Relationship Between Frequency of Medical Marijuana Use and Psychosis-related Outcomes in Adolescents and Young Adults with PTSD

Mohammad Yaseliani, MS
University of Florida

Co-authors: Mohammad Yaseliani¹, Lake Lindo¹, Youngsuhk Jo¹, Md Mahmudul Hasan^1
1University of Florida

Background: The prevalence of marijuana use has previously been estimated to range from 15.3-30.1% among high school-aged adolescents and 52.4% among young adults aged 18-25. Qualifying conditions for medical marijuana (MMJ) use within the U.S. vary according to state; however, can include post-traumatic stress disorder (PTSD). Literature has shown that marijuana use could be considered a risk factor for psychosis.

Objectives: Our present study aims to investigate the relationship between MMJ use and psychosis-related outcomes including psychosis-related hospitalization, time to first psychosis-related hospitalization, new psychosis diagnosis, and new antipsychotic prescription.

Methods: We conducted a retrospective cohort study using the Medical Marijuana Consortium data from 2017 to 2023. Eligible individuals were MMJ users aged 12-24 with PTSD. Index date was defined as the earliest date of MMJ dispensation. Individuals with prior antipsychotic prescription were excluded from the analysis. The primary outcome was psychosis-related hospitalization within 1 year of the index date. The secondary outcomes were: (1) time to first psychosis-related hospitalization, (2) antipsychotic prescription within 1 year, and (3) any diagnosis (inpatient or outpatient) of psychosis within 1 year. We used: (1) independent-samples t-tests to compare the number of MMJ fills per month between groups for the primary outcome and the secondary outcomes of antipsychotic prescription and any diagnosis of psychosis, and (2) Pearson correlation to assess the association between the number of MMJ fills per month and time to first hospitalization.

Results: The study sample included 9,266 individuals with PTSD (52.24 % female). Within 12 months of first MMJ dispensation, 50 (0.54%) were hospitalized due to psychosis, 217 (2.34%) received an antipsychotic medication, and 76 (0.82%) had any psychosis diagnosis. The number of MMJ fills per month was statistically significantly correlated with psychosis-related hospitalization (mean difference = 2.3187, 95 % CI = 0.2986, 4.3388; p 0.0253), time to first hospitalization (r = −0.4820; p = 0.0004), antipsychotic prescription after the index date (mean difference = 1.6179, 95 % CI = 1.0111, 2.2246; p <.0001), and any psychosis diagnosis (mean difference = 2.5182, 95 % CI = 1.0158, 4.0205; p = 0.0013).

Conclusion: The use of MMJ is associated with psychosis-related hospitalization, new psychosis diagnosis, new antipsychotic prescription, and decreased time to first psychosis-related hospitalization. It is crucial to consider these risks when considering MMJ use, particularly in younger patient populations.