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

Psychiatry Res. 2017 Sep:255:36-41. doi: 10.1016/j.psychres.2017.05.009. Epub 2017 May 10.


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.

Keywords: Cannabis; Epidemiology; First episode psychosis; THC.

MeSH terms

  • Adult
  • Antipsychotic Agents / therapeutic use*
  • Cannabis*
  • Female
  • Humans
  • Logistic Models
  • Male
  • Marijuana Abuse / psychology*
  • Medication Adherence / psychology*
  • Prospective Studies
  • Psychotic Disorders / drug therapy*
  • Psychotic Disorders / psychology
  • Time Factors


  • Antipsychotic Agents