New study makes link between use of potent cannabis and psychosis
thejournal.ie
thejournal.ie
My interpretation of their findings is that it doesn't provide safe assertions that Cannabis is the cause or the effect.
Or in other words, does Cannabis usage create psychosis or do people with psychosis choose to use Cannabis?
Similarly, there are unknowns with mental illness and tobacco smoking. Some think that those with mental illness are more likely to smoke as self-medication.
In order to get at that, you'd need to identify people with and without psychosis, and then follow them for many years. See who was more likely to use cannabis. And see whether using cannabis worsened psychosis. Not an easy thing.
The sort of study you describe can distinguish to some extent between "A causes B" and "B causes A" but can't tell them apart from "C causes A and B"
CBD, present in cannabis, is known to be antipsychotic, so the self-medication hypothesis is pretty strong. It's the same case as nicotine, schizophrenics have way higher rates of smoking, only because nicotine has a mild antipsychotic effect, not because smoking turns people crazy.
In reality, the effect is probably not just one, but some mixture of all three. It is extremely likely that people are self-medicating against psychosis with cannabis, that cannabis can increase the risk of psychosis in some people, and that the risk of psychosis is usually co-morbid with other mental health issues for which people also self medicating.
A study like this does nothing to help us understand the link, but yet the Authors seem willing to make strong claims about that link:
> The researchers suggested that if high potency cannabis was no longer available, the incidence of psychosis in Amsterdam would be expected to halve from 37.9 to 18.8 per 100,000 people per year, while in London, it would fall from 45.7 to 31.9 per 100,000 people per year.
That is irresponsible and bad science. It should be called out as such.
And cannabis is a pretty good tool to help alleviate the symptoms of (though not cure) trauma.
I arrived in London with nothing from post Soviet block country.
I was burned out within 6 months.
Then I started partying and one friend introduced me to Cannabis, I started doing it every weekend and made it a point to stay away from it during the week, so it doesn't affect my work in anyway
I managed do lot better, make better connection, climb the corporate ladder faster and make a lot of money
Now, I've my own startup
Not all my friends have been this lucky with their Cannabis use
What I believe is that Cannabis has potential to unlock some capabilities of your mind. Wether it unlocks positives or negatives depends entirely on the person and can't be generalized.
I think publishing such things should be illegal because it causes harm to public.
The original study: http://www.thelancet.com/pb/assets/raw/Lancet/pdfs/14TLP0454...
[0] https://en.m.wikipedia.org/wiki/Substance-induced_psychosis
Did it happen during a night of heavy drinking? Because if not (and even then) I'm really not sure how you can pin it specifically on the alcohol.
The medical professionals explained that heavy use of alcohol screws with your neurotransmitters. Especially dopamine might play a big role in causing psychosis.
https://en.m.wikipedia.org/wiki/Kindling_(sedative–hypnotic_...
>the (heavy) drinking I participated in
You can clearly see how damaging the anti drug propaganda is when people don't even consider alcohol the hard drug that it is.
The two cases at hand are different.
Not usually, no, but at least for me it can induce a similar effect. Though most of the time that is only after I have used something else in the week before.
And then:
> (heavy) drinking I participated in
As far as drugs go, alcohol is one of the worse ones. Arguably a lot worse than cannabis.
What do you do instead now? I don't love my current amount of consumption but It's one of the few ways I can quiet my head at the end of a long day.
Also, possibly consider talking to a therapist about anxiety disorders. The self medication and your description of going to bed really resonated with me. Doing drugs just turned all that "off". I'm not a mental health professional, so take what I'm saying with a grain of salt. But anxiety was definitely a reason why I personally was self medicating so much. Either way, good luck on your journey.
Got off caffeine fully a year ago and that has helped some.
I've got a few diagnosed anxiety disorders. Those certainly contribute. I'm hesitant to try any actual medication though as I've seen it change friends significantly in the past.
