Cannabis in Psychiatric Practice: A Practical Guide

✍ Scribed by Paula Riggs, Thida Thant

• Publisher: Springer
• Year: 2022
• Tongue: English
• Leaves: 221
• Series: Psychiatry Update, 3
• Category: Library

✦ Synopsis

This book educates and familiarizes psychiatrists with the impact of cannabis beyond the scope of addiction and ways to effectively discuss the existing literature and knowledge with patients.

Cannabis in Psychiatric Practice is organized by clinical setting to help tailor the literature to psychiatrists and other mental health clinicians working in all areas, whether traditional outpatient clinics, emergency departments, inpatient psychiatry or medical units. It helps readers, regardless of their training background, learn about the impact of cannabis on a variety of disorders in a manner adjusted to the unique needs and challenges of their particular treatment settings and patient populations. The book also includes clinical cases and practical tips integrating the current evidence, treatment approaches, and psychoeducation needed to effectively practice in the era of modern-day psychiatry and cannabis legalization. Chapters are written in a clear, easy-to-read style, allowing readers to reference specific portions of the book as needed, increasing its utility for the general psychiatrist and mental health clinician.

With the increasing prevalence and availability of cannabis and CBD products, this book is an invaluable reference for psychiatrists who wish to explore the impact of cannabis in their clinical practice.

