Marijuana, Mental Illness, and Violence

whitecoast

The Living Force
FOTCM Member
Awhile back I found an interesting article on sott here, and it spurred me to check out the book discussed. It's called Tell your Children: the truth about marijuana, mental illness, and violence. Its author (Alex Berenson) is a former New York Times writer who also happens to be a Covid-19 skeptic as well, so I get the impression that he is unusually candid and truthful for a journalist formerly affiliated with the NYT.

After devouring the book I wanted to share some of the information in it on here, because it provides some very hard facts and information about an issue which has bad societal consequences and which has received almost no pushback from the public, at least in North America where I live.

From his website:

An eye-opening report from an award-winning author and former New York Times reporter reveals the link between teenage marijuana use and mental illness, and a hidden epidemic of violence caused by the drug—facts the media have ignored as the United States rushes to legalize cannabis.

Recreational marijuana is now legal in nine states. Almost all Americans believe the drug should be legal for medical use. Advocates argue cannabis can help everyone from veterans to cancer sufferers. But legalization has been built on myths– that marijuana arrests fill prisons; that most doctors want to use cannabis as medicine; that it can somehow stem the opiate epidemic; that it is not just harmless but beneficial for mental health. In this meticulously reported book, Alex Berenson, a former New York Times reporter, explodes those myths:

• Almost no one is in prison for marijuana;
• A tiny fraction of doctors write most authorizations for medical marijuana, mostly for people who have already used;
• Marijuana use is linked to opiate and cocaine use. Since 2008, the US and Canada have seen soaring marijuana use and an opiate epidemic. Britain has falling marijuana use and no epidemic;
• Most of all, THC—the chemical in marijuana responsible for the drug’s high—can cause psychotic episodes. After decades of studies, scientists no longer seriously debate if marijuana causes psychosis.

Psychosis brings violence, and cannabis-linked violence is spreading. In the four states that first legalized, murders have risen 25 percent since legalization, even more than the recent national increase. In Uruguay, which allowed retail sales in July 2017, murders have soared this year.

Berenson’s reporting ranges from the London institute that is home to the scientists who helped prove the cannabis-psychosis link to the Colorado prison where a man now serves a thirty-year sentence after eating a THC-laced candy bar and killing his wife. He sticks to the facts, and they are devastating.
With the US already gripped by one drug epidemic, this book will make readers reconsider if marijuana use is worth the risk.

Reviews
  • “[Alex Berenson] has a reporter’s tenacity, a novelist’s imagination, and an outsider’s knack for asking intemperate questions. The result is disturbing.” (―Malcom Gladwell The New Yorker)
  • Takes a sledgehammer to the promised benefits of marijuana legalization, and cannabis enthusiasts are not going to like it one bit.” (―Mother Jones)
  • “A brilliant antidote to all the…false narratives about pot out there.” (―American Thinker)
  • “An intensively researched and passionate dissent from the now prevailing view that marijuana is relatively harmless.” (―The Marshall Project)
  • “Berenson has done an important public service…[Tell Your Children] could save a few lives.” (―The Guardian)
  • “The stakes are high…aren’t we better off listening to Berenson than to some marijuana magnate?” (―The Spectator)
  • “An interesting book that should be read by all concerned.” (―The Washington Times)
  • “Filled with statistics that shock.” (―The Times of London)

The book broadly covers three topics The first covers the modern history of cannabis, starting with Mexico and India in the 19th century and leading up to the recent round of legalization of the 2010's in the United States. The second studies the found connections between marijuana, psychosis, and schizophrenia, also touching on the opioid epidemic. The final part talks about the links between psychosis/schizophrenia and brutal, senseless violence, and how these and other types of crime are increasing disproportionately in places where marijuana is legal. The author brings a lot of studies on each occasion, and they are sobering. The anecdotes about some of the brutal assaults and murders can be rough to read also, so fair warning.


THE HISTORY OF MARIJUANA​


Despite being new to European society and the New World (mostly introduced via the importation of hemp for fiber) marijuana was known throughout most of Asia historically. The oldest recorded reference the the effects of cannabis are in the Chinese pharmacopia called the Pen-ts'ao Ching, written as early as 100 AD, which warned that excessive cannabis consumption caused one to "see spirits."

India
In India, hemp was farmed and traded in heavily by the British, which paid little attention to cannabis in general in the early days of Indian colonisation until the establishment of mental institutions in India in the 1800s and the record-keepers there began to see patterns and connections between ganja and institutionalization of its users by friends or family members. In 1873 the government published survey results finding an increase in insanity and insanity-linked violence due to its habitual use, and recommended higher taxes to discourage consumption.

A later report in 1893, spurred by a British politician concerned about the effects of marijuana, instead concluded that the link was not strong, and therefore was fine to be kept as a taxed and regulated industry. While this report was hailed as a breakthrough in marijuana scholarship by activists, there were several flaws in it. In India, cannabis had three traditional modes of consumption. The first is called bhang, which is a cannabis paste blended into milkshakes and consumed during festivals. The psychoactive potency of these is quite low. Then there is ganja and chara, which in the west are known as the bud and hashish forms of marijuana respectively. These had much higher potency and its users tended to be much heavier, daily users; they were also universally looked down upon by traditional Indian society in ways very similar to how western society stereotypes potheads. And it was these individuals who tended to make up the bulk of those admitted to institutions for drug-induced insanity or violence. Of the British commissioners who approved the report to inform state policy, there were three Indians; two of those three opposed the findings. One of them named Nihal Chand (Punjab Lawyer) published a scathing critique of the study's failures to distinguish between the different types of cannabis consumed. In retrospect what was seen as a victory for social liberalism could instead be seen as the British profiting off of the societal ills that some modes of marijuana consumption produced.

In reality, statistics consistently showed that 20 to 30 percent of asylum patients were ill because of cannabis, he wrote. Chand also noted that about 20 percent of the “criminal lunatics” in the Bengal asylums had a diagnosis of cannabis-related insanity, far more than those whose mental illness was attributed to alcohol or opium. He quoted doctors, police officers, and judges—both Indian and British—who linked the drug to violent crime.

Even after the commission report, other doctors working with mental patients would continue to come forth about how a certified lunatic's friends, relatives, and even the patient him or herself would admit to and blame cannabis. People would improve after being off the drug, leave, relapse, and be re-admitted with regularity, and with symptoms which today would be readily classifiable as psychosis. Twenty percent of those classified as criminal lunatics had their violence linked to cannabis use also. What was striking was that the violence was often unprovoked, against family members and strangers alike. One does not need to be a psychiatrist to know that those in psychosis are dangerous individuals. Everyone knows to avoid the dishevelled man whose every other word is a swear word and whose every other sentence is about God.

Mexico
Contrasting India (a Hindu British colony of 330 million people with a long history of cannabis use) is Mexico; in the 19th century it was Catholic, recently independent, and had 13 million people and a native population that was new to cannabis but familiar with other psychoactive plants such as peyote and salvia. It was not a major industry, and was used mostly by soldiers and the poor.

In spite of all these cultural differences, doctors in Mexico in the 1800s also noticed a link between marijuana use, insanity, and violence. This was a finding reported by a University of Cincinnati professor Isaac Campos in 2012 in a history called Home Grown: Marijuana and the Origins of Mexico's War on Drugs. This was a critical work because it exploded the myth that some activists and scholars have perpetuated in the United States, blaming the US prohibition for Mexico's war on drugs. The truth is that Mexico banned the sale of marijuana long before it became a subject of interest to narcotics control policy-wonks in the US and Europe.

Leading up to this were increasing bouts of violence, and increased defense pleas linked to marijuana-induced insanity. One of the highest profile cases was an incident in which the governor of Mexico city claimed that he murdered a political rival "under the influence," as we say today.

Poor Mexicans were more likely to smoke marijuana than the wealthy. But fear of the drug did not stem from class prejudice. Poorer Mexicans were also concerned about marijuana’s effects. The negative attitude toward cannabis was striking because people in Mexico had experience with psychotropic plants, including peyote and salvia, a type of sage that can produce hallucinations. They had no cultural reason to view marijuana negatively.

Yet they did. As marijuana’s use spread, Mexicans viewed it as different from other drugs. It didn’t merely cause users to hallucinate, like other psychotropics. Or excite them, like cocaine. Or disinhibit them, like alcohol. Instead, especially in large doses, it produced all three effects at once. It led to a delirium indistinguishable from insanity and often accompanied by violence. Newspapers regularly referred to criminals “as either a madman or a marihuano,” Campos wrote.

The most potent type was called sinsemilla (i.e. "without seed"), and was estimated to be around 10% THC.

