Cannabis Use Disorder, Cannabis-Related Disorders, and Board Review (2025-2026 Recording)-Cannabis Use Disorder, Cannabis-Related Disorders, and Board Review Recording

Video Transcription

Video Summary

This didactic session covered cannabis use, cannabis-related disorders, and cannabis use disorder (CUD), with emphasis on epidemiology, neurobiology, diagnosis, and treatment. The speakers reviewed cannabis composition, including THC, CBD, terpenes, and flavonoids, and explained how route of use affects onset, duration, and intoxication. They summarized acute effects such as euphoria, altered perception, tachycardia, hypotension, impaired coordination, and, at higher doses, agitation, psychosis, seizures, and severe pediatric intoxication. Cannabis withdrawal was described as irritability, anxiety, insomnia, appetite changes, and restlessness, generally treated supportively.<br /><br />The lecture highlighted rising cannabis use across age groups, increasing daily use, and the growing prevalence of CUD, especially among younger users and those with psychiatric comorbidity. The endocannabinoid system was reviewed as a key regulator of mood, reward, appetite, pain, and memory, with chronic THC use leading to CB1 downregulation and cognitive effects.<br /><br />Specific cannabis-related disorders discussed included cannabis-induced anxiety, psychotic disorder, sleep disorder, withdrawal, and delirium. The presenters emphasized that while cannabis may worsen or precipitate anxiety and psychosis in vulnerable individuals, causal claims remain difficult due to confounding. They also reviewed risks associated with high-THC products, synthetic cannabinoids, delta-8 products, and legal/illicit supply issues.<br /><br />For management, psychotherapy remains first-line for CUD, especially motivational enhancement therapy, CBT, and contingency management. Medications remain off-label and experimental, though gabapentin, N-acetylcysteine in younger patients, naltrexone, varenicline, CBD, and cannabinoid agonists showed varying levels of preliminary benefit. The session ended with a clinical case and a discussion of possible fentanyl contamination in cannabis, though evidence remains limited.

Keywords

cannabis use disorder

cannabis withdrawal

endocannabinoid system

THC

CBD

cannabis intoxication

cannabis-induced psychosis

cannabis-induced anxiety

synthetic cannabinoids

high-THC products

motivational enhancement therapy

contingency management

gabapentin