# Soft Drug Abuse or Addiction - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - Sources: Cannabis Use Disorder - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK538131/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class PS16.01 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care - Verified date: 2026-08 ## Verified against - No dose - referral pathway, no medicine given in primary care - Cannabis Use Disorder - disease-level clinical article (soft-drug-abuse-clinical.txt) - Cannabis Use Disorder - disease-level clinical article (soft-drug-abuse-full.txt) ## Treatment metadata - No drug therapy in primary care (Referral & Advice) ## Complete treatment card ```text SOFT DRUG ABUSE OR ADDICTION Sources: Cannabis Use Disorder - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK538131/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class PS16.01 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care Review status: REVIEWED against No dose - referral pathway, no medicine given in primary care, Cannabis Use Disorder - disease-level clinical article (soft-drug- abuse-clinical.txt), Cannabis Use Disorder - disease-level clinical article (soft-drug-abuse-full.txt) (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (4) - Acute intoxication brings euphoria or anxiety, increased appetite, inattention, and restlessness [anxiety · inattention · irritability] - Occasional illusions or brief hallucinations occur during intoxication with intact reality testing [hallucinations] - Withdrawal after heavy use produces 3 or more of irritability, anxiety, insomnia, appetite loss, restlessness, or low mood within a week [anxiety · insomnia · irritability · low mood · poor appetite] - Cyclic vomiting that eases with hot showers and recurs with continued use points to cannabinoid hyperemesis syndrome [vomiting] SIGNS - what you find (5) - Vital sign changes on intoxication include a fast heart rate and transient high blood pressure [hypertension · tachycardia] - Red eyes and dry mouth are common head and neck findings [dry mouth] - Typical intoxication shows impaired coordination, an altered sense of time, and impaired judgment - Chronic vaping or smoking can precipitate a collapsed lung [collapse] - Children who ingest edibles are at risk of CNS depression or respiratory failure [drowsiness] TESTS (8) - Severity grades as mild with 2 to 3 criteria, moderate with 4 to 5, or severe with 6 or more - The SIS-C single-item screen runs at 0.88 sensitivity and 0.83 specificity - CUDIT-R uses a cutoff of 9 or above in young adults and 10 to 14 in veterans - The 3-item CUDIT-C screens at 0.91 sensitivity and 0.84 specificity - Urine THC-COOH stays detectable about 3 days after a single use but up to 30 days with chronic use - Blood or saliva testing only reflects use within the last day, mostly for forensic purposes - Hair testing shows long-term exposure but cannot pin down timing - A negative toxicology result does not rule out use IF NOT THIS - what else fits (5) - Stimulant use shows agitation, a fast heart rate, dilated pupils, and psychosis - Opioid intoxication shows pinpoint pupils and respiratory depression, while withdrawal shows dilated pupils, a runny nose, and GI upset - Hallucinogen use brings perceptual distortion, panic, and a sense of unreality - Synthetic cannabinoids cause marked agitation, psychosis, seizures, or dysautonomia disproportionate to reported cannabis use - Psychosis that predates use or persists beyond a month of abstinence points to schizophrenia rather than cannabis-induced psychosis Source StatPearls "Cannabis Use Disorder" - disease-level clinical article Status traced to the source above 1. NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE) [1st line] Adult Regular or dependent use of substances such as cannabis or misused tramadol; the GP screens for harm, offers brief advice, and refers to an addiction service if dependence, psychiatric symptoms, or functional impairment are present. - Refer, with advice Peds Children follow the same pathway: recognise and refer. No primary-care medicine is implied. Source No dose - referral pathway, no medicine given in primary care Why Regular or dependent use of substances such as cannabis or misused tramadol; the GP screens for harm, offers brief advice, and refers to an addiction service if dependence, psychiatric symptoms, or functional impairment are present. Caution No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to. RED FLAG - Underlying psychiatric comorbidity (bipolar disorder present in over half of substance abuse patients, PTSD) requires screening as a root cause. RED FLAG - Severe opioid/sedative toxicity warning sign of sedation causing life- threatening respiratory depression is missing RED FLAG - Psychotic symptoms associated with heavy cannabis use, or escalation to other substances or evidence of dependence. Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)