For the past 27 years, working as an addiction psychiatrist, I have struggled with big industries that push their products more for their financial gain rather than the best interests of the clients they serve. The most disconcerting piece occurs when physicians or other treatment providers or governmental entities appear to be influenced by big industry, touting the party line and minimizing any downsides to the product. I have experienced this with the tobacco industry, the pharmaceutical industry and now with the marijuana industry.
It is clear to me that wherever it happens, the push to legalize medical marijuana is simply a back-door effort, by industry, to legalize retail marijuana. However, the lack of any regulations on the potency of THC in marijuana or marijuana products in Colorado has allowed the cannabis industry to increase the potency of THC to astronomical proportions, resulting in a burgeoning public health crisis.
The potency of THC in currently available marijuana has quadrupled since the mid-1990s. The marijuana of the 1980s had <2% THC, 4.5% in 1997, 8.5% in 2006 and by 2015 the average potency of THC in the flower was 17%, with concentrated products averaging 62% THC.
Sadly, the cannabidiol (CBD) concentrations in currently available marijuana have remained the same or decreased. CBD is the component of marijuana that appears to block or ameliorate the effects of THC. Plants that are bred to produce high concentrations of THC cannot simultaneously produce high CBD. Higher-potency THC has been achieved by genetically engineering plants to product more THC and then preventing pollination so that the plant puts more energy into producing cannabinoids rather than seeds. This type of cannabis is referred to as sinsemilla (Spanish for without seed). (It has also been referred to as “skunk” due to its strong smell.)
In my view, this is no different than when the tobacco industry increased the potency of nicotine by genetically engineering tobacco plants to produce more nicotine and then used additives like ammonia to increase the absorption of nicotine. Industry’s efforts to increase the potency of an addictive substance seem to be done purely with the idea of addicting as many people as possible to guarantee continued customers. This certainly worked for the tobacco industry. And we have increasing evidence that high potency THC cannabis use is associated with an increased severity of cannabis dependence, especially in young people.12
Although marijuana has been used for thousands of years for various medical conditions, we have no idea if the benefit comes from the THC or CBD or one of the other multiple cannabinoids present in marijuana, or a combination. And we have no idea how much is needed or how often. Most of the research indicates that it is likely the CBD that is more helpful but we obviously need research on this. There is no evidence that increasing the potency of THC has any medical benefits. In fact, a study on the benefits of smoked cannabis on pain actually demonstrated that too high a dose of THC can cause hyperalgesia – similar to what is seen with high dose opiates – meaning that the person becomes more sensitive to pain with continued use. They found that 2% THC had no effect on pain, 4% THC had some beneficial effects on chronic pain and 8% resulted in hyperalgesia.3
The discovery of the “active component” in marijuana that makes it so desirable is a fairly recent phenomenon. THC and CBD were first discovered in 1963 in Israel.4
Because cannabis was made a DEA schedule I drug in 1970, very little research has been done on cannabis in the United States and most of the indications for medical marijuana have very little good research backing up the use. The chemical that is made by the body and fits the receptor which accommodates THC was discovered in 1992.5
The researcher named the chemical anandamide which means “supreme joy” in Sanskrit.
However, it turns out that the endocannabinoid system plays a very significant role in brain development that occurs during childhood and adolescence. It controls glutamate and GABA homeostasis and plays a role in strengthening and pruning synaptic connections in the prefrontal motor cortex. The consequences of using the high potency THC products during this period, especially without the protective benefits of CBD, are multifaceted and include disturbance of the endocannabinoid system, which can result in impaired cognitive development, lower IQ and increased risk of psychosis.
There is also evidence that marijuana use contributes to anxiety and depression. A very large prospective study out of Australia tracked 1600 girls for 7 years and found that those who used marijuana every day were 5 times more likely to suffer from depression and anxiety than non-users.6
Teenage girls who used the drug a least once a week were twice as likely to develop depression as those who did not use. In this study, cannabis use prior to age 15 also increased the risk of developing schizophrenia symptoms.
While there definitely are people who can use marijuana responsibly without any untoward effects, similar to how some people can drink alcohol responsibly and not have any problems, there are people who are very sensitive to the effects of THC, and its use can precipitate psychosis. The higher the potency of THC the more likely this may happen and we have no idea how to predict who will be affected. In one of the first double blind randomized placebo controlled trials on smoked cannabis (maximum of 8% THC) for the treatment of pain, a cannabis naïve participant had a psychotic reaction to the marijuana in the study and this then required that all future study participants have some experience with smoking marijuana.7
This kind of makes it difficult to have “blind” unbiased participants.
A 2015 study out of London analyzed 780 people ages 18-65, 410 with first episode psychosis and 370 healthy controls, and found that users of high potency (“skunk-like”) cannabis (THC > 15%) are three times as likely to have a psychotic episode as people who never use cannabis, and the risk is fivefold in people who smoke this form of the drug every day.89 There was no association of psychosis with THC levels < 5%. Most of the marijuana in the U.S. is of the high-THC variety. Many retailers in Colorado sell strains of weed that contain 25 percent THC or more.
Sadly, Colorado has now joined several other states in approving PTSD as an indication for the use of medical marijuana. Marijuana does not “treat” PTSD any more than benzodiazepines or opiates “treat” PTSD. All these addictive drugs do is mask the symptoms, allowing the person to continue life unaffected by the memory of the trauma. However, the psychological trauma is never resolved and the individual has to continue to use the substance in order to cope. This sets the individual up for the development of addiction to the substance or the use of other addictive substances. There is absolutely no good research to support the use of marijuana for PTSD, and there is observational data that this would be a bad idea unless this use was supported by a lot more (andbetter-designed) longitudinal research.
In an excellent longitudinal, observational study from 1992 to 2011, 2,276 Veterans admitted to specialized VA treatment programs for PTSD had their symptoms evaluated at intake and four months after discharge.10
They found that those who never used marijuana or quit using while in treatment had the lowest levels of PTSD symptoms, while those who continued to use or started using marijuana after treatment had worse symptoms of PTSD. Those who started using the drug during treatment had higher levels of violent behavior too.
Those of us working in the trenches in Colorado are seeing the downsides of what our governor has called “one of the great social experiments of the 21st century.” Emergency room physicians are seeing a significant increase in people experiencing consequences from marijuana use since it was legalized. One such physician wrote a very poignant piece about his experience returning to his home town of Pueblo, Colorado where he is now practicing.11
His experiences are totally supported by the Rocky Mountain High Intensity Drug Trafficking Report, volume 4 from September 2016 which documents significant increases in marijuana related emergency department visits (49%) and hospitalizations related to marijuana (32%) compared to rates prior to retail legalization. This report also documents significant increases in the use of marijuana by youth, with Colorado youth “past month marijuana use” for 2013/2014 being 74% higher than the national average, compared with 39% higher in 2011/2012.
In Pueblo, Colorado, where I practice, it has developed into a perfect storm. According to the Healthy Kids Colorado Survey in 2015, we have the highest incidence of youth marijuana use in the state, with 30.1% reporting using marijuana in the last 30 days.
The legalization of retail marijuana seems to be reflected in the increased abuse of opiates and heroin too. In addition to the highest rates of marijuana use by youth, Pueblo has the highest rates of heroin-related deaths in the state.
This is a very disturbing correlation that needs attention. I have definitely seen in my practice that marijuana acts as a gateway drug to opiates, and to relapse to opiates after treatment if the person goes back to using marijuana. The Smart Approaches to Marijuana status report, which assesses state compliance with federal marijuana enforcement policy, following what is known as the Cole memo, documents that Colorado, four years after legalization, has failed to meet the specific DOJ requirements on controlling recreational marijuana production, distribution and use. This report documents a significant increase in drugged driving crashes, youth marijuana use, a thriving illegal black market and unabated sales of alcohol, which supports the idea that people are not using marijuana instead of alcohol but rather in addition to alcohol.
In spite of all this information, powerful people in the government of Colorado have publicly minimized the consequences. Larry Wolk, MD, the Chief Medical Officer for the Colorado Department of Public Health and Environment, has reported that he has “not seen any significant problems” with the legalization of marijuana.
Governor Hickenlooper’s response to Attorney General Sessions recent questions about compliance with the Cole Memo minimized the adolescent use of marijuana by saying that youth marijuana use in Colorado has “remained stable since legalization.” This is not true for Pueblo, but in any event, any use of marijuana by youth in Colorado should not be minimized and should be a major concern for future generations.
