High Prescribing: A Case Study of High‐Potency Medicinal Cannabis Inducing Psychosis
Richard C. J. Bradlow, Sophie Wright, Anamaria Szrajbman Vaz da Silva, Ferghal Armstrong
Case Reports in Psychiatry January 1, 2024 DOI: 10.1155/crps/8870476 via OpenAlex
Summary
AI-generated from the abstractA 21-year-old Indigenous Australian man developed psychosis after switching from illicit cannabis to prescribed medical cannabis, experiencing delusions that his partner was unfaithful (Othello delusions), becoming violent toward her, and attempting suicide. Cannabis use, whether prescribed or illicit, is linked to psychotic illness and elevated risk of cannabis use disorder. Prescribers should screen for risk factors like family history of psychosis, monitor patients regularly, and provide harm reduction advice. The authors call for stricter regulation of medical cannabis prescribing in Australia.
Study at a glance
| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | 21-year-old Indigenous Australian male |
| Intervention | prescription cannabis |
| Topics | Cannabis |
| Keywords | Psychosis Psychiatry Potency Traditional medicine |
| Citations | 3 |
| Key finding | Switching from illicit to prescribed cannabis can trigger psychosis, including violent delusions and suicidal behavior. |
Abstract
Introduction: There has been a recent significant increase in medical cannabis prescribing in Australia despite weak evidence for its effectiveness in treating the most common indications. Concern has been raised about the potential harms of inappropriate prescription of cannabis; however, there have been no prior published cases of psychosis secondary to medicinal cannabis in Australia. Case Presentation: We present a case of a 21‐year‐old Indigenous male with psychosis following switching from illicitly obtained cannabis to prescription cannabis, which resulted in Othello delusions towards his partner, violence towards her and ultimately an attempt to end his life. Discussion: Cannabis use is linked to the development of a psychotic illness whether it is prescribed or obtained illicitly. People who are prescribed cannabis are also at an elevated risk of developing cannabis use disorder (CUD). Cannabis prescribers need to screen for risk factors of drug‐induced psychosis such as a family member with a psychotic illness, review patients regularly and provide harm minimisation advice to prevent damage from their prescription. Conclusion: There are clear dangers to overprescribing medicinal cannabis and the care that needs to be taken by prescribers to avoid them. There is a need for a change in the regulation of cannabis prescribing in Australia. Further research is warranted on the effects of the increase in prevalence of cannabis prescribing.