Cannabis in Psychiatric Practice: A Practical Guide

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