Effect of continued cannabis use on medication adherence in the first two years following onset of psychosis

TY - JOUR

T1 - Effect of continued cannabis use on medication adherence in the first two years following onset of psychosis

AU - Schoeler, Tabea

AU - Petros, Natalia

AU - Di Forti, Marta

AU - Klamerus, Ewa

AU - Foglia, Enrico

AU - Murray, Robin

AU - Bhattacharyya, Sagnik

PY - 2017/9

Y1 - 2017/9

N2 - Uncertainty exists whether the use of non-prescription psychoactive substances following onset of a first episode of psychosis (FEP), in particular cannabis use, affects medication adherence. Data from FEP patients (N=233) obtained through prospective assessments measured medication adherence and pattern of cannabis and other substance use in the first two years following onset of psychosis. Multiple logistic regression analyses were employed to compare the different substance use groups with regard to risk of medication non-adherence, while controlling for confounders. The proportion of non-adherent patients was higher in those who continued using high-potency forms of cannabis (skunk-like) following the onset (83%) when compared to never regular users (51%), corresponding to an Odds Ratio (OR) of 5.26[95% Confidence Interval (CI) 1.91–15.68]. No significant increases in risk were present in those who used cannabis more sporadically or used milder forms of cannabis (hash-like). Other substances did not make an independent contribution in this model, including cigarette use ([OR 0.88, 95% CI 0.41–1.89]), alcohol use ([OR 0.66, 95% CI 0.27–1.64]) or regular use of other illicit drugs ([OR 1.03, 95% CI 0.34–3.15]) following the onset. These results suggest that continued use of high-potency cannabis following the onset of psychosis may adversely affect medication adherence.

AB - Uncertainty exists whether the use of non-prescription psychoactive substances following onset of a first episode of psychosis (FEP), in particular cannabis use, affects medication adherence. Data from FEP patients (N=233) obtained through prospective assessments measured medication adherence and pattern of cannabis and other substance use in the first two years following onset of psychosis. Multiple logistic regression analyses were employed to compare the different substance use groups with regard to risk of medication non-adherence, while controlling for confounders. The proportion of non-adherent patients was higher in those who continued using high-potency forms of cannabis (skunk-like) following the onset (83%) when compared to never regular users (51%), corresponding to an Odds Ratio (OR) of 5.26[95% Confidence Interval (CI) 1.91–15.68]. No significant increases in risk were present in those who used cannabis more sporadically or used milder forms of cannabis (hash-like). Other substances did not make an independent contribution in this model, including cigarette use ([OR 0.88, 95% CI 0.41–1.89]), alcohol use ([OR 0.66, 95% CI 0.27–1.64]) or regular use of other illicit drugs ([OR 1.03, 95% CI 0.34–3.15]) following the onset. These results suggest that continued use of high-potency cannabis following the onset of psychosis may adversely affect medication adherence.

KW - Cannabis

KW - THC

KW - first episode psychosis

KW - epidemiology

U2 - 10.1016/j.psychres.2017.05.009

DO - 10.1016/j.psychres.2017.05.009

M3 - Article

SN - 0165-1781

VL - 255

SP - 36

EP - 41

JO - Psychiatry Research

JF - Psychiatry Research

ER -