EPP130
Impact of cannabis decriminalization on selected psychotic disorders: a retrospective analysis at the Center for Mental Health and Prevention of Addiction (2013–2023) in Tbilisi
L. Jishkariani 1,*, D. Zurabashvili 2, K. Gigolashvili 1, N. Jibuti 1, K. Jmukhadze 1, G. Lezhava 1
1psychiatry, Tbilisi state medical university, 2psychiatry, tbilisi state university, Tbilisi, Georgia
Introduction: Cannabis decriminalization raises concerns about its psychiatric impact, particularly on psychosis risk. As cannabis became decriminalized in Georgia in 2018, questions emerged regarding changes in substance-related and acute psychotic disorders. Examining these trends is essential to guide prevention, treatment, and policy in a shifting drug landscape.
Objectives: This study aims to:
(1) assess changes in rates of substance-associated psychoses following Georgia’s 2018 cannabis decriminalization;
(2) examine diagnostic trends in acute/transient psychoses and cannabinoid-related disorders;
(3) explore clinical and policy implications of observed patterns.
Methods: A retrospective review was conducted of all adult psychiatric inpatient admissions (n = 12,680) at the Tbilisi Mental Health and Prevention of Addiction Center between 2013 and 2023. Unique first-time cases diagnosed with F23.0 (n = 789), F20.0 (n = 2,359), and F06.2 (n = 490) were extracted. Cases were stratified into pre-decriminalization (2013–2018) and post-decriminalization (2019–2023) periods. Substance use status, sex distribution, and diagnostic trends were analyzed descriptively.
Results: Following decriminalization, the number of unique ATPD cases tripled (from 195 to 594). Substance-related psychotic cases increased fourfold (from 243 to 907), with cannabis implicated in over 70% of post-2018 substance cases. The proportion of psychosis cases involving substance use rose from 9.6% pre-2018 to 81.4% post-2018. Cannabis-only use increased 4.2-fold; polysubstance use increased 3.2-fold. Substance-using cases were overwhelmingly male (96%). F20.0 and F06.2 incidence showed a relative decline, potentially reflecting chronicity and under-detection in inpatient settings.
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Conclusions: A significant post-decriminalization rise in ATPD, predominantly among substance-using males, suggests a potential link between cannabis policy changes and psychosis incidence. The findings highlight the need for evidence-based prevention strategies, gender-responsive interventions, integrated dual-diagnosis care, and robust national monitoring systems.
Disclosure of Interest: None Declared