Pubdate: Sun, 08 Jan 2006
Source: Independent on Sunday (UK)
Copyright: Independent Newspapers Ltd.
Contact: http://www.independent.co.uk/
Details: http://www.mapinc.org/media/208
Author: Jeremy Laurance
Cited: Advisory Council on the Misuse of Drugs
http://www.drugs.gov.uk/drugs-laws/acmd/
Cited: Home Office http://www.homeoffice.gov.uk/drugs/
Bookmark: http://www.mapinc.org/find?207 (Cannabis - United Kingdom)
Bookmark: http://www.mapinc.org/people/Charles+Clarke
CANNABIS: CAN IT REALLY DRIVE YOU MAD?
Two years after the law was relaxed, the nation's favourite
recreational drug is to be reclassified. They say it is linked to
psychosis, but can the odd spliff be that dangerous? Jeremy Laurance
reports
It is the world's oldest euphoric drug, long viewed by any liberal
worth their salt as a victim of unfair drug laws. The notion that a
spliff is a safer, sweeter means of relaxing than a pint has over the
years spread way beyond its traditional student constituency to every
corner of society. But two years after the Government listened to
these voices and the law was relaxed, its safety is under question as
never before. A report to be published within the next few weeks is
expected to confirm what some psychiatrists have been warning for
years. That cannabis, reputedly taken by Queen Victoria to banish her
period pains, may be driving its users - many of them children - insane.
Charles Clarke, the Home Secretary, indicated last week that following
the report from the the Advisory Council on the Misuse of Drugs, he is
planning a U-turn on David Blunkett's reclassification of cannabis in
2004. Clarke is expected to take cannabis from Class C back to Class B
status, with tougher penalties for possession. But is cannabis really
so dangerous?
Cannabis is the most widely used illegal drug in the UK, and the
impression that it promises a risk-free high was increased by Mr
Blunkett's move. But in the last two years, evidence has strengthened
that the drug that inspired the hippie generation to make love not war
is a trigger for psychotic delusion that may confine a small minority
of vulnerable users to a lifetime in mental institutions.
There is nothing new about "reefer madness" and the exact role of
cannabis in psychosis is disputed by psychiatrists. But two
developments have increased professional anxiety about its dangers.
First, the cannabis available on the streets is stronger than it was a
two or three decades ago. Much of it is "skunk", a high-octane version
of the more benign "weed", often cultivated hydroponically (without
soil) indoors, under lamps where it is specially bred to increase the
content of the main psychoactive ingredient, tetrahydrocannabidinol,
or THC. A cannabis joint today may contain 10 to 20 times more THC
than the equivalent joint in the 1970s. All drugs carry a risk of side
effects and the more powerful the drug the greater the risk that some
users will suffer harm. Cannabis is no exception.
Second, the age at which young people begin experimenting with
cannabis has decreased. The younger a person is, the more susceptible
they are to drugs of all kinds. Experts believe there is a particular
risk of damage to developing brains from psychoactive drugs. Research
in Australia has shown that the age of first cannabis use has declined
since the 1970s from the early twenties to the mid-teens. In the
Netherlands, the European country with the most liberal drugs policy,
it is between 13 and 14 and in the UK it is between 15 and 16. Studies
in the UK show that two in five 15-year-olds have tried cannabis -
more than in any other country in Europe. The risk of the drug
triggering psychosis may increase with decreasing age.
A psychotic episode can involve hallucinations, fantasies and a loss
of touch with reality which may last days, weeks or months and can be
very frightening. Although it is possible to have a single episode
without recurrence, the risk of attacks is increased after the first.
Robin Murray, professor of psychiatry at the Institute of Psychiatry,
has sounded the loudest warnings about cannabis, but even he says: "It
is obviously ridiculous to say everyone who smokes cannabis is going
to become psychotic. Even in our studies of adolescents, 90 per cent
of those who smoked cannabis did not go on to develop psychosis."
But he points to mounting evidence that the drug can trigger psychosis
in vulnerable individuals. The big question now is: who is vulnerable?
A study by the Institute of Psychiatry published in the journal
Biological Psychiatry last May suggested that people with a variant of
the gene COMT, carried by 25 per cent of the population, had a five
times higher risk of psychosis if they smoked cannabis.