While there are people who believe we need to enforce federal law and go back to making marijuana illegal, I am afraid the horse is already out of the barn and cannot be put back in as we already have several states with “legal” retail marijuana and multiple more with “medical marijuana.” I cannot conceive of any way this could be reversed at this point, when the majority of society supports the legalization of marijuana.
Solutions to our marijuana problems have to be realistic to our current situation/environment. The number one solution is more education. Many people seem to lack a true understanding of the drug and all the potential negative consequences of the higher-potency THC. This is why education is so important. Adults should have the right to make their own decisions but they need informed consent, just like with any drug.
The biggest concern is with adolescent use and the developing brain. This requires a lot more education and increased efforts at prevention, early intervention and treatment. I believe society would be truly served by a federal ban on all advertising of addicting drugs including alcohol, tobacco and marijuana, as well as all pharmaceutical drugs. The decision to use a pharmaceutical medication should be between the patient and the medical professional, not influenced by big industry. We clearly have the big industries— alcohol, tobacco and marijuana—doing everything they can to influence the public and convince them to use their product.
Since we only have anecdotal evidence at this point that marijuana can aid any medical condition, I recommend eliminating “medical marijuana” and just have retail marijuana with limits on THC and regulations similar to alcohol and tobacco. This could help take away the perception, which adolescents and others have, that because is it “medical” it must be “safe.” In order to be able to say it is medical, it should go through the same standards for testing the safety and efficacy of any prescription drug.
In this vein, I believe we do need more research and that marijuana should be reclassified as a schedule II drug so this can occur. Since marijuana has been used medicinally for thousands of years, I believe that the plant deserves some true research to determine if and what parts of the plant are helpful medicinally. The reports that marijuana use resulted in less than 10% becoming addicted to it were done back in the 1990s when THC levels were <5%. Since we are seeing significant increases in people developing marijuana use disorder with the higher doses of THC, perhaps the limits on THC should be <5%.
* * * * *
Editor’s note: for more information, see the pdf of the author’s talk on this topic.
- Freeman TP, Windstock AR. Examining the profile of high-potency cannabis and its association with severity of cannabis dependence. Psychological Medicine. 2015;45:3181-3189. ↩
- Hasin DS, Saha TD, Kerridge BT, et al. Prevalence of marijuana use disorders in the United States between 2001–2002 and 2012–2013. JAMA Psychiatry. 2015;72(12):1235-1242. ↩
- Wallace M et al. Dose-dependent effects of smoked cannabis on capsaicin-induced pain and hyperalgesia in healthy volunteers. Pain and Regional Anesthesia. 2007; 107:785-796. ↩
- Gaoni Y, Mechoulam R. Isolation, structure and partial synthesis of an active constituent of Hashish. Journal of the American Chemical Society. 1964;86:1646–1647. ↩
- Devane WA, Hanus L, Breuer A, Pertwee RG, Stevenson LA, Griffin G, Gibson D, Mandelbaum A, Etinger A, Mechoulam R. Isolation and structure of a brain constituent that binds to the cannabinoid receptor. Science. 1992;258:1946–1949. ↩
- Arseneault L et al.Cannabis use in adolescence and risk for adult psychosis: longitudinal prospective study. BMJ. 2002;325:1212-1213. ↩
- Ellis RJ et al. Smoked medicinal cannabis for neuropathic pain in HIV: a randomized, crossover clinical trial. Neruopsychopharmacology. 2009;34:672-680.. ↩
- DiForti M et al. Proportion of patients in south London with first-episode psychosis attributable to use of high potency cannabis: a case controlled study. Lancet Psychiatry. 2015 doi.org/10.1016/52215-0366(14)00117-5 ↩
- DiForti M et al. Daily use, especially of high potency cannabis, drives the earlier onset of psychosis in cannabis users. Schizophrenia Bulletin. 2014;40:1509-1517. ↩
- Wilkinson ST et al. Marijuana use is associated with worse outcomes in symptom severity and violent behavior in patients with posttraumatic stress disorder. J Clin Psychiatry. 2015;76:1174-1180. ↩
- Roberts B. Dangers of marijuana experienced firsthand ↩
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.
Can someone on this website please write something for Kate Millet? She took a huge hit by writing the loony bin trip and now that she’s dead the new york times writes it as being about “being told she was bipolar.”
No one even interviewed her for the release of her book as far as the liberal feminist psychiatry worshiping elite was concerned the unmedicated “bipolar”was already dead. She helped Peter Breggin with Toxic Psychiatry. If you won’t write it I’ll submit something.
Amity Green, I published this article 14 years ago based on an extensive oral history interview with Kate about her experiences as a psychiatric survivor: http://www.community-consortium.org/pdfs/Interview%20with%20Kate%20Millett.pdf
Amity and Darby thanks for bringing Kate’s death. The article was great. There are a lot of connecting threads to her story in my life story.
One is her experience in the old style institution. Yes. I was in several as a vistor and intern.
And she was more spot on then she knew.
One summer I worked in a small basement room in my county’s probate court microfilming old commitment papers. It was clear the scam was on for many folks by family members. And there was always the death certificate months later for many.
Someone needs to research these records.
And the saddest part for Kate and for myself was we were forced to going to a place we already knew was hell. RIP Kate old gal.
Goddamn, I didn’t know, how long has she been gone? I well remember her incredibly anti-psychiatry Loony Bin Trip as well as her presence at a pre-“Mindfreedom” Support Coalition International event in NYC around 1990. Presente!
I was in Virginia on my way to a family reunion, and fleeing Irma, when I read in USA about Kate Millet’s death.
The Loony Bin Trip definitely has a previleged place on my book shelf.
Kate, and others like her, could definitely use a page. Losing her is a grievous loss to our movement–a movement that needs a few more more Kate Millets, and a few less Kay Redfield Jamisons, Natasha Tracys, Elyn Saks, etc., etc., etc.
Some of us aren’t “sick” and don’t “need” to be abducted, imprisoned, tortured and brainwashed in the name of *cough, cough* medicine.
Here’s to Kate Millet, and more mental patients’ liberation together with less mental patients’ bondage.
Did Kate choose to commit suicide? Or did the psych profession take a more active role?
At least two of my friends have died from psychiatry. Not their “mental illnesses” or suicide. Their “safe and effective treatments” were obviously to blame.
They died WITH THEIR RIGHTS OFF.
To find out in advance who’s likely to freak out when stoned, I’d use the Hoffer-Osmond Diagnostic test, which was used 50+ years ago to screen alcoholics for whether they were appropriate for LSD treatments. Not a personality test, it’s used to establish the stability of one’s perceptions- perceptual instability is a contraindication for hallucinogenic drug use. I don’t know if the International Schiz. Foundation still has a cheap pocket patient copy of the test, which it did when it was the old Canadian Schiz. Foundation.
You wrote: “Since we only have anecdotal evidence at this point that marijuana can aid any medical condition” but I think you are wrong. According to https://www.ncbi.nlm.nih.gov/pubmed/22716160 there is a body of evidence to support the idea that CBD may be a future therapeutic option in what we call psychosis. I have one adult daughter who is struggling with the incredibly difficult task of discerning how many of her psychiatric ‘symptoms’ are caused by original trauma (events stemming all the way into her childhood but also things that occurred as a result of psychiatric abuse (involuntary treatment, forced injection, coercion, restraints, isolation, loss of personal liberties, institutional betrayal by medical doctors etc.) and the psychiatric symptoms caused by the short and long term side effects of powerful “anti-psychotic” ( I use the quotation marks to denote that I do not believe they cure ‘psychosis) medications she was court ordered to take while being civilly committed for nearly eight years. You see, as one’s brain becomes habituated to these powerful drugs, one often becomes a shadow of one’s former self. The symptoms become harder to distinguish-how much is trauma and how much is attributable to the long term side effects of the drugs themselves? The legalization of medical marijuana has given us some interesting options.
My daughter wants to use pot to help her withdraw from meds that she finds even more debilitating than the symptoms of what we call psychosis in order to live safely in the community on her own terms and given some of the adverse drug reactions like akathisia I’ve witnessed while overmedicated, as well as the excruciating pain of acute withdrawal (micro and major withdrawals) which most prescribers arrogantly dismiss as the ‘original illness’ coming back, I would cautiously support an approach using marijuana if my daughter were given such an option. I would like her to have a chance to make her own decisions on what to put in her body and in a corporate environment, patients have become like cattle in a chute, not too many choices. Everyone is different. THC has some potential risks yet doctors like you who point out the most obvious risks of marijuana use are very slow to point out the risk of prescribing opioids, benzos, anti-psychotics, SSRI’s, etc. Pot can’t be much worse than the horrific and debilitating drugs my daughter was forcibly injected with such as Haldol, Thorazine, etc. etc.
