Exploring the Relationship Between Cannabis Use and Schizophrenia

Introduction

Schizophrenia is referred to severe and chronic mental disorder which negatively affects the way a person feels, thinks and behaves making them unable to lead their life in normal way (Sekar et al. 2016). The exact mechanism through which cannabis creates risk of schizophrenia is not yet well-understood. However, the biochemical analysis indicated that the Delta-9-tetrahydrocannabinol (THC) found in cannabis is regarded as the key psychoactive constituent that triggers risk and severe symptoms of schizophrenia among individuals by altering their perceptions (Renard, Rushlow & Laviolette, 2018). In the current case study, it is seen that Sharon smokes cannabis and suffers from Schizophrenia which indicates that her substance abuse may be the reason behind the deteriorated mental health condition. Thus, effective assessment of her health is to be performed so that proper intervention to be made can be determined. In this purpose, the ASPIRE framework is to be used. The Model of Care informs the best care approaches to be used for caring of a person or population so that effective progress in their health status along with different stages of health condition is ensured (Lee et al. 2017). In this assignment, the model of care is to be discussed and the way it can be used to provide health intervention to Sharon is to be mentioned.

Assessment

The ASPIRE framework informs the key elements of care performance examination to be considered and barriers or challenges faced with the care process for the person to be recognised. The ASPIRE framework stands for assessment, systematic diagnosis, planning, implementation, review and evaluation of care (Wilson et al. 2018). The assessment informs that Sharon was picked up for care under section 136. The Section 136 of Mental Health Act informs that police is allowed to take a person to safety if they think the person is mentally ill and require proper care or control of health condition (rethink.org, 1983). Thus, this informs that Sharon is socially unable to maintain proper behaviour due to schizophrenia indicating the person required immediate care approach. The systematic diagnosis informs that Sharon is suffering from schizophrenia because she is hearing voices. In the study Chawla et al. (2019), it is mentioned that nearly 70% of the patient with schizophrenia are found to have auditory hallucinations. The hallucinations are hypothesised to be speech perceptions which are lateralised to the left temporally lobe located in the per-Sylvian region in the brain. Therefore, it is evident that Sharon is facing schizophrenia. In planning and implementation of care for Sharon, the stress vulnerability model and holistic care model is to be used for promoting her well-being. The review and evaluation of the success of the care plan of Sharon is to be determined by accessing feedback and monitoring her health.

Intervention

Stress Vulnerability Model

The Stress-Vulnerability model informs six key elements which are to be addressed for improving and avoiding relapse of mental illness such as alcohol and drug use, coping skills, stress, medication use, meaningful activities and social support (Adams and Townsend, 2018). In the case study, it is reported that Sharon has substance misuse problem and frequently smokes cannabis. As mentioned by Gage et al. (2017), using cannabis use can raise the risk of schizophrenia among individuals as well as makes them experience increased triggers of symptoms related to the disease. This is evident as results from the study regarding the cause-effect relationship of cannabis use and risk of schizophrenia indicate an odd ration of 1.04 (odd ration above 1 means positive relation). As mentioned by Di Forti et al. (2019), lack of alcohol and drugs intake positively influences the biological characteristics of a person to experience less symptoms of psychiatric disorder. This is because lack of drugs and alcohol leads the body unable to trigger different biochemical mechanism that exerts negative effect on the physiology and behaviour of the person responsible for making people express severe symptoms and increase psychological complication related to their mental illness. Thus, it indicates that Sharon is to avoid the use of cannabis which can be accomplished by providing her effective education regarding the way cannabis is deteriorating her health condition as well as her informing the strategies to be implemented to lower her addiction towards cannabis.

