Changes in schizophrenia diagnoses associated with cannabis use disorder
jamanetwork.com
jamanetwork.com
So increased cannabis use after legalization did not result in increased rates of schizophrenia, though it might have made some cases worse.
This is looking at what fraction of schizophrenia cases had significant cannabis use.
If more people use cannabis, there will be more of these cases, even if there's no causal link.
[0] https://slatestarcodex.com/2016/01/11/schizophrenia-no-smoki...
It’s not a helpful coping mechanism, but there’s a reason double blind studies are considered so important. Untangling complex mechanisms especially when they have feedback in both directions is inherently difficult.
You're really going to call for a double blind study here checking if excessive cannabis is bad for people conditional on their lives falling apart? How do you propose to get that past an ethics board?
You can still do a randomized trial and that's the one that wouldn't pass the IRB.
(Or, use high school freshman for the study and really convincing upperclassmen as actors to convince them it is a real bag.)
There aren't many studies on what are the real impacts of CBD.
Are we to presume that the high itself isn't potentially a causative factor?
Sometimes we’re stuck with “I don’t know” and recognizing that is IMO important.
So, I know.
Clearly, smoking a shit ton is bad for people with marginal mental health or marginal emotional health.
Clearly, weed is good
I mean, it kind of does. If you want to design intervention, it helps to know which causes the other to a greater degree.
But, should we (the gov) spend 10 million dollars on social services to prevent people's lives from going to hell, should we spend 10 million dollars on anti-alcohol addiction services or should we spend it half and half, are questions we as a society need answers to.
Sadly, I’m seeing a new trend of people taking too many psychedelics and going off the rails.
The way they’re being pushed as cure-alls for depression is getting scary.
One of my friends developed severe problems after following the microdosing trend. It developed slowly over a long period of time, but he thought he was okay because he was following one of those protocols from one of the biggest microdosing experts.
Like alcohol or opiates will make your good life bad if you fuck too hard with them.
Pot, in my experience, won't really ruin your life unless you're already on that path.
My thing is that it's mostly harmless, but the problem with it is that young people can become complacent with it. It won't necessarily ruin your life, but you'll be content to sit and veg your life away. So not bad, but not good.
So it's not the legalization at fault, it's people who are overdosing any stuff that's available to them. Casual smoking a weed once a week won't harm you that much.
Of course it matters. Different drugs and doses have completely different effects on the brain.
Trying to to equate different drugs and claim they’re all similarly risky goes completely against everything we know.
I suspect that it triggers part of your brain that rewards you for making connections or something like that.
I’ve seen this pattern emerge time and again over decades in people with completely different backgrounds. It expresses itself in different ways but smoking absolutely rewires your brain, makes you more receptive to “secret insider information”.
Maybe one that examines the rise of the alt-right and it's relation to legalization. The timing seems correlated.
From one of the papers: “the Aberrant Salience (AS) construct […] refers to an excess of attribution of meaning to stimuli that are otherwise regarded as neutral, thereby transform them into adverse, dangerous, or mysterious entities. This leads the patient to engage in aberrant and consequently incorrect interpretative efforts concerning the normal perception of reality and its relationship with our analytical abilities. AS appears to play a significant role in the onset and perpetuation of psychotic disorders. The internal conflict arising from aberrant attributions of significance leads to delusional thoughts, ultimately culminating in the establishment of a self-sustaining psychosis.” — https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1343...
People with the Val158Met COMT polymorphism are more susceptible to develop schizophrenia sooner if they are exposed to cannabis. And that genetic mutation make them more successible to have cannabis use disorder. Knowing that I don't understand the question that this study is attempting to answer.
I support legalization but from my personal experience, I’ve suffered psychosis twice after smoking weed, and that’s enough for me.
Just accept the risks and live your life. Nothing is without risk. Drink your beer and smoke your joint, why bother living if you aren’t going to enjoy yourself
Cannabis is one of the least toxic substances available.
They have absolutely nothing in common.
Hallucinations (e.g., hearing voices), delusions (e.g., believing one has special powers), disorganized speech and behavior, reduced emotional expression, lack of motivation, withdrawal from social interactions, problems with attention, memory, and decision-making
I highly recommend r/leaves to read other people's stories trying or wanting to quit weed.
