Psychiatric Disorders and Comorbid Cannabis Use

Abstract

Cannabis use is common among individuals with psychiatric disorders, including those seeking treatment in mental health care settings. Yet, not all cannabis use is harmful, and providers are often unsure how to determine which patients are at risk for cannabis use-related problems and how to help. As cannabis use becomes more widely accepted in some regions of the US and many states move toward legalization, it is crucial for mental health providers to be well equipped to identify, assess, and treat problems of a range of possible severity, including cannabis use disorders. The first article in this 2-part series reviewed the prevalence of cannabis use and related problems among individuals with psychiatric disorders. 1 This companion article describes strategies for cannabis use screening, assessment, and intervention in the context of mental health care. SCREENING AND ASSESSMENT It is important to screen individuals seeking mental health services for any use of potentially problematic substances, including cannabis. Brief, validated self-report questionnaires such as the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) 2 are useful and can be integrated into self-administered computerized screening systems. 3,4 Key questions on the ASSIST include frequency of use; presence of health, social, legal, or financial cannabis-related problems; and symptoms of cannabis and other substance use disorders.