I also focus on finding the source of my stress symptoms and resolving them. That's of course easier said than done. I decided to not pursue an advanced degree and currently work not a high amount of hours.
I notice I am becoming less anxious without alcohol as well after being sober for a year.
The relationship between common cannabinoids and psychosis is already quite well understood.
At large enough doses, THC is psychotic and CBD is antipsychotic (likely CBG too), so much so that CBD is used to treat positive schizotypal symptoms.
E.g. https://www.researchgate.net/publication/51146763_Cannabis_w... and multiple studies
I hate seeing science abused for political reasons, and this study is ripe for that.
Why doesn't the study talk about the reason those high THC strains are so popular in the first place? That to me is the real tragedy. Ultra high THC strains are the "moonshine with too much head" of cannabis prohibition.
My guess is, that for some people those drugs act like a tipping point, and bring underlying problems into full blossom. In my case, it was developing an anxiety disorder. Thus, as you don't know where or what your tipping point is, I'm strongly against taking those drugs. Even a one-time experiment with mushrooms can wreck your life.
>In the case that led Ab Klink to propose the ban in October 2007, a 17-year-old French girl committed suicide by jumping from a bridge into busy traffic. It was later revealed that the girl, not old enough to legally enter a smart shop herself, had asked a friend to buy her some mushrooms.
http://www.dutchamsterdam.nl/662-mushrooms-ban-amsterdam-net...
I also believe that this was helped by the advanced education motto (the longer the studies the better).
Again, it's anecdotal, and there could be a myriad of contributing factors - I know he had also begun drinking during that time period. But, until this happened, the idea of anyone going mad from cannabis was laughable to me. Now, I think about him sometimes when I'm visiting legal states and indulge myself in some quality edibles.
Some can deal with it easily and are unaffected, many are eventually a bit debilitated by it, and for some it triggers major problems. No need to sweep this under the rug.
I believe people with psychosis are drawn to weed as they are to other substances.
This study adds nothing new. It just demonstrates that people predisposed to psychosis are more likely to smoke weed. Anyone here could've told you that without a study being done. There is no cause and effect demonstrated in the paper.
Notice they did not say smoking weed causes the psychosis even though they found a 'strong' link.
I've seen it many a time and never seen someone have a psychotic episode.
While they may have had some paranoia not a single one of them suffered from psychosis. On the contrary most seem quite happy, laid back and well adjusted. Most have the same issues we all have, weed or no weed.
For example, I've been hit much more heavily by stress than by substances and consider the use of medical grade marijuana one of the reasons I'm still able to work in a competitive environment.
When I read this story, I think of how a high paying gig in the bay area sounds super stressful and would absolutely wreck me.
Someone else might pick up on the drinking, or perhaps his age, location, etc.
This is true, but it isn't yet self aware.
If truth was their goal why keep doing the same broken study with pitiful sample sizes. 2000 samples is too small to a/b test a site, but good enough for a medical study?
If high strength cannabis made you five times more likely to have psychosis, then it follows that countries like America, Spain and Netherlands should have psychosis rates five times higher than other countries, but it's about 1% world wide[1].
Obviously you would need to take into account population and other proven causes of psychosis such as alcohol[2]. Similar studies have been done[3] with much larger sample sizes than these clowns.
[1] https://www.mentalhelp.net/articles/schizophrenia-symptoms-p...
[2] https://gateway.euro.who.int/en/indicators/hfa_390-2401-numb...
You're not counting actual prevalence of psychosis. You're counting prevalence of diagnosed psychosis.
Also, cannabis doesn't increase risk for all types of psychosis. There are different types. Cannabis only increases risk for one or two types of psychosis.
True but the countries I listed are first world countries where accurate diagnosis is common.
The third reference I give is to a study on the prevalence of psychosis across 52 countries. It takes in to account that in developing countries diagnoses is uncommon and not accurate, any decent study would do this. The world health organisation study I linked used a sample size of 200,000 compared to the 2,000 sample size the cannabis study used.
