Safety considerations for patients using cannabis

Cannabis is the most used federally illicit substance in the United States, yet there is limited knowledge about its pharmacology; efficacy for various medical conditions; or, more importantly, its safety profile. There is significant interest in exploring the full extent of the pharmacologic effects of cannabinoids. Psychoactive effects of cannabis are well-established, but the other effects of cannabinoids, including their effect on mood symptoms; suicidal ideation; and activity outside of the central nervous system, including actions on the cardiovascular system, are still being uncovered. With an increasing number of states in the United States independently authorizing medicinal and, in some cases, recreational use of cannabis, it is essential that our health care professionals are aware of these potential risks when caring for patients who are using cannabis. The objective of this manuscript is to describe how mood symptoms, suicidality, cardiovascular effects, and drug interactions may be associated with cannabis use.