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In Reply - Can Cannabis Drive You Crazy?

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I'm not a fan of rebuttals, they can often be interpreted as rude or standoffish. This is certainly not the flavour of my reply, and so with this ample disclaimer in place, I would like to politely address Mr Rupert Wolfe-Murray's first HuffPo blog; Can Cannabis Drive You Crazy?

As ever, when cannabis becomes a contested issue, it provokes reaction. Why is such an emotive investment given to a plant, and why do we still have an insipid discussion over this drug? Well, the first clue is in Mr Wolfe-Murray's first paragraph:

"...cannabis can help the elderly and infirm dull their pain"

Although the original prose is not about therapeutic benefits of cannabis, Rupert's opener does give some insight as to why such passion orbits the subject. Cannabis has many recognised and peer reviewed benefits, and to an individual who's locked in a battle with ill health, cannabis does provide a unique lifeline and harm minimisation in comparison to pharmaceuticals. So when a substance becomes a generic black and white issue that focuses on the negatives, and it's for everyone to be swept along with the same risible broom - the result is a backlash from those who are impassioned. As understandable as this is, it doesn't often prove useful. Current law and dialogue exsist to deter children from using, but the result is that all consensual adults still face up to 14 years in prison.

Mr Wolfe-Murray goes on to ask:

But can someone please explain the logic of decriminalising the possession of a substance which is illegal to supply? If I'm allowed to smoke dope does that mean the law turns a blind eye when I do a transaction with my supplier?

The logic is simple, and it's one that the Home Office acknowledges. When addressing the legal high market, the government did not choose to criminalise those in possession once the ban came into play. It was said that the criminalisation of the young has no societal benefits - this is owing to the lack of prospects due to a criminal record. Emphasis was placed on chasing supply routes. This, in essence, is how Portugal handle their drug policy.

Mr Rupert Wolfe-Murray then says,

When I was a student I thought cannabis was a harmless pastime, no worse than alcohol, and I was encouraged by the fact that it's not addictive.

Many years later I ended up working for an addiction rehab clinic in Scotland where I found out that not only is cannabis addictive but the skunk version of the drug is known to send as many as 20% of users into a psychotic state. In other words, it can drive you mad. And everyone knows that the THC content of street cannabis has been going up for years.

Pretty much any scientist would of course agree with Rupert's statement that cannabis is less harmful than alcohol: The Lancet published a harm scale of drugs and is widely regarded as accurate. The Department of Health also conveys an accurate source of information and drug related harms; the publication: A Summary of the Health Harms of Drugs is aimed at healthcare professionals; there's a notable disparity between the messages of harms that we've come to know in the UK to what is actually scientifically proven. Does this impact the drug education of our young? When reality doesn't measure up to the projected, virulent harms -- does this give way to a distrusting and confused youth?

Rupert Wolfe Murray continued:

I wonder if Sir Richard and his chums on the Global Commission on Drug Policy have been fully informed of the risks involved.

They should talk to Sue Philips from Newcastle as she was addicted to almost every drug available, as well as the methadone peddled by the NHS, for over 30 years.

Putting a pin in the example of a lady that admits she's been addicted to most drugs, it soon becomes apparent that Mr Wolfe-Murray hasn't read the Global Commission Report, or even indulged in a summary of the paper. It is owing to the potential and possible risks of any drug that the Global Commission makes its recommendations of a regulated market. At no point in the Global Commission report does it allude to any drug being safe, harmless, fun. Like most reform groups, it has seen the alarming trend in related harms owing to the feral nature of current drug controls, and addresses the complexity of the problem. This is perhaps the most irksome point of drug policy: the stringent belief that those wishing for reform do so based on nothing other than how 'safe' and beneficial a drug is when the antipode is true.

Of course, children should be prevented from using any substance, that's a given, but current law is compounding the culture of illicit substance use. A regulated market will not eliminate underage drug use, but it will certainly curtail and restrict.

As someone who works in an addiction field, Mr Wolfe-Murray must be aware how unattractive it is for those wishing to seek help with substance abuse owing to the punitive nature of law. Invariably, only those that can afford the privilege of rehab are the ones that can beat addiction. The example of a lady who has been addicted to most drugs is a clear indication that the notion of addiction & abuse is the problem, and not generic perceptions of individual substances. By all means, harms of all drugs need addressing, but current law does not allow this in a 'just say no' culture. Living in a constant state of altered consciousness is of course going to be crucially affecting, but the lack of citations in Mr Wolfe-Murray's blog becomes lucidly apparent at the mention of cannabis psychosis -- working in a treatment environment, you will get to see more cases of addiction and psychosis than the average person, but there's a statistic that Mr Wolfe-Murray uses that many have been left wanting a source. He says,

I found out that not only is cannabis addictive but the skunk version of the drug is known to send as many as 20% of users into a psychotic state. In other words, it can drive you mad.

The 'it can drive you mad' statement is a gross misinterpretation to say the least, no scientist will put their name to such a overstated claim. The ACMD undertook one of the most comprehensive reviews of cannabis to date. The conclusion? To stop 1 case of cannabis psychosis, you'd need to stop 5000 young men from using, and 7000 young women. And if that's not enough, I often use Dr Ben Goldacre of Bad Science at this juncture, and I should do so once again, he is indeed hard to argue with. By anyone's measure, the risks of psychosis are incredibly slim.

And to finally address 'skunk?' - I have done so at length.

So in answer to Mr Wolfe-Murray: cannabis does not drive you mad, and it is dangerously hyperbolic to suggest so. Drug policy is trying to move away from sensationalism and onto an evidence based platform where we can address harms and give rise to emplacements that will sufficiently decrease them. A regulated market of cannabis will give a correct balance of cannabinoids over the dire quality 'street weed' and 'soapbar' that now makes up most of the UK market. Regulation will give proper titration advice so as to avoid inadvertent abuse, and will stem the flow of teenage usage.

Or, we can continue down our current path and see more of the same.

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