United States (1900 to 1979)
As the fears about marijuana in the United States increased throughout the 1910s and 1920s, with more local and state-wide laws restricting its sale coming into effect, the first federal law restricting the drug was passed in 1937 and imposed a $100/oz tax on marijuana for purposes other than very limited industrial or medicinal use. One character which gets bandied about a lot in this time period was Harry J. Anslinger, who was the commissioner of the Federal Bureau of Narcotics. He created reports on some highly publicized incidents of violence caused by perpetrators supposedly in the throes of a marijuana psychosis. The evidence of marijuana's connection to violence was a lot weaker then than it was today, ironically. One of the casualties of this time was the hemp industry. At the time THC was not yet discovered, and so it was not possible to gauge the psychoactive properties of a hemp plant scientifically. Anslinger like many of the time was also openly racist, which is fact heavily exploited by advocates to retroactively malign opposition to marijuana as of racist origin.

Around the time of its prohibition, the percentage of Americans who tried marijuana was still in the single digits. Once the counter-cultural movement (psyop) picked up, that increased to 12 percent by 1973; for those 18 to 24 it was 50 percent. It was around this time that advocacy for legalization became more common. The flagship for this was the magazine High Times, published by Tom Forcade. His rational that High Times could be a beachhead for more liberal attitudes toward a vice traditionally looked down upon, similar to how Playboy was for pornography. Alongside this cultural operation was the advocacy group National Organization for the Reform of Marijuana Laws (NORML), founded by a young Indiana lawyer in 1970 named Keith Stroup, who was even financially backed by Hugh Hefner.

A lot of the strategy around this time in history revolved around reducing the sentences for marijuana consumption. Some of the most draconian laws existed in Texas, where one could get 9 years in jail for smoking marijuana. By 1973 possession was a felon in only two states, although a misdemeanor offense could still give someone a year in jail. And the amount of arrests increased twenty-fold between 1965 and 1973 with increased use of the drug. So at this point it began to have a larger impact on middle class white families, and the full impact of these types of laws were brought to bear more in the public consciousness, making them receptive to the message of reform. Oregon ended up being the first state to decriminalize in 1973, with four more states following two years later.

In addition to the harsh legal penalties, another factor contributing to the loosening of marijuana laws was the fact that it did not seem as dangerous as the forbears of the marijuana issue in the US made it out to be. People were not committing the heinous and senseless crimes of marijuana-induced psychosis dubbed "reefer madness."

The reason for this was quite simple. The weed imported en masse from Mexico was often of extremely cheap quality, even intermixed with seeds and other weeds. With the discovery of THC in 1967, testing found that US marijuana was rarely over two percent THC, with some measures even dipping below one percent. For reference today, any cannabis plant with less than 0.3 percent HTC is considered a hemp plant. To compare this to the Indian classifications, the majority of Americans smoking pot around this time were consuming the equivalent of bhang, which causes a mild buzz after consuming a lot. A group would need to share fifty joints in order for each smoker to receive 25 - 50 mg THC. This fact led to the common enough trope that people "didn't feel anything" after smoking a joint with friends. Mexican sinsemilla at the time was prohibitively expensive in the US ($400/oz pre-inflation).

Contrasting this is today's marijuana, which is normally 20 - 25 percent THC. A single joint delivers more than 100 mg of the drug: far more potent than anything the Mexicans had access too back in the 19th century. This moves modern marijuana use more toward the category of ganja or chara, which was often implicated as a cause of psychosis or worsening schizophrenia or bipolar disorder for those institutionalized.

Amusingly enough, on the heels of this decriminalization was the growth of the drug paraphenalia trade, which even had its own trade association. This group became increasingly notorious as the perception became more common they were marketing drug paraphernalia to minors. This led to a backlash by parents, which were becoming increasingly aware of the effects of the drug on their children, especially habitual users.

On top of this was a scandal in 1977 involving Dr Peter Bourne (President Jimmy Carter's drug policy advisor) who had in fact was discovered to have used both marijuana and cocaine with Keith Stroup (of NORML); this telegraphed the notion loudly that the biggest advocates for legalization were just interested in getting high. This scandal, fueled by the "gateway drug" hypothesis from the 1950's was a lightning bolt to the American consciousness and instantly associated marijuana with cocaine, the use of which in 1979 had tripled since 1972. Stroup eventually resigned from NORML a year later and the movement to decriminalize marijuana went into hibernation until the 1990s.

United States (1980 - present)
In spite of acute awareness of the harm of cocaine, its use continued to spread due to decreasing prices. Following this was the rise of crack (cocaine baked with baking soda and water into a smokeable pellet). This trend led to a rising tide of crime and violence in the US, rising 41 percent from 1983 to 1991. The number of dead was almost half of the amount of American men killed in Vietnam over the course of the war. Alongside this was the explosion in AIDS among gay men and heroin users. During this time marijuana use continued to decline.

Dr Ethan Nadelmann, a 1979 Harvard graduate in the law-PhD program, viewed the source of all these problems with violence as prohibition, drawing analogies between the current drugs in vogue and alcohol. Throughout the 1980's he fought an uphill battle to get greater recognition for the problems prohibition created, while toning down rhetoric about the legalization of the drugs themselves. After a fortuity lunch with the billionaire investor George Soros he received financial backing to advocate for the liberalization of the drug laws in the United States and elsewhere. With this backing he founded the Lindesmith Center (named after a sociologist who was also an advocate for decriminalization) to advocate for drug policy reform.

One of the first success stories they had was with Prop 215 in California, which was a ballot initiative to legalize the use of marijuana for those with a physician's prescription. By the late 1980s meagre epidemiological (i.e. hypothesis-forming) studies have shown marijuana may be useful in treating epilepsy, chemotherapy-related nausea, and also as a way to counteract wasting from AIDS, which was pervasive in Northern California at the time. This drove activists to seek Lindesmith Center's support. Since Dr Nadelmann worried a downvote for the proposition would add to the narrative that marijuana was unpopular, he solicited Soros for money to conduct a state-wide survey on marijuana attitudes to see if the proposition had legs. To their surprise it did, and so the Center aggressively backed the initiative to get it on the 1996 election ballot, which passed and decriminalized medicinal marijuana. Through this initiative the goal of severing the connection between cocaine and marijuana in people's minds was achieved by re-framing the marijuana debate in terms of medicine.

In spite of this victory, as the crack epidemic began to decline more police resources were turned toward marijuana again, although this time around the punishments were much more lenient. The arrests for possession became increasingly the subject of scrutiny for civil rights groups also.

Civil libertarians and liberal groups focused on the fact that African Americans were arrested two to three times as often as whites, though the two groups had similar rates of marijuana use. (The groups skimmed over the fact that “similar” didn’t mean the same; federal surveys showed that African Americans used marijuana somewhat more than whites, and those black people who did use tended to be heavier smokers. A 2016 paper in the journal Drug and Alcohol Dependence that was based on federal surveys covering more than 340,000 people showed that black people were almost twice as likely to report marijuana abuse or dependence as whites.)

The Lindesmith Center merged with the Drug Policy Foundation (a DC-based reform organization) to for the Drug Policy Alliance, into which George Soros funded more than a $100 million dollars over the course of the 2000s; a representative of his when asked for comment by the author framed the contributions in terms of protecting marginalized populations and vulnerable individuals.

Alongside the increasing racialization of the issue in the public consciousness were more claims on marijuana's medicinal properties. One NGO founder even said they would prefer their children to smoke marijuana instead of imbibe alcohol, saying that in the end the ideal goal would be for marijuana to be cheaper and "significantly more available than alcohol or pills."

In spite of the rosy view given by activists, most doctors were reticent about prescribing medical marijuana, as a lot of the scientific evidence itself was weak and doctors were normally very conservative about experimental treatments. This resulted in a relative minority of doctors writing the vast majority of marijuana prescriptions. NORML did have a registry of doctors who were willing to prescribe medical marijuana; in California this number was 1500 vs the 100,000 physicians in total in the state.

California didn’t keep a mandatory registry of its patients, but surveys showed they were mostly white, under 45, and had been regular cannabis users before getting a medical card. Pain was a far more frequent reason for authorization than cancer or other serious illnesses. By 2014, some physicians charged as little as $30 for an authorization. Even medical marijuana supporters complained that the process was a joke.... The situation was similar [in Oregon] and elsewhere... other states had even looser rules (not requiring a physician's authorization).

