Risk of Psychotic Disorders Among Patients with Medical Cannabis Authorization: A Longitudinal Cohort Study

Introduction: The use of cannabis for recreational purposes is associated with an increased risk of psychotic disorders (1,2). However, the risk of psychosis is not well characterized for patients using cannabis for medical purposes. Objective: Thus, this study assessed the risk of emergency departm...

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Bibliographic Details
Published in:Drug safety 2022-10, Vol.45 (10), p.1243-1243
Main Authors: Lee, C, Lunghi, C, Eurich, D T, Dyck, J R B, Hyshka, E, Hanlon, J G, Zongo, A
Format: Article
Language:English
Subjects:
Cannabis
Cohort analysis
Disorders
Emergency medical care
Emergency medical services
Hazard assessment
Health care
Health hazards
Hospitalization
Medical marijuana
Mental disorders
Patients
Psychosis
Recreational use
Risk assessment
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Summary:Introduction: The use of cannabis for recreational purposes is associated with an increased risk of psychotic disorders (1,2). However, the risk of psychosis is not well characterized for patients using cannabis for medical purposes. Objective: Thus, this study assessed the risk of emergency department (ED) visits or hospitalization for psychotic disorders among adult patients authorised by their healthcare providers to use cannabis to treat a health condition in Ontario, Canada, from 2014 to 2020. Methods: This was a longitudinal retrospective cohort study of patients who received medical cannabis authorization and followedup in cannabis clinics, matched by high dimensional propensity scores to population-based controls (with a ratio of patients in cannabis clinics to controls of 1:3). Clinical and health administrative data were used. The primary outcome was an ED visit or hospitalization with a primary diagnosis reason (ICD-10 codes) related to psychotic disorder. Conditional Cox proportional hazards regressions accounting for the matching were used to assess the risk. Results: A total of 60,414 cannabis patients were matched to 180,397 controls. Less than half of the patients (42%) were aged < 50 years, and 54% were female. Incidence rates for psychotic disorders were 2.25/1000 person-years (95% CI 2.02-2.51) in the cannabis group and 1.56/1000 person-years (95% CI 1.45-1.68) in the control group. The hazard ratio (HR) based on the conditional Cox model further adjusted for age, sex, and history of psychotic disorders was 1.25 (95% CI 1.05-1.36). Among patients without a history of psychotic disorders, the HR was 1.25 (95% CI 1.07-1.46). Conclusion: Medical cannabis authorization was associated with an increased risk of ED visits or hospitalization for psychotic disorders. Careful benefit-risk assessment is needed before medical cannabis authorization.
ISSN:0114-5916
1179-1942