> Cannabis only increases risk for one or two types of psychosis.
Then the study should only target those types of psychosis.
Yes other studies with larger sample sizes have proven this correlation before, but correlation in itself is meaningless. My argument was that if they really wanted the truth they could have done a study to show causation, but instead they showed correlation using quack sample sizes and then a bit of choice wording to scaremonger.
The fact that people with psychosis are more likely to smoke cannabis, doesn't mean cannabis will increase your risk of psychosis. It just means people with psychosis are more likely to smoke cannabis.
This is why the "health benefits" arguments for legalization of drugs are generally a bad route to take. It would be far more fruitful to argue for legalization based on individual responsibility, personal choice, and related themes.
It was similar with gay right. Marriage rights, parental rights and such were driven first by "born this way," argueing that sexuality is unchangeable. Then, it came via normalisation as people came out and your friend end turned out to be gay. Eventually people concluded that homosexuality is fine, not a vice. "I think it's wrong, but freedom" only plays a role after the gay rights side wins. The dissenters can console themselves with it and put the issue to bed.
That doesn't mean no one actually idealises freedom, but it rarely adds up to political change.
No one's opinions are their own. If you grew up in a different time and place, your opinions would be different.
Isn't it? It seems to me that Brexit in particular happened because the people who voted for it embraced a message of "taking back control", and similar arguments about political freedom from the EU that was portrayed as oppressive and undemocratic, etc.
(Though it's hard to know- I think a much more accurate model of the Brexit vote was that the country flipped a coin).
You could also argue that remain is the "liberty side," freedom of movement, capital & goods. Being rhetorical and abstract, it just begets abstract questions like "what is freedom?" or "what's a nation?" Cannabis & gay rights are personal, so less abstract. There's no sane way to argue that freedom to be smoke pot (also crack, cyanide) is not a freedom.
In any case, no brexiter argues that europe works great, but we need out because freedom. That'd be the test, IMO. I think cannabis, homosexuality or whatever is bad, but it should be legal because freedom.
My point/argument is that this doesn't work politically. People may justify the (new or old) status quo with because freedom, but it doesn't drive change. Cannabis & homosexuality laws change because people stop considering it a terrible vice, generally.
There's the second-order phenomenon sometimes called the "iron law of prohibition" at work as well -- legal regimes of prohibition tend to incentivize optimizing potency per unit volume above everything else (including safety).
Since THC is the chemical in marijuana that, to first approximation, gets you high; prohibition (through that "iron law") has engineered a prevalence of high-THC marijuana strains. These strains tend have lower amounts of other, less/non-psychoactive cannabinoids such as CBD. Notably, there is research showing that CBD has anti-psychotic properties, which likely counteract the deleterious effects of THC that are mentioned in the article.
For the record, I'm not a marijuana user (the smell alone disgusts me), I don't subscribe to the "weed is a harmless drug"/"weed is good for you" meme-theories, and I don't wish to promote irresponsible drug use -- I'm just pointing out that the set of incentives that prohibition creates are very strongly responsible for making drug use needlessly dangerous (for users and society at large alike). It's not about the health benefits of the drugs, it's about the health benefits (or the lack thereof) of prohibiting the drugs.
And yes, prohibition is definitely still the law of the land, regardless of state/local-level "legalization" initiatives that withhold punishment for small "personal use" amounts or the like. People _still get_ searched/arrested/convicted/jailed for marijuana-related crimes, and as long as that is the case, the "iron law of prohibition" will keep doing its hideous work.
I don't consume any drugs other than alcohol and don't have any interest in doing so, but if I did, it would be trivial to obtain them in my (smallish) city. Everyone knows where to go.
