Although cannabis use can impact multiple aspects of normal human functioning, in- cluding the cardiovascular, immune, neuromuscular, ocular, reproductive, and respira- tory systems, as well as appetite and cognition/perception, there are few clear medical conditions that commonly co-occur with cannabis use disorder. The most significant health effects of cannabis involve the respiratory system, and chronic cannabis smokers exhibit high rates of respiratory symptoms of bronchitis, sputum production, shortness of breath, and wheezing.
A. Recent use of cannabis.
B. Clinically significant problematic behavioral or psychological changes (e.g., impaired motor coordination, euphoria, anxiety, sensation of slowed time, impaired judgment, social withdrawal) that developed during, or shortly after. cannabis use.
C. Two (or more) of the following signs or symptoms developing within 2 hours of canna- bis use: 1. Conjunctival injection.
2. Increased appetite.
3. Dry mouth.
4. Tachycardia.
D. The signs or symptoms are not attributable to another medical condition and are not better explained by another mental disorder, including intoxication with another substance.
Specify if:
With perceptual disturbances: Hallucinations with intact reality testing or auditory, vi- sual. or tactile illusions occur in the absence of a delirium.
Coding note: The ICD-9-CM code is 292.89. The |CD-10-CM code depends on whether or not there is a comorbid cannabis use disorder and whether or not there are perceptual disturbances.
For cannabis intoxication, without perceptual disturbances: If a mild cannabis use disorder is comorbid, the lCD-10-CM code is F12.129, and if a moderate or severe cannabis use disorder is comorbid, the |CD-10-CM code is F12.229. If there is no co- morbid cannabis use disorder, then the |CD-10-CM code is F12.929.
For cannabis intoxication, with perceptual disturbances: If a mild cannabis use disorder is comorbid, the |CD-10-CM code is F12.122, and if a moderate or severe cannabis use disorder is comorbid, the |CD-10-CM code is F12.222. If there is no co- morbid cannabis use disorder, then the |CD-10-CM code is F12.922.
When hallucinations occur in the absence of intact reality testing, a diagnosis of substance/ medication—induced psychotic disorder should be considered.
The essential feature of cannabis intoxication is the presence of clinically significant prob- lematic behavioral or psychological changes that develop during, or shortly after, canna- bis use (Criterion B). Intoxication typically begins with a ”high" feeling followed by symptoms that include euphoria with inappropriate laughter and grandiosity, sedation, lethargy, impairment in short-term memory, difficulty carrying out complex mental pro- cesses, impaired judgment, distorted sensory perceptions, impaired motor performance, and the sensation that time is passing slowly. Occasionally, anxiety (which can be severe), dysphoria, or social withdrawal occurs. These psychoactive effects are accompanied by two or more of the following signs, developing within 2 hours of cannabis use: conjuncti- val injection, increased appetite, dry mouth, and tachycardia (Criterion C).