Addiction Today

CANNABIS: THE FACTS

Eddie Nestor invited Addiction Recovery Foundation CEO Deirdre Boyd onto his BBC Radio London show – at midnight! – Sunday [4 May] to debate the reclassification of cannabis with legalisation campaigner Steve Rolles. For listeners, these are the statistics and references used in the show – with acknowledgment to the help of ARF trustee Dr Andrea Grubb-Barthwell, formerly the [White House] deputy drug czar.

BACKGROUND:

Cannabis is the most commonly abuse illicit drug in the US and Europe. Its main active chemical is THC (delta-tetrahydrocannabinol). The membranes of certain nerve cells in the brain contain protein receptors which bind to THC. Once in place, THC kicks off a series of cellular reactions which ultimately lead to the high that users experience when they first smoke marijuana.

HARMS: LEGAL v ILLEGAL DRUGS

"Annual drug-related deaths are about 1,600 people a year -- compared to 22,000 from alcohol, 90,000-100,000 deaths from tobacco use – even benzodiazepine-related deaths each year exceed that of all illegal drugs except heroin. The harms by making drugs legal are multiples of illegal drugs, indicating that lessening their availability is a better option than legalisation."   The sources for this data are below.

“Drug -related deaths for the year are 1,608”
“Measuring the harm from illegal drugs: the drug harm index 2005”, Home Office update 2007

“Alcohol-related harm costs around £20billion a year”
Tony Blair, Prime Minister’s Foreword, Alcohol Harm Reduction Strategy for England

“The annual cost of alcohol misuse includes... up to 22,000 premature deaths per annum”
Alcohol Harm Reduction Strategy for England

“In Britain, 6 million deaths were caused by tobacco over the past 50 years” Average – 120,000 pa.
British Medical Journal 2004.

“Involuntary addiction to prescribed tranquillisers is the most serious drug problem in the UK today. Benzodiazepine-related deaths each year exceed that of all illegal drugs except heroin. The number of addicts (1.5) million exceeds by far the number addicted to all illegal drugs. And tranquillisers are more addictive than heroin”
All Party Parliamentary Group for Involuntary Tranquilliser Addiction, Newsletter 1, 22 January 2008

Hospital emergency visits:  alcohol-related 48.7%   cocaine 20%   marijuana 12.6%
Reference: Drug Abuse Warning Network, www.samhsa.gov

FACT: “MEDICAL MARIJUANA” SENDS THE WRONG MESSAGE TO KIDS

Benchmark surveys of drug use show that when young people believe a drug is harmful, the fewer young people use that drug.

US states which passed “medical” marijuana laws have among the highest past-month drug use (8 out of the 10 top slots) and addiction (7 out of the 10 top slots). Follow-up studies show this is a consistent cluster in those states.

The most recent study released in 2008 shows that these states are in the majority of the top 10 for first-time use of marijuana in the past year – for people aged as young as 12 to 25.
References: Monitoring the Future Survey, which has tracked drug use annually among US high-school students since1974. National Household Survey on Drug Abuse, which has tracked drug use among Americans aged 12 and older since 1972.

FACT: MARIJUANA IS THE No 1 DRUG CHILDREN ARE IN TREATMENT FOR

In 2004, 14.6million Americans used marijuana at least once in the month before being surveyed; about 6,000 people a day started to use it for the first time: 2.1million people – of which 63.8% were younger than 18.
Reference: NIDA IndoFacts: Marijuana, National Institute of Drug Abuse.  2004 National Survey on Drug Use and Health: National Findings (Office of Applied Statistics), SMA 05-4061.

One study showed that, of about 182,000 children in treatment, 48% were admitted for abuse or addiction to marijuana – compared to ‘only’ 19.3% for alcohol, 2.9% for cocaine, 2.4% for methamphetamine and 2.3% for heroin.
References: Monitoring the Future, National Institute of Health, National Institute on Drug Abuse – www.monitoringthefuture.org Overview of Findings from the National Survey on Drug Use and Health.

FACT: HOSPITAL EMERGENCY ROOMS

Every year, marijuana accounts for over 99,000 young people admitted to US hospital emergency rooms with marijuana-related complaints. Adults multiply the numbers. The figures are:

6-11 year olds                      380
12-17 year olds                    39,035
18-20 year olds                    27,742
21-24 year olds                    32,154   
T o t a l = 99,311
Reference: Drug Abuse Warning Network.

FACT: OTHER DAMAGE FROM “MEDICAL” MARIJUANA LAWS

“Medical” marijuana laws open the door for kids to use drugs. In California, high-school students openly smoked pot in class under protection of such laws – they managed to get it prescribed for conditions such as “sleeplessness” and “stress”.

The mixed message of “medical” marijuana will most likely have a terrible effect on parents’ ability to provide unequivocal information about drugs to their young children.
References: Office of National Drug Control Policy: What every American should know about medical marijuana. www.whitehousedrugpolicy.gov.  DEA Congressional Testimony, statement by Thomas Constantine, administrator of the Drug Enforcement Administration, US Dept of Justice; 2 December 1996.

