Evaluation of Co-occurring Psychiatric Disorders and Cannabis Use in the Outpatient Setting

Abstract

In the outpatient mental health setting, patients initially present with a wide variety of symptomatic complaints, seeking appropriate diagnosis and treatment recommendations. Such patients are typically at elevated risk of concurrently using cannabis, either identifying it as a recreational substance or even as a “treatment” for their underlying distress. Psychiatrists, in contrast, often recognize that despite the patient’s attitude toward cannabis, evidence-based literature indicates that it is more likely to exacerbate rather than ameliorate psychopathology. This chapter will delineate recommendations for comprehensively evaluating the relationship between the patient’s cannabis use and psychiatric history in the outpatient setting, incorporating both formal and informal screening tools. Furthermore, this chapter will focus on adopting a nonjudgmental approach in order to optimize therapeutic alliance and set the stage for managing potentially problematic cannabis use.