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Andrew Farah
The recent trend towards legalization and commercialization of marijuana in the US has resulted in a significant drop in the perceived risks of cannabis use among all age groups. Thus, legalization has further advances the common misperception that cannabis abuse and dependence are generally safe and devoid of neuropsychiatric sequelae. Yet there are numerous acute, as well as numerous long-term neuropsychiatric consequences of cannabis use. In addition to acute psychosis and agitation, this review will discuss the long-term issues of cognitive decline, permanent psychotic disorders, syndromes of prolonged depersonalization, as well as psychological and physical dependence, and related withdrawal symptoms. Cannabis use, particularly repeated exposure, is an established contributory cause of schizophrenia by way of a classic gene-environment interaction, with the vulnerabilities associated with cannabis-induced schizophrenia involving multiple genes. There is also evidence that in utero cannabinoid exposure will impair brain maturation in developing infants and predispose them to neurodevelopmental disorders during childhood. This summary will inform clinicians of the most prevalent consequences associated with cannabis abuse and dependence, and better equip them to educate patients as to these risks. Further, there are treatments that may help patients achieve abstinence, and even neuroprotective strategies to employ in cases of new-onset cannabisinduced psychosis, as well as for cases of in utero exposure.