FACTS: OTHER DAMAGE TO CHILDREN

“Cannabis use and educational attainment”
VOX, 18 September 2007

“Differential effects of delta-9-THC on learning in adolescent and adult rats”
Pharmacology Biochemistry and Behavior, 2 May 2005

“Occurrence of cannabis use disorders and other cannabis-related problems among first-year college students”
Addictive Behaviors 33(3): 397-411, March 2008

FACTS: THERE ARE BOTH SHORT- AND LONG-TERM EFFECTS, including WITHDRAWAL

“”Drug craving and withdrawal symtoms can make it hard for long-erm marijuana smokers to stop abusing the drug. People report irritability, sleeplessness and anxiety...”
NIDA InfoFacts: Marijuana. Psychopharmacology 1999, 143(3):302-308 “Changes in aggressive behaviour during withdrawal from long-term marijuana use”

“... They also display increased aggression on psychological tests, peaking about one week after the last use of the drug”
NIDA InfoFacts: Marijuana.  Psychopharmacology 1999, 141(4):395-404 “Abstinence symptoms following smoked marijuana in humans”

“The short-term effects of marijuana can include problems with memory and learning; distorted perception; difficulty in thinking and problem solving; loss of coordination; and increased heart rate. Research findings for long-term marijuana abuse indicate changes in the brain similar to those seen after long-term abuse of other major drugs.”
Reference: NIDA IndoFacts: Marijuana, National Institute of Drug Abuse.  Science 1997, 276(5321): 2050-2054 “Activation of cortocotropin-releasing factor in the limbic system during cannabinoid withdrawal”. Proc National Academy of Science 1998, 95(17): 10269-10273 “Melolimbic dopaminergic decline after cannabinoid withdrawal”

FACT: CANNABIS IS LINKED TO VIOLENCE

“Cannabis linked to aggression”
Press Association 2006, www.scotsman.com/news

“Marijuana had a greater effect on increasing the degree of violent behaviour in non-delinquent individuals than in delinquent individuals”
Journal of Addictive Disorders 2003, 22: 63-78

FACTS: DAMAGE TO PHYSICAL HEALTH

Birth defects: 

“Risk of Selected Birth Defects with Prenatal Illicit Drug Use”
Reference: Journal of Toxicology and Environmental Health, part A, 70: 7-18, 2007.

“Some babies born to women who abused marijuana during pregnancy display altered responses to visual stimuli, increased tremulousness, and a high-pitched cry, whic may indicate neurological problems in development”
NIDA InfoFacts: Marijuana. Neurotoxicology and Teratology 1987, 9(1): 1-7 “Neonatal behavioural correlates of prenatal exposure to marijuana, cigarettes and alcohol in a low-risk population”
Child Development 1989, 60(23/24): 764-771 “Effects of marijuana use during pregnancy on newborn crying”

During pre-school years, marijuana-exposed children performed tasks involving sustained attention and memory more poorly than nonexposed children”
NIDA InfoFacts: Marijuana. Life Sciences 1995, 56(23-24):2159-2168 “”The Ottawa prenatal prospective study: methodological issues and findings. It’s easy to throw the baby out with the bath water”
Neurotoxicology and Teratology 2001, 23(1):1-11 “A literature review of the consequences of prenatal marihuana exposure: An emerging theme of a deficiency in aspects of executive function”

“In the school years, these children are more likely to exhibit deficits in problem-solving skills, memory and the ability to remain attentive”
NIDA InfoFacts: Marijuana. Life Sciences 1995, 56(23-24):2159-2168 “”The Ottawa prenatal prospective study: methodological issues and findings. It’s easy to throw the baby out with the bath water”

Pain:

“Too much cannabis worsens pain”
BBC News, 24 October 2007

“Marijuana won’t stop multiple sclerosis pain”
Neurology 2002, 58: 1404-1407

“[Shedding] light on controversial medical marijuana study”
Pushing Back, www.pushingback.com

Respiratory system damage:

“Marijuana smoke contains higher levels of certain toxins than tobacco smoke”
Science Daily, 18 December 2007

“Marijuana smokers face rapid lung destruction – as much as 20 years ahead of tobacco smokers”
Science Daily, 27 January 2008

“One cannabis joint is as bad as five cigarettes”
Reuters UK, 31 July 2007

“Someone who smokes marijuana regularly may have many of the same respiratory problems that tobacco smokers do”
NIDA InfoFacts: marijuana. Western Journal of Medicine 1990, 152(5): 525-530 “Pulmonary complications of smoked substance abuse”

“Use of marijuana impairs lung function”
Addiction 2002, 97: 1055-1061

“Marijuana users usually inhale more deeply and hold their breath longer than tobacco smokers do, which increases the lungs’ exposure to carcinogenic smoke”
NIDA InfoFacts: marijuana.

“Study: Smoking cannabis causes damage to lungs”
Reuters UK

“Respiratory and immunologic consequences of marijuana smoking”
Journal of Clinical Pharmacology 2002

“Respiratory effects of marijuana and tobacco use in a US sample”
Journal of Gen Intern Medicine 2004, 20:33-37

“A study of 450 individuals found that people who smoke marijuana frequently but do not smoke tobacco have more health problems and miss more days of work than non-smokers. Many of the extra sick days were for respiratory illness.”
Reference: NIDA IndoFacts: Marijuana, National Institute of Drug Abuse. Western Journal of Medicine 1993, 158(6): 596-601 “Health care use by frequent marijuana smokers who do not smoke tobacco” 

Cancer:

“Association between marijuana use and transitional cell carcinoma”
Adult Urology 2006, 100-104

“A study comparing 173 cancer patients and 176 healthy patients produced evidence that marijuana smoking doubled or tripled the risk of head and neck cancers”
NIDA InfoFacts: Marijuana.  Cancer Epidemiology, Biomarkers & Prevention 1999, 8(12): 1071-1078 “Marijuana use and increased risk of squamous cell carcinoma of the head and neck”

“Marijuana use has the potential to promote cancer of the lungs”
NIDA Infofacts: Marijuana. NIDA InfoFacts: marijuana.
Western Journal of Medicine 1990, 152(5): 525-530 “Pulmonary complications of smoked substance abuse”.
Journal of Psychoactive Drugs 1994, 26(3):285-288 “Possible role of marijuana smoking as a carcinogen in the development of lung cancer at a young age”.
Recent Advances in Phytochemistry, 1975 “On the carcinogenicity of marijuana smoke”.

