Cannabis Use in the Presence of Psychotic Disorders: A Harm Reduction Approach

Cannabis has been found to be associated with the formation of schizophrenia and exacerbations of schizophrenia. These detrimental effects have been attributed to Δ9-tetrahydrocannabinol (THC), the cannabinoid responsible for the psychotomimetic effects of cannabis. The other prominent cannabinoid present in cannabis is cannabidiol (CBD), which is not psychotomimetic and instead has antipsychotic properties. Five studies were reviewed to determine if CBD is effective in mitigating the harmful psychological effects of THC, thereby reducing the psychotic-like symptoms associated with cannabis use. The research indicates that CBD is protective against the transient psychotic effects of THC in non-mentally ill populations. If these findings are applied to populations prone to the development of psychotic disorders or with existing psychotic disorders, there is an important role for harm reduction through patient education. Following the review of the five studies, the role of the Advanced Practice Registered Nurse (APRN) as the educator regarding the protective nature of cannabis with a high CBD content is provided.