Previously in DSM-IV as two categories: Cannabis Abuse and Cannabis Dependence; The DSM-5 combined them into one category: Cannabis Use Disorder
What is cannabis?
The most important of these is delta-9-tetrahydrocannabinol (THC), which was discovered by two Israli biochemists in 1964.
THC induces a variety of sensory and psychological effects including:
Heightened sensory awareness
Impaired Short Term Memory
Altered sense of time and space
Enhanced sexual desire
A tendency to enhance introspection
For cannabis to release THC into the bloodstream it must be heated above 100oC i.e., it must be cooked or smoked.
The first documented evidence of medicinal cannabis sativa, based on carbon-14 dating techniques, dates back to 4000 BC. It was utilized as an anesthetic during surgery.
Marijuana is by far the most widely used illegal drug in the United States
The prevalence of 12-month and lifetime DSM-IV cannabis abuse (1.1% and 7.2%) exceeded the corresponding rates of cannabis dependence (0.3% and 1.3%).
40% of the North American population aged 12 or older
Recent Use (12 month/1 month)
16% of North Americans aged 18-25 years reported past month use
Near Daily or Daily Use (taken from the populations who reported past year use)
North Americans: 14% near-daily to daily basis (2007)
Two Consistent correlates of cannabis use are gender and age—gender differences appear to be diminishing among more recent cohorts of users.
Cannabis dependence was significantly associated with low income.
Co-morbidity was high between cannabis use disorders and other Axis I and II disorders.
Case to case basis
Criteria too broad
Commonly caused by other disorders
Concentrations of THC
Parental substance abuse
Social context and reference groups
Age of first cannabis use
Transmissible liability index (TLI)
Diagnostic Criteria (DSM 5)
A problematic pattern of cannabis use leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12-month period:
Cannabis is often taken in larger amounts or over a longer period than was intended.
There is a persistent desire or unsuccessful efforts to cut down or control cannabis use.
A great deal of time is spent in activities necessary to obtain cannabis, use cannabis, or recover from its…