Aids/HIV:

“Marijuana component opens the door for virus that causes Kaposi’s Sarcoma”
Science Daily, 2 August 2007

Strokes:

“More evidence ties marijuana to stroke risk”
Reuters Health, 22 February 2005

“Pot use tied to stroke in three teenagers”
Reuters Health, 26 April 2004

Heart attack:

“An abuser’s risk of heart attack more than quadruples in the first hour after smoking marijuana”
Reference: NIDA IndoFacts: Marijuana, National Institute of Drug Abuse.  Circulation 2001, 103(23): 2805-2809 “Triggering myocardial infarction by marijuana”

Immune system damage:

“Immunological changes associated with prolonged marijuana smoking”
American College of Allergy, Asthma and Immunology, 17 November 2004

Infertility:

“Marijuana firmly linked to infertility”
Scientific American, 22 December 2000

Brain damage:

“Marijuana may affect blood flow in brain”
Reuters UK, 7 February 2005

FACTS: DAMAGE TO MENTAL HEALTH

Schizophrenia, depression:

“Cannabis-related schizophrenia set to rise”
Science Daily, 26 March 2007

“Using pot may heighten risk of becoming psychotic”
Associated Press, 26 July 2007

“Anterior cingulated grey-matter deficits and cannabis use in first-episode schizophrenia”
British Journal of Psychiatry 2007, 190: 230-236

“Marijuana increases risk of both psychosis in non-psychotic people as well as poor prognosis for those with risk of vulnerability to psychoses”
American Journal of Epidemiology 2002, 156: 319-327

“Psychophysiological evidence of altered neural synchronisation in cannabis use: relationship to schizotypy”
American Journal of Psychiatry 2006, 163: 1798-1805

“Marijuana linked to schizophrenia, depression”
British Medical Journal, 21 November 2007

“Cannabis shows anti-depression benefits but too much has reverse effect”
Canadian Press, 24 October 2007

“Depression, anxiety and personality disturbances have been associated with chronic marijuana use”
NIDA InfoFacts: Marijuana.
NYS Psychologist, January 2001, 35-39 “The effect of early marijuana use on later anxiety and depressive symptoms”.
Journal of Academy of Child and Adolescent Psychiatry 1998, 37(3): 322-330 “Longitudinal study of co-occurring psychiatric disorders and substance use”.

FACTS: ADDICTION TO MARIJUANA AND GATEWAY EFFECT

“Occurrence of cannabis use disorders and other cannabis-related problems among first-year college students”
Addictive Behaviors 33(3): 397-411, March 2008

“Regular or heavy use of cannabis was associated with increased risk of using other illicit drugs”
Addiction 2006, 101: 556-569

“As marijuana use rises, more people are seeking treatment for addiction”
Wall Street Journal, 2 May 2006

“Adolescent cannabis exposure alters opiate intake and opioid limbic neuronal populations in adult rats”
Neuropsychopharmacology 2006, 10-9

“25-year longitudinal study affirms  link between marijuana use and other illicit drug use”
Congress of the United States, 14 March 2006

“New study reveals marijuana is addictive and users who quit experience withdrawal”
All Headline News, 6 February 2007

“Cannabis withdrawal among non-treatment-seeking adult cannabis users”
American Journal on Addiction 2006, 15: 8-14

“Escalation of drug use in early onset cannabis users vs co-twin controls”
Journal of the American Medical Association 2003, 289: 4

FACTS: LEARNING AND SOCIAL BEHAVIOUR

“Because marijuana compromises the ability to learn and remember information, the more a person uses it the more s/he is likely to fall behind in accumulating intellectual, job or social skills. Moreover, marijuana’s adverse impact on memory and learning can last for days or weeks after the acute effects of the drug wear-off”.
NIDA InfoFacts: Marijuana.
JAMA 1996, 275(7): 521-527 “The residual cognitive effects of heavy marijuana use in college students”.
Psychopharmacology 1993, 100(1-2): 219-228 “Effects of chronic marijuana use on human cognition”.

“Students who smoke marijuana get lower grades and are less likely to graduate from school, compared with their non-smoking peers”
NIDA InfoFacts: Marijuana.  Addiction 2000, 95(11): 1621-1630 “”Effects of adolescent cannabis use on educational attainment: a review”
Archive General Psychiatry 1996, 53(1):71-80 “High school students who use crack and other drugs”
Australia NZ Journal of Psychiatry 1990, 24(1):45-56 “Adolescent marijuana use: risk factors and implications”
Am Journal of Public Health 1999, 89(10):1549-1554 “The risks for late adolescence fo early adolescent marijuana use”.

“The ability of long-term heavy marijuana abusers to recall words from a list remained impaired for a week after quitting but returned to normal in 4 weeks”
NIDA InfoFacts: Marijuana.  Archive General Psychiatry 2001, 58(10):909-915 “Neuropsychological performance in long-term cannabis users”

“Depression, anxiety and personality disturbances have been associated with chronic marijuana use”
NIDA InfoFacts: Marijuana. NYS Psychologist, January 2001, 35-39 “The effect of early marijuana use on later anxiety and depressive symptoms”.
Journal of Academy of Child and Adolescent Psychiatry 1998, 37(3): 322-330 “Longitudinal study of co-occurring psychiatric disorders and substance use”.