While the amount of marijuana users has never been particularly high, the roll-out of marijuana as a medicinal industry created an entrenched economic interest further provided funding to support wider advocacy for full legalization. This positive feedback loop between industry and drug reform NGOs has ended up supporting the wave of medicinal and full legalization of the 2010s. Another silver lining to the issue was that it had near bipartisan support from the public, compared to more contentious issues such as abortion, immigration, or left wing authoritarianism and violence, making it a safe schilling point for politicians to campaign on. Often times argument for legalization was couched in terms of right-wing talking points, such as providing additional tax base to keep taxes lower for others, or to help clear out red tape. As of 2020 marijuana is fully legal in 14 states, and medicinal marijuana is authorized in 48, and shows only signs of further liberalization.

Between the notions of addressing racial inequality, draconian punishments, and medical uses for cancer and AIDS, the author infers that the main strategy used to advocate for the decriminalization and gradual legalization of marijuana was to make the topic of marijuana about literally anything other than the actual reason the vast majority of users take it, which is to get high.

MENTAL HEALTH EFFECTS OF MARIJUANA​


Psychosis and Schizophrenia
In 2017 the US National Academy of Medicine issued a 468 page report composed of the work of 16 professors and doctors and 13 understudies to compose a meta-analysis of the health effects of cannabis. They found it did not seem to be linked to lung cancer, but the mental health effects were a different story.

The committee found strong evidence that marijuana causes schizophrenia and some evidence that it worsens bipolar disorder and increases the risk of suicide, depression, and social anxiety disorder. “Cannabis use is likely to increase the risk of developing schizophrenia and other psychoses; the higher the use, the greater the risk,” the scientists concluded.

The higher the use, the greater the risk. In other words, marijuana in the United States has become increasingly dangerous to mental health in the last fifteen years, as millions more people consume higher-potency cannabis more frequently.

The usual response given to this by cannabis advocates is arguing that cannabis use did not correlated with psychosis or other psychiatric illnesses. This is a response that, according to the author, leans heavily on the generally poor epidemiological data which exists for psychosis and schizophrenia. Neither the National Institute of Mental Health, the Center for Disease Control, nor the states themselves track the prevalence of psychosis or schizophrenia. No definite and objective test exists for schizophrenia or psychosis, often simply observations or self-assessments.

The limited data which does exist is provocative. In the US, between 2006 and 2014 emergency rooms had a 50 percent increase of admissions with a primary diagnosis of psychosis. Those with a primary diagnosis of psychosis and secondary diagnosis of cannabis abuse tripled in this period, up to 90,000. Eleven percent of those diagnosed with psychosis also had the cannabis abuse diagnosis, and according to primary research done by the author and a colleague the vast majority of those had no other drug problems diagnosed other than marijuana. Studies from Denmark and Finland showing increases in mental illnesses including schizophrenia and psychosis. The latter cited this 2011 paper, which I quote below:

The increase in comorbid cannabis-specific SUDs across the two cohorts in this study is of particular interest due to the controversial nature of the relationship between cannabis use and psychosis. Historical [31] and birth cohort studies [32,33] have both found cannabis usage to precede psychotic symptom onset. There has also been a growing body of evidence to suggest an association between cannabis use and heightened risk of a psychotic illness, with heavier use posing an even greater risk [10]. The dose–response effect is particularly important due to the escalation in potency of the drug and the development of more sophisticated, indoor, hydroponic growing techniques introduced in England in the early 1990s [34,35].

A lot of the earlier studies linking marijuana with psychosis and schizophrenia in the 1980s were dogged by the criticism that correlation does not equal causation, and many critics brought up the possibility that those with genes or environments more predisposed to cause psychosis or schizophrenia may also simply make a person more predisposed to marijuana use. Another explanation was that marijuana was being used by psychologically deteriorating individuals to self-medicate, but this was more readily dismissed by clinical observations that those in psychiatric care got their symptoms under control suffered relapses if they returned to marijuana use.

A large prospective study out of Dunedin in New Zealand, published in 2002, tracked children born in 1973 every couple of years (up to their middle age adult years) for their mental health status, drug use, and criminality. They found that "people who used cannabis at age 15 were more than 4 times as likely to develop schizophrenia or schizophreniform syndrome as those who never used. Even after accounting for those who had shown psychotic symptoms at age 11, the risk remained threefold higher." This study was noteworthy for putting to bed the idea that schizophrenics were simply self-medicating due to marijuana use.


Time Lag in the Development of Psychosis and Schizophrenia

Marijuana users generally start smoking between 14 and 19; first-time psychotic breaks most often occur from 19 to 24 for men, 21 to 27 for women. In other words, almost no one develops a permanent psychotic illness the first time he uses marijuana—or even after a few months. The gap between when people start smoking and when they break averages six years, according to a 2016 paper in the Australian & New Zealand Journal of Psychiatry that examined previous research. The Finnish paper showing that almost half of cannabis psychosis diagnoses convert to schizophrenia within eight years is more evidence of the time lag. A problem that seems temporary becomes permanent.

The time lag is crucial. It implies that the 1990s increase in cannabis use—and the increase in potency that began then and continues today—wouldn’t have immediately affected psychosis rates. Instead, if marijuana slowly drives some people into permanent psychosis, rates of schizophrenia and other psychotic disorders might have trended higher in the 2000s, with the increase visible after 2010.

That trend is exactly what some research has found.
....
[According to the Agency for Healthcare Research and Quality the] number of people arriving at emergency rooms with marijuana-related problems has soared in the last decade. In 2014, the most recent year for which full data is available, emergency rooms saw more than 1.1 million cases that included a diagnosis of marijuana abuse or dependence—up from fewer than 400,000 in 2006.... Cases involving marijuana rose far faster than those involving cocaine—and even faster than those involving opiates. In 2006, cannabis cases were less common than the other two drugs. By 2014, they were more common than opiates and twice as common as cocaine. Only alcohol, which is far more widely used, contributed to more emergency visits.
...
Besides the huge increase in marijuana use disorder, the database showed a big rise in psychosis-related cases. In 2006, emergency rooms saw 553,000 people with a primary diagnosis of schizophrenia, bipolar disorder with psychosis, or other psychosis. By 2014, that number had risen almost 50 percent, to 810,000. Including cases where psychosis was either a primary or secondary diagnosis, the increase was even faster, from 1.26 million in 2006 to almost 2.1 million in 2014.
....
In 2006, about 30,000 emergency room patients had a primary diagnosis of psychosis and a secondary marijuana use disorder. Eight years later, that number had almost tripled, to nearly 90,000. Put another way, every day in 2014 almost 250 people showed up at emergency rooms all over the United States with psychosis and marijuana dependence. They accounted for more than 10 percent of all the cases of primary psychosis in emergency rooms. Most of those patients had problems only with cannabis, not other drugs, our analysis found.

Marijuana disorder was also associated with more severe psychosis—as measured by being hospitalized instead of released following emergency treatment. Psychotic patients with a marijuana sub-diagnosis were about twice as likely to wind up hospitalized as those who didn’t have one.

Finally, the emergency room data showed that marijuana dependency was linked to opiate and cocaine addiction. The number of emergency room patients who had a primary diagnosis of opiate addiction and a secondary diagnosis of marijuana use disorder nearly tripled between 2006 and 2014—more evidence that the theory that marijuana can help people stop using opiates is dangerously wrong. (more on this later)

What was also interesting was that the research showed people developing psychosis and later schizophrenia after people were well into their thirties, which is unusual for both illnesses which have typically have onsets in early adulthood. Advocates have backpedalled to saying that marijuana only accelerates the development of psychosis or schizophrenia and isn't an independent causal factor to it. The data does not bear that out.

Cannabis in the UK and Europe vs United States
In the UK the awareness of marijuana's effects of mental illness were kept more in the public eye by the psychiatrist Sir Robin MacGregor Murray, who, in spite of the lack of professional interest his education paid to marijuana (calling it an "entirely safe drug"), began to see more and more connections between cannabis and psychosis and schizophrenia. After becoming the head of the Institute of Psychiatry at King's College in London he was in an advantageous position to conduct research and reviews and raise awareness, which he did all throughout the 2000s - eventually becoming the most cited schizophrenia researcher in Europe and receiving a knighthood.

Since 2000 cannabis in the UK moved down the list of drug schedules to what was effectively decriminalization in 2004. In spite of all this the marijuana use in the UK did not increase at the rates that it was in Canada (another country which decriminalised in the early 2000s) and the US, and still lags behind them both to this day. The author links this directly to the much more widely disseminated awareness of the links between marijuana , psychosis, and schizophrenia, since the amount of adults in favor of decriminalization actually DECREASED over the 2000s from over 50 percent to about one third in 2010, increasing over the 2010s but still remaining below 50 percent. Cannabis use itself fell from 10 percent for adults and ~30 percent for young adults to 6 percent for adults and ~17 percent for young adults. In spite of this (or because of this) Murray and the Institute of Psychiatry has been the target of a lot of character assassination by the cannabis law reform group CLEAR, accusing he and them in 2015 of confusing correlation with causation (starting to see a pattern?) or even financially benefiting from cannabis prohibition.

