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Are users smoking less, to compensate for the drug’s new potency? Is high-potency cannabis more of a problem for younger users or for older ones?
Messamore reports that, following the recent rise in marijuana use in the U. (it has almost doubled in the past two decades, not necessarily as the result of legal reforms), he has begun to see a new kind of patient: older, and not from the marginalized communities that his patients usually come from.
These are otherwise stable middle-class professionals. Berenson writes, “A surprising number of them seemed to have used only cannabis and no other drugs before their breaks.
The disease they’d developed looked like schizophrenia, but it had developed later—and their prognosis seemed to be worse.
Their delusions and paranoia hardly responded to antipsychotics.”Messamore theorizes that THC may interfere with the brain’s anti-inflammatory mechanisms, resulting in damage to nerve cells and blood vessels.
If you include cases where schizophrenia was a secondary diagnosis, annual admissions in the past decade have increased from 1.26 million to 2.1 million. The delusions and paranoia that often accompany psychoses can sometimes trigger violent behavior.
If cannabis is implicated in a rise in psychoses, should we expect the increased use of marijuana to be accompanied by a rise in violent crime, as Berenson’s wife suggested?The authors assumed that alcohol use among students would be a predictor of violent behavior, and that marijuana use would predict the opposite.In fact, those who used only marijuana were three times more likely to be physically aggressive than abstainers were; those who used only alcohol were 2.7 times more likely to be aggressive. Between 20, the state’s aggravated-assault rate rose seventeen per cent, which was nearly twice the increase seen nationwide, and the murder rate rose forty-four per cent, which was more than twice the increase nationwide.A few years ago, the National Academy of Medicine convened a panel of sixteen leading medical experts to analyze the scientific literature on cannabis. His wife’s remark alarmed him, and he set out to educate himself.The report they prepared, which came out in January of 2017, runs to four hundred and sixty-eight pages. Berenson is constrained by the same problem the National Academy of Medicine faced—that, when it comes to marijuana, we really don’t know very much. And the few studies we do have were done mostly in the nineteen-eighties and nineties, when cannabis was not nearly as potent as it is now. It’s hard to study a substance that until very recently has been almost universally illegal.It contains no bombshells or surprises, which perhaps explains why it went largely unnoticed. But he has a reporter’s tenacity, a novelist’s imagination, and an outsider’s knack for asking intemperate questions. The first of Berenson’s questions concerns what has long been the most worrisome point about cannabis: its association with mental illness.It simply stated, over and over again, that a drug North Americans have become enthusiastic about remains a mystery. Many people with serious psychiatric illness smoke lots of pot.For example, smoking pot is widely supposed to diminish the nausea associated with chemotherapy. The marijuana lobby typically responds to this fact by saying that pot-smoking is a to mental illness, not the cause of it—that people with psychiatric issues use marijuana to self-medicate. In some cases, heavy cannabis use does seem to cause mental illness.But, the panel pointed out, “there are no good-quality randomized trials investigating this option.” We have evidence for marijuana as a treatment for pain, but “very little is known about the efficacy, dose, routes of administration, or side effects of commonly used and commercially available cannabis products in the United States.” The caveats continue. As the National Academy panel declared, in one of its few unequivocal conclusions, “Cannabis use is likely to increase the risk of developing schizophrenia and other psychoses; the higher the use, the greater the risk.”Berenson thinks that we are far too sanguine about this link.