While I agree with your call for more regulation such as a cap on the amount of THC in retail marijuana, I think you are throwing the baby out with the bathwater.
Ironically, early screening for depression in youth in our public school system has most certainly resulted in an up tick in the number of children being medicated with powerful medications that have never been tested on children. Many SSRI’s carry black box warnings for increased suicide among youth. Strange, how doctors have been very quick to recognize the dark side of THC which I acknowledge exists, but very slow to criticize those in the addiction industry and depression industries who are quick to get their patients habituated to powerful drugs with debilitating side effects.
Thank you for saying this.
I am sorry to hear about your daughter’s situation and your experiences. I agree with you about the harm that psychotropic medications can do. In fact I have spent most of my career getting people off psychotropic medications. I find that many people are “misdiagnosed” in my opinion and that they are often suffering from previous life trauma and medications are not the solution. I see them because they have often turned to addictive drugs as a way of “self-medicating” and then they get put on all other kinds of medications with no one ever stopping any – just adding more. It is often extremely difficult to get people off medications when they have been on them for a long time but we have been fairly successful in helping quite a few people do this – but it takes commitment and support. I have indeed seen the research you are referring to but this is about pure CBD and is in very preliminary stages – as they say – “might” help with psychosis. I do think there might be benefits from CBD for many things however I believe we still need more research. For example, there have been anecdotal reports of children with severe seizure disorder benefiting from CBD oil but there are also reports of severe side effects from the CBD and in some cases worsening of the seizures. I would not recommend someone with psychosis smoking “pot” to see if it helps if it has any THC in it. I would not recommend “smoking” anything as a matter of fact.
My son’s girlfriend was recently diagnosed with cervical cancer. She is suffering from chronic daily pain but she has a hard time tolerating the side effects of prescription painkillers (narcotics) so she tried CBD yesterday. She was embarrassed to ask her treatment provider for a medical marijuana card and not only did her gynecologist approve, he called around town to find a dispensary that offers pure CBD. She called me yesterday to report the CBD works! (She is taking half the dose of the narcotics with much better results and no side effects. She is pain free, in good spirits, waiting for the scan results to see if the cancer has gone into her lymph nodes. Knowing that she has a new tool in her tool kit to deal with chronic pain, has given her a new sense of hope and optimism. She reported that she is not groggy and ‘on edge’ as with the narcotics, alone. If this is placebo, it comes with a powerful body of anecdotal evidence behind it and we are now a part of this movement away from legally prescribed pharmaceutical drugs, many of which have wrecked lives more than the average MD is willing to admit. The marijuana prohibition for decades delayed people’s ability to experiment with this tool but we need more choices not fewer. It may need more regulation but be wary of ringing the alarm bell prematurely until people have had a chance to experiment judiciously with this new tool.
Bless your heart, “madmom”! Yes, the human body does have an endocannabinoid system. CBD oil does not contain THC, the main “psychoactive” ingredient in cannabis. CBD itself also have many complicated chemicals wrapped up in their. Different strains of cannabis have different profiles of CBD, and different effects. The “cutting edge” of cannabis science is advancing so quickly, that it’s hard even for experts to keep up. A good dispensary, and good people who you can talk with, ask questions, and get good information from, is crucial. They ARE out there! Please keep us posted, and we will pray for you and your family and loved ones.
I have heard cannabis can soothe extreme nausea and help chemo patients put on weight. It might be good to legalize it for medicinal use, but since no one will admit your daughter has an iatrogenic illness from those “safe and effective” poisons it wouldn’t help her. Sad.
My 80 year old mother had a large sarcoma in her lower back. The pain was excruciating and the chemotherapy made it impossible to keep food down. She was constantly nauseous. My brother got her to smoke marijuana and her appetite not only increased, she was finally able to hold food down. She enjoyed a complete recovery from cancer and lived another decade (she died of heart disease ten years later). After her recovery from cancer, she no longer smoked marijuana, and joked about her foray into crime (at the time it was illegal). The only sad part about that story is that my brother risked incarceration by purchasing pot illegally from a street source.
….according to Elizabeth Stuyt, she should have become a violent, psychotic cannabis addict!….. (Honestly and realistically, he was risking arrest, yes, and maybe criminal prosecution, but his risk of actual incarceration was VERY low, except in a few backwards areas…. I’ve had several local cops tell me that they are NOT looking for weed users, only the “hard stuff”….) Yeah, I know, but still….
I find all the concern about the potency of the drug to be a little lame. In the past, people had to smoke a lot of pot to get really high if they wanted to – and they did, when they wanted that. Now people don’t have to smoke nearly as much. Smoking less seems good for the person’s lungs. The idea that high potency equals danger seems to rest on the idea that people will get way more high just because it is more potent – as though people have no ability to regulate how much they smoke, or otherwise ingest.
Like any drug, we need to hear about the bad as well as the good about pot. But for too many years, we have had lots of hype about how bad it is, and all this concern about dosage sounds like more hype to me. (For example, the hype that pot use leads to other drugs. In regards to opiates for example it seems more likely that pot use leads to less opiate use – https://www.nbcnews.com/health/health-news/legalized-marijuana-could-help-curb-opioid-epidemic-study-finds-n739301 )
There was an experiment at the Institute of Psychiatry at King College, London, that looked at the relationship of the effects of the two main ingredients in cannabis, THC and CBD. You can see a video of a reporter participating in the experiment here. Her mixture of THC and CBD left her with the giggles: “No matter how hard I tried to take the experiment seriously, it all seems hilarious.” But with pure THC, it was a different story. “It’s horrible. It’s like being at a funeral . . . Worse . . . It’s just so depressing. You want to top [kill] yourself.” Here’s a link to a video of the above: https://www.youtube.com/watch?v=6U8XARojnbM
The concerns with the rapidly growing strength of marijuana in its THC content is because of its relationship with psychosis. Nora Volkow, the current NIDA director, published a study noting where the adverse health effects related to the recreational use of marijuana was the highest in adolescents, “Adverse Health Effects of Marijuana Use.” Cannabis use as a component in the emergence of psychosis is reliably documented, and was noted anecdotally as far back as 1845 in “Hashish and Mental illness.” Read about these claims and more, if you are interested, in my articles, “Shatter and Psychosis” and “Marijuana & Adverse Health Effects” on http://faith-seeking-understanding.org/
Chuck, if the experience of taking pure THC is so terrible, I’m sure we don’t need laws to keep people from doing it! One of the nice things about having pot be legal is that people can know about the balance of THC and CBD in the strain they are buying, so they are more likely to get the experience they want.
Of course, it’s also possible that some people will enjoy the same drug that another person hates. People don’t all react the same to a substance.
I would agree that it makes sense to discourage pot use in adolescents, and that at least in some cases, pot use can contribute to psychotic experiences (I had that happen to me when I was a teenager.) But it is not clear that pot on average is making more teenagers psychotic – see articles like https://www.scientificamerican.com/article/can-marijuana-cause-psychosis/ We need a balanced approach to this topic, not one that exaggerates problems and then advocates for arresting and imprisoning people to “solve” those problems (without ever considering that there are huge costs to labeling people’s choices as criminal and locking them up.)
From an article I wrote: “Listening to Marijuana Research”:
Staci Gruber, who is the director of the MIND project, has been doing research into the effects of MJ since the early 1990s and has documented some interesting neurological effects from MJ. She led a 2013 study that found there were differences in the brain’s white matter and impulsivity between teenagers and young adults smoked an average of 25.5 joints of MJ per week and a control group who did not smoke MJ. Their research suggested that in some individuals who begin smoking MJ at an early age, differences in brain function and structure emerge during development. The study sample was small and it was not clear if the brain changes resulted from MJ use or predated MJ use. The changes could have occurred as the result of either chronic MJ use or reflect a delay in brain development in MJ smokers.
“These data represent the first report of significant alterations in frontal white matter fiber tract integrity that are associated with self-report measures of impulsivity in chronic, heavy MJ smokers, and appear to be related to age of onset of MJ use. . . . Future investigations should include additional measures of behavioral impulsivity and their relationship to age of onset of MJ use to more fully explore the potential neurodevelopmental aspects of white matter changes in MJ smokers. Findings from this study suggest that changes in white matter microstructure may be predictive or associated with increased impulsivity, and may ultimately contribute to the initiation of MJ use or the inability to discontinue use.”