Unfortunately knowledge of the connection between marijuana and psychosis has had a difficult time crossing the Atlantic Ocean to the United States. Part of this was due to different approaches; European psychiatry tends to focus more on epidemiology and finding trends and causal associations between behaviors and outcomes, whereas American psychiatry is more focused on neuroimaging and finding exactly how an exposure alters neuronal functioning. In the marijuana field this has led to psychiatrists ceding discussion of the issue to marijuana advocates in the US. It should come as no surprise that most of information about marijuana's mental health effects come out of Europe:

• “Association Between Cannabis Use and Psychosis-Related Outcomes Using Sibling Pair Analysis in a Cohort of Young Adults,” Archives of General Psychiatry , May 2010: 3,801 participants in Australia: Using cannabis beginning at age 15 raised risk of hallucinations by almost 3 times at 21.
• “Linking Substance Use with Symptoms of Subclinical Psychosis in a Community Cohort over 30 Years,” Addiction , 2011: 591 participants in Switzerland: Using cannabis regularly in adolescence raised risk of paranoid ideas such as “Someone else can control my thoughts” by 2.6 times.
• “Substance-induced Psychoses Converting into Schizophrenia: A Register-based Study of 18,478 Finnish Inpatient Cases, Journal of Clinical Psychiatry , January 2013: Almost half of patients hospitalized with cannabis psychosis were diagnosed with schizophrenia within eight years. Psychosis caused by other drugs had lower rates of conversion, with alcohol at 5 percent.
• “Association of Combined Patterns of Tobacco and Cannabis Use in Adolescence with Psychotic Experiences,” JAMA Psychiatry , January 2018: 5,300 participants in England: Teenage cannabis use roughly tripled the risk of psychotic symptoms; tobacco use did not show a risk after adjusting for cannabis use.
• “Adolescent Cannabis Use, Baseline Prodromal Syndromes, and the Risk of Psychosis,” British Journal of Psychiatry , March 2018: 6,534 participants in Finland: Using cannabis more than five times raised the risk of psychotic disorders almost sevenfold; after adjusting for parental psychosis and other variables, cannabis tripled the risk.

One area of research in which the US was ahead was in the creation of synthetic cannabinoids. Some of these were developed for weight loss (blocking the CB1 receptor) but these were taken off the markets by 2008 due to depressive side effects like anxiety, depression,and suicidal thinking. Another class of cannabinoids (CB1 agonists) were synthesized as ways to test the CB1 receptor, but which eventually made their way into clandestine labs and corner store outlets as a cheap way to get high while passing drug toxicology screenings (at least for awhile). These novel synthetics were often sprayed onto cannabis for additional potency, and led to several high profile cases of psychotic breaks leading to permanent juries (a graduate student with no history of mental illness kept his hand on a stove element to the cost of his right arm), as well as one 5-person homocide where a man killed five of his children (age range: 1 to 8), and the like. The use of these synthetics peaked around 2015, after being explained away on purist grounds that these CB1 agonists were NOT cannabis. The inconvenient fact is that most of these synthetic were phased out in favor of pure THC extracts, which only seems to stimulate the CB1 receptor. Tragedies like this are something advocates for THC and cannabis ignore at the risk to communities by not educating the public properly on the mental health risks.

This series of anecodes were, I thought, poignant:

Dr. Melanie Rylander, a psychiatrist in Colorado and assistant professor at the University of Colorado–Denver, said that heavy smokers have extraordinary denial about the drug’s impact. “In eleven years of practicing psychiatry, I have yet to convince anyone that marijuana is causing problems for them,” she said. “A lot of time those conversations are not very productive.”

People with severe mental illness are often so impaired that they lack basic awareness that they are ill, Rylander said. But even people who know something is wrong with their minds rarely connect their symptoms to marijuana. Unlike alcohol, cocaine, or opiates, marijuana rarely causes acute physical crises, she said. Users can tell themselves that their psychiatric problems would have happened anyway.

Dr. Scott Simpson works alongside Rylander in the psychiatric emergency room at Denver Health Medical Center. He said he typically tries to talk around the issue instead of discussing the drug’s dangers directly. “Usually my approach is, ‘Marijuana is great for you, tell me how things are going for you in general,’ ” he said. “ ‘Why is it that you can’t work, why is it that you can’t complete school?’ ”

I could imagine that style working for Simpson. He was friendly and boyish-looking despite the flecks of gray in his hair. Rylander was tall, intense, and angular, but equally thoughtful. Rylander, Simpson, and I were talking in a conference room down a short hallway from Denver Health’s psychiatric ER, which came complete with seclusion rooms where seriously psychotic patients could be restrained to their beds.

Simpson told me of a typical case: a man in his early twenties brought in by his parents. “An immigrant family, they are taking care of him . . . he’s a pretty sick guy, talks to himself. And, by the way, he smokes pot three times a week.”

Marijuana can be “very insidious,” he said. Smokers don’t think of themselves as addicts. But quitting or even cutting back is difficult. Meanwhile, their psychiatric symptoms worsen little by little. “They have anxiety, new symptoms, and they’re smoking pot every day, and it’s much more difficult to tease out.”
I couldn’t help thinking of what George Francis William Ewens had written in the Indian Medical Gazette almost 114 years before:

[quote}There is, however, equally little doubt that any form of the drug produces a violent craving for it, that the amount taken is gradually increased, and that apart from the physical effect a general moral deterioration, as in alcoholism, sooner or latter [ sic ] sets in . . .[/quote}

As I talked to Rylander and Simpson, tens of thousands of people gathered a mile to the north for Denver’s annual Mile High 420 Festival. It was April 20, the unofficial cannabis holiday. Billed as the largest cannabis-themed event that day anywhere in the world, the festival was a free concert at Denver’s Civic Center Park, with Lil Wayne as the headliner. On my way to the hospital, I had walked through lines of people waiting to pass through security screening.... Within a few hours, some of those users would arrive at Denver Health. As Simpson told me later, in the dry language of medicine, the hospital’s medical and psychiatric emergency rooms had “several cannabis-related presentations” that day.

But as Rylander, Simpson, and I spoke, the ward around us was still quiet. Should psychiatrists speak out about what they were seeing to discourage cannabis use, I asked? Simpson said that in Colorado, psychiatrists had tried and failed. “We’ve put it out there, and the community is not receptive.” At this point, his job as a physician was to try to deal with the wreckage, “treat what comes in the door.”

What did he think would happen in five years, I asked? What would the Denver Health emergency room be like, especially if cannabis continued to grow in popularity?

Simpson had a three-word answer: “It’ll be busier.”


Touching on the Opiate Crisis
One line of argument used by advocates early in the 2010s was the notion that marijuana use could reduce dependency on opiates, in part because marijuana is alleged to have analgesic properties (alcohol also has analgesic properties). This originated in a publication in 2014 by JAMA Internal Medicine claiming that in a survey of states conducted by Dr. Marcus Bachhuber that those with legalized marijuana had a 25 percent reduction in opiate overdoses throughout the 2000s. One major problem with this study was that very few people registered with the study in the first two years of the study (just 94 in Colorado): the time period where the negative correlation was found to be strongest. This is an issue a lot of statistical analysis can face at times called regression to the mean, where the results of a small sample size are cited as evidence of a trend in a broader population instead of properly seen just as an artifact of that small population's idiosyncracies.

The information collected by Dr. Sanford Gordon of New York University also failed to replicate the findings of Bachhuber. The author and Dr. Gordon compiled epidemiological data on marijuana use, cocaine use, and overdose death rates from 1999 to 2016 from databases of the CDC and the Substance Abuse and Mental Health Services Administration. The published conclusions were that

Not only did findings from the original analysis (of Bachhuber) not hold over the longer period, but the association between state medical cannabis laws and opioid overdose mortality reversed direction from −21% to +23% and remained positive after accounting for recreational cannabis laws. We also uncovered no evidence that either broader (recreational) or more restrictive (low-tetrahydrocannabinol) cannabis laws were associated with changes in opioid overdose mortality. We find it unlikely that medical cannabis—used by about 2.5% of the US population—has exerted large conflicting effects on opioid overdose mortality. A more plausible interpretation is that this association is spurious. Moreover, if such relationships do exist, they cannot be rigorously discerned with aggregate data. Research into therapeutic potential of cannabis should continue, but the claim that enacting medical cannabis laws will reduce opioid overdose death should be met with skepticism.

