With the increasing push to legalize cannabis in Western nations, there is a need to gauge the potential impact of this policy change on vulnerable populations, such as those with mental illness, including schizophrenia, mood and anxiety disorders. This is particularly important as there are strong motives in these individuals to seek short-term reward (e.g., “getting high”). Nonetheless, data to support the beneficial effects of cannabis use in psychiatric populations are limited, and potential harms in patients with psychotic and mood disorders have been increasingly documented. This article reviews the effects of cannabis in people with mental illness. Then, we provide a reconciliation of the addiction vulnerability and allostatic hypotheses to explain addiction co-morbidity in mentally ill cannabis users, as well as to further aid in developing a rational framework for assessment and treatment of problematic cannabis use in these patients.
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