Current perspectives in cannabis use disorder Discussion prof. Haney
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1 Current perspectives in cannabis use disorder Discussion prof. Haney 10 e Congrès International d Addictologie de l ALBATROS Carlos Roncero MD PhD Head of Addiction and Dual Diagnosis Unit Department of Psychiatry Hospital Universitari Vall Hebron. CIBERSAM Universidad Autónoma de Barcelona (Spain) croncero@vhebron.net
2 Author disclosure Statement of Potential Conflicts of Interest, May 2016 Relating to this presentation, the following relationships could be perceived as potential conflict of interests: Carlos Roncero has received fees to give lectures for Janssen-Cilag, Ferrer-Brainfarma, Pfizer, Indivior, Lundbeck, Otsuka, Servier, Lilly, GSK, Rovi and Astra. He has received financial compensation for his participation as a member of the Janssen-Cilag, Lilly, Gilead and INDIVIOR board. He has carried out the PROTEUS project, which was funded by a grant from Reckitt-Benckisert/Indivior.
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4 IS IT IMPORTANT? DO WE HAVE TREATMENT/S?
5 IS IT IMPORTANT?
6 IS IT IMPORTANT?
7
8
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10 N= 287
11 N=
12
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14 Opioid Maintenance treatment (2011): N= 624 N
15 Opioid Maintenance treatment (2011): N= 624 N When the study was conducted, 82% of the patients were abusing drugs, especially tobacco (81%). Opiates were abused by 32% of patients, mainly using heroin (27% of all patients). The leading items in the rankings for abused drugs were cannabis (50%), alcohol (42%), benzodiazepines (30%) and cocaine (29%).
16 IS IT IMPORTANT?
17 B.D. Psychosis Schizophrenia Anxiety Anxiety attack CANNABIS Drug dependence ADHD Personality disorders Depression Suicide
18 . N= 48 patients Cannabis is the main drug used by patients All of them are cannabis dependents At least a 6 month follow-up
19 . Gender (%) 23% 77% WOMEN MEN
20 . T. PSICÓTICO NO ESPECIFICADO vs PSICOSIS CANNABICA,,,,,,, N N TP NO 14 ESPECIFICADO coca N sí N 13,,,,,,,,,,,,,,,,,,,,,,,,? N??????????,,,,,,, N N TEA D.coca N S TDAH 12,,,,,,,,, N sí S TLP + TDAH D. Coca N S T. DEPRESIVO RECURRENTE + TDAH???????? ex-oh+coca S N CICLOTIMIA? T. BIPOLAR? T DEPRESIVO RECURRENTE?,,,,,,,,,, N N 10 TLP + TDAH?????? 9,,,,,,,,,,? S TDAH D. coca N N CRISIS ANGUSTIA,,,,,,, N N T P NO 8 ESPECIFICADO,,,,,,, N S T PSICÓTICO NO ESPECIFICADO ex-oh+coca S N T P NO ESPECIFICADO 6 6,,,,,,,,,,,,? N TLP OH N N 6 T. PSICÓTICO NO ESPECIFICADO vs PSICOSIS CANNABICA ex-op N 5 N 4 2 PSYCHIATRY COMORBIDITY PSYCHOTIC ADHD AFFECTIVE BLP ANXIETY ADHD+BLP OTHERS NONE
21 . OTHER DRUG USE NONE ALCOHOL COCAINE Ab COCAINE De EX-OH EX-OH- COCAINE OPIATES EX-OPIATES COCAÍNA +OH
22 IS IT IMPORTANT?
23 Eur Psychiatry Mar;28(3):141-6 A logistic regression analysis was performed, finding that a model consisting of amount of cocaine consumption, presence of an antisocial personality disorder and cannabis dependence history had 66.2% sensitivity 75.8% specificity predicting the presence of CIP.
24 IS IT IMPORTANT?
25 DO WE HAVE TREATMENT/S?
26 DO WE HAVE TREATMENT/S? Antidepresant?? Eutimizants?? Antipsychotic?? Dronabinol, etc? Buspirone? Opiates: naltrexone?.
27 DO WE HAVE TREATMENT/S? Contingency treatment.
28 DO WE HAVE TREATMENT/S? Contingency treatment. But. somebody is going to pay?
29 DO WE HAVE TREATMENT/S? Are the patiens of the RCT representative of CUD-patients? CUD +others SUD Dual diagnosis
30 DO WE HAVE TREATMENT/S? More questions than answers.
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33 Current perspectives in cannabis use disorder Discussion prof. Haney 10 e Congrès International d Addictologie de l ALBATROS Carlos Roncero MD PhD Head of Addiction and Dual Diagnosis Unit Department of Psychiatry Hospital Universitari Vall Hebron. CIBERSAM Universidad Autónoma de Barcelona (Spain) croncero@vhebron.net
Psychiatric Comorbidities I
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