EMPLOYABILITY:

“A study of 450 individuals found that people who smoke marijuana frequently but do not smoke tobacco have more health problems and miss more days of work than non-smokers. Many of the extra sick days were for respiratory illness.”
Reference: NIDA IndoFacts: Marijuana, National Institute of Drug Abuse. Western Journal of Medicine 1993, 158(6): 596-601 “Health care use by frequent marijuana smokers who do not smoke tobacco” 

“Several studies associate workers’ marijuana smoking with increased absences at work, tardiness, accidents, workers’ compensation claims and job turnover”
NIDA Info Facts: Marijuana.  JAMA 1990, 264(20): 2639-2643 “Efficacy of pre-employment drug screening for marijuana and cocaine in predicting employment outcome”

“Heavy marijuana abusers reported that the drug impaired several important measures of life achievement including cognitive abilities, career status, social life and physical and mental health”
NIDA InfoFacts: Marijuana. Psychological Medicine 2003, 33(8): 1415-1422 “Attributes of long-term heavy cannabis users: a case control study”

QUOTES FROM EXPERTS:

“Five years ago, 95% of psychiatrists would have said that cannabis doesn’t cause psychosis. Now I would estimate that 95% say it does.”
Professor Robin Murray, director – Institute of Psychiatry, London, October 2006

“The mistake was that in its 2002 report, the Advisory Council on the Misuse of Drugs denied that cannabis was a contributory cause of schizophrenia, continued to deny this for the next two years and thus misled ministers into repeatedly stating that there was no causal link between cannabis and psychosis.”
Professor Robin Murray, letter to the Guardian, 19 January 2006

“Use more often than twice a week for even a short time, or use for 5 years or more even once a month, may each lead to a compromised ability to function to their full mental capacity, and could possibly result in lasting impairments.”
Dr Nadia Solowij, “Cannabis and cognitive functioning” 1998

“THC encourages both physical and psychological dependence and is highly abusable. It causes mood changes, loss of memory, psychoses, impairment of coordination and perception, and complicates pregnancy.”
The warning on Nabilone, a THC replacement

“In the 60s and 70s, the average THC content of herbal cannabis was under 1%. Today’s specially bred varieties such as skunk and nederweed have THC contents of anything from 9-27%. These strong types are now commonly grown in the UK and are thought to account for 60% of cannabis consumed here.”
Mary Brett, former head of health education, Dr Challoner’s Grammar School, Amersham, Bucks

THE INDEPENDENT, 16 Sept 2007

“When the Independent on Sunday campaigned for decriminalisation of cannabis, we reflected the common view... that the drug was less dangerous than either tobacco or alcohol. Our editorial line was followed by the Daily Telegraph. Now that confusion has become a real problem... No sooner had cannabis been downgraded in the eyes of the law than most credible authorities began to warn it was considerably more dangerous than originally thought. That evidence led this newspaper, in March to renounce its campaign to decriminalise cannabis.

“For most people, cannabis is not as dangerous as amphetamines or heroin; the trouble is you cannot be sure who is susceptible to the risk of serious psychological harm. For those people, cannabis can be as destructive of personality as any other illegal drugs. [There is] a simple test to identify vulnerability to cannabis-induced psychosis, but ti will not be generally available for several years.

“We report a further complication. One of the arguments for reclassifying cannabis as less serious was that users did not tend to steal to pay for their habit. But disturbing new research suggests otherwise. An academic study in Sheffield suggests one in four young offenders stole to pay for cannabis.

“As we also report, many young people think that cannabis is legal and harmless. They are not aware that under-18s should be arrested for possession of cannabis.

“Public information campaigns have not succeeded so far. The simpler the message, the better; and the simplest is that cannabis is dangerous and illegal.”

Consistent policing is important. It is not clear that most poice forces ahve a zero-tolerance approach to amoking cannabis in public places, which is essential to reinforce the message that the drug is illegal.

Criminalising young people is no answer. The best way to get across information about the health risks of cannabis is to make it a medical or mental-health issue rather than one of criminal justice.

SUPER-STRONG SKUNK: UPDATE

The super-strong 'slunk' strain of cannabis is typically 2-3 times stronger than other forms of the drug and now accounts for 75% of cannabis seized, according to the Daily Mail [ 2 May 2008].

80,000 street warnings were given to cannabis smokers last year. And drug offences leapt by over 50% since 2004, when cannabis was downgraded.

The number of people seeking treatment for mental illness has increased since 2004, standing at 25,944 last year, including 9,259 under-18s.

MENTAL ILLNESS UP AFTER CANNABIS DOWNGRADE

The number of people admitted to hospital with schizophrenia and psychosis has shot up since the laws on cannabis were relaxed in 2004, according to figures given to MPs [24 April] in advance of the publication this week of a report  from the Advisory Council on the Misuse of Drugs on whether cannabis should be again upgraded.

Newspapers are reporting that the ACMD is expected to recommend that the drug stays in class C, based on research by one of its members in Keele University – see item below for the flaws Addiction Today identified in this.   

Cannabis was downgraded in January 2004. Admissions for patients with primary or secondary diagnoses of schizophrenia in England rose 12.7% since then to 45,955 people. Admissions for primary or secondary cases of psychosis rose 20.8% over the same period to 213,624 people.

The figures increased even more since Labour’s David Blunkett first indicated in 2001 that cannabis would be reduced from a class B to C drug. The increase in schizophrenia admissions since then is 24%, in psychosis 42%.

