Research Reports - Psychosis following traumatic brain injury and cannabis use in late adolescence

 Am J Addict. 2016 Mar;25(2):91-3. doi: 10.1111/ajad.12338. Epub 2016 Feb 5.

Rabner J(1), Gottlieb S(1), Lazdowsky L(1), LeBel A(1).

BACKGROUND: Both cannabis and traumatic brain injury (TBI) pose risks on the
developing brain, including a potential increased vulnerability for developing
psychosis. Recent reports detail an upward trend in both adolescent cannabis use
and the concentration of THC, the most potent psychoactive component in cannabis.
Similarly, it is estimated that 1.7 million Americans incur a TBI each year.
Previously trivialized as a minor nuisance, attitudes towards TBIs are changing
as researchers and the public recognize TBIs' possible long-lasting sequelae.
CASE REPORT: Two cases are presented of adolescent patients with histories of TBI
and self-reported heavy, recreational cannabis use who developed symptoms of
psychosis.
DISCUSSION: Similar neuronal signaling pathways involved in cannabis ingestion
and TBI recovery, specifically CB1 receptors of the endocannabinoid system, as
well as the allostatic load model provide context for the two presented cases.
Given the cases and theories presented, we believe that cannabis use may act as a
neurological stressor and risk factor for psychosis outweighing its possible
benefits as a therapeutic solution for pain in late adolescent and young adult
populations.
SIGNIFICANCE: The presented cases provide further support for the compounded risk
of developing psychosis following TBI and cannabis use.  

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