"The gene is involved in the breakdown of dopamine in the brain and
anything that impedes this we know increases the risk of psychosis,"
explains Professor Murray. "We are saying a quarter of the population
are vulnerable. It is the same as for heart disease. We know some
people can smoke cigarettes and eat a high-fat diet without suffering
a heart attack, but if you have a family history or genetic
predisposition then the risks are increased."
Several other studies have shown varying proportions of the population
are at increased risk. The drug is known to increase the production of
dopamine in the brain, an excess of which produces the hallucinations
characteristic of schizophrenia. Any drug that stimulates release of
dopamine is therefore likely to worsen the symptoms of
schizophrenia.
Professor Murray says that overall, results from a number of studies
suggest that smoking cannabis raises risk of psychosis by two to four
times - increasing the incidence from one in 100 to up to four in 100.
In south London, where he works, the incidence of schizophrenia has
doubled since 1964. Although this is partly accounted for by
immigration - schizophrenia is higher among Afro-Caribbeans - the rate
is also up within the white population.
Critics argue that the evidence for cannabis's damaging effects shows
an association between the drug and psychosis, but not that one is the
cause of the other. The more likely explanation for the link, they
claim, is that people who are in the early stages of mental illness
may turn to drugs including cannabis as a form of self-medication.
Cannabis is widely used by patients on mental health wards - to the
despair of psychiatrists who say it worsens their condition.
Trevor Turner, consultant psychiatrist at St Bartholomew's Hospital,
London, and vice president of the Royal College of Psychiatrists, said
there were three reasons why the case against cannabis remains to be
proved: "First, there has been no increase in schizophrenia in this
country despite a massive increase in cannabis smoking. Second, there
is no evidence that cannabis-growing populations such as Jamaica have
a higher incidence of psychosis. Third, you can show an association
[between the drug and the illness] but you can't show a cause."
Patients with schizophrenia often have long-standing prior problems of
depression, withdrawal, school refusal and behavioural difficulties
before they are diagnosed.
"People feeling not quite right are likely to go for something to calm
them down. In teen culture that is cannabis," says Professor Turner,
who has spent decades as a front-line psychiatrist in Hackney, east
London. He says he has never seen a case of cannabis-induced
psychosis. Cannabis smoking might trigger the emergence of
schizophrenia sooner than it would otherwise have emerged - but it did
not cause it. "It could well be that cannabis makes overt a covert
disorder," he says.
But he concedes that the risks of skunk are greater, due to its higher
concentration of THC. There are at least 60 active constituents of
cannabis and the higher the content of THC the more "spacy" the
effects of the drug. The higher the content of a second constituent,
cannabidinol, the more tranquillising its effects. "Any drug that has
psychoactive effects can have toxic effects. It is like drinking
whisky instead of beer," he says.
Although Professors Murray and Turner disagree on the exact role of
cannabis in psychosis, they agree that criminalising cannabis smoking
is unlikely to reduce the harm. Professor Turner says the safest
option would be to legalise the drug so that its quality and strength
could be controlled and users screened to minimise harm. Legalisation
would have to apply across Europe to prevent drug tourism. "By not
legalising it you bring the law into disrepute among the young and you
criminalise an activity that is harmless for the great majority of
people. It is poisoning society ."
Professor Murray believes education is the key. The Advisory Council
on the Misuse of Drugs has called for an education campaign about
cannabis, the only recommendation from its report that the Home
Secretary revealed last week and pledged to implement. "People should
know the risks of cannabis," says Professor Murray. "Consumption has
decreased in the last year because of all the fuss about it. We need a
campaign like the anti-smoking campaigns in the US. This is one of the
rare occasions when we should follow the Americans."
WEED OUT THE FACTS
3.6m: The estimated number of cannabis users in England and Wales -
more than 10 per cent of the population
13,304: People convicted of cannabis possession in
2004.
11%: Of schoolchildren aged between 11 and 15 took cannabis in 2004,
says the Home Office.
