Chunk #32 — Conceptualizing Problematic Cannabis Use in Mental Illness: Addiction Vulnerability versus Self-Medication Hypothesis — The Perception of Self-Medication
Nonetheless, it is understandable why the self-medication hypothesis has stood the test of time. Emotion dysregulation, common in mental illnesses, and lack of protective coping mechanisms, illustrated by Khantzian [84] who initially described this hypothesis, make this population vulnerable, which primarily drives one to using a substance. Moreover, cannabis users have been described to have prominent affective dysregulation, such as higher levels of anhedonia, placing this population at even further risk [41]. The perception of cannabis’ ability for self-medication contributes to this notion, as these individuals rely on a substance to replace social and neuropsychological mediators. For example, in a study of veterans using cannabis, as symptoms of PTSD increased, heightened use of cannabis and expectations for cannabis to aid symptom severity followed [45]. The belief that cannabis can be used to medicate symptoms of mental illness combined with acute withdrawal relief, including the relief of symptoms not limited to anhedonia-like reports, anxiety and headaches, together primes reinforcement for further drug use [1, 84, 87]. This perception may place individuals with mental illness at higher addiction risk.