So illegalization doesn't meet its purpose (making drugs difficult to get) and yet it does have negative effects (the drugs sold have no quality control at all -which often causes deaths-, pay no taxes, are sold without any legal warranty, etc.) I'd rather they were sold in pharmacies, being dispensed together with reliable information (like tobacco), forbidden to minors (which could actually work reasonably well, because no one would go to the trouble of setting a black market exclusively to sell to minors) and paying taxes that could be used to fix the problems they cause.
To me, this is enough grounds for legalization, regardless of the exact health effects of drugs.
but too many people have a job through this regulation as is (police can easily improve quotas, prosecutors/legal advice etc., in my country there are medical staff in state institutions doing nothing else but testing people if they used cannabis/again ...), so the resistance is great to change anything.
Most people do not know how to get hard drugs.
If hard drugs were legal, they'd be in soda, candy, food, cigarettes - it would be sold literally on every street corner and grocery store.
So the contrast between 'arms reach' and 'most people do not know how to get opium' is quite high.
For weed, it's a different story, but for pretty much all other drugs, prohibition has a pretty dramatic effect on supply and demand.
Opioids have legit medical use obviously, and they are legal for those, and even then we have to be very careful.
This is a pragmatic perspective, but if you care I will share a principled one.
I think the bigger problem is with the principle of individual liberty. What right has a king or bureaucrat to order armed thugs to enter my home and tell me what plants I can or can't eat, smoke, or whatever?
I also think if you look at history, one of the most glaring lessons is that authoritarianism "has been tried for a long time and it just doesn't work."
This isn't really true from a historical viewpoint. By far the most common societal regime in history is empire, nearly all totalitarian empires, from the Babylonian totalitarian kings/emperors on forwards to the Greeks, Romans, Ottomans, Aztecs, Incas, etc. If you want more on this, refer to the writings of Yuval Harari in his book Sapiens, as well as podcast with Sam Harris, where he lays out how empire is indeed the most frequent/stable regime we've devised.
While I make no claim for the superiority of any particular governmental regime, totalitarianism has worked for itself for thousands of years, proving itself out far more than democracy has yet to do. If we look to the height of democracy in the USA, it had not even existed for 100 years before a savagely brutal civil war to end slavery, the scars of which are still open sores upon our American psyche. In a totalitarian regime, it may have been possible to dispatch slavery in a far less bloody and scarring manner. Therefore, I do not agree that history has shown totalitarianism to not work, perhaps you care to elaborate.
I ask you then, which other democracy or form of govt is truly the shining example that you would point to?
Under every other regime (except perhaps Haiti) slavery was "dispatched" without a bloody civil war.
And the US civil war wasn't fought over slavery as they want you to believe, freeing the slaves was merely a byproduct of the war between the industrialized north and agrarian south (mostly) over tariffs.
As who want you to believe? Because if you read the declarations of succession and the words of senators from confederate states at the time, they clearly cite slavery and "property" (read: slaves) rights.
But Lincoln, and before him, Jackson, specifically said the northern aggression towards the south was not because of slavery. Jackson even made a very explicit statement that exactly this was happening, and that slavery was only a "pretext" and not the real reason.
That is reality though it is very unfortunate that humans can often be like this.
The winners (who always write history).
They say it was "the war to free the slaves" but before the southern states seceded the federal government had no intention of starting a civil war and in fact had no legal basis to conduct military operations on US soil even if they wanted to forcefully end slavery.
> Because if you read the declarations of succession...
It's painfully obvious the southern states wanted the institution of slavery to continue but they knew that having been outlawed in the territories that its days were numbered, they would easily be outvoted as new states were formed and slavery would be (peacefully) ended.
And, no, I'm not some kind of pro-slavery crazy person it's just one of my many pet peeves that it's taken as dogma that was the justification for the US government to invade the southern states when slavery was ended everywhere else on earth without a massive civil war.
I was speaking with an assumption of prosperity and liberty as inherent virtues in humanity. You seem to be suggesting that other forma of governance, totalitarianism, is better because it has existed for longer periods of time.
