Murray Robin M, Paparelli Alessandra, Di Forti Marta, Morrison Paul
Department of Psychosis Studies, Institute of Psychiatry, King's College London, de Crespigny Park, SE5 8AF, London, UK.
NHS Highland Health and Social Care Partnership, Lochgilphead, Scotland, UK.
Neuropsychiatr. 2025 Aug 20. doi: 10.1007/s40211-025-00541-7.
Recreational use of psychotogenic drugs has become more common in the last 30 years with consequent increase in drug-induced psychosis; 25-50% of such psychoses progress to schizophrenia within 5 years. Most cases result from abuse of methamphetamine or cannabis. The spread of methamphetamine psychosis has occurred without any liberalisation of laws; it is highly addictive and easy to make in small "kitchen" labs. The increase in cannabis use has been facilitated by a softening of attitudes towards the drug, and in some countries, especially in North America, by legalisation for so-called "medicinal use" and then recreational use. The potency of cannabis has greatly increased, especially in countries that have legalised its use, and the worldwide legal sales of cannabis for 2025 are estimated at $ 65 billion. The consequences are being seen with many reports of increases in the incidence of cannabis-psychosis and schizophrenia. In the 1980s some physicians predicted an epidemic of obesity and diabetes due to changes in diet and life style. Sadly, their predictions were correct. We are now at the beginning of a similar epidemic of drug-induced psychosis. Public education campaigns of the type that decreased tobacco smoking are necessary to avoid psychiatric services being overwhelmed.
在过去30年里,消遣性使用精神致幻药物变得更为普遍,由此导致药物性精神病增多;此类精神病患者中有25% - 50%会在5年内发展为精神分裂症。大多数病例是由滥用甲基苯丙胺或大麻所致。甲基苯丙胺性精神病的蔓延在法律未作任何放宽的情况下就已出现;它极易成瘾,且在小型“家庭作坊”式实验室中很容易制造出来。大麻使用的增加一方面是由于对该药物的态度有所缓和,另一方面在一些国家,尤其是北美,是由于所谓“药用”然后是消遣性使用的合法化。大麻的效力大幅提高,尤其是在已将其使用合法化的国家,预计到2025年全球大麻合法销售额将达650亿美元。大麻性精神病和精神分裂症发病率上升的诸多报道已显现出这些后果。在20世纪80年代,一些医生曾预测由于饮食和生活方式的改变会出现肥胖症和糖尿病流行。可悲的是,他们的预测是正确的。我们现在正处于类似的药物性精神病流行的开端。开展类似减少吸烟的公众教育活动对于避免精神科服务不堪重负是必要的。