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Brigham and Women’s Hospital, Boston, MA (Drs. Hsu and Shah); Beth Israel Deaconess Medical Center and Harvard Medical School, Boston (Dr. Hill) mhsu7@partners.org
The authors reported no potential conflict of interest relevant to this article.
You renew Ms. F’s asthma medications, discuss her cannabis use, start her on a selective serotonin reuptake inhibitor, and refer her to an outpatient psychiatrist. Over the next few weeks, you and the outpatient psychiatrist employ brief motivational interviewing around cannabis use, and you provide psychoeducation around potential harms of use when driving and in light of the patient’s asthma.
Factors to consider in cannabis use include the method of ingestion, percentage of THC content, and times of day cannabis is used.
The patient’s anxiety symptoms decrease with up-titration of the SSRI by the outpatient psychiatrist and with enrollment in individual CBT. She is slowly able to taper off cannabis vaping with continued motivational interviewing and encouragement, despite withdrawal-induced anxiety and sleep disturbance.
CORRESPONDENCE Michael Hsu, MD, Brigham & Women’s Hospital, 75 Francis Street, Boston, MA 02215; mhsu7@partners.org.
