Medical Marijuana, Cannabis Exposure, and Psychosis

Representative facts: A patient presented to a primary care physician with chronic low back pain. The physician recommended and certified the patient for medical marijuana. Over the following year, the patient used multiple cannabis products, including vape pens, edibles, and capsules. The patient later developed auditory hallucinations, including voices commanding him to harm his wife, and was involuntarily hospitalized with psychosis.

Issues for expert review:

· Did the certifying physician meet the applicable standard of care in recommending and continuing medical marijuana?

· What role, if any, did cannabis exposure play in the development or worsening of psychosis?

· Were the risks of cannabis use, psychiatric adverse effects, dose, product type, and monitoring adequately addressed?