50,000: People took part in a Cardiff University study which found
those who used cannabis more than 50 times before turning 18 were
three times more likely to develop schizophrenia
'I WOULD WITHDRAW FOR DAYS, LOST AND ANXIOUS'
After a 20-year habit, Lulu le Vay says cannabis is the worst drug of
all
I smoked my first joint aged 13. The ritual in my family was to be
"initiated" by an older brother by the fallen oak tree at the end of
our rambling East Sussex garden. But in my case, one particular
brother, a decade my senior, decided to pop my pot cherry in a club in
north London. He produced a bag of weed that nearly knocked me out
just by smelling it. It was a smell that to me, even at 13, was so
familiar - a thick, juicy odour that had tumbled out from under
various bedroom doors and windows along with wafts of George Benson
and Stevie Wonder. I can't remember much of that night (no big
surprise) but I know that to me, my older brothers were the coolest
human beings on the planet. I finally felt accepted. Over the next few
years I dabbled, but it was the dawn of acid house in the late 1980s
that transformed me into a spliff-chugging monster. I tried just about
anything, but smoking weed was a regular habit.
I smoked through my college years and the start of my career as a
writer and music promoter. Smoking a spliff was as natural as putting
the kettle on first thing, an act which was often followed by sparking
up a cheeky one - before breakfast. But along with my blossoming
career came a deterioration in my mental and physical health. At the
time I would have never considered puffing a contributory factor to my
increasing spells of depression, anxiety, and weight gain. Back then
an entire weekend could be easily - and was often - consumed by
watching Sopranos box sets in bed, washed down with a few kebabs and a
drip of red wine and diet coke. Once, I got so high, I actually phoned
the BBC Complaints Department to inform them that the audio on the
television was completely out of lip synch. To me that was normal behaviour.
In the beginning, getting high acted as a blanket between me and the
real world. Reality was smudged, that feeling of being knocked
slightly out of the zone distracted me from having to deal with real
life issues around me, and those of the past - I hadn't yet dealt with
unresolved issues from a tempestuous upbringing. I would withdraw for
days, lost and anxious - staring at the ceiling trying to work out
what the fuck I was going to do with my life. It wasn't all bad, there
were moments of genius - being stoned inspired some of the most
creative feature ideas of my journalistic career to date. But over
time, the depression and anxiety increased until I hit crisis point. I
was a bleary-eyed, bloated, existential mess.
Smoking pot has become increasingly acceptable. Skinning up a joint to
accompany an afternoon cuppa and a Hob Nob has become no knee-quaking
big deal. Right now, thousands of young people - and some adults - are
locked away in their bedrooms with a bag of skunk in one hand, and a
remote control in the other - hypnotised by crap TV and hooked to the
escapist antics of Playstation games. For some parents with a concern
for their child's future, a dabbling in cocaine is a far more
digestible alternative. "I'd rather my son take a more proactive, less
habitual drug like cocaine, than lock himself away and play video
games" says Roxanne Richardson, 35, who has a young son, and is
expecting another. "It's so lazy. At least with pills and coke you're
out and about doing something."
My older brothers not only enjoyed smoking dope, but hoodwinked our
dear mother by cultivating and harvesting loads of it in the back
garden. And they're still at it. The eldest, who is now almost 50, is
still nurturing and smoking his stash with as much joie de vivre as he
did when he was in his teens. His reclusive lifestyle and
self-alienation from the rest of the family - not to mention lack of
real ambition and aptitude to full-time work - is an obvious indicator
of what the drug has done to his mental health. He is lost in his own
world and has become a stranger.
The other brothers are also still pretty keen. One dips into his
teenage son's stash when he's out of the house, and another once
travelled all the way to Brixton tube station from the suburbs in pure
desperation - all he ended up with was a bag of fresh lawn grass.
Other people in my life haven't been so lucky. One friend suffered
from such severe skunk-induced psychosis he threw his lodger up
against his bedroom wall and put a carving knife to his neck. Yet in
contrast, one close mate is able to smoke four pure skunk spliffs at
breakfast before heading off on his weekly 10-mile run. Remarkable.
Hitting 30 and my father dying resulted in an epiphanal moment about
what life was and where mine was going, and I made the decision to
make the best of it, before it was too late. But I didn't sack off the
spliffs intentionally, it just naturally happened. I swapped the late
nights lost in a haze of anxiety for a new pair of trainers and an
early morning run around the block. The permanent brain fog began to
disappear and a year later I started training for the London Marathon.
In time I realised that natural endorphins versus smoking marijuana
was no contest.
- ---
MAP posted-by: Richard Lake