Comorbidity of mental disorders and substance use: a brief guide for the primary care clinician
9.3 Major clinical issues with eating disorders and cannabis/ hallucinogen use
Table of contents
- Acknowledgments
- Abbreviations
- Preface
- Introduction
- Comorbidity of mental disorders and substance use: a brief guide for the primary care clinician
1. Levels of evidence- 2. Management of people with comorbidity of mental disorders and substance use
- 3. The common drug groups
- 4. Tobacco
- 5. Depression and substance use
- 6. Anxiety disorders and substance use
- 7. Psychosis (schizophrenia and bipolar disorder) and substance use
- 8. Personality disorders and substance use
9. Eating disorders and substance use- 9.1 Eating disorders
- 9.2 Comorbidity with eating disorders
- 9.3 Major clinical issues with eating disorders and cannabis/ hallucinogen use
- 9.4 Major clinical issues with eating disorders and alcohol use
- 9.5 Major clinical issues with eating disorders and opioid use
- 9.6 Major clinical issues with eating disorders and stimulant (including methamphetamine) use
- 9.7 Major clinical issues with eating disorders and benzodiazepine use
- 9.8 Major clinical issues with eating disorders and inhalant/ solvent use
- 10. Somatoform disorders and substance use
- 11. Gambling and substance use
- 12. Brain injury, mental disorders and substance use
- 13. Bibliography
- 14. Appendices
- Cannabis has been shown to be one of the most commonly used substances across eating disorders and its frequency of use has been correlated with the frequency of bulimia.
- Management of cannabis use should be determined by the level of impact associated with its use.
- In the absence of other proven forms of treatment, CBT is, at present, the most widely employed form of treatment for cannabis use.
9.3.1 Effects of cannabis and other hallucinogens on eating disorders
- Cannabis has been shown to be one of the most commonly-used substances across eating disorders and its frequency of use has been correlated with the frequency of bulimia(341, 351, 352, 360).
- As cannabis has been shown to cause appetite stimulation(369), its role in people with eating disorders is complex.
- Use of LSD in people with eating disorders has been shown to be of low frequency(347).
9.3.2 Interactions between cannabis and other hallucinogens and therapeutic agents for eating disorders
- Cannabis can exacerbate the sedative effects of antidepressants such as tricyclicsx.
- LSD may induce a serotonin syndrome (Appendix 1), therefore caution should be exercised when prescribing SSRIs or MAO-Ix(127).
- Cannabis and antidepressants are metabolised by CYP 450 enzymes which may result in the inhibition or induction of either drug group. Therefore, individuals should be monitored closely to ensure outcomes are appropriatex.
9.3.3 Management approaches to comorbid eating disorders and cannabis or other hallucinogen use
- Management of cannabis use should be determined by the level of impact associated with its use.
- Abstinence from cannabis is a difficult goal to achieve in cannabis dependent people(128).
- In the absence of other proven forms of treatment, CBT is, at present, the most widely employed form of treatment for cannabis use****(128).
