With the legislation passing in support of the legalization of both medicinal and recreational cannabis across the country, our role will often include both education on the risks of use and the possible benefits. Please look at the evidence (cite resources) and discuss different populations that are at a higher risk with recreational cannabis use and clinical implications for medicinal uses.
Case study: You are in private practice at a Brooklyn mental health clinic where you see patients both via telemedicine and in person. A 60 y/o female with treatment-resistant depression comes in and is hopeless, helpless, and having passive suicidal ideations. She feels broken, tired of trying so hard, and like giving up. This is the second time you have seen her after her last psych provider of 15 yrs retired. You have yet to adjust her medications as she states in the last year she has had more than 20 medication changes and tried “every medication out there in the last 30 years.” Medications either don’t really help, they cause side effects, or they stop working overtime. She even had a genetic testing panel which did not help in her search for a viable medication option.
Her current regimen includes: Wellbutrin 450 1 x day; Modafinil 200mg 1 x day, Viibryd 40mg, Clonazepam 0.5 BID PRN, Ambien 10mg QHS. You have heard that ketamine is a viable treatment option for depression and now has FDA approval for treatment-resistant depression.
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