A July 2017 paper in the Journal of Opioid Management found that medical cannabis laws were associated with a 22 percent increase in age-adjusted opioid-related mortality between 2011 and 2014. Worse, mortality increased as time passed.

“It was surprising for me too, when I ran the numbers and got the results,” said Elyse Phillips, the study’s author. “When you just look at yes or no having a medical marijuana law, there was a correlation with those states having much higher deaths.”
...
An even more worrisome result came from a 2017 study that traced drug use in individuals over time rather than depending on state-level data. Trying to tease out all the factors driving marijuana or opiate use in an entire state is next to impossible. Looking at changes in individual behavior over a period of years is a far better way to determine cause and effect.

So what scientists really needed was a big national survey that asked people about their drug use and then returned to the same people years later.... Dr. Mark Olfson, a psychiatrist at Columbia University who specializes in addiction, realized that he could find the data in a survey initially designed to measure alcohol use. In 2001–2002 and again three years later, the National Institute on Alcohol Abuse and Alcoholism surveyed 34,000 Americans on their substance use and psychiatric problems.

These studies corroborated previous findings connecting marijuana with heroin use, both as a predictor of opioid use later in life from adolescence and as a predictor of relapse for recovering opioid addicts. Two twin studies out of Australia and the Netherlands in 2003 and 2006 for example found that marijuana users were several fold more likely to develop an opiate or cocaine use disorder than their abstaining twins.

Aside from these studies, the higher amount of opioid overdoses per capita in the United States and Canada compared the the UK lines up with the increased marijuana use in North America as well, although nation-wide studies are fraught with all sorts of confounding variables. Opiate overdoses began to increase in the 1990s, well before the major resurgence in interest in marijuana advocacy. But it still makes you wonder. In any case, without further education on the mental and physical health risks presented we can only expect marijuana use to increase until a breaking point is reached and there is blowback, similar to how Mexico originally introduced prohibition.

(continued in part 2)

 

whitecoast

The Living Force
FOTCM Member
(continued from part 1)

MARIJUANA'S LINKS WITH INCREASED VIOLENCE​


This piece of the puzzle is the most critical one, and also seems to be the one that invites the most incredulity from the public due to ignorance. "Hey man, everyone knows Reefer Madness is just a myth." And then they bring up alcohol and say that's a drug that makes people more violent. But all one needs to do is simply look at the statistics and see the connection.

Studies connecting Marijuana with Violence
Marijuana is more strongly connected to violence than alcohol is.
• A 2013 paper in the Journal of Interpersonal Violence used data from a federal survey of more than 12,400 American high school students to examine the link between alcohol, marijuana, and aggression. The researchers’ initial hypothesis, which they published as part of the paper, was that alcohol increased violence while marijuana reduced it. Instead, they found that students who had recently used marijuana—but not alcohol—were more than three times as likely to be physically aggressive as those who abstained from both, even after adjusting for race and sex. Those who used alcohol, not marijuana, were 2.7 times as likely. (Those who used both were almost 6 times as likely.)
• A 2016 paper in Psychological Medicine examined marijuana use and criminal behavior among 400 boys in London who were followed for more than forty years beginning in 1961; their marijuana use was surveyed when they were 18, 32, and 48. The paper found that marijuana use at all three times was associated with a ninefold increase in violent behavior even after adjusting for other variables.
• A 2013 paper in the American Journal of Psychiatry examined all 278 people charged with homicides, excluding vehicular homicides, in Alleghany County, Pennsylvania, between 2001 and 2005. It found that 90 defendants had been diagnosed with cannabis dependence or abuse, compared to 65 with alcohol dependence or abuse.
•A 2008 paper in the European Journal of Public Health surveyed 3,000 vacationers aged 16 to 35 in the Spanish resorts of Ibiza and Majorca to find out what factors predicted fighting. Cannabis use doubled the risk. Surprisingly, alcohol use did not change it, except for visitors who were drunk more than five days a week, who had a 2.5 times risk for fighting.
• A 2017 paper in Social Psychiatry and Psychiatric Epidemiology surveyed 2,000 young men in Britain and 4,000 in China to see if different factors led to violence in the two countries. Drug abuse was far more common in Britain and associated with a fivefold increase in violence. The study didn’t break out marijuana versus other drugs but noted that “young British men overwhelmingly reported misuse of cannabis.” Alcohol abuse was associated with a threefold increase in violence.
• A 2018 study in the journal Translational Issues in Psychological Science showed that among 269 men who had been court-ordered to treatment for domestic violence, marijuana use was associated with physical, psychological, and sexual violence, even after accounting for alcohol use.
• A 2017 analysis of 11 previous studies in Drug and Alcohol Dependence found that marijuana use was associated with a 45 percent increase in violence during dating by adolescents and young adults, compared to a 70 percent increase for alcohol use.
• A 2012 paper in the Journal of Interpersonal Violence examined data from a federal study of 9,421 American teenagers over a 13-year-period. It found that marijuana use was associated with a near-doubling of the risk of committing domestic violence by age 26, even after accounting for factors such as depression and binge drinking. (The study showed that binge drinking was associated with a 31 percent increase in the risk of being a victim of domestic violence but a reduced risk of being a perpetrator.) “We found that any use of marijuana during adolescence and young adulthood increases the risk of intimate partner violence,” the authors wrote. “Consistent users were at greatest risk of perpetration and victimization.”

This also includes violence in relationships:
• A 2018 study in the journal Translational Issues in Psychological Science showed that among 269 men who had been court-ordered to treatment for domestic violence, marijuana use was associated with physical, psychological, and sexual violence, even after accounting for alcohol use.
• A 2017 analysis of 11 previous studies in Drug and Alcohol Dependence found that marijuana use was associated with a 45 percent increase in violence during dating by adolescents and young adults, compared to a 70 percent increase for alcohol use.
• A 2012 paper in the Journal of Interpersonal Violence examined data from a federal study of 9,421 American teenagers over a 13-year-period. It found that marijuana use was associated with a near-doubling of the risk of committing domestic violence by age 26, even after accounting for factors such as depression and binge drinking. (The study showed that binge drinking was associated with a 31 percent increase in the risk of being a victim of domestic violence but a reduced risk of being a perpetrator.) “We found that any use of marijuana during adolescence and young adulthood increases the risk of intimate partner violence,” the authors wrote. “Consistent users were at greatest risk of perpetration and victimization.”

The findings are interesting in that they tend not to fit the popular stereotype of the relaxed an easygoing pothead. At worst regular uses can sometimes mention becoming paranoid. But some also develop full-blown psychotic episodes. Marijuana causes psychosis. The link is at least as strong "as the link between smoking and cancer." Most smokers don't develop cancer. We still say it causes cancer. We need to be able to say the same about marijuana. Marijuana causes paranoia, psychosis and schizophrenia. All three of these psychological traits are causal factors in violence.

People with psychosis or schizophrenia are five times as likely to commit crime as those who are not, and 19.5 times more likely to commit murder. The 19.5 statistic was found by a meta-analysis published in PLOS Medicine in 2009 by Dr. Seeena Fazel (U of Oxford), and was more or less replicated exactly (1.94) by a 2010 paper in the American Journal of Psychiatry in a survey on the deaths of young children in Taiwan.

It's estimated there are 1 to 3 million schizophrenics in the United States, and they make up 5 to 10 percent of murders. In the UK and seventeen other countries the rates are similar. Expanding analysis from schizophrenia to forms of psychosis other than schizophrenia strengthens the link even more. According to the US Justice Department 15 to 20 of US prisoners have a diagnosable psychotic disorder.

In spite of the obvious deduction that "marijuana causes psychosis and schizophrenia; psychosis and schizophrenia cause violence; therefore marijuana causes violence," there's a lot of evidence that marijuana is a direct cause of violence also.

The studies that demonstrate that psychosis causes violence also show that most of that violence occurs when people with psychosis are using drugs....In other words, when a patient with schizophrenia stays on antipsychotic medicines and away from recreational drugs, he is only moderately more violent than a healthy person.... But many people with schizophrenia do not stay on their antipsychotics for long. And people with psychosis use and abuse drugs far more than the general population—and when they do, they become far, far more likely to commit violent crimes than healthy people are.

Fazel’s meta-analysis in 2009 that found people with psychosis had a fivefold increased risk of violence showed that the risk was tenfold when those people were also substance abusers. (It was about double for those who had psychosis but didn’t abuse drugs.)