Edit: For those wondering, after being sober for 1.5 years, I'm pretty much back to my old self. My memory took a while to come back but it's drastically better than it was when I first quit. I feel much more motivated in life. My relationships with family and friends are better and so is my physical health. I was smoking about 0.5g - 2g/day for 1.5 years.
It's unlikely you were experiencing schizophrenia unless you were actually hearing voices, thinking that you were a "Targeted Invididual", things like that.
I never got to that point though I believe I would have eventually had I continued. The weed I had access to were of questionably quality and wasn't professionally grown like the dispensary ones. I also never tried THC oil or other super strong weed products - which I read can drastically increase schizophrenia.
All it does for me is make me feel relaxed and euphoric. If I use a lot I feel more relaxed and euphoric.
I am normally a person who is very detached from what people call a sense of self.
I believe this immunizes me from the anxiety many feel when losing self control under substances.
I do find annoying how many "pot heads" seem to think that weed is a panacea rather than a pacifier with some risks for some people.
Although the effects are different I would very much consider it akin to alcohol or an opiate.
If you have problems it will likely make them harder to deal with.
If you are just looking to relax or escape and are not prone to anxiety then it is effective but in my experience not much different from alcohol or opiates except less physical harms or potential for physical addiction.
I agree with the posters that for many if not most people, including myself, weed can give the illusion of some special insights or special connections to others but it is important to recognize just that, that this is an illusion, that our subjective feelings at any given time do not necessarily correspond to objective reality.
It is shocking to me how many people in all kinds of areas of life think that because they feel something is true it must be true or important or relevant.
Weed evidently makes many weed users feel it is a wonder drug, thus propagating and sustaining the mind virus.
I think it should be legal.
I also think if you want to be successful in life habitual use is ill-advised.
I can certainly see how for anxious, over thinking, controlling types it could lead to psychosis, like any number of other things, even including ideas. However I believe this effect is more due to a pre-existing neurotic psychology of the specific user rather than an intrinsic property of the drug.
But regardless it's not harmless.
Additionally the long term effects are not well known.
The problem imo with this kinds of studies is that people can’t take the nuance and rather see it as “weed = bad” or some other binary outcome.
Imo all drugs have a potential to be dangerous — all adults should have free agency what they do with their bodies.
Sure cannabis, alcohol or mushrooms are dangerous, but I would argue a society that makes their use completely illegal without nuance is not a free society
I always wondered if other people had the same experience of THC as I did, but responded _psychologically_ differently to me, or if it was a _physiologically_ different experience. It was very confusing during high school.
Bizarrely I've found this react to weed much more common in the UK than California. There would be no reason for that to be true, though.
5mg is not a small amount for someone without tolerance.
An old chemistry major college friend went into the THC industry. His company was very careful about production, measurement, and labeling.
He said it was very common for people to tell him that they needed some high number of milligrams to feel anything, then they’d ask him for samples from his company. They’d take what they thought was their normal dose and get completely knocked out.
A lot of products are (or were in the past) apparently very optimistic about their THC content. 5mg is actually a significant dose for most people without tolerance.
I wonder this too. Maybe, say, non-autistic people would interpret differently what I see as mild dissociation, and experience all of the... whatever the fuck THC is supposed to do to Normal People. Or so the theory goes.
It is pretty common for people to have panic attacks while using cannabis. Those can be the symptoms of a panic attack.
> There would be no reason for that to be true, though.
Concentration, cannabinoid composition, adulteration (analogues, enhancement, etc), contamination (heavy metals, pesticides, mold, environmental or biotic toxins) are a few things that come to mind.
I think it's just an expectations thing. I was doing max doses of acid for a long time before I ever used marijuana, and that ain't "some slight dissociation". On acid, you would watch the houses across the street stand up, join hands, and dance around in circles. Pot just didn't move the needle.
I've seen it a few times, and I have no idea why it's like that for some people.
Effect wise - I mostly notice it in sensation of time. Two hours feels like four. And it’s not smooth flow of time - almost skips occasionally.
I think the sticking point for me is that I refuse to knowingly cause myself permanent brain damage. That heavily limits my options.