This is a common assumption about the purpose of drug prohibition, but historically things are more complicated. Racism played a much bigger role in drug prohibition and the war on drugs than genuine concerns about public health. The basic concept is that some non-white group is corrupting white youth/white women with drugs; therefore, to protect white people, the police are empowered to imprison/kill those scary drug peddlers. On some level it was about making drugs harder to get, but the assumption was that white people have no interest in drugs until some non-white person pushes it on them. The assumption was always that the impact of drug prohibition would be mostly concentrated on non-white populations.
all US-imposed policies.
For examples China under Mao, 'cured' the opium problem using extreme repressions [1]. Have you got any evidence that Singapore or Duterte's repression was requested by the US?
[1] https://en.wikipedia.org/wiki/History_of_opium_in_China#Unde...
Drug laws vary wildly in the regions you mentioned. Just about the only thing that they have in common is that drugs are illegal.
And it's not just a question of laws, either. Laws are one thing, and policing is another. There are countries which don't really enforce the law for personal use amounts.
The US has draconian laws, and punitive policing. There's your problem. It turns out that the worse you treat your criminals, the worse your crime problem gets.
Here is the quote from John Ehrlichman, counsel and Assistant to the President for Domestic Affairs under President Richard Nixon
https://harpers.org/archive/2016/04/legalize-it-all/
> At the time, I was writing a book about the politics of drug prohibition. I started to ask Ehrlichman a series of earnest, wonky questions that he impatiently waved away. “You want to know what this was really all about?” he asked with the bluntness of a man who, after public disgrace and a stretch in federal prison, had little left to protect. “The Nixon campaign in 1968, and the Nixon White House after that, had two enemies: the antiwar left and black people. You understand what I’m saying? We knew we couldn’t make it illegal to be either against the war or black, but by getting the public to associate the hippies with marijuana and blacks with heroin, and then criminalizing both heavily, we could disrupt those communities. We could arrest their leaders, raid their homes, break up their meetings, and vilify them night after night on the evening news. Did we know we were lying about the drugs? Of course we did.”
Portugal legalized everything a while back and it was a major success. It is worth reading up on their experience. A great quote I heard a couple years back: "It is an atrocity what we do to people when we don't like what they do to themselves." - Anon
Most people definitely do not know how to get something beyond weed.
Most people live really normal lives, the might 'know someone or know someone who knows someone' who smokes weed, but not coke, lsd, mushrooms or crack.
Illegalization 100% makes things 'hard to get' - it's a game of supply and demand: if opiates were legal, they would be infused into coca cola, cigarettes, candy and orange juice and be available in every corner store tommorow.
I'm a fairly 'experienced' individual and as of today I'd have zero idea how to get a hold of opiates. If they were legal, they'd be within arms reach.
Legalization of hard drugs, particularly opiates would cause a public health crisis like we've never seen. Only a small percent of people can handle that stuff, the rest go downhill very quickly and our health services would be overflowing, people would not be showing up for work.
And fentanyl basically closes the argument. That drug is like Russian Roulette and has caused a marked upswing in overdoses around the world - and it's something the junkies are asking for (because they like the potency). Legalize that and it would be like the plague.
I would legalize weed but not allow for commercialization, and then make hard drugs a health issue not a criminal issue.
And of course, open things up for research. It's really silly universities can't experiment safely with weed.
For a tooth removal I got 2 pills total. Literally a prescription for 2!
For most things you get nada. And it's tracked.
So this problem can be fixed basically by doctors treating them like the very addictive substances they are.
But you're right - this is where a lot of people are addicted!
Maybe only in the US. Drugs are illegal in places like the UAE or Singapore, and the prohibition seems quite effective there. There seems to be more things involved here.
my position is that people should only be held accountable for harming others or risking doing so. for example by driving while intoxicated with whatever drug. but every adult should have the right to do with themselves whatever he or she pleases. from that perspective the question of whether weed is harmful becomes secondary and reduces to harm reduction and medical assistance.