Advocates for the mentally ill put great emphasis on the fact that people with psychosis aren’t overly violent if they don’t use drugs. But they rarely acknowledge the flip side of the issue, that people with psychosis are frequently drug abusers—and that as a result their overall risk for violence is very high.
...
In other words, if predisposed to delusions, marijuana seems to function as a supercharger for sudden, extreme violence. Their underlying fears make them prone to lash out uncontrollably if cannabis provokes their paranoia.

The Gruesome and Senseless Nature of Psychotic and Schizophrenic Violence
One thing that needs to be brought home is the difference in the types of violence that marijuana users and alcoholics can commit. The type of violence caused by alcohol (excluding drunk driving which is more along the lines of criminal negligence) is of a more belligerent nature and related to mild intoxication and dis-inhibition. Marijuana use can be found in similar circumstances, but marijuana-related violence also makes up two other categories of violence: (1) "murders and assaults by mentally ill people who are also heavy cannabis users" and (2) people who become violent from a temporary cannabis psychosis."

Advocates for the mentally ill often say the media stigmatizes people with schizophrenia by highlighting crimes they’ve committed. The truth is the opposite. Reporters and news outlets dislike covering these cases, especially when the victims are family members. The crimes are brutal and ugly but without much mystery. People with severe psychosis rarely make much effort to hide what they’ve done. Even when they do, they are obvious suspects, and police often arrest them quickly. These are the murders the New York Post writes about for a day or two and the elite media ignores as tabloid fodder.

Still, the cases popped up frequently. After a while, I grew to recognize murders that involved psychosis even when it wasn’t explicitly mentioned. They were chilling both in their lack of obvious motive and in the degree of violence. Often, they involved bats or knives rather than firearms. They were the cases where parents suffocated infant children, or children clubbed their adult parents, or men stabbed to death women they’d never met before in libraries.

Of course, I couldn’t always be sure cannabis played a role. Prosecutors don’t usually bother with a marijuana charge when they indict someone for beheading his best friend. But mental illness is no barrier to having a Twitter account or a Facebook page.... Over and over, I found that defendants themselves revealed either their love of marijuana or their psychosis or both.[/quote]

Some more anedotes of incidents - not to show a trend (which anecdotes can't) but to give a characterization of the types of marijuana-associated violence psychotics and schizophrenics can wreak:
I grew to take a certain cold comfort in the PDFs filling folders on my computer. The studies and reports were real, even if no one knew about them. Besides, they were easier to read than the arrest warrants and news stories and police reports. I found victims even when I wasn’t looking:

• Christian Pearson, 10, an Arizona boy allegedly beaten and burned to death by his mother and stepfather in June 2017. His mother told police officers she had just come home from a medical marijuana dispensary when she found him severely injured.
• Giovanni Diaz, 15, a Florida teen allegedly beaten to death with a baseball bat by his 16-year-old “best friend” in March 2018 after they smoked marijuana in a park.
• Jimi Patrick, 19, Dean Finocchiaro, 19, Thomas Meo, 21, and Mark Sturgis, 22, Pennsylvania men lured to a farm in July 2017 by a man who offered to sell them marijuana. Once they arrived, the dealer, who had been diagnosed with schizophrenia, killed them, burned three of their bodies, and buried all four in a mass grave.
• Mia Ayliffe-Chung, 20, and Tom Jackson, 30, British backpackers stabbed to death at a hostel in Queensland, Australia, in August 2016 by a French traveler. Judge Jean Dalton—the same justice who oversaw the Raina Thaiday child-killing case—found the killer not guilty by reason of marijuana-caused schizophrenia. He had smoked four cigarettes a day for years and believed the people at the hostel wanted to kill and cook him.
• Ashley Mead, 24, a Colorado mother killed by the father of her 1-year-old daughter in February 2017. He dismembered her body and left her torso in a Dumpster. In an arrest warrant, the Boulder police noted a large box “half-full of empty marijuana bottles” in the apartment Mead and her boyfriend shared and reported a neighbor smelled marijuana smoke constantly.
• The nineteen residents—yes, nineteen—at a Japanese nursing home stabbed to death in July 2016 by a 26-year-old man who had been hospitalized less than five months earlier for cannabis psychosis. Twenty-six other residents were wounded. According to a Japanese newspaper, the man told investigators he wanted to legalize marijuana and believed drug gangs were targeting him, so he had no choice but to “complete his mission.”

These types of murders would be classified as "disorganized" by Rober Ressler, the criminologist who wrote Whoever Fights Monsters, meaning there is very little premeditation or methodicalness to the carnage, little attempt on the part of the criminal to hide what happened, and generally unsuccessful attempts to hide from the police, if it is attempted at all.

To quote from the thread, Ressler's own thoughts on criminality were as follows:

My research convinced me that the key was not early trauma but the development of perverse thought patterns. These men were motivated to murder by their fantasies.
--
They are obsessed with fantasy, and they have what we must call nonfulfilled experiences that become part of the fantasy and push them on toward the next killing.
--
Faced with a difficult happenstance such as the loss of a job, they turn inward and focus on their own problems to the exclusion of all else, and on fantasies as the solution to the problems.
--
The fantasies are substitutes for more positive human encounters, and as the adolescent becomes more dependent on them, he loses touch with acceptable social values.
--
His thinking patterns are all turned inward, designed only to stimulate himself.
--
I had long argued that the aberrant behavior of killers is in some ways only an extension of normal behavior.

It doesn't take a forensic neuropsychiatrist to see how marijuana-induce paranoia, psychosis, and schizophrenia can supercharge these types of aberrant thinking and behavior.

Violence Type 2: people who become violent during a temporary cannabis psychosis
This is probably the most depressing section of the book. Even though the violence tends to be less graphic in this category the cases are typically more tragic, where the perpetrator has no criminal record and the violence is inexplicable. Several anecdotes are given at the start of it; in one 2017 incident someone eats an edible and then went on a plane, began to freak out mid-flight, tried to break into the flight cabin, and almost assaulted a flight attendant; in 2018 two cousins and a friend smoked marijuana with THC extract, one of them shortly after picked up a pistol and, believing his cousin possessed by the devil, killed his cousin; in 2016 one Colorado man who smoked marijuana every day shot his wife and a neighbor, remarking, "the Lord is risen" and "This is Indian Country." This type of senselessness is typical of psychosis.

Marijuana has also been independently linked to the death of children due to abuse or neglect. In the Texas Department of Family Services there were 172 reported cases of child death due to abuse or neglect. In over 90 of these drug use was involved; of this number 56 used marijuana, 23 used alcohol, 16 used cocaine, and 14 used methamphetamine; of the 56 30 of them used marijuana every day. This was especially concerning since Texas falls well below the national average for marijuana use. About 2 percent of Texans use Marijuana daily, yet they comprise over a third of the cases of child death due to abuse or neglect.

The Increase in Violence in the United States

One ongoing obstacle to obtaining accurate statistics about crime related to marijuana is that "drug crime" as a causal category is extremely vague; it includes people committing crime under the influence, possession itself, crimes committed to pay for drugs, and trafficking-related conflict. In spite of some of these obstacles a picture is beginning to emerge that implicates increase marijuana legalization as a causal factor in the increase in violence. Advocates for legalization have often said that the violence associated with marijuana is due to its illegal nature, and that legalizing the drug will reduce the incidents of crime.

Unfortunately this is incorrect. The legalization in Alaska, Colorado, Oregon, or Washington did not eliminate the black market for marijuana - the weed and extracts available on the black market just became cheaper and a lot more potent. And all of these states have increases in murder and aggravated assaults disproportionate to the national average. For example in Washington, between 2013 and 2017 the amount of murders and aggravated assaults increased from 160 and 11,700 to 230 and 13,700 respectively. The increase was about 44 percent for murder and 17 percent for aggravated assaults, compared to the national average increase of 20 percent for murder and 10 percent for aggravated assaults. Statistically speaking, the odds of the difference being due to chance alone was about 6 percent for murder, but extremely low for aggravated assault. However, it is unlikely that something which has been determined to be a strong causal factor for assault would not also be a strong causal factor for murder.

There are no victims, cops sometimes say. What they mean is that violence victims are rarely completely innocent. The person who winds up dead after a bar fight or a gang shooting might easily have been the killer.... But marijuana’s madness makes its victims exceptions. They are children, wives, parents, even strangers, people whose only crime was being near someone in the grip of psychosis. That risk—not racism—is the reason that societies have always been wary of marijuana. And the new high-THC products worsen it. Why on earth would we want to encourage people to use this drug?