✦ Table of Contents

Foreword
References
Series Editor Introduction
References
Preface
Introduction and Acknowledgements
Contents
Contributors
1: Public Health Concerns of Cannabis
Introduction
Epidemiology and Review of Legalization in the U.S.
Medical Impact: Special Populations
Medical Impact: Emergency and Hospital Patients
Legal Impact
Economic Impact
Conclusion
References
Part I: Pharmacology of Cannabis
2: Clinical Pharmacology of Cannabinoids
Endocannabinoid System Review [3–7]
Pharmacodynamics
Cannabinoid Subtypes
Endocannabinoids (ECs)
Phytocannabinoids [10, 11]
Synthetic Cannabinoids [14]
Tolerance to Exogenous Cannabinoids [9, 15–18]
Dosage Forms
FDA-Approved Cannabinoids [10–12]
Pharmacokinetics [3, 5–7, 9, 20]
Absorption
Distribution
Metabolism
Elimination
Drug-Drug Interactions [5, 10–12, 22–25]
CYP450 Properties of THC and CBD [5, 9, 25]
Adverse Events
Drug and Genetic Testing
Drug Testing
Summary
References
3: Cannabidiol: Overview, Complexities, and Opportunities for Behavioral Health
What Is Cannabidiol (CBD)?
Is CBD Legal?
How Does CBD Work?
Unknowns and Concerns: Efficacy, Safety, and Quality
Clinical Applications
Conclusions
References
Part II: Cannabis in Child and Adolescent Mental Health Settings
4: Developmental Impact
Introduction
Neurodevelopment
Neuromaturation: Neurogenesis, Synaptogenesis, and Myelination
Neurotransmitter System Development
Neurodevelopmental Impact of Cannabinoid Exposure
Cannabinoid Potency and Timing of Exposure
Mechanisms of Exogenous Cannabinoid Exposure
Teratogenicity of Exogenous Cannabinoids
Cognitive Effects of Prenatal Cannabis Exposure
Infancy
Early Through Late Childhood
Adolescence
Cognitive Effects of Adolescent Cannabis Exposure
Neuroimaging Studies of Adolescent Cannabis Use
Future Directions
References
5: What Clinicians Need to Know About Adolescent Cannabis Use in Outpatient Mental Health Settings
Case
Introduction
Substance Screening and Clinical Evaluation
Treatment for Cannabis Use Disorder
Integrated Treatment and Coordinated Care for Youth with Co-occurring Psychiatric and Substance Use Disorders
Summary and Conclusion
References
6: Cannabis in the Child and Adolescent Emergency and Inpatient Psychiatric Settings
Clinical Case
Introduction and Literature Reviewwe
Psychotic Disorders
Mood and Anxiety Disorders
Management of Psychotic and Mood Disorders Associated with Cannabis Abuse
Considerations with the Use of Second-Generation Antipsychotics
Management of Mood Disorders Associated with Cannabis Use
Conclusion
References
7: Clinical Considerations for Cannabis in the Child and Adolescent Consultation-Liaison Setting
Clinical Case
Introduction
Product Types and Concentrations
Synthetic Cannabinoid Receptor Agonists (SCRAs)
Pediatric Clinical Presentations
Acute Intoxications
Unintentional/Exploratory Intoxications
Initial Evaluation for Intoxication
Laboratory Studies
Clinical Management
Acute Intoxication
Approach
Management
Conclusion
References
Part III: Cannabis in Adult Mental Health Settings: Outpatient Mental Health Setting
8: Disease Course and Prognosis
Clinical Case
Significance to Current Clinical Practice
Psychotic Disorders
Bipolar and Related Disorders
Depressive Disorders
Anxiety Disorders
Trauma- and Stressor-Related Disorders
ADHD and Cannabis
Cannabinoids as Treatment
Treatment Approach and Patient Psychoeducation
Summary and Conclusions
References
9: Evaluation of Co-occurring Psychiatric Disorders and Cannabis Use in the Outpatient Setting
Clinical Case
Introduction
Review of Literature
Opening the Conversation: Broaching the Topic of Cannabis While Building Rapport
Gathering Details: Diagnosing Underlying Substance Use Disorder
Chicken or Egg: Correlating Psychiatric History and Cannabis Use History
Formal Screening Instruments
Summary and Next Steps
References
10: Treatment of Co-occurring Psychiatric Disorders and Cannabis Use in the Outpatient Setting
Introduction
Review of Literature
Psychoeducation and Harm Reduction
Psychosocial Interventions
Pharmacologic Options
Summary and Next Steps
References
11: Acute Intoxication and Agitation/Violence
Clinical Case
Introduction and Literature Review
Medical and Psychiatric Symptoms of Intoxication
Managing Ongoing Violence Risk
Treatment Approach
Conclusion
References
12: Cannabis and Psychosis
Case
Introduction
Prevalence and Epidemiology
Neurobiology
Clinical Presentations, Diagnoses, and Treatments
Acute Intoxication
Substance Induced Psychotic Disorder
Schizophrenia or Other Chronic Psychotic Disorder
Synthetic Cannabinoid Intoxication
Conclusion
References
13: Self-Harm and Cannabis Use
Treatment Approaches
Summary
References
14: Cannabis in the Adult Medical and Consultation-Liaison Settings
Complications of Cannabis Use in the Medical Setting
Case
Introduction and Literature Review
Delirium
Catatonia
Cannabis Hyperemesis Syndrome
Cannabis Withdrawal
Treatment Approaches
Delirium
Catatonia
Cannabis Hyperemesis Syndrome
Cannabis Withdrawal
Conclusion
References
15: Cannabis in the Perinatal Period
Introduction
A Note on CBD
Epidemiology and Risk Factors
Pregnancy-Specific Reasons for Use
Obstetrical and Neonatal Outcomes
Lactation
Screening
Legal
Treatment
Summary
References
16: Cannabis in the Geriatric Population
Geriatric Populations and Cannabis
Case
Introduction and Literature Review
Trends in Use
Metabolism of THC in the Elderly
Falls, Cannabis, and the Elderly
Driving, Cannabis, and the Elderly
Dementia and Cannabis
Insomnia, Cannabis, and the Elderly
Chronic Pain, Cannabis, and the Elderly
Other Cannabis Usage in the Elderly
Treatment Approaches
Conclusion
References
17: Marijuana Use in Organ Transplantation
Introduction
Brief Overview of Organ Transplantation
Unique Features of Transplant Patients
Overview and Significance of Marijuana in Organ Transplantation
Logistical, Legal, and Ethical Matters
Marijuana Stigma and Idealization
Brief Review of Existing Transplant-Specific Marijuana Literature
Liver
Heart and Lung
Kidney
Potential General Benefits of Marijuana Use in Transplant Patients
Potential General Risks of Marijuana Use in Transplant Patients
Evaluating and Treating Marijuana Use in Transplant Patients
General Approach
Psychiatric and SUD Comorbidities
Psychometric Instruments
Toxicology
Transplant Policy Awareness and MH/SUD Treatment Adherence
Summary
References
Index