A follow up study done by Gruber and others was published that same year, 2013. The study confirmed that heavy MJ smokers had lower levels of white matter in the corpus callosum region of the brain; and that earlier age of MJ use was associated with these lower levels of white matter. MJ smokers also had higher levels of impulsivity.
“Taken together, these findings reinforce the idea that early onset of MJ use negatively impacts white matter development and is associated with behavioral impulsivity, a combination that may have enduring negative effects, particularly on the developing brain. Data from this study highlight the importance of early identification of MJ use among emerging adults and the need for efforts aimed at delaying or preventing the onset of MJ use.”
Then a third study by Gruber and her research team at MIND published in the March 2016 issue of the Journal of Studies on Alcohol and Drugs found that MJ smokers had poorer executive brain function than the control group. The difference seemed to be primarily the result of early onset of MJ use, before the age of 16. The differences remained even after the frequency and amounts of MJ used were controlled. Additionally, the early MJ use and the greater amounts of MJ used predicted poorer performance and errors on the Wisconsin Card Sorting Test (WCST), which is used to assess abstract thinking. “The WCST is also considered a measure of executive function because of its reported sensitivity to frontal lobe dysfunction.”
“These findings underscore the impact of early onset of marijuana use on executive function impairment independent of increased frequency and magnitude of use. In addition, poorer performance on the WCST may serve as a neuropsychological marker for heavy marijuana users. These results highlight the need for additional research to identify predictors associated with early marijuana use, as exposure to marijuana during a period of developmental vulnerability may result in negative cognitive consequences.”
Here is a link to the full article: http://faith-seeking-understanding.org/2017/02/20/listening-to-marijuana-research/
Here is a link to MIND (Marijuana investigations for Neuroscientific Discovery): http://drstacigruber.com/mind/
You wrote that “These findings underscore the impact of early onset of marijuana use on executive function impairment independent of increased frequency and magnitude of use.” Well no, they don’t. You are jumping ahead of the actual evidence.
The problem is that the experimenters didn’t just randomize kids into those who were going to smoke early and those who wouldn’t smoke: instead, they worked with a group who self selected to smoke or not. And a contrary hypothesis would be that those who decide to smoke a lot are those who already are likely to have the brain differences you mentioned. The marijuana itself may have nothing to do with it.
I seem to recall a study where it was found that kids who smoke marijuana were more likely to have been sexually abused, and the sexual abuse itself may be what often led to brain changes that then led to vulnerability to psychosis. Other kinds of trauma, and factors in addition to that, could also be at play. I’m not saying we should rule out the possibility that pot is itself causing serious problems, it’s just that we shouldn’t jump to that conclusion, especially when there are so many people ready to ruin lives in another way, by throwing people in prison for the crime of using or selling substances not provided by psychiatry.
You have to actually read the studies on this. Yes it is true that there was a reduction in hospitalizations for opioid overdoses (13%) in states that legalized medical marijuana but the people in the studies were middle aged folks who were using opiates for chronic pain and they found by switching to marijuana, they experienced some benefit and reduced their opiate use. And this was all before the legalization of retail marijuana anywhere. So for this group of people – there was this benefit. However, especially since 2013 with the legalization of retail marijuana, marijuana use in adolescents and young adults has significantly increased and the use of opiates in this group has also significantly increased, with a significantly steady increase in opioid overdose deaths in this group. They are not using marijuana for chronic pain. They are using marijuana to get high and they are not using it instead of other drugs, they are using it in addition to other drugs.
Since 2013 the use of opiates has increased all over the US. Is it possible that this, and not legalized pot, might be behind any increase in teen use of opiates?
Maybe instead of making recreational pot illegal again, so sacrificing tax revenue, turning the recreational pot market over to black market people, and then spending lots more tax money to arrest and imprison people (and you have to add on the massive social cost of harming the people who are imprisoned) – maybe instead of that idiocy, we could actually spend a little money helping protect teens from abuse and helping them find something better to do than use drugs? Remember rat park http://www.brucekalexander.com/articles-speeches/rat-park/148-addiction-the-view-from-rat-park
After sidelining Madness In America for months due to a grossly irresponsible post on cannabis (Marijuana and Suicide, March 24, 2017), my careful response ignored by the editors, I made the tactical error of having a look this morning. Elizabeth Stuyt’s post is a similar conflation of poorly-understood political economy, refusal to accept a long-standing body of knowledge, and attempting to use nonexistent/prohibited research to buttress an argument.
It’s bitterly ironic that lashing out at the cannabis industry as profit-driven and unconcerned with public health frequently pivots toward the authority of dysfunctional institutions, an avenue down which Dr. Sue Sisley was waylaid, and also lurks Big Pharma. What could go wrong?
In short, while MIA serves an important function in questioning the motives of psychiatry and the avalanche of worthless/dangerous psychotropic meds, on cannabis the editors have not made it past the fear, uncertainty, and doubt that have fueled the utterly failed Drug War for almost fifty years. It’s quite unacceptable.
Throughout the lies and deceptions of long-term cannabis prohibition, average people have, as with many other herbal remedies, established their own methods of understanding and developing use of this most benign of plants. The best news is that acceptance of cannabis among the younger generation continues to expand beyond historic boundaries, and baseless fear-mongering sits nervously in Darwin’s waiting room. In Massachusetts, home grow has taken off like a rocket; before long it won’t be “You’re growing?” but “Why aren’t you growing?”
In time, the false gravitas of articles like this will be reduced to weak punch lines. Here’s to it.
Until then, thank you for attempting to restore reason to the discussion.
Let’s add a little bit more balance to this issue.
“Sadly, the cannabidiol (CBD) concentrations in currently available marijuana have remained the same or decreased.”
Maybe in *your* neighborhood, but as someone who has lived in an area almost wholly supported by the pot industry, this statement is bunk. Lots of growers are specializing in CBD strains; it’s all the rage.
This author needs to get out more.
Yes, I get the types that have increased CBD levels, and I find them very helpful…
Age 18 and not responsible for your actions ?
“In physics, we use the same laws to explain why airplanes fly, and why they crash. In psychiatry, we use one set of laws to explain sane behaviour, which we attribute to reasons (choices), and another set of laws to explain insane behaviour, which we attribute to causes (diseases).” Szasz
I was encouraged to see your article, Dr. Stuyt. As a therapist working primarily in addiction settings for about thirty years, I’ve had similar concerns about the issues you noted here, namely the growing strength of marijuana, the backdoor strategy with medical marijuana approval as a gateway to recreational marijuana, and the largely under-regulated or unregulated nature of the market. I recently wrote an article on how legalization has helped the black market for marijuana to flourish, “Pot Market Getting A ‘Black’ Eye,” instead of the rhetoric that it would lead to weakening or the end of illegal marijuana sales. Here’s a link to the article, if anyone is interested: http://faith-seeking-understanding.org/2017/09/08/pot-market-getting-a-black-eye/
Thanks Chuck, You are absolutely correct, the black market is flourishing here in Colorado. Especially in Pueblo where the cost of living is cheaper than most of the state and it is easy for people to buy houses and turn them into grow sites. We have also had numerous grows in the National Forests surrounding Pueblo and recently there was a report that the police have confiscated over 27,000 plants so far.
Absolutely, the black market is flourishing and drug cartels have gone no where. They are targeting children under 18, doing great in places like Oregon where marijuana was legalized but pot shops were voted down, and all of the reasons you mentioned too.
I don’t think it was mentioned in your article, but since some states have legalized, the Mexican drug cartels took a hit in marijuana profits and are now pushing more heroine, crystal meth and fentanyl. It’s working out great for them, actually, beaucoup profits with our horrendous opiod epidemic.
I’m not getting this “appeal to nature” fallacy that comes up when the topic of marijuana comes up, either. Arsenic, cyanide, toxic mushrooms, cocaine and heroine (poppies) are “natural” too, natural doesn’t necessarily mean not harmful or safe. If anyone wants a mostly “safe” natural herb for relaxation, with minimal side effects, try passionflower or lemon balm.
And no, unleashing everything harmful into society because some harmful things are legal too is no solution and completely foolish. Even Portugal is telling us don’t do what they did in a small, homogenous nation in a place like the United States (and despite what people like to pretend, it’s not all sunshine and rainbows over there either). You do see more drug usage when people see substances as not being that harmful, addiction/ substance abuse rates go up (and we love our substances here in the States), and more people seek treatment when things don’t end up being as safe and harmless as they thought. And we all know what happens in “treatment”, they just churn out more people with diagnoses and put them on prescription psych meds. Seriously, be careful what you wish for.
