Disorders due to use of cannabis

Disorders Due to Use of Cannabis are characterized by the pattern and consequences of cannabis use. Cannabis is the collective term for a range of psychoactive preparations of the cannabis plant, Cannabis sativa, and related species and hybrids. Cannabis contains cannabinoids, a class of diverse chemical compounds that act on endogenous cannabinoid receptors that modulate neurotransmitter release in the brain. The principal psychoactive cannabinoid is δ-9-tetrahydrocannabinol (THC). Cannabis is typically smoked in the form of the flowering heads or leaves of the marijuana plant; tobacco is often mixed with cannabis when smoked. There are also cannabis oils that are prepared from these same sources. These preparations vary considerably in their THC potency. Cannabis has predominantly central nervous system depressant effects and produces a characteristic euphoria that may be part of the presenting features of Cannabis Intoxication, which may also include impairment in cognitive and psychomotor functioning. Cannabis has dependence-producing properties resulting in Cannabis Dependence in some people and Cannabis Withdrawal when use is reduced or discontinued. Cannabis is associated with a range of Cannabis-Induced Mental Disorders. Other medical conditions are also associated with cannabis use, including some respiratory and cardiovascular diseases.

Cannabis is the most commonly used illicit drug worldwide but its legal status varies considerably; in certain countries it is legally available for medicinal or personal use. Acceptance of cannabis use also for recreational or medical purposes also varies widely by culture. Variations in legal status and cultural acceptability are related to differential consequences for detection of use (e.g., arrest, school suspensions, or employment suspension), affecting the probability the person may seek treatment.

Diagnostic Categories that Apply to Cannabis

Following is a list of specific diagnostic categories of that apply to cannabis:

• 6C41.0 Episode of Harmful Use of Cannabis
• 6C41.1 Harmful Pattern of Use of Cannabis
• 6C41.2 Cannabis Dependence
• 6C41.3 Cannabis Intoxication
• 6C41.4 Cannabis Withdrawal
• 6C41.5 Cannabis-Induced Delirium
• 6C41.6 Cannabis-Induced Psychotic Disorder
• 6C41.70 Cannabis-Induced Mood Disorder
• 6C41.71 Cannabis-Induced Anxiety Disorder
• 6C41.Y Other Specified Disorder Due to Use of Cannabis
• 6C41.Z Disorder Due to Use of Cannabis, Unspecified

An additional category of disorder induced by psychoactive substances is included in another part of the ICD-11 chapter on Mental, Behavioural, and Neurodevelopmental Disorders. This is cross-listed in the section below on Substance-induced Mental Disorders for reference:

• 6A41 Catatonia Induced by Substances or Medications

The first three diagnoses listed above (Episode of Harmful Use of Cannabis, Harmful Pattern of Use of Cannabis, and Cannabis Dependence) describe the pattern of cannabis use. One of these three diagnoses, or Disorder Due to Use of Cannabis, Unspecified, for cases in which the use pattern in unknown at the time of evaluation, is considered to be the primary diagnosis. That is, one of these four diagnoses should be assigned when making a diagnosis of a Disorder Due to Cannabis Use.

The remaining diagnoses reflect the impact of the pattern of cannabis use and are thus considered to be associated with one of the primary use pattern diagnoses. These diagnoses should therefore be assigned together with the relevant primary diagnosis. For example, 6C41.1/ 6C41.5 is Harmful Pattern of Use of Cannabis associated with Cannabis-Induced Psychotic Disorder, 6C41.2/6C41.70 is Cannabis Dependence associated with Cannabis-Induced Mood Disorder, 6C4Z/6C41.3 is Disorders Due to Substance Use, Unspecified associated with Cannabis Intoxication (i.e., the pattern of use in this last case is unknown).

Cannabis-induced Mental Disorders are characterized by psychological, cognitive, or behavioural symptoms that develop during or soon after cannabis intoxication or withdrawal or use or discontinuation of certain medical cannabinoids. The duration or severity of the symptoms is substantially in excess of the characteristic syndrome of Cannabis Intoxication or Cannabis Withdrawal.