Risks of Using Cannabis

On Marketwatch today I read that two cannabis companies are at the top of a popular stock watch list. Across the country politicians are getting more and more in tune with advocates and users to promote the legalization of medical and recreational marijuana use as a low-risk way to raise tax revenue and reduce crime. With only a little research, it becomes apparent that the claims of pot enthusiasts and advocates couldn't be further apart from the actual findings from medical studies.

Almost everything advocates claim to be true about cannabis is wrong. Since the 1970's, I've heard that marijuana has many medical uses. In fact, marijuana with its active ingredient THC have been shown to be effective in only a few narrow conditions, most commonly prescribed for pain relief. Some studies support moderate relief of symptoms, but just as many associate its use with even greater pain over time. 

We've been told that cannabis helps stem the use of opioids, but as a pain killer marijuana is too weak for people who really need opiates, like terminal cancer patients. My own personal experience watching a close friend succumb to cancer demonstrated that marijuana as an opioid replacement was ineffective. The United States is the Western country with the most use of cannabis anywhere in the world, but it is also the country with the greatest problem with opioids. If anything, studies show that cannabis users are three times more likely to begin using other drugs than non users.

A common claim is that marijuana is not just safe for psychiatric patients, especially those with depression and anxiety, but is useful as a potential treatment. A mountain of research in top medical journals indicates just the opposite - that marijuana can cause or worsen severe mental illness, especially psychosis. Studies show that teens who smoke marijuana early on are three times as likely to develop schizophrenia, the worst kind of psychotic disorder. The higher the use, the higher the risk.

Interestingly, the legalization of marijuana over the past decade has NOT led to a huge increase in people using it, rising to 15% of Americans using cannabis at least once in 2017, up from 10% in 2006. In contrast 65% of Americans had a drink of alcohol in 2017. What is increasing is the number of people considered heavy users. In 2017 about 8 million smokers used cannabis at least 300 times a year compared to 12 million Americans who drank alcohol every day.

Cannabis is a lot more potent today than ever before. When I tried weed in my early days the amount of THC in a joint was less than 2%. By contrast today's THC content can range between 20 and 25%, creating a stronger high more quickly. Patterns of mental illness have been shown to have increased at a correspondingly similar rate during the same time difference. A case in point is that adults aged 18 - 25 met the criteria for serious mental illness at a shocking rate of 7.5% in 2017, double the rate from 2008.

Advocates for people with mental illness don't like talking about the link between schizophrenia and crime, correctly arguing that most mentally ill people are not violent. But wishful thinking won't make the exceptions disappear. In truth, psychosis is a high risk factor for violence. Studies have shown that people with schizophrenia are five times as likely as healthy people to commit violent crimes, and twenty times as likely to commit homicide. The marijuana-psychosis-violence connection is even stronger than these figures suggest. When psychotic people use drugs, the risk of violence skyrockets.

Aside from alcohol, the drug most commonly used by psychotics is marijuana, and while it has a reputation for making its users relaxed and calmer, cannabis seems to provoke many psychotics to violence through its tendency to cause paranoia. For people with psychotic disorders, paranoia is well known to fuel extreme violence. Unfortunately, the known link between marijuana and violence is not limited to people with preexisting psychosis.

The relationship between marijuana and madness dates back 150 years to the British asylum registers in India. For even longer, people worldwide have understood that cannabis causes mental illness and violence. So far we have largely ignored the costs of marijuana use as we increasingly embrace the marginal benefits. As the momentum for legalization continues, its negative impact may be too widespread to ignore.

Legalization is largely a political issue. Advocacy aside, we all need to come to terms with the truths about marijuana. Like alcohol and smoking, it presents formidable risks. Like alcohol and smoking it needs to be accompanied by warnings of those risks so that people knowingly choosing to use it are clearly made aware of potential consequences.