The increase in murder and violence due to more widespread marijuana availability is a real phenomenon, and it is not widely known enough. One obstacle is that the attention given to drug crime surrounds methamphetamine and heroin/fentanyl for the most part. Nobody is expecting to see a marijuana - violence connection because of how must public perception of the drug has been shaped and changed by questionable interests over the years, especially in the United States. And because people don't look for it they don't find it. But it is there in the data. People with no partiality against marijuana can look at datasets and find the connections even when that isn't the specific goal of the dataset. Some look at crime, some look at mental health, some look at drug use. The pieces just need to be put together by people who are willing to question their assumptions and the popular opinions of activists and, let's face it, drug addicts.

CONCLUSION

The book ends with some advice and recommendations, based on the fact that the marijuana-psychosis and -schizophrenia connections are unassailable and that as marijuana use continues to increase in frequency and potency the incidents murders and assaults linked with psychosis, schizophrenia, and marijuana use will also go up.

The author recommends increased federal funding to study the connections between marijuana and other drugs. The early hope and preliminary data about marijuana helping the opiate crises needed better research, as do trials on the medical benefits of THC. CBD has already been approved by the FDA to help with epilepsy. Marijuana's reputation rides on the coattails of this even though most recreational marijuana has very little CBD and has THC levels far above anything known historically. People say it's a mild analgesic, and research done to find this out compare it to placebos instead of painkillers. Alcohol is also analgesic and nobody calls alcohol medicine or prescribes it. The research on the medical benefits needs to be done so that urban legends about it can be put to bed.

Since this is 2020 we also need to talk about the civil rights and race issues surrounding marijuana. Arrests for marijuana fall disproportionately on black communities in the US; the black community uses marijuana more, has higher incidence of schizophrenia, and are more likely to be perpetrators and victims of violence. It could be seen as a form of racism in and of itself not to recognize that black communities are disproportionately victimized by marijuana more than other ethnicity, and that's the viewpoint that needs to inform policy decisions.

The author comes out and says that he advocates for decriminalization but against legalization. The former keeps drug users from counterproductive incarceration, while the latter creates entrenched financial interests who have economic incentives to increase public marijuana consumption and finance corrupt science to explain away the damage it causes to the community.

The most important issue to the author is not the specific legal status of the drug, but public awareness and education about the risks. In the UK for example the marijuana-psychosis link is well understood even by regular people, while that information has been very slow to penetrate into the North American consensus. Analogous campaigns to reduce teen smoking in the 1990s and 2000s purely by public education campaigns have been very successful, and the same could be done with marijuana and its links to psychosis, schizophrenia, and violence.

Some evidence has emerged that the popularity of marijuana may be starting to peak, with industry forecasts growing more conservative after the initial optimism of legalization has worn off. And in the US at least one NGO called the Office of National Drug Control Policy is attempting to push back against of the liberalization deemed harmful, although it is nowhere near the size of pro-marijuana groups.

MY OWN THOUGHTS

What I enjoyed the most about the book is its very well-read history of the legal and scientific issues around marijuana, and how so much of what I learned through osmosis growing up and in my early adulthood about cannabis was built on rather weak evidence. It really seems that the people who went before us to ban the drug weren't doing so out of racism of any kind, especially since multiple cultures have come out against the consumption of high-THC drugs due to the paranoia, psychosis, schizophrenia, and violence it caused. None of this is to provide excuses for any heinous crime, but based on some of the anecdotes on how some people with no criminal records or history of mental illness completely lose their minds temporarily, come to to find family members or strangers murdered, and spend the rest of their lives in jail and despised, it's hard not to wish our society adopted a more circumspect approach to the drug issue.
 

SMM

The Living Force
It's the first time I am coming across this SOTT article, work and book. I wanted to add that I have observed the statement below to be true in many and multiple ways, alas:

MARIJUANA'S LINKS WITH INCREASED VIOLENCE

In terms of thinking errors leading to lapses in choices and judgements, psychosis, schizophrenia, paranoia and ultimately violence.

As for your takeaways from the book, i too wish society adopted a more circumspect approach to high-THC drugs, other drugs and the drug issue.

Going to read the full posts you've shared before adding anything else, as I merely skimmed them both.
 
If there is a more appropriate thread for this, please move. From here nov 4 2022
More control on people... nothing new.

Czech Republic Plans To Legalize Cannabis In Coordination With Germany


The Czech Republic is on the way to legalizing adult-use cannabis, and it aims to coordinate with Germany to share information and the best practices to regulate the legal industry.

Following Germany’s announcement to legalize cannabis, the Czech Republic has just started to embark on the journey toward cannabis legalization, aiming to harmonize its legislation with Berlin.
The Czech coalition government is drafting a bill to regulate the industry, which is expected to be presented in March 2023, while full legalization may be entered into effect by January 2024
In September, the government commissioned drug commissioner Jindřich Vobořil to draft a law to legalize adult-use cannabis.
Vobořil announced that Czech officials are in contact with the German government to coordinate and consult each other over their proposals.

“We are in contact with our German colleagues, and we have repeatedly confirmed that we want to coordinate by consulting each other on our proposals,” he said in a Facebook post.
The Czech Republic is considered one of the most liberal countries regarding cannabis legislation.
Although its recreational use is still illegal, it decriminalized cannabis possession for personal use in 2010 and legalized medical cannabis in 2013.

In addition, the Czech Republic is one of the few European countries that cultivate hemp with a THC content of up to 1% for industrial purposes. In comparison, other EU member state legislations have set the limit to about 0.2%, although the European Union recently decided to increase the THC level from 0.2% to 0.3% for authorized hemp crops used for industrial purposes.
Hence, the regulation of the recreational market appears to be a natural path to follow for a country in which about 30% of the adults have tried cannabis, and 8% to 9% use it regularly, according to the Addiction Report released in August by the National Monitoring Center on Drugs and Addiction (NMS).

Despite the decriminalization for personal use, the illegal market still thrives because no legal production has been established, and the supply chain lacks quality control and control of sales to young people under 18.
Some experts believe that legalization has the potential to generate significant revenues from cannabis consumption taxation, taking into consideration that there are about 800,000 active cannabis users in the country.
According to the Czech Pirate Party, the smallest political group inside the government coalition and one of the most prominent cannabis advocates in the country, cannabis products could generate about €800 million in tax revenue annually.
Furthermore, the government’s National Economic Council (NERV) suggests that regulating the legal cannabis industry would help the Czech Republic to fight high public budget deficits.

In an interview with a local news media outlet, Vobořil said that cannabis would be sold in selected pharmacies upon a license’s authorization and likely in licensed dispensaries.
Furthermore, municipalities should have the opportunity to decide whether allow or ban cannabis stores.
Vobořil also wishes to start a trade partnership with Germany to supply each other, although Berlin’s plan to legalize adult-use cannabis would exclude imports of cannabis products.
 

Zzartemis

Dagobah Resident
I've qualified for medical use for a number of reasons, but have had no desire to apply. For one thing, the plant has been altered. Two, this changes the spirit of the plant also...Marijuana was always a plant to use cautiously. It can help but to see it psychically, it sort of wraps around you, protectively ( the original) but to use as anything other than a temporary crutch, that 'protection' could become possessive, wrapping one tighteter, as if cocooned...or so I saw it as such.

The new stuff, the legalization, well, nothing is offered without strings attached. As I said, the spirit of the plant has been changed, looked at below, in the physical, as an increase in potenancy. I started noticing that young adults prescribed MJ for anxiety are anything but less anxious...

How Weed Became the New OxyContin

Big Pharma and Big Tobacco are helping market high-potency, psychosis-inducing THC products as your mother’s ‘medical marijuana’
BY
LEIGHTON WOODHOUSE
AUGUST 30, 2022

SNIP:
For 30 years, Dr. Libby Stuyt, a recently retired addiction psychiatrist in Pueblo, Colorado, treated patients with severe drug dependency. Typically, that meant alcohol, heroin, and methamphetamines. But about five years ago, she began to see something new.

“I started seeing people with the worst psychosis symptoms that I have ever seen,” she told me. “And the worst delusions I have ever seen.”

These cases were even more acute than what she’d seen from psychotic patients on meth. Some of the delusions were accompanied by “severe violence.” But these patients were coming up positive only for cannabis.

READ ALL:
 

c.a.

The Living Force
FOTCM Member
I have never felt this condition of violence using any cannabinoids.

Though when cannabis is mixed with alcohol things do get weird and I'll agree with that.

