Cannabis Makes Young Men Jumping Mad
Large M, Sharma S, Compton MT, Slade T, & Nielssen O (2011). Cannabis Use and Earlier Onset of Psychosis: A Systematic Meta-analysis. Archives of general psychiatry PMID: 21300939
‘The results of this study provide strong evidence that reducing cannabis use could delay or even prevent some cases of psychosis. Reducing the use of cannabis could be one of the few ways of altering the outcome of the illness because earlier onset of schizophrenia is associated with a worse prognosis and because other factors associated with age at onset, such as family history and sex, cannot be changed. Building on several decades of research, this finding is an important breakthrough in our understanding of the relationship between cannabis use and psychosis. It raises the question of whether those substance users would still have gone on to develop psychosis a few years later. However,even if the onset of psychosis were inevitable, an extra 2 or 3 years of psychosis-free functioning could allow many patients to achieve the important developmental milestones of late adolescence and early adulthood that could lower the long-term disability arising from psychotic disorders.The results of this study confirm the need for a renewed public health warning about the potential for cannabis use to bring on psychotic illness’ (2011, n.pag).
It is very naughty of pro-prohibition psychiatrists, who seek to find pre-emptive evidence of emerging psychosis everywhere (and I mean everywhere), when the evidence in support of their sweeping claims is, well, decidedly pale. That is not to deny that some people can be adversely affected by some substances at some particular points in time. See me, for example, when I skip that second heart jolter coffee in the morning and snooze starts to look like reality around noon. I just must have that delicious liquid energy to keep me going. However, if in addition to fatigue I also started to experience hallucinations or delusions or felt particularly paranoid in this post-Wikileaks era, would that indicate a causative link between caffeine and psychosis?
Your choice of answers here are ‘yes’, ‘no,’ and ‘maybe.’ No, you do not have to choose one of the aforementioned options, since all three are equally as valid as they are not. Herein lies the rubbish-scape of combining backwards proving (that cannabis did cause your psychosis) with predictive capacity into the ether (that cannabis will cause your psychosis). Throw in the junk variable that psychosis itself is culturally constructed and made up of whatever ingredients (or symptoms, behaviours, etc.) to which psychiatry is currently enamoured, and you are pushing shite up hill to genuinely prove the link. Still, authority can suffice for reality when knowledge is yours to make, so we continue to build this disturbing clamour around cannabis and leave the big drug problem, that is, alcohol, safely in the back bar…
I agree with this post except for one point: Psychosis is not a cultural construct. It is a real brain state that some experience chronically but all are vulnerable to it given the right combination of environmental stress and faulty brain chemistry. I think the jury is still out about whether or not cannabis can cause schizophrenia or tip susceptible people over the edge into schizophrenia (could just be a scare tactic, but at the same time the brain is insanely complex and its not outside the realm of possibility) and I say this as a 25 year old daily cannabis smoker who thinks it should be legalized.
If you look at the history of psychosis, you will see that it has indeed been a movable feast in terms of what psychiatrists ‘think’ it is. That is not to invoke the banal, march of progress argument, that is, that as science marches forward it invariably discovers ‘more’ and thus changes its stance on any given issue. Psychosis has been expanded by psychiatry from acute, severe to now also include chronic, low grade, for reasons that are predominantly cultural (political, ideological, economic, etc). Moreover, psychiatry has engaged in the great disconnect, whereby behaviours that might be called ‘psychotic symptoms’ are mysteriously excised from the lived experience of sufferers. Ironically, purporting a cannabis enhancing risk predisposition is about as close as psychiatry gets to conceding the pivotal role of context in terms of how we do or do not do certain things, in certain ways. Attractive though it may be, the psychosis as brain ‘disease’ proposition completely lacks objective evidence.
So what exactly would you say to the person who is actively psychotic, delusional and hallucinating? How do you explain delusions, paranoia and hallucinations being a showing up in dementia, brain injury parkinson’s disease or any other progressive neurological condition? What about MRIs, fMRI’s, CAT, PET and other scanning techniques showing grey matter atrophy and other morphological changes in the brains in psychotic persons (this damage is worse in unmedicated people, by the way) except to conclude psychosis is biologically based in a malfunctioning, damaged brain?
My half-brother suffers from schizophrenia, and about a year ago showed up at my house disheveled, talking about a dream he had about killing my house pets and asking if it had actually happened. Is he ill? I think so.
The definition of psychosis has necessarily changed over the past century (like the definition of any illness or disorder) as medicine advances and the human mind and nervous system are better understood. It hasn’t changed much though, and has always included delusions, hallucinations, paranoia, muddled thinking, etc. I don’t disagree that in the past (about half a century ago) psychiatry was rife with abuse — lobotomy, insulin shock — and in some places, especially the former Soviet Union, psychiatry was used to marginalize and crush dissidents. It doesn’t follow that that is still happening in 2011 though, and you make this assertion with no evidence.
A full complete 100% of psychotics and other drug users have spent their entire lives drinking water and breathing air. Pretty conclusive cause and effect there, I challenge anyone to provide a study disputing that. Take away their air and water, we’ll have no problems. Right?
All of our thoughts, feelings, emotions, etc., are ‘brain states’, even the ones we might find distressing or upsetting (in ourselves or what we observe in others). It is psychiatry who then decides, and who chop and change like the wind in this regard, as to what brain states are a ‘mental illness’ and what are not. They have no objective evidence for this curious classification of certain brain states to be mental illness.
Why do people persist in believing these myths about cannabis usage? Not to mention that prohibition would, if they were true, make these issues worse. Let’s see, yes let’s grow pot indoors to reduce it’s anti psychotic component, and select for excessive and unknown levels of THC! That’s a brilliant solution. Gah…