The stress can worsen the biological vulnerability along with deteriorate symptoms and relapse of psychotic disorder. This is because stress leads the body to increase production of cortisol which can damage the brain area known as hippocampus which controls emotions and memorising ability of the individuals (Tas et al. 2018). In the study by Reed et al. (2017), it is mentioned that stress is triggered among individuals due to negative events in life or when the individuals do not have enough purpose in life to live. The presence of stress among people is seen to make them prone to use drugs and alcohol (Steiner et al. 2017). Thus, according to the model, any stresses faced by Sharon is to be managed and treated so that she feels relaxed and clam which would make her avoid using cannabis that is further deteriorating her schizophrenic condition. As argued by Schaub et al. (2016), coping skills in the stress-vulnerability model mentions social and relation skill to be educated to the person so that they can deal with stress and conflict. In case of Sharon, the use of coping skills to be made includes use of own voice to drown other voices, wearing earplug to avoid voice and writing down hallucination events to check with reality so that her auditory hallucinations can be controlled.

The Stress-Vulnerability Model informs that people suffering from mental disorder are to be involved in meaningful activities as it helps to offer them a purpose in life, in turn, reduces their stress and psychotic symptoms (Pruessner et al. 2017). In case of Sharon, it is seen that she is suffering from schizophrenia and to control her condition she is required to involve in meaningful activities such as caring for the child, execute activities related to homemaking and involve in part-time job. This is required so that her mind can be diverted from any stress. As commented by Gross et al. (2016), effective social support is to be provided to individuals suffering from mental illness to assist them cope with challenging emotions. This is because effective social support allows the people with mental illness access help in opening up to discuss their symptoms to avoid misunderstanding and resolve area of conflicts that are making them isolated from society which in turn is negatively affecting their psychological health. As argued by Hankir et al. (2017), in Muslim communities mental illness is not supported in society and they stigmatise mental illness as punishment of God that have no effective remedy and it is a shameful act to have a mentally-ill patient in the family. This leads the Muslim communities to socially discriminate people suffering from mental illness. In Sharon’s case, it is found that she is Muslim and quite religious. Thus, social support from Muslim community in the form of emotion is required which offer her concern, empathy, affection, acceptance, love and encouragement as it would be effective to help her cope with the illness that is schizophrenia.

Holistic Model of Care

The Holistic Model of Care refers five key aspects of care which are physical, emotional, social, economic and spiritual needs of the patients that are to be fulfilled to ensure the individual’s well-being (Davis, Schwartz & Cefus, 2017). As mentioned by Davis, Schwartz & Cefus (2017), physical needs of the patients or individuals are determined by analysing the physical signs and symptoms of health of the individual. In case of Sharon, the physical needs analysed for her includes that she is to be provided information along with help to take proper dosage of medication to control type-2 diabetes along with schizophrenia and arrange ways to avoid her take cannabis. As criticised by Li et al. (2018), lack of fulfilment of physical health issues leads individuals to develop mental disorder as a result of burden of the illness. Thus, physical health issue of type-2 diabetes along with cannabis abuse is to be resolved for Sharon to ensure her better quality life and well-being.

The emotional needs are to be fulfilled for the patients because it offers them mental satisfaction along with feeling of happiness and contentment which assist to resolve stress and negative psychological condition (Howes et al. 2017). As criticised by Shah, Grover & Kulhara (2017), the negative emotional condition leads people to remain confused and stressed, in turn, avoiding accessing proper care and developing addiction to normalise emotions resulting to deteriorate the psychotic condition. Thus, in Sharon's case, resolving her stress, positive emotion can be boosted which would make her lower her addiction towards taking cannabis and provide good response toward the medications and care offered to control her type-2 diabetes and schizophrenic state. As criticised by Munikanan et al. (2017), social needs are referred to the demands present among the individuals to develop effective relationship with others. In case of Sharon, the social needs of the individual are that she is to be allowed to remain socially active to remain encouraged through her friends and partner to access services for schizophrenia to improve her health.

