CONTACT A case study: Medical marijuana use and suicidality - Dr. Christian Thurstone

I hope you’ll read this paper I co-authored with Dr. Abraham Nussbaum and Dr. Ingrid Binswanger in The American Journal of Psychiatry. We explain the case of a 29-year-old woman who presented with marijuana addiction, a history of depression and a history of suicidality.

Some main points this one case brightly and boldly underscores:

  • Marijuana is physically and psychologically addictive. Reputable science no longer even debates this.
  • The associations between marijuana use and mental illness are numerous. As we wrote: “In the United States, marijuana is the most frequently abused illicit substance, with over 16.7 million Americans reporting past-month use, and it is identified as the primary substance of abuse in 17.1% of substance treatment admissions. A growing body of evidence associates marijuana use with an earlier onset and more adverse course of psychotic disorders.” It’s also worth noting that marijuana dependence and addiction is the No. 1 reason why adolescents are admitted for treatment in the United States — and that 95 percent of my patients are my patients because of their marijuana addiction. Referrals to my clinic have tripled since the rise of Colorado’s medical marijuana dispensaries in 2009.
  • Marijuana use is linked to depression. Also from our paper: “… Longitudinal studies associate marijuana use with depression. While infrequent marijuana use does not appear to be associated with depressive disorders, the medicalization of marijuana encourages regular use, and regular use has a modest but significant association with depression that endures even after controlling for possible confounders. A recent prospective cohort study of 7,735 adults with no history of anxiety or mood disorders found that adults who used marijuana at the beginning of the 3-year study period were at an increased risk of having a first depressive episode (odds ratio=1.62, 95% CI=1.06—2.48) in comparison to nonusers, and this association was stronger with more frequent use. Animal models have found that both activation and blockade of the endocannabinoid system can lead to depression.

About Chris Thurstone

Dr. Christian Thurstone is one of about three dozen physicians in the United States who are board certified in general, child and adolescent and addictions psychiatry. He is medical director of one of Colorado’s largest youth substance-treatment programs and an associate professor of psychiatry at the University of Colorado Denver (UCD), where he conducts research on youth substance use and addiction and serves as director of medical training for the university’s addiction psychiatry fellowship program.

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