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Correspondence |
Clinical Services Building, Bloomfield Hospital, Forest Road, Orange 2800, Australia
I note the recent flurry of papers on the dangers of cannabis use
(Ashton, 2001;
Johns, 2001;
MacCoun & Reuter, 2001;
Robson, 2001). As a clinician
working with alcohol and drug users for 18 years, I find my mind strained by
the disparity between what I read and what I see. Cannabis is almost
universally used by my patients, yet only rarely can significant problems be
attributed to its use. This is not to say that squirrel monkeys locked in
cages with nothing to do but get stoned do not seem addicted to
9-tetrahydrocannabinol (THC)
(Tanda et al, 2000;
contrast with Peele, 1990). But
what does that mean to humans living in complex interconnected worlds? We read
that cannabis use "generally provokes relapse" in schizophrenia
(Johns, 2001) but the commonest
cause of relapse is schizophrenia itself. Many people choose to reduce
symptoms, feel more in control or stay numb through drug use, irrespective of
what we say or fear. Generally, as symptoms improve with more effective
treatments, and as life's chaos subsides, alcohol, tobacco and other drug use
declines or stops.
A crucial point many do not concede is that people will and do use cannabis, at an increasing frequency in most Western countries, and that dire warnings in the face of growing public acceptance will achieve only loss of credibility for medical bodies. Driving a car, crossing a road, moving into a new relationship, let alone taking aspirin or a tricyclic antidepressant, are all dangerous, but we balance the risk with the benefit. No doubt all the reported effects of cannabis are correctly documented. But only those who can see no benefit in cannabis seem to pounce on another piece of information to confirm what they already know to be true, that cannabis really is a deadly drug. The rest of us get along with a pragmatic, balanced view.
REFERENCES
Ashton, C. H. (2001) Pharmacology and effects
of cannabis: a brief review. British Journal of
Psychiatry, 178,
101-106.
Johns, A. (2001) Psychiatric effects of
cannabis. British Journal of Psychiatry,
178,
116-122.
MacCoun, R. & Reuter, P. (2001) Evaluating
alternative cannabis regimes. British Journal of
Psychiatry, 178,
123-128.
Peele, S. (1990) Addiction as a cultural concept. Annals of the New York Academy of Sciences, 602, 205-220.
Robson, P. (2001) Therapeutic aspects of
cannabis and cannabinoids. British Journal of
Psychiatry, 178,
107-115.
Tanda, G., Munzar, P. & Goldberg, S. R. (2000) Self-administration behavior is maintained by the psychoactive ingredient of marijuana in squirel monkeys. Nature Neuroscience, 3, 1073-1074.[CrossRef][Medline]
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| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
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