Abstract

Between 1990 and the mid-2010s, France registered a sharp rise in the spread and consumption of cannabis. At the same time, there has been an increase in the concentration of Δ9-tetrahydrocannabinol contained in cannabis. The aims of our study are to measure addictive and psychiatric comorbidities in cannabis users in France, and to compare characteristics between women and men. Three hundred and forty-twoheavy cannabis users seen in a cannabis clinic between 2004 and 2014 were assessed during a 2-h clinical interview (DSM-IV, MINI). 83.2% of users are currently cannabis dependent, 10.6% alcohol dependent, and 2.1% cocaine/crack dependent. 37.8% have a current mood disorder, 47.6% have a current anxiety disorder, and 8.8% are psychotic. Women suffer significantly more often than men from major depressive episodes, dysthymia, agoraphobia, social phobia, generalized anxiety disorder and posttraumatic stress disorder (PTSD), both current and lifetime. Logistic regression shows that women have a significantly higher risk than men of suffering from PTSD over their lifetime (odds ratio [OR] = 5.48; p < 10-3). The vast majority of women suffering from PTSD report having been sexually assaulted in the course of their lives. In addition, women are at greater risk of cannabis dependence (OR = 3.87; p < .05) for lower cannabis consumption (grams smoked per week) (OR = 0.96; p < .05). French women heavy cannabis users are particularly at risk of PTSDand are more likely than men to be dependent despite consuming fewer. Further studies are needed to clinically quantify cannabis consumption and distinguish its impact on women and men.

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