I’m reminded of that saying, “today’s problems are a result of solutions to yesterday’s problems” (or something like that). At the very least we should just leave things alone and observe, not create more problems for the future with our “solutions”.
Interesting read on what’s been going on with the drugs coming in from Mexico in recent years. We don’t live in a pot happy, safe, utopia bubble here in the States (even if some people don’t have the negative side effects), what we do affects other countries too, and is fueling some pretty serious problems:
(And for the record I’m not over 70 or a Republican..not that there’s anything wrong with that!)
Hey if the problem is high potency THC happening due to industry and that some people use medical marijuana with other drugs here is solution.
Allow USA citizens to grow their own in their back yard and will be able to go back good THC levels.
If they grow too much or sell make that illigal.
This is highly misleading. For example, you forget to mention that ‘Colorado Department of Public Health and Environment says cannabis consumption by teenagers in the state “has not changed since legalization either in terms of the number of people using or the frequency of use among users.” That conclusion is based on data from NSDUH and the Healthy Kids Colorado Survey, which has a much larger sample of Colorado teenagers.’ https://reason.com/archives/2017/04/20/does-legalization-boost-teen-m
Also, this: “Survey data released today indicate that teenagers were less likely to smoke pot last year than at any point since 2002, despite the message supposedly sent by the relaxation of marijuana laws during that period.” https://reason.com/blog/2017/09/07/despite-legalization-adolescent-marijuan
As for the increase in hospitalizations, it could easily be the result of people experiencing a bad high (getting paranoid and all) being more willing to seek help now that it’s legal, whereas before, they’d tough it out on their own.
As for long-term problems like anxiety and depression, you haven’t established causation at all. It could be the other way around just as easily: People with problems could be more likely to smoke more as a way to “escape” (or at least try to).
The “gateway theory” has long since been debunked and I am surprised you are even bringing it up. The great majority of pot smokers don’t go on to hard drugs like heroin.
But even with hard drugs, it’s not black and white. For example, ‘ https://reason.com/blog/2017/08/16/heroin-death-rate-rises-among-teenagers
‘The CDC reports that the rate of heroin-related deaths among 15-to-19-year-olds tripled between 1999 and 2015, rising from 0.3 to 1 per 100,000. Yet during the same period, according to the Monitoring the Future Study, the incidence of heroin use among 10th- and 12th-graders fell by 64 percent and 55 percent, respectively. By 2015 teenagers were much less likely to use heroin and much more likely to die as a result of using heroin.’
So contrary to the expectations of many, a decrease in heroin users is actually not leading to a decrease in deaths.
Overall, very sloppy article. Disappointing.
Studies looking at whether marijuana is a “gateway” to other drug use have typically looked at the general population level and they have found that marijuana is not a gateway drug. BUT I don’t ever recall seeing or hearing of an investigation of the marijuana “gateway” theory that looked at a sub-population of individuals at high risk, say individuals with a family history of at least one parent with a drug/alcohol misuse problem; or some other sub-population factor or history of personal or family dysfunction. So Dr. Stuyt’s comment that she has “definitely” seen marijuana as a gateway drug to using opiates and to relapse back into using opiates after they quit is valid. I have regularly seen the same thing in my clinical experience.
Marijuana is not a “gateway” drug to using harder drugs at the general population level. But with sub-populations of high risk individuals or individuals who have a history of opioid misuse, alcohol misuse, etc. social/recreational use of marijuana can lead to experimenting with opiates or cocaine, etc., or lead the person back to the active opioid use they were trying to avoid while “recreationally” using marijuana.
Chuck, I tghink you can’t see the whole big, beautiful forest for looking too long and hard at a few diseased trees. (Pun intended.) To whatever miniscule extent cannabis may be a so-called “gateway drug”, it is FAR MORE a GATE-KEEPER “drug”. Most cannabis users do NOT go on to use other, stronger/harder drugs. So, *IF* cannabis is a “gateway drug”, then what’s the “gateway drug” to cannabis? Alcohol? Tobacco? OTC’s? PhRMA? Kool-Aid? Pop-Tarts? Doritos?….
I find your entire argument pedantic, outdated, and intellectually deficient. As Goebbels showed us, you can’t make the untrue true simply by repeating it often enough, but you CAN get the gullible to believe and repeat it….. Happy, well-adjusted people don’t EVER become addicts or abusers of ANY drug or substance….
We will make little, if any progress by continuing to play the Blame Game against inanimate substances….
(c)2017, Tom Clancy, Jr., *NON-fiction
….it’s ALSO VALID to say that I continue to receive Christmas presents from Santa Claus….
I really like how you have “re-framed” this Chuck. Yes – it is the population of people who are at risk for addiction, for what ever reason, in which I believe marijuana is a gateway drug. I have had several patients who were addicted to heroin in our program who told me that they knew they needed to stay away from marijuana or they would be right back to using heroin if they started using marijuana again. One even bemoaned the fact that he felt like he would have to leave his beloved state of Colorado in order to stay away from heroin because there are marijuana dispensaries on every corner – his words.
Thanks for the effort, Explorer86, but on cannabis MIA is like Animal House:
D-Day: Drug war’s over, man. Voters dropped the big one.
Bluto: …Was it over when the Germans bombed Pearl Harbor? Hell, no!
Boon: Forget it, he’s rolling.
THC/CBD concentrations and ratios are something for the market to decide, it should not be regulated, as a plethora of strains are available.
Selective breeding is hardly “genetic engineering” btw.
Why is there such a fear and denial of the deleterious effects of marijuana? Those I know who have died of drugs began drug use with marijuana, not with opioids. Other than Chuck Sigler, I am shocked that the people writing here question the validity of a doctor runs an addictions center in a state where marijuana is commercialized. She would have the experience to know what she’s talking about. I find Roy Unger’s dismissal of the high potency marijuana disturbing. This stuff led to the horrific deaths of Daniel Juarez and Levy Thamba. In Washington it is bet/22 and 28% THC. I went into Portland dispensaries and found mostly high THC, low CBD products–nothing that was balance.
The truth about THC is Colorado had a chance to lower the THC last year, as residents introduced a ballot to cap the THC at 16%. The marijuana industry bought off the ballot. They spent about $1 million to do it. So Dr. Stuyt’s idea of limiting the THC cannot become reality. These are greedy businesses that want to make money. It’s amazing that people who see through tobacco and pharma can’t see through the pot industry. If you pay attention, there’s nothing it doesn’t heal in the industry’s opinion.
Even recently in Oregon, an 18-year-old named Brandon Powell went psychotic from dabs and then went missing. He was found dead a month later. I wouldn’t be surprised if the 15-year-old from Vancouver who threw the firecrackers that started the Eagle Creek fire was stoned. His friends also — they were giggling as they did it.
Those who write on this thread didn’t comment on the studies that linked it to teen depression, especially females, a serious issue today. Why do they not take these concerns seriously? I think it’s because pot using people have propagandized that it is not addictive and that it’s safe to drive and that it won’t give you cancer. I have friends whose children or family members have gone psychotic from marijuana use. They end up permanently disabled, and in a few cases they killed themselves or tried to do it after heavy pot use. The number of people led to suicide from marijuana use is staggering, and the connection to schizophrenia is serious. (Read Patrick Cockburn’s book, Henry’s Demons). In fact the best way to protect yourself from having mental health problems is to never use marijuana. For so many people, marijuana was the gateway to psychiatric treatments We could largely get away from the need for psychiatrists and MIA, if we educated better against pot and other drug use.
Those I know who have died of drugs began drug use with marijuana, not with opioids.
Actually I bet they started with cigarettes, coffee and/or sugar.
You forgot the heavily marketed OTC’s……and the snake oil and patent medicines from the 1800’s….. What “jewelsfs”, et al, all want to ignore, is our DRUG $OAKED SOCIETY…..and those who PROFIT from that…. After all, it was Bayer which gave the world Heroin, as a patented, trademarked, brand name CONSUMER PRODUCT, – over 125 years ago!….
I have known a great many casualties of psychiatric drugs. Some of them may have started with marijuana. Some of them wouldn’t touch the stuff. You’ve got people on benzos who wouldn’t touch alchohol. I’d say they might as well. There’s not that much difference between the “anxiety relief” benzos provide, and the lowering of inhibitions you get with social drinking.
Explorer 86, I wonder why you believe all those reports? What about the fact that the survey you quote (and politicians quote it in Colorado, too) that left out the largest counties? Do you believe everyone is honest. In Pueblo where Dr. Stuyt lives, the teen use is really an ongoing social problem. So is the homelessness.