Downgrading cannabis gave the message to young people that smoking it causes little harm and is officially tolerated. Click here for a list of damage. Read today/Comment.   

DIFFERENT STRAINS OF CANNABIS CAUSE DIFFERENTPROBLEMS

People who smoke different strains of cannabis show different psychological symptoms, states a study in the April British Journal of Psychiatry. Research suggests a link between cannabis use and psychosis, such as schizophrenia. But cannabis contains a number of chemicals known as cannabinoids, which might have different effects.

The main component of smoked cannabis is a cannabinol known as THC, which is thought to be responsible for the psychosis-like effects of the drug. THC has been shown to raise anxiety levels and psychotic symptoms in healthy people. In contrast, another cannabinol, known as CBD, has been found to lower anxiety and to have antipsychotic properties. The ratio of these two compounds in smoked cannabis varies – there are higher levels of THC in ‘skunk’ or genetically modified strains of the plant. People who use cannabis regularly have been shown to be more prone to psychosis and delusions. No research had examined the link between these effects and the CBD/THC ratio in cannabis until this study used hair analysis to determine levels of THC and CBD in 140 drug users and relate these to measures of psychosis proneness and delusional thinking.

54 people scored positive for cannabis. Both THC and CBD were found in the hair of 26 of them, and THC alone in the hair of 20 others. Participants completed a questionnaire to assess psychosis proneness - for example, experience of hallucinations and delusions, thought disorder, social withdrawal and impulsiveness.

The researchers found significant differences between the 3 groups (THC only, THC+CBD, and no cannabinoid). The THC only group had significantly higher scores for psychosis proneness than the no cannabinoid group and the THC+CBD group. The THC+CBD group also had significantly lower scores for social withdrawal compared with the no cannabinoid group.

Compared with the no cannabinoid group, there were significantly higher scores for delusional thinking in the THC-only group, and a trend for greater scores in the THC +CBD group.

The researchers comment that this study is the first to show that hair analytic techniques can be used to distinguish different groups of cannabis users. The implication is that people who smoke different strains of cannabis have different psychological symptoms.

These findings suggest that smoking strains of cannabis containing CBD in addition to THC may be protective against the psychotic-like symptoms caused by THC alone. However, another explanation of these results might be that pre-existing differences in psychosis proneness between people who use cannabis could draw them to smoke different strains of the drug.

This research highlights the importance of distinguishing between different cannabinoids, and has implications in the debate over the link between cannabis and psychosis.

Morgan C J A and Curran HV (2008). Effects of cannabidiol on schizophrenia-like symptoms in people who use cannabis. British Journal of Psychiatry, 192, 306-307.

For further information contact Dr Celia Morgan, University College London, or Valerie Curran.

   

CANNABIS AND SCHIZOPHRENIA: THE LINKS

1972: Study of US servicemen finds widespread cannabis smoking contributed to a five-fold increase in schizophrenia between 1968-1971.

1974: Researchers find cannabis could trigger latent schizophrenia, intensify symptoms and cause the condition even where it would not otherwise occur.

1981: Study of 16-year olds in Sweden finds that heavy users are three times as likely to have mental-health problems by 27 years old - a 10% risk.

1986: US National Institute for Drug Abuse finds that schizophrenics who smoked cannabis have worse symptoms, more relapses, need more help and are less responsive to treatment.

1987: Study of 45,000 swedish military conscripts finds that those who smoked cannabis 50 times or more by age 18 are six times more likely to suffer schizophrenia later.

2002: A 26-year study by King's College London shows that people who began smoking it in early teens faced four-fold increase in risk of schizophrenia as adults, and established that the drug directly triggered the disease.

2003: US scientists show that those using cannabis before the age of 17 are up to five times more likely to have drug and alcohol problems later in life.

2005: Study led by the Institute of Psychiatry in London finds that one in four cannabis users are genetically predisposed to suffer mental ilness due to the drug.

2005: Danish researchers find almost 50% of cannabis users who suffer a drug-induced psychotic episode go on to develop long-term schozophrenia.

2007: The Institute of Psychiatry finds that cannabis' most powerful active ingredient reduced activity in a part of the brain which helps to keep people sane.

2007: Study by the universities of Cardiff, Bristol, Cambridge and Imperial College London finds that heavy users of cannabis are more than twice as likely to suffer mental illness.

NURSES CALL FOR CANNABIS TO BE CLASS B DRUG

Mental Health Nurses Association/Unite "utterly reject" ACMD comment

News reports that the Advisory Council on the Misuse of Drugs (no ACMD hyperlink openly available) would decide to keep cannabis as a class C drug were criticised as “deeply regrettable” by Unite/Mental Health Nurses Association. It stated that the drug remaining on the class C list “flies in the face of established medical facts and common sense”.

“We utterly reject the reported recommendation from the advisory council that cannabis should remain a class C drug,” said Unite/NHNA chair Andy Lauder.

“It has been proved time and time again by well-respected medical studies that there are strong links between significant cannabis use and those suffering from mental health problems, or have a disposition to mental illness.

"The image that cannabis is harmless, or relatively harmless and can be passed around without side effects at smart middle-class dinner parties is very far from the grim reality that mental-health professionals have to deal with on a daily basis in psychiatric wards in hospitals across the country, where patients are recovering from psychotic breakdowns induced from excessive cannabis use.

“And there are now much stronger strains of cannabis, such as skunk, entering the UK in response to so-called market forces.”

