How to prevent cannabis-induced psychological distress . . in politici

[entheofarm]

Author Grotenhermen, Franjo

Title: How to prevent cannabis-induced psychological distress . . . in politicians

Journal: THE LANCET

Date: May 15, 2004

Issue: Vol 363

Pages: 1568-1569

 

 

 

Cannabis can cause anxiety, agitation, and anger among politicians. The consequences of this cannabis-induced psychological distress syndrome (CIPDS) include overreaction with respect to legislation and politics and a lack of distinction between use and misuse of cannabis. In times of a war against drugs, this distinction might even be regarded as unpatriotic,1 as irresoluteness in the face of the enemy. One trend associated with CIPDS involves taking away the driving licence of people who drive and are discovered to have inactive tetrahydrocannabinol metabolites in their urine.2 In a more severe state of paranoia even medicinal use can be perceived as a threat to society, since it might “destabilize the societal norm that drug use is dangerous”,3 ignoring the fact that many prescription and over-the-counter drugs are potentially harmful. Exaggerated laws on cannabis made by anxious individuals could be regarded as a modern version of the generational conflict.4 Rationality and factuality are needed to calm down politicians affected by CIPDS. That cannabis might cause infertility, cancer, cognitive decline, dependency, traffic accidents, and heart attacks, and that it can lead to the use of more dangerous drugs, are all arguments that have been used to justify the war on cannabis. Drugs can be harmful, whether they are legal or illegal, but claims about the dangers of cannabis are often overstated.5,6 One main justification for today’s war on cannabis is its possible detrimental effect on the mental health and social wellbeing of adolescents. In this week’s Lancet, John Macleod and colleagues show that the causal relation is less certain than often claimed, and point out several common misunderstandings about the difficulties encountered when studying drug use, such as the limits of confounder adjustment. The results of one often-cited Swedish study,7 for example, indicate a crude odds ratio of 6·7 for schizophrenia risk at age 26 years in individuals who used cannabis more than 50 times before age 18 years. This finding suggests cannabis is an important contributor to schizophrenia. After adjustment for several possible confounders, however, the risk decreased to 3·1, a strong indication of residual confounding— ie, the presence of factors that would further reduce the risk if included in the statistical model but that could not be included because of a lack of data. Another review8 details the findings of an investigation into the association between cannabis and psychosis on the basis of five longitudinal studies. The authors conceded that only one of these studies was able to record whether prodromal manifestations of schizophrenia preceded cannabis use. The results of the study9 indicated that “cannabis users at age 18 years had elevated scores on the schizophrenic symptom scale only if they had reported psychotic symptoms at 11 years”,8 and that people who used cannabis at age 15 years had a higher risk for adult schizophreniform disorder at age 26 years even if psychotic symptoms at age 11 years were controlled for.9 The researchers concluded that cannabis was a causal factor for psychosis in “vulnerable youths”.8 There is some reason to believe that cannabis contributes to psychosocial problems in adolescents and young adults, and no responsible adult would want young people to take drugs. There is no question that this issue is an important candidate for education and prevention, but there is a fierce debate on the place repressive measures should have in this context. There is little reason to believe that criminalisation has had a strong effect on the extent of cannabis use by young people.10 Moreover, prohibition itself seems to increase the harmfulness of drug use and cause social harm. By stopping all cannabis users from being treated as criminals, I believe this year’s change by the British Government of its cannabis law (a declassification from class B to C) is a sensible attempt to balance the possible harms caused by cannabis and its prohibition. The concern expressed by Peter Maguire of the British Medical Association and others,11 that “the public might think that reclassification equals safe”, is based on the wrong assumption that cannabis became illegal because its use is unsafe and dangerous. Many unsafe activities are legal, including skiing downhill, having sex, drinking beer, eating hamburgers, and taking aspirin. Cannabis did not become illegal because it was shown to be dangerous but, more likely, because Harry Anslinger, Commissioner of the US Bureau of Narcotics 1930–62, and his colleagues needed a new target and battlefield after the end of alcohol prohibition in 1933. Reputed dangers, presented in his statements before the US Senate in 1937,12 were used as a shocking means of manipulation—eg, “A man under the influence of marijuana actually decapitated his best friend; and then, coming out of the effects of the drug, was as horrified as anyone over what he had done.” The representative of the American Medical Association strongly opposed the Marijuana Tax Act of 1937: “To say . . . that the use of the drug should be prevented by a prohibitive tax, loses sight of the fact that future investigation may show that there are substantial medical uses for cannabis.”13 We live in a time in which the unrealistic and unproductive paradigm of complete abstinence from drugs is slowly dissipating. Proponents of a drug-freesociety find this fact hard to accept, and responsible politicians and doctors can find achieving an appropriate position in the debate difficult. However, we must learnto deal with drugs and their possible dangers without fear.

I have no conflict of interest to declare.

Franjo Grotenhermen

Nova-Institut GmbH, D-50354 Huerth, Germany

(e-mail: franjo.grotenhermen@nova-institut.de)

[Nooby]

ahhh, wall of text needs paragraphs!

 

Otherwise not a bad article. ;-)

[entheofarm]

yes sorry about that, my fault.

 

I can't seem to edit the post so for those wishing to read the article

 

http://www.thc-ministry.net/downloads/cannabis-comm.pdf