Explorer 86, there are articles by Dr. Jasmin Hurd that shows that using marijuana primes the offspring for heroin addiction. Yes, it was a gateway for those who died of drug abuse.
this appears to be a very poorly researched article. there is quite a lot of study looking at how CBD and THC interact and how they are each medicinal and when.
I’ve spent time in CBD groups on facebook and the results for quite a lot of brain injured and neurologically damaged folk is pretty phenomenal some of the time. there is lots of evidence to it’s being very supportive to the nervous system….
no attempt to speak how THC and CBD differ is also pretty irresponsible and suggests a complete lack of knowledge about how these substances are being used.
in states where THC is not legal CBD is gaining ground and it certainly comes in all sorts of dosages…
this article made very little sense to me in terms of what I’ve learned and experience among folks who use cannabis products.
in the end these products are herbals. like all things they are not appropriate for everyone all the time but they are, at least some of the time, also saving lives. … most notably children with severe epilepsy respond very well to CBD…
I don’t know much about cannabis, but I know a lot about people thinking that whatever drug/”medicine” will be the solution to all their problems, or just some of them.
People thinking that there’s an easy way out.
Thinking that they can numb the feelings and get through life like that. Well, they can. But don’t call it healing.
Just be aware of what you’re doing and why. Taking marijuana – or coffee, or sugar, or heroin – why?
And not kidding anyone that any of this stuff is harmless. You can never predict how it’s going to affect YOU.
It’s Reefer Madness all over again!
It’s not only Colorado that has a big problem with “recreational” marijuana. This hospital in Washington has 1-2 new psychosis patients everyday. They stabilize the patients by giving them Risperdal, perhaps hooking them into the mental health care system. http://www.theolympian.com/news/local/marijuana/article54985485.html
Gotta ask, are you:
A Psychiatrist-addiction specialist?
A medical professional associated with the psychiatric industrial complex?
Have you ever taken anti – depressants?
Do you work for a pharmaceutical company that competes with cannabis products?
Do you smoke cigarettes? (If you’re a psychiatric nurse, you may)
Have you ever been hooked on legal, big pharmaceutical drugs?
Do you have relatives with Cancer?
Have you ever met someone with Cancer?
Do you belive that opiods and cigarettes are also seriously addictive, and are gateway drugs?
I believe you are certainly misguided. Ask yourself: Who am I harming? What are my motives? Why am I in league with those who harm others. Then quit because you are not helpful, nor welcome on a site that is frequented by those who seek refuge from those that would harm them for profit. Be well!
5 & 6 Was a smoker and the only time I took an anti-depressant was for a different purpose, to quit smoking. It was Welbutrin (Zyprexa) and it did the trick. I took it for about 6 months.
7. No relatives have cancer although there have been in the past.
8. The people I know who were recommended to try marijuana for their nausea related to cancer did not like it.
9. Of course I believe opioids and cigarettes are seriously addictive. Marijuana is more of a gateway drug than either opioids or cigarettes, in my opinion.
10. Did you read Libby Stuyt’s article and read how teen girls are harmed by it? For you information, my views are from living with a family member who was seriously unhinged by marijuana use, and delusional. Most of us who have such awful reactions to being against the drug were somehow affected by it in our families. We are not close-minded, conservatives as you’d like to say. I am curious to understand why you think it is just fine to let people mess up their brains, as those people in Olympia, WA who get roped into the mental health system from doing marijuana “dabs”? I do not buy the idea that racism is the reason that pot was made illegal. Massachusetts banned it in 1911 and it wasn’t a racial issue there. It was because there are people who become psychotic from it. It is a public health and safety issue, as well as the desire to create addiction for profit, which is what the marijuana industry does.
How do you explain psychosis in people who never used cannabis? Considering the MANY factors that can cause this so-called “psychosis”, HOW do you even know you’re talking about the same thing, in different people. There is NO blood, lab, chemical, or objective physical test for this illusory “psychosis”. “Psychosis” is just you calling some people crazy sometimes. If cannabis caused “psychosis” to the extent that you claim it does, then we should in fact have a lot more crazy people than we do…. And, Olympia Hospital discharges “most patients in a couple of hours”….That sounds like a pretty low-level “crisis” to me…. And 1-2 per day is not much, given the population size, and rise in numbers of new users, and lack of organized cannabis use education….
Sorry made a mistake. It was Zyban that I took for 6 months to quit smoking awhile back, and that is also called Wellbutrin (not Zyprexa, which is a much more potent drug.
I agree that we should keep recreational Cannabis out of the hands of people under 21.
However, it’s fair to assume that people who frequent this site agree that psychiatry isn’t the best option for the mentally ill because of profit motive, greed, hubris, addiction, and many other issues that psychiatrists wrestle with.
The author is also an addiction specialist and a Psychiatrist! They make money off of addicts. Should cannabis be legalized they stand to lose a great deal of money and prestige.
There are bigger concerns for our medical professionals to tackle. Things like: mending bones, creating more options for the physically impared, practicing their golf swing; restraining their colleagues from writing excessive Adderal, Oxy and Klonopin prescriptions, researching Cancer (in a non-profit way).
There are so many positive things doctors can be doing, but they make less money doing them, or they simply enjoy a carreer that is easy for them to maintain.
Cannabis isn’t for everyone, but neither is alcohol, opioids, anti depressants, heroin, asprin, coffee and sugar.
Also, much of the research for or against cannabis use isn’t there because cannabis is illegal and thus difficult to study.
Ms. Stuyt and her industries’ Medical Doctors will always have their 8 years of medical training to fall back on, and she will always have other “addictions” to treat. If not, I’m sure she and her colleagues will make them up as they go along.
Most of the studies are not from the USA. They come from around the world. Also, the World Health Organization put out a huge study about cannabis last year with tons of footnotes. You may want to check it out. The National Academy of Sciences put out a study in January. For its final paper, it reviewed 100 studies; the 100 studies were chosen for close examination from 10,000 medical studies. I strongly disagree with the statement that cannabis has not been studied well.
This document has 13 pages which summarizes some of the studies on cannabis: http://momsstrong.org/wordpress/wp-content/uploads/2016/01/Summary-of-literature-on-marijuana-and-psychosis.pdf
Again, as I stated above, I lived in an area whose economy revolved around marijuana. In my non-scientific, personal opinion, I saw FAR MORE damage from alcohol and methamphetamine than I ever did pot.
Pot is smoked by *all kinds* of people, not just bums and deadbeats. Humans have been altering their consciousness for millennia! Herbs and plants have been used in rituals and ceremony for eons! Pharmaceuticals cause far more damage than pot, imo.
Those who go on to other recreational drugs and become addicted have more going on in their social milieu that predisposes them to escape their pain with drugs. *gateway drug* HOW QUAINT!
Who funds this author? Who funds these naysayers? Who is threatened by legalization? Cui bono?
The history of the criminalization of marijuana is an interesting one; it has everything to do with threatened industries and not much to do with ‘protecting’ the public.
If I wasn’t feeling so impaired after my years of psych meds, I’d give out some links, but in my world all this is common knowledge.
You new commenters; where did you come from and who do you work for???
Humanbeing, I agree with your post, “reefer madness” was started for racial issues stemming back to Anslinger, and to the DEA of today.
It’s insane how these individuals have no compassion for the sick, repressed or uninsured. That is, unless they are making money off of them.
I agree with many of the views on this website. However, I do disagree with most Mr Whitaker’s views on psychedelics, and their impact on mental health.
He’s missing that some Baby boomers didn’t have to be medicated on psychadelics to become jerks. They were brought up that way. That should be researched a lot more than the dangers of cannabis.
Cannabis may not perfect, but it’s better than the synthetic garbage the big pharmaceutical companies push.
Doctors should fix peoples’ bodies, and they shouldn’t be shills. I have to believe that even they philosophically agree with that.
We have bigger fish to fry than attack a plant that heals people; However annetotal the evidence is on both sides of the argument.
you clearly do not know me and you are making a lot of assumptions about me that are not true. I am afraid you probably don’t care to know the truth because it helps you to lump all psychiatrists together but I have spent most of my career trying to help people get off drugs and that includes psychiatric drugs. I have never been a big fan of medication. They are definitely never the solution. Sometimes they are necessary in the short term but I work very hard to help people get off psychotropics. Initially it is usually a hard sell because people have been led to believe that they “have to have them”. However, with commitment and perseverance my team has been successful in helping a lot of people find recovery and do it totally drug free (including tobacco and pharmaceutical drugs). I work in a state funded 90-day dual-diagnosis inpatient program where the state foots the bill so I am not “profiting” off of addiction or patients. It is amazing that we have this program available for those who have failed previous treatments. And is it very gratifying to see people find that they can live life without any mind altering chemicals – whether it is pharmaceutical or an addictive chemical including marijuana. This is why I work in this field.
