A vulnerable young adult using cannabis for therapeutic purposes despite emerging psychosis

There is widespread support of cannabis for therapeutic purposes (CTP) despite lack of federal oversight and inconsistencies in screening, consenting, and authorizing use. Young people may have increased vulnerability to adverse effects including psychosis, substance use disorder, reduced academic achievement or other symptoms. We describe a case of a 20 year old who was prescribed CTP in the context of an emerging psychotic illness. The student was hospitalized for a psychotic episode and CTP a risk factor that complicated care. Use of CTP in this patient was concerning for several reasons, including emergence of psychosis, escalating cannabis use, as well as the lack of coordination among health care providers. This case illustrates the complexity of evaluating and treating high-risk youth; every precaution should be taken to prevent harm, reduce pathology and improve functioning. Without federal regulation and oversight, variable guidance for screening, consenting, authorizing and procuring CTP will unfortunately continue.