Why present this as a "western" thing? Where exactly is there more nuance? More willingness to admit exceptions to a general rule, law, or social norm? It rather seems that people have a serious issue with nuance. A tendency to see (or portray) everything in terms of pure black or white is one of the most universal of human traits.
It's good actually, because it's the young mostly, and we're out of jobs in my country... more jobs for me!
On a more serious note, cynicism is one way to fail to cope properly with reality, not something that gets you far and high in life. But hey, more jobs for us positive folks compared to bitter sad cynics!
Not to mention that it is almost always mixed in with a little tobacco which is a smell I can do without.
(Note: I don't have a horse in this race- I don't use marijuana because I don't like the effects, but I'll be the last person to act like it's some demon plant out to hurt capitalism's productivity.)
Where do you live? Because growing up in the Netherlands I can say all the negative side-effects were very clearly explained to us in high school, without stigmatizing it.
EDIT: it is a sincere question - obviously the Netherlands is in a kind of special position here. And my experience is from the late 90s, so who knows how things have changed since then too.
The lightest strain in a coffee-shop was pretty strong.
But with that said, yes, we do. I even know someone who had it, and they quit using weed after that. It's kind of treated like the complicated thing that it is: genetics and existing mental and physical health are all risk factors, and as a teenager there is the still-developing brain to consider (just like with alcohol). You basically have to decide for yourself if all of that seems worth it.
This goes back to the root comment in this thread that people see this issue as very black and white.
I wonder where you are from. If not from USA, you've been misinformed. If from USA, stop assuming you're the frontrunner of anything please.
I've never seen this attitude in the wild. In fact, most heavy cannabis users I know express a desire to use less.
I don't smoke a lot, though. Just a hit every few hours, enough to give me a buzz. If I get too stoned to do anything, that defeats the purpose for me. Weed is a tool, weed is for work. If I want to just have fun, I'll drink.
It does, however, contribute to psychotic episodes sometimes. But it's never the only contributing factor, it's usually in combination with too much isolation and/or not eating/sleeping properly. If I feel like my thoughts are starting to get more and more unorganized, I generally take that as a sign I need to get out of my apartment and go see my friends. My psychotic episodes are pretty benign, though, all that really happens is my thoughts get too rapid fire and disorganized for me to do anything but sit there in a stupor because I can't get it together enough to execute tasks. They're over when I wake up the next morning. (I will also say, they were pretty frightening before I realized what they were just because it's frightening to feel like you've lost control of your own brain like that.)
Climate change has scientific consensus from decades of study across the world.
There also wouldn't be a statistic if people do not report to a doctor about 'hearing voices' for example.
Also the Netherlands has shown the increase in schizophrenia
https://www.who.int/substance_abuse/publications/cannabis_re...
For a deeper discussion see
https://theconversation.com/if-cannabis-is-getting-stronger-...
Also the low rates of smoking in NL undermines you because it directly demonstrates that legalisation doesnt lead to high uptake.
No crisis in California, Washington or Colorado. We are all doing just fine.
But what's way more important: The study shows that the only correlation is with daily use of high THC consumption. No correlation with low THC products (see figure 2 in the study). Results from e.g. the alcohol prohibition and recent cannabis legalization in the US suggest the share of high THC product would actually decrease once cannabis would be legal in Germany. So IF high-THC cannabis is the main cause of schizophrenia, it would actually be probable that legalization would decrease schizophrenia incidence in Germany.
[1] https://en.wikipedia.org/wiki/Epidemiology_of_schizophrenia
[2] http://www.gbe-bund.de/gbe10/abrechnung.prc_abr_test_logon?p...
But yes, if the number of people is low it won't be a problem..
My point was that there won't be a societal crisis, even if the assumption of THC being the main cause of schizophrenia were true.
With or without legalization, better drug abuse prevention through education, widely accessible addiction treatment and de-stigmatisation of mental health issues are things we should strive for - because those measures actually affect peoples lives for the better.