The government asked the council to review cannabis's legal status amid concerns over stronger forms of it. The council refused to confirm or deny any decision. Its chairman Professor Sir Michael Rawlins said a report would be sent to Home Secretary, Jacqui Smith later this month.

Click here for Unite/MHNA press release.

UNITE.

Unite (Amicus section) is the third largest union in the NHS. It has seven professional sections: the Community Practitioners’ and Health Visitors’ Association, the Mental Health Nurses Association, the Guild of Healthcare Pharmacists, the Society of Sexual Health Advisers, the Medical Practitioners’ Union, College of Healthcare Chaplains, and the Hospital Physicists Association.
Unite was formed by an amalgamation of Amicus and the Transport and General Workers’ Union in May 2007.

ACMD THINKING IS FLAWED IF IT BASES ADVICE ON KEELE REPORT

IF ACMD BASES CANNABIS ADVICE ON KEELE UNIVERSITY REPORT, IT IS FLAWED

The BBC reports that the Advisory Council on the Misuse of Drugs has decided cannabis should remain a class C drug. Its home affairs correspondent Danny Shaw said the decision, in a private meeting, was based on research from Keele University which "found nothing to support a theory that rising cannabis use in the 1970s, 1980s and early 1990s led to increases in the incidence of schizophrenia later on".

There are three fundamental flaws with this argument.

The most obvious is that cannabis available 35 or so years ago was 7-12 times weaker than the product available today. It might have the same name but this study is NOT comparing like with like. 21st-century cannabis has been refined and intensified over a third of a century and causes more damage.

The second flaw concerns the ACMD's statement that schizophrenia numbers should have increased since the 1970s if there is a causal connection and "they have not" - wrong. In 2003, Boydell and others found a continuous, significant rise in the incidence of schizophrenia between 1965-1997. It doubled in the south east of London, with the increase greatest in people under 35.

In 2004, Fischer and others from Keele University monitored 3% of England's population by looking at GP practice records - from 1993-1998, the number of people using drugs and having mental illness rose 62%, with the average age falling to 34. Between the ages of 25-34, the cases more than doubled.

And a Parliamentary Question by Rosie Winterton in 2006 revealed that the number of cannabis users admitted to hospitals with mental illness rose by 20% in the first year since down-classification of cannabis.

Last but not least, the ACMD should not ignore research showing that cannabis abusers quadruple their risk of heart attack in the first hour after smoking, that cannabis smokers have more lung health problems than tobacco smokers, that it impairs the immune system, that depression and anxiety and personality disturbances are linked with chronic marijuana use, that it hinders the ability to learn and remember information and thus school and job prospects, that it adversely affects babies of pregnant women, that it affects the reproductive systems of both men and women.

Addiction Today has been told that, of 76 research papers confirming cannabis damage, the ACMD looked at only 3; we have not confirmed this.

But this is not even taking into account the indavertently damaging messages being sent out about some drugs being "safer" or "more legal" than others. Or the arguments of the police, judiciary and medical establishment.

In 2000, before the ACMD/government downgraded the classification of cannabis, Addiction Today printed an article with the research on its harms. Read it here.

For the latest infofacts on marijuana, click here.

ESTABLISHMENT "COMPLACENT" OVER PERILS OF CANNABIS

The health establishment is "complacent" over the dangers of cannabis, UK mental-health tsar Professor Louis Appleby has stated [5 February 2007]. "From the perspective of mental-health services, cannabis is a harmful drug that is part of, and contributes to, a pattern of relapse and risk in mental-health patients.

"Now the evidence is pointing towards cannabis as a cause of severe mental illness. A change in classification could reinforce a strong public-health message."

Appleby also revealed that drug dealers are preying on mental-health wards - with 30% saying they operate on the premises or just outside.

His admission came at the start of the Advisory Council on the Misuse of Drugs hearing to decide whether it should recommend ministers to reclassify the drug back to class B.

An Ipsos MORI poll for the ACMD found that 58% of the public want cannabis to be rated higher than the current class C. Of these, 24% said it should be pushed to class A. Doctors, police, magistrates and families whose lives have been ruined by cannabis demanded the reversal of Labour's decision to downgrade cannabis, taken just over four years ago.

Dr Matathew Hickman, a drugs expert at Bristol University, told the ACMD that, by 2010, a quarter of all new cases of schizophrenia will be cannabis linked.

Dr Les King, an adviser to the Home Office scientific development branch, said several hundred cannabis samples seized by police in the past few weeks showed that levels of skunk - a highly potent form of the drug - had rocketed, while cannabis resin had slumped.

The Association of Chief Police Officers said it "unequivocally" wanted cannabis restored to class B. Relaxation had led to an explosion in the number of cannabis farms, and confusion that the drug might be legal.

The Magistrates Association said the reclassification had caused harm on the streets by sending out "mixed messages and confusion".

The ACMD rejected the case for change as recently as January 2006. Critics state that, apart from perceived prejudice, ACMD members had not read all the evidence submitted, and had misinterpreted other submissions.

If the ACMD decides later this year that cannabis should remain a class C drug, the Home Office will face the dilemma of whether to ignore its recommendation or not.

With acknowledgment to the Daily Mail and Home Affairs editor James Slack.

NIDA INFOFACTS: MARIJUANA

The science of drug abuse and addiction

Research overview from the National Institute of Drug Abuse and Addiction; current as at 2 January 2008

EFFECTS ON THE BRAIN

Scientists have learned a great deal about how THC (delta-9-tetrahydrocannabinol) acts in the brain to produce its many effects. When someone smokes marijuana, THC rapidly passes from the lungs into the bloodstream, which carries the chemical to organs throughout the body, including the brain.

