GPs and cannabis in France: should we ask our young patients about their use?

Background. Cannabis use among 15-34 years old is higher than tobacco and alcohol consumption in France. The short- and long-term adverse effects of cannabis use are numerous and well known. The use of the CAST tool for screening and of the brief intervention for treatment of moderate consumption are widely encouraged. However, GPs do not frequently ask their patients. Aim. To support the screening for cannabis consumption by the GPs, especially with young people. To provide general information on interventions to be conducted with patients. Method. Narrative review conducted from PubMed and Cochrane databases, national government and health sites, guidelines and laws of several countries. Results. The GP can use several tools to get familiar with cannabis-based products, and thus better address the issue with his patients. Acute and chronic risks of cannabis use, whether biomedical or psychosomatic are now well established. Cannabis use causes neuro-brain damage and results in acute and chronic neuropsychiatric effects, sometimes irreversible. Observational studies conducted in various countries do not currently allow to assess the effects of the legislative system on consumption. The GP should adopt a health expert posture and disregard representations and societal debate. Conclusion. GPs should systematically screen cannabis use, especially in young patients, regardless of their initial reason for consultation. This initial assessment, including the somatic and psychosocial impact, should guide their intervention toward either brief intervention or referral.