2012, between 125 million and 227 million, people were estimated to have used cannabis, corresponding to between 2.7% and 4.9% of the population aged 15-64 years. There is a trend of increasing use of cannabis in America, Oceania, and several Asian countries. [sup][1] Data from the National Household Survey in India demonstrated a prevalence figure of 4% and 3.3% for lifetime and current cannabis users. [sup][2] Cannabis once thought to be a "harmless" to even as a medicinal herb, now has a cumulative evidence for its potentially damaging consequences. It has been linked to a plethora of psychopathology, cognitive dysfunction, and other psycho-social adversities. Interestingly, in recent times, especially after the discovery of endocannabinoids (eCB) system, there has been a renewed attention for the use of cannabis derivatives for therapeutic purpose.

In the year 1994, a paper titled "Cannabis-related psychiatric syndrome: A selective review" was published in this journal. [sup][3] The area was revisited in 2004, [sup][4] after a period of 10 years. Now, after yet another decade, there has been a perceived necessity to have a re-look on the entire conundrum of cannabis and related disorders. It would be useful, in fact, imperative to carry this review forward from the previous one, published in 2004. In their concluding remarks, the authors acknowledged that though there has not been any earth-shattering research in the area of cannabis, there were several large-scaled well-controlled epidemiological studies which had the potential to accept, reject or to modify the existing literature. Apart from the ever baffling phenomenon of cannabis and schizophrenia, authors had recognized several other areas of controversy, starting from cannabis withdrawal to cannabis-related cognitive impairment, eventually opening up an opportunity to explore the enigma. In the last decade, there has been some clarification in many of these areas; there is emerging interest in some new areas; waning of interest in other few areas; and a few replication researches to substantiate the existing knowledge. The PubMed search word "cannabis" generated 5820 results during this period (2004-2013) as compared to 1879 from 1994 to 2003 and 871 from 1984 to 1993. These numbers signify an ever growing enthusiasm in cannabis research. Not only in terms of number of publications, the global community has responded to the increasing concern of cannabis use by various conferences like recently an "International Scientific Conference on Cannabis and Health" has been announced by the European Union.

Though there has been a controversy regarding cannabis policy owing to the scuffle between the liberal and the conservative lobbies, this area has been consciously overlooked in this review because the author's thought this to be beyond the purview of this article. …

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