In the brain, THC connects to specific sites called cannabinoid receptors on nerve cells and influences the activity of those cells. Some brain areas have many cannabinoid receptors; others have few or none. Many cannabinoid receptors are found in parts of the brain that influence pleasure, memory, thought, concentration, sensory and time perception, and coordinated movement⁴.

The short-term effects of marijuana can include problems with memory and learning; distorted perception; difficulty in thinking and problem solving; loss of coordination; and increased heart rate. Research findings for long-term marijuana abuse indicate changes in the brain similar to those after long-term abuse of other major drugs. For example, cannabinoid (THC or synthetic forms of THC) withdrawal in chronically exposed animals leads to an increase in the activation of the stress-response system⁵ and changes in the activity of nerve cells containing dopamine⁶. Dopamine neurons are involved in the regulation of motivation and reward, and are directly or indirectly affected by all drugs of abuse.

EFFECTS ON THE HEART

One study has indicated that an abuser's risk of heart attack more than quadruples in the first hour after smoking marijuana⁷. The researchers suggest that such an effect might occur from marijuana's effects on blood pressure and heart rate and reduced oxygen-carrying capacity of blood.

EFFECTS ON THE LUNGS

A study of 450 people found that those who smoke marijuana often but do not smoke tobacco have more health problems and miss more days of work than nonsmokers⁸. Many of the extra sick days among the marijuana smokers in the study were for respiratory illnesses.

Even infrequent abuse can cause burning and stinging of the mouth and throat, often accompanied by a heavy cough. Someone who smokes marijuana regularly can have many of the same respiratory problems as tobacco smokers, such as daily cough and phlegm production, more frequent acute chest illness, a heightened risk of lung infections, and a greater tendency to obstructed airways⁹. Smoking marijuana possibly increases the likelihood of developing cancer of the head or neck. A study comparing 173 cancer patients and 176 healthy individuals produced evidence that marijuana smoking doubled or tripled the risk of these cancers¹⁰.

Marijuana abuse also has the potential to promote cancer of the lungs and other parts of the respiratory tract because it contains irritants and carcinogens^9,11. In fact, marijuana smoke contains 50-70% more carcinogenic hydrocarbons than tobacco smoke¹². It also induces high levels of an enzyme that converts certain hydrocarbons into their carcinogenic form—levels that can accelerate the changes that ultimately produce malignant cells¹³. Marijuana users usually inhale more deeply and hold their breath longer than tobacco smokers do, which increases the lungs' exposure to carcinogenic smoke. These facts suggest that, puff for puff, smoking marijuana may be more harmful to the lungs than smoking tobacco.

OTHER HEALTH EFFECTS

Some of marijuana's adverse health effects might occur because THC impairs the immune system's ability to fight disease. In laboratory experiments that exposed animal and human cells to THC or other marijuana ingredients, the normal disease-preventing reactions of many of the key types of immune cells were inhibited¹⁴. In other studies, mice exposed to THC or related substances were more likely than unexposed mice to develop bacterial infections and tumours^15,16.

LEARNING AND SOCIAL BEHAVIOUR

Research clearly shows that marijuana has the potential to cause problems in daily life or make a person's existing problems worse. Depression¹⁷, anxiety¹⁷, and personality disturbances¹⁸ have been associated with chronic marijuana use. Because marijuana compromises the ability to learn and remember information, the more a person uses marijuana the more he or she is likely to fall behind in accumulating intellectual, job, or social skills. Moreover, research has shown that marijuana’s adverse impact on memory and learning can last for days or weeks after the acute effects of the drug wear off^19,20,25.

Students who smoke marijuana get lower grades and are less likely to graduate from high school, compared with their nonsmoking peers^21,22,23,24. A study of 129 college students found that, among those who smoked the drug at least 27 of the 30 days before being surveyed, critical skills related to attention, memory, and learning were significantly impaired, even after the students had not taken the drug for at least 24 hours²⁰. These "heavy" marijuana abusers had more trouble sustaining and shifting their attention and in registering, organising, and using information than did the study participants who had abused marijuana no more than 3 of the previous 30 days.

So someone smoking marijuana every day could be functioning at a reduced intellectual level all the time.
More recently, the same researchers showed that the ability of a group of long-term heavy marijuana abusers to recall words from a list remained impaired for a week after quitting, but returned to normal within 4 weeks²⁵. Thus, some cognitive abilities may be restored in individuals who quit smoking marijuana, even after long-term heavy use.

Workers who smoke marijuana are more likely than their coworkers to have problems on the job. Several studies associate workers' marijuana smoking with increased absences, tardiness, accidents, workers' compensation claims, and job turnover. A study among postal workers found that employees who tested positive for marijuana on a pre-employment urine drug test had 55% more industrial accidents, 85% more injuries, and a 75% increase in absenteeism compared with those who tested negative for marijuana use²⁶. In another study, heavy marijuana abusers reported that the drug impaired several important measures of life achievement including cognitive abilities, career status, social life, and physical and mental health²⁷.

EXPOSURE DURING PREGNANCY

Research has shown that some babies born to women who abused marijuana during their pregnancies display altered responses to visual stimuli²⁸, increased tremulousness, and a high-pitched cry, which might indicate neurological problems in development²⁹. During the preschool years, marijuana-exposed children performed tasks involving sustained attention and memory more poorly than nonexposed children do^30,31. In the school years, these children are more likely to exhibit deficits in problem-solving skills, memory, and the ability to remain attentive³⁰.