When I tried the tincture, I took 50mg of THC orally. (250mg per 30oz, so 6oz.) Although I guess I could just be unable to take THC orally, which would suck, because smoking it is miserable. (I am really not a smoker...)
Psychotic acid flashbacks aren't real
However, on an individual level, I think people need to know about the psychosis risks. It undoubtedly can trigger schizophrenia and make it much worse once it exists.
I know more than a few people who have severe alcoholism problems in their families, and just chose to never drink alcohol. I think a similar choice may be wise for cannabis if there is a history of psychosis.
On a public health level there was a theory that people would substitute cannabis for alcohol. But unfortunately, this doesn't seem to be bearing out.
Regardless in a free society people should have agency over what they do with their bodies.
Education about these substances is the most important thing.
Indeed.
"obviously much worse than a few people who develop mental issues."
So maybe start by comparing the average heavy weed smoker, to the average non drug user, to see if the issue with cannabis is really "just some people developing mental issues"
(Disclaimer blabla: I always was pro legalisation and am happy, it finally is legal in germany now)
So while weed is not without harm i think alcohol has a magnitudes worse impact on society
But it has been some years and I believe (and hope) at least that changed a bit. Otherwise alcoholism is epidemic. But stoners, or well, people combing both and meth and whatever is a thing as well.
Either way, also weed on its own is not harmless either, easily abused and your comment gave me the impression it is no big deal. Just like it was introduced to me as a teenager from the cool kids. And this is dangerous.
Results: Alcohol was the most frequently used substance, with a 30-day prevalence of 70.5% (36.1 million people), followed by non-opioid analgesic drugs (47.4%; 24.2 million) and conventional tobacco products (22.7%; 11.6 million). E-cigarettes were used by 4.3% (2.2 million) and heat-not-burn products by 1.3% (665 000). Among illegal drugs (12-month prevalence), cannabis was the most frequently used (8.8%; 4.5 million), followed by cocaine/crack (1.6%; 818 000) and amphetamine (1.4%; 716 000). Rates of problematic use among the study participants were 17.6% for alcohol (9.0 million), 7.8% for tobacco (4.0 million), 5.7% for psychoactive medications (2.9 million), and 2.5% for cannabis (1.3 million).
From https://www.aerzteblatt.de/int/archive/article/226333/The-us...
So yes weed is dangerous but alcohol is more than 10 times as dangerous- this nuance is often lost in public debate
That is quite subjective and not solid data. At least I am not aware of a scientific consensus in that regard.
Alcohol is just more widespread because it was legal and part of the culture, so more abuse there. But this context here is about how that might change with the legal status.
Laut dem Alkoholatlas 2022 des Deutschen Krebsforschungszentrums ( DKFZ ) starben in Deutschland im Jahr 2020 rund 14.200 Menschen (davon 10.600 Männer und 3.600 Frauen) an Krankheiten, die ausschließlich auf Alkoholkonsum zurückzuführen sind.
That are 14200 deaths solely due to alcohol in Germany every year — the only figure I found for cannabis was about 1-200 - so it’s more than 100 times more dangerous if you only look at official death statistics — this is as solid as the data gets.
Sure things might change with legalisation— but looking at the Netherlands the opposite is most likely the case.
So yea I retract my earlier statement— alcohol is not 10 times more dangerous, it’s >100 times more deadly.
This doesn’t even account for all the accidents and other injuries related to alcohol.
"Tesla founder." You'd hope that the BBC would get right that he's not the founder but an early investor that ended up taking over the company and kicking out the original founders.
When I hear people say that, it just sounds like a blind hater/memeist/chronically online person and I discount their views entirely.
We literally still call Hitler Hitler. We can call Elon Elon no matter how bad you think he is.
So its the same as seeing your own mother naked
This is a perfectly valid reason to avoid heavy cannabis use before the age of 25.
I don't think pretty much any of that video is reliably supported but oh boy is it food for thought.
1) very solid evidence of correlation at a population level
2) a lot of clinical experience from doctors that patients with psychotic disorder diagnoses who use cannabis tend to do worse. and, similar stories from family members of people with psychotic symptoms who aren't in treatment.
so unfortunately I think there is something real here, it's not just people having transient bad reactions to weed and going to the ER and getting a diagnosis.