I couldn’t agree more with this entire article. I would hope that people will recognize that Big Marijuana is no different from Big Pharma.
Dr. Berezin, you’d do better to agree much less with this propaganda article….. “Big Marijauna”, “Big PhRMA”, (please get the acronym correct!), and “Big Media” are ALL in the SAME tool set used by TPTB….. And please, it’s racist to perpetuate the fake term “marijuana”. Call it cannabis. Or hemp. And please read Johan Hari’s “Chasing the Scream”. We are really talking about RE-legalizing cannabis, which was a valued treatment in the U.S. Pharmacopea until the early 1900’s…..
Excellent point, as those who have worked to restore cannabis legalization well know. Big Cannabis, though it lacks the old-money cachet of Big Pharma, includes some very seamy characters. I’m not referring to growers, of course, but the hot-money financiers who are eager to add dispensaries and recreational shops to their portfolios, with state assistance through outrageous licensing expenses.
But that point is also quite irrelevant and is used irresponsibly in this debate; political economy is not pharmacology any more than individual cases dictate cannabis use across the spectrum of human experience.
Under the guise of concern, MIA has made a habit of posting questionable efforts to breathe life into the corpse of the Drug War. It’s toxic irony that a web site dedicated to contesting unaccountable and scientifically-indefensible practices is itself engaging in them.
Comment found on the Internet yesterday in reaction to a story of marijuana problems in youth: “My son, who is now 28, had his first Bipolar manic episode triggered by marijuana which he first tried his junior year in college. His psychosis was so severe he didn’t recognize his father and I. Unfortunately, the psych tech who evaluated your son was a moron. It is very well known by those in the mental health field that marijuana causes psychosis in roughly 10% of the population. In fact, the psych nurse who first cared for him in the hospital told us that he sees more first-time involuntary psychiatric hospitalizations from marijuana than any other drug. It took 3 years and 18 inpatient hospitalizations to restore his sanity. We know it was “only pot” because he was drug tested in the hospital and there were never any other drugs used. Thankfully, he didn’t continue to use it, but I believe it was easier for him to reject that life because he didn’t try it until age 20. It has been medically proven than children who start are far more likely to get addicted. Watch ‘Chasing the Dragon’ on FBI.gov, most opioid and heroin addicts started with marijuana at age 11 or 12.” Why does anyone want this to happen to other people? It’s a cruel trick.
I call bullshit.
I have been around pot smokers my entire adult life. Some people react badly, sure. I know people who don’t do marijuana because they have had negative experiences (mostly anxiety/paranoia). But ‘mania/psychosis’? I suggest there were additional drugs in play.
no, it’s not bullshit and there is lots of documentation about marijuana (thc) triggering psychosis. I’m very familiar with the phenomena via the work I’ve done with clients for several decades now as well as knowing friends who’ve been impacted that way. I remain very open to appropriate use of cannabis (both thc and cbd) but to claim it doesn’t cause psychosis in some individuals is simply wrong and doesn’t help anyone’s credibility. The real risks involved need to be acknowledged if there is any hope for appropriate and safe usage for those who can benefit. CBD actually calms psychosis in many individuals and can help heal the nervous system….it need not be taken forever. That’s what is nice about herbs…they actually work with the body to heal it…but most people take both CBD and THC the way western medicine has made them think about substances…forever. Which truly isn’t the way any healing herbal medicine should be used in most cases.
Guess that’s why the federal government keeps it listed as a class one drug.
Guess all those people serving time in for profit prisons for marijuana offenses is justified. It’s a dangerous drug.
I see the light now.
that’s ridiculous. I’m all for legalization of marijuana and all drugs actually. … that it’s dangerous for some doesn’t mean it’s dangerous for most… your flight into black and white thinking is completely uncalled for.
My concern with this article, Monica, is that it seems to support what the federal government has been claiming for decades.
I’m with you about legalization of all drugs…and I never meant to imply that pot cannot be a ‘bad trip’ for some folks. The comments inspired by this article are frightening to me…and seem to have an agenda other than just ‘warning’ folks of the possible dangers from using cannabis products. I also think psych/pharma drugs, which are legal, cause way more damage to unsuspecting and trusting ‘consumers’ than pot ever did.
I’m also reacting to my one experience in the county ‘crisis’ unit after a brutal separation from my abusive husband. I was monitored closely for ‘marijuana’ use when out in the world fulfilling my only part-time job at the time. The staff couldn’t understand why I would drive a half hour to do this job if it didn’t involve my injesting marijuana somehow. Except I wasn’t. I was keeping with a routine that gave me a modicum of meaning while in a state of chaos.
I hear you humanbeing. And I feel ya too. I’m sorry you’ve dealt with such trauma. and I agree some comments and this article are pretty disturbing…
still, we need to stay clear about facts to be as credible as possible. denying the lived experience of folks who have found marijuana to be a horribly traumatizing and destructive experience isn’t a good idea in my opinion.
Read my comment below…you might get a kick out of it.
The reason they’re serving time in prison is because they didn’t pay their dues to the APA like Big Pharma can afford to do.
Six quick questions for everyone debating here.
1) Is alchogol an addictive psychoactive drug?
2) Is alchogol a “gateway” drug?
3) Can alchogol lead to mental, social and physical problems for its users?
4) Are potential negative consequences of alchogol usage worse that the ones of cannabis?
5) Why alchogol is universally legal and legality of cannabis is still something to struggle for?
6) Why are alchogol often treated and regulated separately from other mind-altering substances (which are often indiscriminately condemned)?
I encourage everyone to think about these questions, and answer them!
I think alcohol is one of the most destructive and useless drugs there is. There is little to no medicinal value for example. Marijuana and cannabis have huge medicinal value…so, of course, these questions are legitimate and yes to questions 1 thru 4.
Alcohol is a brain deadening substance and marijuana is a brain enlivening substance…it brings consciousness to people while alcohol removes consciousness…so I think that’s why alcohol is embraced. It doesn’t threaten the status quo like cannabis does.
that psychosis is the result of the altered state that marijuana creates on occasion isn’t actually bad in and of itself…what is bad is that there are so few people who know how to help people through such potentially deeply healing crisis. (chew on that everyone!)
Reports of “astronomical” increases in THC are greatly exaggerated. The samples tested in the early years were chiefly imported cannabis that had been seized by law enforcement; the quality of those samples would be severely degraded by the time any testing could be done.
A number of factors affect the potency of a given sample including the particular strain, plant part and its position on the plant, age and growth stage of the plant at harvest, the time elapsed since harvest, exposure of the sample to light, heat, humidity, and so on. And then there’s the damage to the sample caused by the testing method itself (see link below).
To make a long story short, it’s challenging to get standardized samples from two plants of the same kind grown at the same time and in the same location, but it’s quite impossible to compare those to plants of unknown origin and handling that were tested 20 or 40 years ago. And why would anyone believe the results from previous decades when they were provided by the same government that has lied about this subject from the start?
The fact is that high-potency cannabis has been around for a very long time. Skunk #1 was first bred in the late 1970s, with a THC content measuring 15% using gas chromatography. And the famed Acapulco Gold of the 1960s reportedly had a 23% THC content.
Substrate – you are exactly right and it is the high dose THC that has caused the most problems (15% or higher). There is no evidence anywhere that these concentrations of THC are helpful medicinally. Most of the research that has been done with smoked cannabis have the highest THC at 8%. Are you saying all these researchers were clueless as to the actual potency of the THC? The “astronomical” increases I was referring to are in the cannabis concentrates such as oil, shatter, dab etc. that folks are smoking with blow torches – this is no longer marijuana but is “crack cannabis” in which THC can be 80-90%. And with the increases in THC potency we are seeing increases in violence and aggression. It is no longer the “calming weed” it used to be. This is a fascinating article including case reports on highly popularized story lines in which marijuana led to unnecessary violence, health risk and in most cases, both. It analyzes the role marijuana may have played in the tragic outcomes. It includes the planned parenthood shooter, the Boston marathon bombers, and even Osama Bin Laden. Miller NS and Oberbarnscheidt T. Marijuana violence and law. J Addiction Research and Therapy. 2017 doi:10.4172/2155-6105.1000S11-014.
