Soyka M, Preuss U, Hoch E
Psychiatrische Klinik, Universität München, Nussbaumstraße 7, 80336, München, Deutschland.
Privatklinik Meiringen, Postfach 612, 3860, Meiringen, Schweiz.
Nervenarzt. 2017 Mar;88(3):311-325. doi: 10.1007/s00115-017-0281-7.
Use and misuse of cannabis and marihuana are frequent. About 5% of the adult population are current users but only 1.2% are dependent. The medical use of cannabis is controversial but there is some evidence for improvement of chronic pain and spasticity. The somatic toxicity of cannabis is well proven but limited and psychiatric disorders induced by cannabis are of more relevance, e.g. cognitive disorders, amotivational syndrome, psychoses and delusional disorders as well as physical and psychological dependence. The withdrawal symptoms are usually mild and do not require pharmacological interventions. To date there is no established pharmacotherapy for relapse prevention. Psychosocial interventions include psychoeducation, behavioral therapy and motivational enhancement. The CANDIS protocol is the best established German intervention among abstinence-oriented therapies.
大麻的使用与滥用屡见不鲜。约5%的成年人口为当前使用者,但仅有1.2%对其产生依赖。大麻的医疗用途存在争议,但有一些证据表明其可改善慢性疼痛和痉挛。大麻的躯体毒性已得到充分证实,但较为有限,而大麻所致的精神障碍更为相关,例如认知障碍、无动机综合征、精神病性障碍和妄想性障碍以及生理和心理依赖。戒断症状通常较轻,无需药物干预。迄今为止,尚无已确立的预防复发的药物疗法。心理社会干预包括心理教育、行为疗法和动机增强。在以戒酒为导向的疗法中,CANDIS方案是德国最完善的干预措施。