Cannabis. Friend or foe? This is another one of those questions that provokes very polarised views amongst health professional and general public alike. Some view cannabis as essentially harmless, a ‘social drug’ with few side effects and a nice mellowing effect that chills people out and with little or no consequence. I also often hear that cannabis, is ‘no worse than alcohol’ and that it doesn’t leave you with a hangover and lasting physical symptoms the morning after using it.
The rise of cannabidiol (CBD) for those with ‘medical conditions’ is also likely to lead more and more people to believe that cannabis is harmless and should be legalised with no restrictions to its recreational and medicinal use in society.
I have several issues with this. Firstly, and very personally, I hate the smell of the stuff! It makes me feel sick, sometimes to the point of gagging, the second its sickly, sweet, musty awfulness hits the back of my throat. I will also use the Bill Clinton book of drug related excuses and state that ‘I used it once in college’, well, it was a mini owners club meeting somewhere around the north of the M25 when I was nineteen, and it made me vomit for somewhere between two to three hours. I had mixed the ‘weed’ with drinking a large volume of vodka and to this day I have never experienced a hangover as bad as the one that followed that little life adventure.
Safe to say, I have not used cannabis in any form since and have not missed out on anything as far as I am concerned as a result.
Following this, I was largely ambivalent around cannabis, not really having a strong opinion for or against (unless there was someone smoking it within reach of my rather sensitive nose. In that case it was very much awful, and I would have to move quickly to find some fresh air). I had several friends use it regularly during my twenties and early thirties and the worst I saw impact on them, was an increase in levels of paranoia and a general inability to move or speak in any coherent way once they had consumed a decent amount of it.
My view on cannabis use changed when I met my first client who had experienced cannabis induced psychosis. They described in-depth how this had impacted on their life, going from enjoying successfully studying at a red brick university, to being in an out of secure mental health facilities in the space of a few months.
As anyone who has experienced directly, or has worked with someone who has had an episode of psychosis knows, your risk of experiencing another episode increases exponentially each time you have one, making you, over time, more and more susceptible to experiencing more frequent psychotic episodes and with the risk that each one may last longer and be more difficult to recover from.
Hearing at first hand the experiences of people who had no idea how dangerous using cannabis can be to their mental health was sobering for me and changed my view on recreational cannabis use. It is not ‘harmless’ and has many side effects that are downplayed by people who advocate its use.
Whilst it is true some people can use cannabis for many years with few negative effects, it is also true people who have been using it for many years can also suddenly experience the onset of psychosis or other negative symptoms related to their cannabis use. It is also true that it is possible for someone to smoke cannabis on just a few occasions and they can experience a psychotic episode or other related symptom.
Cannabis is not harmless to every person that uses it.
There is currently no way of knowing for certain if a person is likely to react negatively to one of the many (there are over 100 in total) psychoactive compounds in cannabis, as there has not been enough research done to be sure why some people experience psychosis after using cannabis and some people do not. Brain chemistry, genetics and probably dumb luck all play a part, but nothing is certain at this point in time.
Research going back to the 1960’s shows that the main culprit is THC or delta-9-tetrahydrocannabinol, it is this compound that can lead to hallucinations and other visual and auditory effects that can have a serious impact on a person’s state of mind. It also the compound that gives the person using it the ‘high’ that helps to increase pleasurable experiences when using cannabis. Ironic that the compound that gives people the most pleasure it also the one that poses most risk to their health.
More research needs to be done on the effects of all the compounds in cannabis. The CBD compound, which is the one most commonly being prescribed for people with medical conditions or pain relief appears to have a lot of the benefits of THC, but none of the side effects. This is obviously a great discovery and will likely benefit many people in the future. More caution needs to be taken around THC though and more money needs to be pout into objective research about cannabis use in general and whether THC is being included in any medical products being prescribed to some potentially physically and emotionally vulnerable people.
One thing is for sure, until there is a form of cannabis grown or developed that does not contain THC, there will always be a clear risk to the person using it recreationally or for medical purposes. We need to do more I think to get this message objectively out to those people most vulnerable and at risk through using any cannabis product containing THC.
I need to credit Judith Grisel who is a behavioural neuroscientist and her book:
Never Enough: The Neuroscience and Experience of Addiction
As being the influence and the reference for me and this blog.
Please also check out the Guardian article that Judith wrote around this subject:
https://www.theguardian.com/commentisfree/2019/mar/24/cannabis-regulation-science-psychosis