Most of the research that has been done with smoked cannabis have the highest THC at 8%. Are you saying all these researchers were clueless as to the actual potency of the THC?
I’m saying that those were degraded samples and not representative of the average in potency.
You said that “the potency of THC in currently available marijuana has quadrupled since the mid-1990s.” I’m saying that it hasn’t quadrupled.
The focus on increased potency is a red herring anyway. Even low-potency cannabis can easily be ‘screened’ to separate the resin glands from the rest of the plant matter, resulting in a high-potency loose form of hash. Further, smoked cannabis has a point of diminishing returns that is quickly reached; smoking a given variety beyond that point will not get a person much higher.
I reject the notion that cannabis causes violence. For those who didn’t read the article, it actually tries to blame the events of September 11, 2001 on marijuana. Good grief!
OMG…just took a look. That article reads like a paranoid wrote it which is rather interesting. (perhaps they smoked some pot before writing it) … wow. Scary. I’m glad I took a look. I suggest others do too.
Dr. Stuyt, could you reply to my point about alchogol, please? It is your view, as the one of this post’s author, which was the most interesting for me.
Would be grateful to learn your opinion!
Vortex – I apologize, I didn’t reply before because I wasn’t exactly sure what you meant by “alchogol” however, if you mean alcohol – of course it is potentially addictive and a problem for many people and of course it can be a gateway drug if started in adolescence – this is why most states have laws that limit alcohol purchase to those 21 and over. However it is water soluble and if consumed in moderation (one glass for women, up to 2 for men a few times a week)- especially with food, it is metabolized by the body fairly quickly to water and CO2 and the negative effects can be minimal. There are many reports of health benefits of low dose of alcohol. The problem comes when people drink excessively or alcoholically, especially the high potency alcohol with higher proof. So this situation could be similar with marijuana – or at least marijuana with less than 5% THC and balanced CBD. However, it is fat soluble so it takes longer to be metabolized and stays in the body longer, especially the brain which is full of fat. The point I was trying to make with my blog is the biggest problem with our current marijuana is the increased potency of THC, which has no known health benefits – similar to how I don’t think Everclear has any known health benefits – and it is potent purely to get people addicted so they continue to use the product and provide money to the dealers. For marijuana users who do not think they are addicted to it they need to quit smoking for a while to see if they are. For people who use occasionally they probably are not just like people who drink alcohol occasionally are not addicted to it. However, if they smoke marijuana every day – they most likely are addicted to it. I definitely see this with tobacco smokers who never thought they were addicted to nicotine until they had to quit.
Shooters and bombers on Mary Jane? Not too surprising considering the origin of the word assassin.
My problem with marijuana was that it never got me high enough. I’d just sleep it off. Hashish though, was something else. Problem solved.
The family of the Nice terrorist said that he smoked really potent marijuana while in high school and that he had his first psychotic break at age 19. Later he was taking a cocktail of other drugs.
I agree with Bruce Levin, that it’s sickening that people condemn “bad drugs” that alter the mind and push people to take “good meds” that also alter the mind even if they would rather not and become horribly sick.
I have hinted to my folks that Rx psych drugs are really no different than the kind you can buy off the street. They would be horrified if I did that. They would be equally horrified if they knew I “went off my meds” though.
If your dealer wears a pretty white coat and has lots of letters after his name, buy whatever stuff he tells you to. Then he can serve as a deacon at your church and be looked up to as a respected pillar of the community.
Psychiatrist.com published the case of a 20-year old man who went into psychosis from first time marijuana use. The paper says: “Several first-time, non-chronic cannabis users have presented to our clinic with psychosis or thought disorders lasting months after first- or second-time cannabis use.” He did not have family members with psychotic disorders. The authors work at Columbia University Department of Psychiatry and the New York State Psychiatric Institute. http://www.psychiatrist.com/PCC/article/Pages/2017/v19n01/16l01993.aspx
You have to take seriously this high THC marijuana of today, even if it isn’t wax, dabs or shatter. Since it comes from Colorado and California, it’s very potent, and our kids are getting hooked on it and other drugs. We need more primary prevention, education against drug use. It would be ideal if no one had to take either Rx drugs or street drugs. To that goal, we need better recognition of traumatized children and interventions before they turn to drugs or develop mental illnesses. But not all drug users turn to drugs out of trauma; they’re doing it because our society is normalizing drug use.
Here’s a video about the potent pot of Colorado. They tried to get a cap on potency but it did not work: https://www.youtube.com/watch?v=W34pKwIcz80&feature=youtu.be
You may want to check out the work of Gabor Mate…all those who abuse drugs have trauma histories as far as he’s concerned and he makes a very compelling argument. Having also worked with those with substance abuse issues most of my career I’m in complete agreement with him. People do not display addictive behaviors if they don’t have a history that includes emotional pain/trauma.
Yes, I have read about Gabor Mate and his work and I am very concerned about the history of emotional pain and trauma and how it can be worked out. One trauma therapist, Janina Fisher, finds that heroin and marijuana are the two drugs that numb the pain of PTSD most effectively. Covering up the trauma doesn’t resolve the root of the trauma. And it is very disconcerting because by adding drug use to their trauma they are making it more difficult for themselves to heal from that trauma. We know victims of child abuse are more likely to abuse drugs. Bessel van der Kolk says about 50% of those who have childhood trauma will become drug or alcohol abusers. I certainly understand why. Those that don’t abuse drugs may become workaholics, exploitative of others, etc., as a coping mechanism. For treating the root of the trauma, I think we’d be better by using EMDR, biofeedback, Emotional Freedom Techniques, DBT, CBT and other therapies. Everyone has insecurities and I think some people abuse drugs not mainly because of trauma but because we live in a society that is encouraging and normalizing drug abuse and telling us that every little challenge in life, like ADHD and pain, needs to be medicated. The US society has fostered this love of drugs, and government allows advertising on TV. Would prefer if Gabor Mate did not enable drug abuse for the trauma victims, as it does not heal the root of trauma. I know there are people saying that MDMA can heal the trauma, but I wouldn’t trust that it could be done in careful, controlled settings like the testing is done. Would prefer the somatic healing strategies mentioned before to any type of drugs.
By the way, Monica, I find your website, Beyond Meds, wonderful and helpful in nearly all issues, physical healing and emotional healing. Thank you for doing what you do. Loved your podcast on MIA, too. Thanks.
thank you jewelsfs,
not sure why you think Gabor Mate is enabling. That’s a bizarre conclusion in my mind. He’s explaining what happens and why…not advocating drug abuse. Not in the very least bit. Otherwise, yes to most of the rest of what you’re saying. Best to you and your loved one. xo
Thanks for your explanation…..Best to you and yours also.
Sorry if I yawn but most of these anti-marijuana arguments are mere variations on the same propaganda that’s been propagated since I was 16. The new twist now that legalization is on the horizon is the “anti-corporate” angle as a way of attacking herbal aids to meditation, pain relief, etc.
The neat part of this however is that with some education anyone can grow their own pot to meet their own needs and specifications. Then they’re free from any capitalist exploitation vis. a vis. the potency of the herbs they consume. Maybe the author and other “mental health professionals” with similar concerns could lend their expertise to helping people learn to cultivate marijuana at home, and produce the most beneficial strains for whatever ails them (if anything does)?
Even with lots of education, growing pot is not as easy as people think. Gotta watch out for things like spider mites, powdery mildew, and these little gnats that eat the roots. And even if the plant is pristine at harvest, you can ruin it if you don’t dry and cure it correctly.
Yeah, You are right the CBD products are made for the human body for natural treatment. If someone is feeling anxiety or disorder and mentally upset, he can use this beautiful gift which provided by nature. I am very happy you have also mentioned the legalization theory in your post. Before it, there was a lot of confusion with Legality of Hemp products, then I researched and read blogs online and look over the difference between CBD and hemp.
It’s not only Colorado that has a big problem with “recreational” marijuana. This hospital in Washington has 1-2 new psychosis patients everyday. They stabilize the patients by giving them Risperdal, perhaps hooking them into the mental health care system.
Medical marijuana has already been successfully legalized in 23 US states and Washington DC. Why? Because there is substantial scientific proof that weed is actually good for you. In fact, some researchers claim marijuana to be a natural panacea to a large number of diseases.
Here are some known benefits of cannabis:
chronic pain relief;
muscle spasm reduction;
epileptic seizures control;
anxiety and stress management;
arthritis discomfort relief;
opioids withdrawal treatment.