Tetrahydrocannabinol use disorder
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Tetrahydrocannabinol Use Disorder: Insights from Recent Research
Introduction to Tetrahydrocannabinol (THC) and Its Effects
Delta-9-tetrahydrocannabinol (THC) is the primary psychoactive component of cannabis, known for its effects on the brain and behavior. THC interacts with the cannabinoid CB1 receptors, which play a significant role in the rewarding and reinforcing effects of cannabis, contributing to its potential for abuse and dependence5. This article synthesizes recent research on THC use disorder, focusing on its implications for psychosis, cognitive function, and potential treatments.
THC and Psychosis: A Complex Relationship
THC-Induced Psychotic Symptoms
THC has been linked to the onset and exacerbation of psychotic symptoms. In healthy individuals, THC can produce schizophrenia-like positive and negative symptoms, alter perception, increase anxiety, and impair cognitive functions such as word recall and working memory3. These effects suggest that THC can mimic some aspects of psychotic disorders, warranting further investigation into its role in psychosis3.
THC and Schizophrenia
In patients with schizophrenia, THC exacerbates core psychotic and cognitive deficits, including learning and recall impairments, perceptual alterations, and increased schizophrenia symptoms1. Schizophrenia patients are particularly vulnerable to the cognitive effects of THC, indicating a potential dysfunction in brain cannabinoid receptor function that may contribute to the cognitive deficits associated with the disorder1.
THC Use Disorder: Dependence and Withdrawal
Mechanisms of Dependence
The CB1 receptor is crucial in mediating the dependence and withdrawal symptoms associated with THC use. Chronic cannabis smokers often struggle to maintain long-term abstinence due to the rewarding effects of THC, which are reinforced through CB1 receptor activation5. This receptor also plays a role in the expression of withdrawal symptoms upon cessation of THC use, highlighting the challenges in treating cannabis use disorders5.
Self-Reporting and Biological Measures
In patients with cannabis use disorder and psychosis, self-reported cannabis use correlates highly with plasma THC levels, suggesting that self-reporting can be a reliable measure of cannabis consumption6. This finding is significant for clinical settings where biological measures may not always be feasible6.
Potential Treatments for THC Use Disorder
Cannabidiol (CBD) as a Therapeutic Agent
Cannabidiol (CBD), another component of cannabis, has shown promise in attenuating THC-induced psychotic symptoms and positive symptoms in schizophrenia2. Preliminary data on CBD's efficacy for cannabis use disorders are mixed, but ongoing studies may provide further insights into its potential as a treatment option2.
THC and Tourette Syndrome
THC has been investigated for its therapeutic effects in Tourette syndrome (TS). Studies have shown that THC can significantly reduce tics and associated behavioral disorders in TS patients without causing serious adverse effects7 9. These findings suggest that THC, under controlled conditions, may have therapeutic benefits for certain neuropsychiatric conditions7 9.
Conclusion
THC use disorder presents significant challenges due to its complex relationship with psychosis, cognitive impairments, and dependence mechanisms. While THC can exacerbate psychotic symptoms and cognitive deficits, particularly in vulnerable populations like schizophrenia patients, potential treatments such as CBD offer hope for mitigating these effects. Further research is needed to fully understand the neurobiological mechanisms underlying THC use disorder and to develop effective treatment strategies.
Sources and full results
Most relevant research papers on this topic
Delta-9-tetrahydrocannabinol effects in schizophrenia: Implications for cognition, psychosis, and addiction
Delta-9-tetrahydrocannabinol (Delta-9-THC) transiently exacerbates core psychotic and cognitive deficits in schizophrenia patients, with schizophrenia patients being more vulnerable to its effects.
RCT
Rigorous Journal
Highly CitedEfficacy of Cannabidiol for Δ-9-Tetrahydrocannabinol-Induced Psychotic Symptoms, Schizophrenia, and Cannabis Use Disorders: A Narrative Review
CBD may attenuate psychotic-like symptoms induced by THC and positive symptoms in schizophrenia, but mixed results on its efficacy for cannabis use disorders.
Systematic ReviewRigorous JournalThe Psychotomimetic Effects of Intravenous Delta-9-Tetrahydrocannabinol in Healthy Individuals: Implications for Psychosis
Intravenous delta-9-tetrahydrocannabinol (-9-THC) produces transient symptoms, behaviors, and cognitive deficits in healthy individuals that resemble some aspects of endogenous psychoses.
RCTRigorous JournalHighly CitedCannabidiol (CBD) and Δ9-tetrahydrocannabinol (THC) for chronic insomnia disorder (‘CANSLEEP’ trial): protocol for a randomised, placebo-controlled, double-blinded, proof-of-concept trial
A single dose of an oral cannabis-based medicine (ETC120) containing 10 mg THC and 200 mg CBD may improve sleep and daytime function in individuals with chronic insomnia disorder.
RCTRigorous JournalActions of delta-9-tetrahydrocannabinol in cannabis: Relation to use, abuse, dependence
The CB1 receptor mediates the rewarding and reinforcing effects of THC in cannabis, contributing to its dependence and reinforcement, and opioidergic modulation of these effects.
Literature ReviewHighly CitedCorrelations and agreement between delta-9-tetrahydrocannabinol (THC) in blood plasma and timeline follow-back (TLFB)-assisted self-reported use of cannabis of patients with cannabis use disorder and psychotic illness attending the CapOpus randomized clinical trial.
Timeline follow-back (TLFB)-assisted self-report of cannabis use correlates highly with plasma-delta-9-tetrahydrocannabinol in patients with comorbid cannabis use disorder and psychosis, potentially being superior to blood analysis beyond 19 days of recall.
RCTRigorous JournalTreatment of Tourette's syndrome with Delta 9-tetrahydrocannabinol (THC): a randomized crossover trial.
A single-dose treatment with Delta(9)-THC is effective and safe in treating tics and obsessive-compulsive behavior in Tourette's syndrome patients, with potential clinical effects caused by 11-OH-THC.
RCTHighly CitedEffects of ∆9-tetrahydrocannabinol on aversive memories and anxiety: a review from human studies
Low doses of THC can suppress anxiety and aversive memory expression in healthy humans and PTSD patients without significant adverse effects when combined with CBD.
Systematic Review
Very Rigorous JournalDelta 9-tetrahydrocannabinol (THC) is effective in the treatment of tics in Tourette syndrome: a 6-week randomized trial.
THC is effective and safe in reducing tics in Tourette syndrome patients, suggesting the central cannabinoid receptor system may play a role in the condition.
RCTHighly CitedEffect of cannabis on glutamate signalling in the brain: A systematic review of human and animal evidence
Chronic cannabis use may reduce glutamate levels in the brain, potentially contributing to psychotic symptoms by altering glutamate neurotransmission.
Systematic ReviewHighly Cited