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More evidence for a causal link between daily high-potency marijuana use and psychosis

A novel new study adds evidence to the scientific debate over whether marijuana use causes or is only correlated with the onset of psychotic disorders.
Researchers Marta Di Forti and colleagues studied 901 patients with first-episode psychosis across 11 sites (10 in Europe and one in Brazil) and 1,237 population controls from those same sites. Daily marijuana use was associated with increased odds of psychotic disorder compared with never users, increasing to nearly five-times increased odds for daily use of high-potency marijuana.
The researchers calculated that, assuming causality, if high-potency marijuana were no longer available, first-episode psychosis could be prevented across the 11 sites by 12 percent, “rising to 30 percent in London and 50 percent in Amsterdam.”
Most importantly, the researchers show the first direct evidence that patterns of marijuana use influence the incidence of psychotic disorders from one site to another. Sites where daily use of high-potency marijuana was prevalent had more cases of first-episode psychosis than those where less potent marijuana was available.

See Comment published in the same issue below.
Read full text of Lancet Psychiatry study here.

Cannabis and psychosis: 
triangulating the evidence
After describing the novel aspects of the Di Forti study, Liverpool University researcher Suzanne H. Gage asks in a comment published in the same issue of Lancet Psychiatry, “Does this mean we can now be sure that (daily and high potency) cannabis causes psychosis?”
“Unfortunately, not all the evidence utilizing different methods is consistent about causality.”
This “study adds a new and novel study design to the evidence available, which consistently indicates that for some individuals there is an increased risk of psychosis resulting from daily use of high potency cannabis.”
She concludes that given the changing legal status of marijuana across the world, the next priority is to identify which people are at risk and develop interventions to reduce their risk for developing psychosis.

Read Lancet Psychiatry commentary here.

What is the ABCD study?
ABCD stands for the Adolescent Cognitive Brain Development study, a unique, inventive way to learn about brain development and children’s health. The long-term study will increase our understanding of factors that affect brain and cognitive development that can enhance or disrupt a young person’s life trajectory.
The study is being conducted at 21 research sites around the nation. It will image the brains of children ages 9 and 10 at enrollment and follow them throughout their adolescence and young adulthood “while tracking social, behavioral, physical, and environmental factors that may affect brain development and other health outcomes.”

The study has completed recruitment. There are 11,874 children ages 9 and 10 participating in the study, including 2,100 young people who are twins or triplets. The study will shed light on brain characteristics associated with impulsive action, the impact of health behaviors on cognitive and brain development, traits associated with media use, risk and resilience factors for mental illness and substance use, and exposure to positive and negative environmental events.
Coordinated by the National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism, several other National Institutes of Health and offices as well as the Centers for Disease Control and Prevention are helping sponsor this landmark effort.
See more about the ABCD study and a list of federal sponsors here.
See list of research institutions conducting the study here.
See ABCD Newsletter for participating families here.
See list of papers already published about aspects of the ABCD study here.

Pictured above: a study participant in South Carolina prepares for his MRI scan. Pictured below: An fMRI image of a pre-teenage child’s brain at work on a memory task. Like your local weather map, yellow and red are most active.

The Marijuana Report is a weekly e-newsletter published by National Families in Action in partnership with SAM (Smart Approaches to Marijuana).

Visit National Families in Action's website, The Marijuana Report.Org, to learn more about the marijuana story unfolding across the nation.

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The Marijuana Report Staff
Executive Editor
Sue Rusche
Nicole Carter
IT Consultant
Lee Clontz
Social Media Coordinator
Margarita Eberline
We are grateful to our Board of Directors and Senior Adviser for their support of National Families in Action, which produces The Marijuana Report website and e-newsletter.
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Board of Directors

William F. Carter, Chairman of the Board
Realtor Berkshire Hathaway HomeServices – Georgia Properties, Atlanta.

Sue Rusche, President and CEO, Atlanta.

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Attorney (Ret.), Lakewood Ranch, Florida
Founder & Chairman, Sudden Cardiac Arrest Association 

Jeannine F. Adams, Director
President and CEO, J. Addams & Partners, Atlanta.

Jack L. Arbiser, MD, PhD, Director
Thomas J. Lawley Professor of Dermatology
Winship Cancer Institute, Emory University, Atlanta

William H. Avery, Director
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Robert Margolis, PhD, Director
Founder, Caron Solutions Intensive Outpatient Program, Roswell, Georgia.

Shannon Murphy, MD FAAP, Director
Birmingham, Alabama 
Senior Adviser
Kent “Oz” Nelson, Chairman and CEO (Ret.)
United Parcel Service, Atlanta.
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