ADDICTIVE POTENTIAL

Long-term marijuana abuse can lead to addiction for some people; that is, they abuse the drug compulsively even though it interferes with family, school, work, and recreational activities. Drug craving and withdrawal symptoms can make it hard for long-term marijuana smokers to stop abusing the drug. People trying to quit report irritability, sleeplessness, and anxiety³². They also display increased aggression on psychological tests, peaking approximately one week after the last use of the drug³³.

37 research references are available from NIDA.

WE NEED A CAMPAIGN OF INFORMATION

Should cannabis be decriminalised or not? Should it be classifed as a class B or C drug? Debates are irrelevant while they are entrenched in misinformation and disinformation

This article by Deirdre Boyd appeared in Addiction Today, November 2000 - before the ACMD advised then Home Secretary David Blunkett to reclassify it downwards to a class C drug. On the urging of prime minister Gordon Brown, the ACMD is again hearing evidence this February. The facts here have not dated - in fact, more recent research validates them further.

The most noticeable factor in ongoing debates about cannabis is the vast foundation of ignorance on which people are basing the most emotive, entrenched arguments. The fewer facts people have, the more heated they seem to be. This country needs a strategy of health information about cannabis which is as available and comprehensive as that eventually offered by anti-tobacco campaigners.

Cigarette smoking started to reduce because people were - after a battle spanning decades - given the facts about its risks. Cannabis smokers also deserve the truth so that they can make informed decisions about their own health and that of their families.

For example, are the people - including government ministers - who argue that they took pot in the 1960s and 1970s without any harm aware that the pot/marijuana/cannabis of today is not the same substance they took back then? Like every other profitable product, cannabis has been refined over the decades so that it is now four to 12 times more potent than it was 20 years ago.

So, for the moment, let's put to one side the legal and criminal ramifications and look at what studies show about the effects of cannabis on health.

IDENTIFIABLE SYMPTOMS

When asked by a teacher suspicious of wide swings in academic performance in some of his students what symptoms could help to identify a pupil using cannabis, Dr James West of the Betty Ford Center gave the following answer.

"Cannabis affects the cerebral, cariovascular, pulmonary and neuroregulatory systems. Acute or chronic use leads to: euphoria, decreased mental functioning, faster pulse, decreased pulmonary function, exacerbation of asthma, conjunctival injection (red eyes), pharyngitis (sore throat), bronchitis, stuff nose, dry mouth, sinusitis, perceptual delusions, paranoia, mood shifts, sleepiness, sexual arousal, anxiety/panic, lethargy and lack of ambition, plus angina in a pre-existing heart disease.

"The symptoms of overdose are very rapid pulse, very high blood pressure, delusions, hallucinations, seizures in epileptics and acute mental changes including psychosis. Terea re also withdrawal signs for regular users who quit abruptly: irritability, restlessness, insomnia, mild tremors/ bouts of chills and sometimes a low-grade fever."

CANCER

A report by the British Medical Association found that smoking a cannabis cigarette leads to three times more tar inhalation than from a tobacco cigarette - and long-term use can lead to lung cancer. Dr West states that cannabis contaiins four to five times the lung-cancer-producing hydrocarbons as does tobacco.

BRONCHITIS AND OTHER RESPIRATORY DISORDERS

Such disorders linked with smoking can also be caused by long-term use.It is unclear if there is more risk of these disorders than with tobacco. But cannabis users tend to inhale more deeply and the drug does contain more tar. "Cannabis irritates the respiratory system and obstructs smaller airways with a form of bronchitis-emphysema," explains Dr West.

HEART PROBLEMS

The heart responds to cannabis with an increased heart rate proportional to the dose of the drug. Usually, after smoking pot, the heart rate iincreased by 20-40 beats per minute, and rapid rates of 140 beats per minute are not unusual. Chronic use can lead to angina in people with pre-existing heart problems.

ADDICTION

Although infamous for recommending the decriminalisation of cannabis, the Runciman Report states that "the number of people seeking help from drug agencies for problems with cannabis use has doubled from 1,400 in 1993 to 3,300 in 1998 (10% of the total seeking help). This is only the people who identified cannabis as their "main drug".

Cannabis is addictive, concludes a survey by the US National Institute of Drug Abuse. It found that 75% of people who gave up cannabis had cravings for it, and 70% switched to tobacco in an attempt to stay off. Almost 50% said they became irritable and many were bored after giving up the drug.

And in more recent experiments with monkeys, a NIDA team warned that cannabis might be as addictive as heroin and cocaine.

A 1994 report from the Center on Addiction and Substance Abuse at Columbia University found that 60% of children who smoked pot before the age of 15 years moved on to cocaine, and 20% of those who first smoked pot after age 16 then used cocaine.

RELAXING QUALITIES versus DEMOTIVATION & DEPRESSION

Cannabis is best known as a relaxant. This can lead to lower blood pressure, increased appetite, feelings of relaxation, mild intoxication and increased sociability. Smokers usually feel its effects in minutes and they can last up to three hours. The effect is delayed when eating or drinking, so that it lasts longer and can be harder to control. And the relaxing effect can go too far. Research shows that cannabis affects almost ever bodily system, slowing down reaction times, causing drowsiness and confusion.

MEMORY LOSS

Because cannabis is absorbed into the brain cell wall, it is considered more destructive to brain tissue than opioids. Heavy use impairs general intellectual functioning such as memor and comprehension. Even in small doses, dope smoking is knwon to cause short-term memory loss.

ACCIDENTS

Even "casual use" of cannabis impairs psychomotor