Mental health services in the Somali region of Ethiopia

been associated with impaired cognition, motor vehicle accidents, anxiety and paranoia, and exacerbation of medicines, dispensary cannabis is not standardised or purified, and there is little evidence to guide patients on what to purchase among the myriad available products, let alone how much or how often to use cannabis. In states with MCL, after a physician issues a recommendation for cannabis, there is often little-tono follow-up with the recommending physician, and in states with RCL, physicians have been removed entirely from the process of obtaining cannabis. Thus, cannabis use disorder can easily develop if there is a loss of control over cannabis intake with no follow-up care. The passage of MCL and RCL will probably expand in the future, leaving clinicians to grapple with how best to advise patients in an increasingly permissive regulatory environment with a rapid expansion of the commercial cannabis market. There is little guidance on how clinicians should advise patients. Although the US Preventive drug use, including cannabis, in adult primary care settings, these recommendations specifically reference illegally obtained substances.8 Hospital screeners often do not mention cannabis specifically, and in some states cannabis would not be captured if a screener uses the term illegal or illicit drugs. Thus, identifying cannabis use disorder in the clinic largely depends on a patient