Definitions of Risky and Problematic Cannabis Use: A Systematic Review

ABSTRACT

Although cannabis is widely used, it remains unclear which consumption patterns are more likely to produce future consequences (risky/hazardous use) or current damage (problematic/harmful use). This unresolved issue contributes to cannabis public health implications. In order to facilitate further consensus, this review analyzes previously used definitions in the literature. Methods: This systematic review was performed following the PRISMA guidelines. Articles published before October 2015 in the Medline, Scopus–Elsevier, ISI-Web of Knowledge and Cochrane databases and fulfilling a-priori decided criteria were retrieved. Definitions in preselected websites of national and international organizations addressing drug problems were also included. Results: Definitions identified in articles (n = 46) and official websites (n = 3) widely varied from each other. Weekly cannabis use was mostly considered risky. Problematic cannabis use was mostly described with the Cannabis Abuse and Screening Test. Evidence-based definitions as well as information on quantities consumed, time-frames and special considerations for risky groups were very limited. Conclusions: Working on official definitions is highly necessary as criteria used remain incomplete, leading to increased confusion in the field. Recommendations to improve existing definitions are given.

KEYWORDS:

• Cannabis
• risky use
• problematic use

Declaration of interest

Hugo López-Pelayo has received travel grants from the laboratories Lundbeck, Lilly, Pfizer, Rovi, and Esteve, and honoraria and travel grants from Janssen and Lundbeck. Laia Miquel and María Mercedes Balcells have received honoraria from Lundbeck. Antoni Gual has received honoraria, research grants, and travel grants from Lundbeck, Janssen, Pfizer, Lilly, Abbvie D&A Pharma, and Servier. All other authors declare no potential conflict of interest. Previous stated honoraria had no influence on this article.

Funding

This work was supported by Plan Nacional sobre Drogas, Ministerio de España [Grant number 2013I082].