Cannabis Use Disorder DSM-5, 305 20, 304.30 Therapedia

Since 2012, 12 US states have legalized the recreational use of cannabis, and most of these states have approved commercial production and sale of cannabis302. Canada legalized the commercial sale of cannabis for recreational use across all provinces in 2018 (REF.305), and the Canadian Federal government licenses and regulates cannabis producers and taxation. Bureau of the Census administered the AUDADIS-IV using laptop computer-assisted software with built-in skip logic and consistency checks. The interviewers had an average of 5 years experience on census and other health-related national surveys.

Multifactorial model of CUD

However, in the most recent edition of the DSM (DSM-5) there is only one CUD category of ‘Cannabis use disorder’, based on statistical evidence that the symptoms of cannabis abuse and dependence fall on a single severity dimension29,172 (TABLE 1). A diagnosis of DSM-5 CUD requires the presence of 2 of the 11 symptoms that have produced marked clinical impairment or distress over the past 12 months, and the severity of CUD is assessed by symptom count (TABLE 1). Of note, remission specifiers can be used for patients who previously met CUD criteria. By contrast, ICD-11 classifies cannabis use into Hazardous cannabis use (potential to cause harm), Harmful pattern of cannabis use (causing harm, similar to ‘Cannabis abuse’ in DSM-IV-TR173) and Cannabis dependence (similar to ‘Cannabis dependence’ in DSM-IV-TR). ICD-11 uses diagnostic guidelines that can allow more scope for clinical judgement and cultural variations174. For both current and lifetime dependence, the diagnostic criteria met by the highest proportion of individuals were inability to cut down, use despite physical/psychological problems, and large amounts of time spent in substance-related activities (Table 3).

Common Pitfalls to Avoid

Mr. M’s case demonstrates the potential effectiveness of combining pharmacological interventions like gabapentin and NAC with psychotherapeutic approaches such as CBT in treating severe CUD. His experience highlights the importance of individualized treatment plans, ongoing support, and the development of coping strategies to manage triggers and prevent relapse. This case contributes to the growing body of evidence supporting integrated treatment approaches for cannabis use disorder. DSM-IV included nicotine dependence, but experts felt that abuse criteria were inapplicable to nicotine (163, 164), so these were not https://www.isabelledegrandmaison.com/2023/06/23/recovery-stories-real-people-real-transformations-2/ included. Nicotine dependence has good test-retest reliability (165–167) and its criteria indicate a unidimensional latent trait (39, 40, 62, 67, 168).

• Since its first publication in 1952, DSM has been reviewed and revised four times; the criteria in the last version, DSM-IV-TR, were first published in 1994.
• The diagnostic criteria for substance use disorders (SUD) underwent considerable revision in the Diagnostic and Statistical Manual of Mental Disorders – 5th Edition (DSM-5).
• Clinical documentation must clearly distinguish between cannabis use disorder with intoxication (F12.20) and without intoxication.
• Is a medical writer with a knack for turning complex billing and healthcare topics into clear, actionable insights.

Enhancing Healthcare Team Outcomes

Smoked cannabis induces cough, wheezing, and dyspnea; increases sputum production; and exacerbates asthma. Clinicians across all specialties need to familiarize themselves with the effects of cannabis use. The evidence supporting the use of marijuana for specific conditions is limited and often derived from pharmaceutical preparations of isolated THC. Researchers struggle to gain funding for these studies given that the drug is a Schedule I controlled substance. Patients who are pregnant should be counseled at length on the potential impact of cannabis on the fetus and the pregnancy.

3. Current and lifetime abuse

In surveys, individuals who report using higher-potency cannabis extracts report more symptoms of dependence and mental distress than users of herbal cannabis use disorder cannabis245. In the Netherlands, the number of persons seeking help to quit cannabis use increased as cannabis potency increased and later fell when it declined246. A major concern is that the use of high-potency cannabis may increase the risk of psychotic disorders247. Some approaches such as restrictions on high-potency products, taxes based on the THC content of the product, clear labelling on dosage and risks, and robust monitoring of sales and impacts could reduce the negative effects of the marketing of these products248.

Factors associated with lower-risk cannabis use in adults in their mid-thirties

• While many individuals consume medical cannabis without developing problematic patterns, a substantial subset experiences adverse consequences that meet the diagnostic criteria for CUD.
• Cannabis use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by cannabis.
• Though previous DSMs permitted assessing SUD severity based on symptom count (Hasin and Glick, 1992), DSM-5 was the first version to formally define severity, including mild (2–3 criteria), moderate (4–5 criteria), and severe (≥6 criteria).
• Cases in which all four abuse criteria were met were observed only for lifetime diagnosis (Table 4).

Research on pharmacotherapies for CUD is less developed than for other drugs of abuse. The main classes of medications that have been investigated are summarized in TABLE 3. The most promising are cannabinoid agonists that can be used in the same way as the nicotine patch for tobacco smoking (cessation), or as long-acting opioid agonists such as methadone and buprenorphine in heroin dependence (maintenance). The pharmacological agonists offset cannabis withdrawal symptoms and reduce the motivation to use cannabis by occupying CB1 receptors.

In conclusion, Mr. M’s successful navigation through the complexities of CUD treatment serves as a testament to the efficacy of a holistic, patient-centered approach. His experience offers valuable insights for clinicians, researchers, and policymakers striving to improve outcomes for individuals grappling with cannabis use disorders. By embracing comprehensive, individualized treatment strategies, we can foster recovery and resilience in those Sober living house affected by CUD.

Fig. 5 . A multifactorial model for cannabis use disorders.

Approximately 9.9% of individuals who reported cannabis use in the past year were daily or near-daily users1. Cannabis use disorder (CUD) is broadly defined as the inability to stop consuming cannabis even when it is causing physical or psychological harm4,5. Global data on CUD are incomplete, but according to the most recent global estimate 22.1 million persons met diagnostic criteria for CUD in 2016 (289.7 cases per 100,000 people)6. To examine the sensitivity of our assumptions to alternative conceptualizations, we conducted a series of supplementary analyses using different operationalizations of cannabis use disorders. For these analyses, we examined the subtypes that would arise if only 1 out of 11 criteria (to mimic the diagnostic threshold for abuse) or 3 out of 11 criteria (to mimic the threshold for dependence) were required. Substance use and other mental disorders frequently co-occur, complicating diagnosis because many symptoms (e.g., insomnia) are criteria for intoxication, withdrawal syndrome, or other mental disorders.