The fulfilment of spiritual needs is important for the patients as it helps to improve their quality of life by healing their mental pain (Izuhara et al. 2018). In Sharon’s case, her spiritual needs are related to Muslim culture and thoughts which are to be fulfilled by allowing her to spent time at the mosque and practice her faith to make her feel mentally calm to cope with schizophrenia. The mental needs are referred to the demands present among patients related to their psychological health (Alanen, 2018). In case of Sharon, it is seen that the person is suffering from schizophrenia which is a vital mental health disorder. This is because schizophrenia affects the brain parts that control emotion and manage logical thinking making the person show improper behaviour and less activity (Jauhar, Laws & McKenna, 2019). In order to improve psychological health of Sharon regarding schizophrenia, the Cognitive Behaviour Therapy (CBT) and WRAP is to be used. The CBT is referred to the nature of psychotherapy which assists the patients to understand and determine the thoughts and feelings that are negatively influencing their behaviour, in turn, making them aware of the aspects to be avoided to act normally and have better mental health condition (Lystad et al. 2017). According to NICE guidelines, minimum of 16 planned sessions are to be organised and the therapy is to be provided by experience health professionals by monitoring the thoughts and feelings of the patient to ensure improvement of their mental functioning and lower distress (ice.org.uk, 2015). The benefit of providing CBT to schizophrenia patients is that it helps to specifically control hallucinations and other psychotic symptoms as well as stress and depression related with the presence of schizophrenia (Laws et al. 2018). Since Sharon is suffering from schizophrenia, thus CBT is going to be effective in controlling her psychotic symptoms such as hearing voices and others to ensure enhanced well-being.

The Wellness Recovery Action Plan (WRAP) is developed by Copeland which mentions five key principles to be followed to assist individuals cope with mental health issues. The five principles are hope, personal responsibility, education, self-advocacy and support (cwp.nhs.uk, 2018). As mentioned by (Olney & Emery-Flores (2017), hope to have better health is to be provided to mentally ill people to make them develop positive feelings regarding their health. This is because hope creates desire among the mentally ill people to respond to care services in proper manner. As argued by Cleary et al. (2016), lack of hope to recover from mental illness makes people show lack of compliance to accept care and perform vulnerable activities. This is because without hope mentally ill people develop lack of purpose to lead life and execute hindered activities to. In case of Sharon, it is seen that she is suffering from schizophrenia and hearing voices as a result of the condition. She is to be provided hope to recover from the situation so that she develop compliance in accepting proper care services to have improved health and avoid creating any nuisance.

The proper education regarding the cause, impact and symptoms of the mental disorder is to be informed to the patients to make them understand the reason for their behaviour and develop awareness to avoid executing such negative behaviour (Halpern-Manners et al. 2016). As argued Laine et al. (2019), lack of health education of mentally ill people regarding their health condition makes them develop confusion regarding the way they are acting. This leads them act improperly and feel lack of hope to survive. Thus, Sharon is to be provided health education regarding schizophrenia to make her aware the reason behind her current hindered health and to be informed about the way to cope with it so that she is able to lead a normal life.

Conclusion

The above discussion informs that Sharon is suffering from schizophrenia and is admitted to the care settings under section 136 of the Mental Health Act. This indicates that she was admitted in the hospital on the context that the police determined from her activities in the park that she requires effective mental health care to ensure her good health. The care model to be followed for offering support to Sharon is Stress-Vulnerability Model and Holistic Model of care. The Stress-Vulnerability model informs the use of proper medication as prescribed along with coping skills to avoid substance abuse is to be educated to Sharon to improve her health condition. The Holistic Model of Care informs that emotional, social, physical, mental and spiritual needs of Sharon are to be fulfilled to ensure her quality health and well-being. In order to provide proper care, WRAP and CBT is to be used for Sharon.

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Appendix

Relation of Cannabis with Schizophrenia

In the study, when the THC was isolated it resulted in the formation of a G protein-coupled receptor to which THC was seen to exert saturable and specific binding indicating the availability of endogenous receptors would allow cannabinoids to implement their impact in creating altering within the body. The study also informed that cannabidiols have 64 active isomers being present with each having a significant impact on altering the normal health and behaviour of an individual (Shrivastava et al. 2014).