Meanwhile:

January 9, 2023
Screenshot 2023-01-10 at 10-29-44 New molecular insights into medical cannabis.png
End-point assays of compounds tested. (A) Chemical representation of Δ9-trans-tetrahydrocannabinol (THC), cannabidiol-dimethylheptyl (CBD-DMH), 9(R)-Δ6a,10a-THC (6a10aTHC), JWH018, tetrahydrocannabinolic acid, 2-arachidonoylglycerol, cannabidiol (CBD), and anandamide. (B, C) End-point assay for (B) ATX-β and (C) ATX-ɣ inhibition with various cannabinoids and endocannabinoids. All error bars represent the SEM (n = 3). (B, C) Activity rate of 99 and 65 mMol end product/mM ATX/min has been found for (B, C), respectively. ANOVA comparison between CTRL and other conditions showed statistically significant differences for THC, 6a10aTHC, tetrahydrocannabinolic acid, CBD, and 5-DMH-CBD for ATX-β and ATX-γ inhibition (P < 0.005). ATX was not significantly inhibited by JWH018, anandamide, and 2-arachidonoylglycerol (P > 0.005). Credit: Life Science Alliance (2023). DOI: 10.26508/lsa.202201595
In various European countries and North America, medical cannabis or medicines based on cannabinoids are authorized for therapeutic purposes. While the cannabis plant contains over 100 cannabinoids, THC (D9-tetrahydrocannabinol) and CBD (cannabidiol) are the two best-known and characterized constituents.

THC and CBD are administered under different pharmaceutical forms, showing therapeutic effects such as pain and inflammation relief. However, little is known about how THC and other cannabinoids work in the human body at the molecular level.

Based on clinical trials, cannabinoid-containing medications can help to alleviate symptoms of mental disorders such as epilepsy, Alzheimer's disease, asthma, and cancer, and help prevent weight loss during clinically challenging treatments for AIDS and different forms of cancer.

EMBL Grenoble researchers have investigated the interaction between THC and some proteins it might bind to. In a recent study, they showed in vitro that THC inhibits an important human enzyme called autotaxin. This enzyme is involved in many different cellular functions, specifically producing a molecule called lysophosphatidic acid (LPA), which stimulates cell proliferation. A dysregulation of LPA production can lead to development of cancer, inflammation, or pulmonary fibrosis. Autotaxin is therefore a major target for drug development.

New molecular insights on THC

Understanding how THC and other cannabinoids interact in our cells at the atomic level would help to administer THC more efficiently in therapeutic contexts.

The field of structural biology is particularly relevant to obtain this kind of information. Structural biologists focus on elucidating at the atomic scale the three-dimensional structure of molecules, like proteins or enzymes, and how they interact with each other. These structural results further lead to understanding molecules' particular function and how to modulate their activities with specific compounds—which are crucial insights to develop effective drugs.

The first step in structural and biochemical studies is to determine how a specific component interacts with molecules in vitro—meaning in the controlled environment of the laboratory—before going for further investigation in vivo, in living organisms.

During their investigation of THC, the McCarthy team obtained the three-dimensional structure of the THC cannabinoid bound with autotaxin. By employing macromolecular crystallography with EMBL's beamline at the PETRA III synchrotron in Hamburg, they could lay the molecular basis of how THC inhibits this enzyme.

A path to further investigations

Identifying this enzyme as a binding target for THC expands the knowledge on this cannabinoid and provides more data on its possible therapeutic effects at the molecular level and how medical cannabis might contribute to therapy.

"Autotaxin is an essential enzyme in human beings," said Mathias Eymery, Ph.D. student on the McCarthy team and first author of the publication. "It is responsible for the production of LPA, a major membrane-derived lipid signaling molecule that mediates many different cellular functions. Dysregulations of LPA production by autotaxin are known to have a role in the development of cancer, inflammation, or pulmonary fibrosis."

In vivo studies are necessary to confirm that the binding between autotaxin and THC is linked to the therapeutic effects of THC administration—as the main known targets of THC in the human body are the CB1 and CB2 cannabinoid receptors, that mediate the psychoactive and pain relieve effects of cannabinoids. Further investigation will help determine further potential of cannabinoids for medical research and drug development.

The work is published in the journal Life Science Alliance.
 

c.a.

The Living Force
FOTCM Member
Just in with this article brings some interesting information about elderly novice adults using cannabis (aged 65 and older).

Remembering that current cannabis strains offered can top out at 26% THC which for the inexperienced adult, will alter one's state of mind-affecting basic motor skills and cognizance.

Also, the black market offerings (crossing the borders) can include mold and cross-contamination by contaminated soils infected by pesticides and heavy metals.

Obviously, know your limits and never drive under the influence of any mind-altering substance (FWIW).

 

Mrs. Peel

The Living Force
FOTCM Member
I've qualified for medical use for a number of reasons, but have had no desire to apply. For one thing, the plant has been altered.
My partner Michael has a medical card, and he also remarked on the "altered" state of the pot store plant, vs. the "homegrown" variety, which he gets from a few friends who grow it that he trusts. Pot has been a godsend for him with the cancer for anxiety and pain management. We joke about the different strains, he smokes the "hungry" pot when he needs to stimulate his appetite during chemo, and the "sleepy" pot at night before bed to get rest. Sometimes if he's being silly, I ask it he's been smoking the "stupid" pot. :-D

Just in with this article brings some interesting information about elderly novice adults using cannabis (aged 65 and older).

I object to being called "elderly" at age 66, ;-) Wanting to know what the fuss was all about, I've tried pot on numerous occasions throughout my life, but it has never had any effect on me if I smoke it. Maybe because not being a cigarette smoker, I can't get the hang of the inhale, and end up burning my lungs out or having a coughing fit each time, but I did get it in me. Once I tried a pot-laced brownie (how stereotypical), and the only effect was to make me feel uncomfortably lightheaded and slightly distorted. I can feel basically the same way when my blood sugar gets low, so why would I seek that out otherwise?

When I'd complain that I never felt any different after smoking it, Michael would say maybe I was high and didn't realize it. If that's the case, what's the purpose? Seriously! Kind of like the Emperor's New Clothes. :lol:
 

Magnolia

Jedi
I object to being called "elderly" at age 66, ;-)
Thank you. I have chuckled or grimaced at equally absurd numerical assertions reflected from a variety of "news" sources (MM and Alt), but have chosen to let things be -- till you spoke up. We all are (or are going to be) subject to that culturally ingrained bias, at one "time" or another. BTW If time does not exist, how can age? Either we look through a glass darkly and are subject to the public contagion about "age" or we set ourselves free from such influences and mis-education and instead see clearly.

As a spiritual counterpoint: "But the Lord said unto Samuel, Look not on his countenance, or on the height of his stature; because I have refused him: for the Lord seeth not as man seeth; for man looketh on the outward appearance, but the Lord looketh on the heart." (Sam 16:7)

Many mystics state that the aspect of our being that is important is immortal, immutable, ageless; it is never born, never sick, never dying; it is always at the standpoint of perfection. Material man is generally considered "real," because popular reality is defined as that which is tangible and accessible to sensory validation. But, as much on this website attests, there are things which are intangible, that are not accessible to sensory validation; and true "Reality" can potentially be expanded to infinity. "While we look not at the things which are seen, but at the things which are not seen: for the things which are seen are temporal; but the things which are not seen are eternal." (2Cor 4:18)
 

c.a.

The Living Force
FOTCM Member
April 12, 2022
Could hemp help prevent infection or treat COVID-19? Research at Oregon State University shows potential.
Richard van Breemen, a researcher in Oregon State’s Global Hemp Innovation Center, College of Pharmacy and Linus Pauling Institute has identified two hemp compounds that may prevent the coronavirus that causes COVID-19 from infecting human cells.

Using a mass spectrometry-based screening technique that was invented at Oregon State, van Breemen, OSU colleague Ruth Muchiri and five collaborators from Oregon Health & Science University found that a pair of cannabinoids — cannabigerol acid (CBGA) and cannabidiolic acid (CBDA) — bind to the coronavirus spike protein, blocking a critical step in the infection process.


Hemp is a rich source of unique natural products that have therapeutic value. Unlike other cannabinoids that have psychoactive properties, the CBGA and CBDA compounds are not controlled substances and have a good safety profile in humans, van Breemen says, and they also have potential to prevent as well as treat COVID-19 infections.

van Breemen expects preclinical trials will happen within a few months. He says preclinical trials, required by the U.S. Food and Drug Administration before any clinical testing in humans can begin, involve using cell cultures and/or animal models to test the safety and efficacy of a new drug candidate.

COVID-19 hasn’t been beaten yet. But the discoveries made at Oregon State could be an effective tool in the fight.

Screenshot 2023-01-29 at 10-17-41 Hemp vs. Covid OSU finds compounds that could prevent infect...png
 
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