New Labour’s schizo policy on cannabis

Today, the British government will ignore its own Advisory Council on the Misuse of Drugs (ACMD) and announce its intention to reclassify cannabis so that possession of it will carry harsher penalties. This is despite the fact that cannabis use has declined in the four years since it was ‘downgraded’ and the police will not change the way they deal with possession on the street.

Up until four years ago, cannabis was categorised as a ‘class B’ drug, which meant that in theory – if not in practice – people caught in possession of the drug on the street could expect to be arrested. The maximum penalty for possession of a class B drug is five years. In January 2004, cannabis was downgraded to ‘class C’, meaning lower penalties and a ‘presumption against arrest’.

current drug classification (source: Home Office)

The main excuse given for returning cannabis to class B is a link between smoking ‘skunk’ cannabis and the development of schizophrenia – even though causation is a long way from proven.

Over the next few days, conventional wisdom will be often repeated, even by those who should know better. The myth (usually expressed in a tone of regret) is that the mild and mellow hash smoked by the flower-power generation has been swept aside by genetically modified ‘super skunk’ (1) that is 10-30 times stronger. Just one spliff raises the threat of schizophrenia by 40 per cent (2) and can cause lifelong mental illness or suicide (3). Teenagers who smoke cannabis regularly can turn into psychotic, slavering serial killers (4).

Reclassification of cannabis is supposed to ‘send a message’, but the message it sends is that politicians do not understand either young people or probability.

‘Using cannabis doubles your risk of getting schizophrenia’ – say psychiatrists (5). Even if that statistic is proved true, it could almost be a pro-dope argument:

• If 100 teenagers do not use cannabis, one will eventually develop schizophrenia
• If 100 teenagers use cannabis regularly, two will eventually develop schizophrenia
• If 100 teenagers use cannabis heavily for several years, five will eventually develop schizophrenia.

In other words, 95 per cent of teenagers could smoke the drug every day for years and not get schizophrenia. Teenagers despise hypocrisy, double standards and scare stories. In fact, programmes that try to scare teenagers into ‘better’ conduct actually lead to more offending behaviour (6).

Instead of spending years locked in a bedroom smoking dope, teenagers should be out exploring the world, having new experiences and relationships, doing things they enjoy and things they will regret, testing their limits and learning about life. That politicians and the generation in charge have created a nation in which so many young adults want to spend their formative years in a stupefied dope haze demonstrates the contempt our society has for the young in general. Rather than address this wider issue, the powers-that-be seem happier to crack down on the symptoms – dope smoking – rather than tackling the cause – the loss of any sense of purpose in society.

Sadly, the cannabis/schizophrenia controversy is too great a temptation for all the vested interests not to take advantage. Gordon Brown looks tough as he contradicts the advice of namby-pamby ‘experts’, clinical researchers get grants for more studies, mental health charities have their turn in the spotlight, newspapers can scream about axe-murderers … and drug dealers profit from free advertising about ‘super strong skunk’.

But, every part of the conventional wisdom is simply wrong.

The super-skunk fallacy

Just about every commentator trots out the ‘fact’ that powerful ‘skunk’ has replaced cannabis resin (‘hash’) and is 10 (or more) times stronger than in the 1960s, ‘…when I was a flower power acolyte, smoking grass’ – says Marjorie Wallace of SANE, the mental health charity (7).

‘Skunk’ is sinsemilla, which has always been available at a price. It is composed of the unpollinated, flowering buds of the female cannabis plant and, in its raw state, has a higher concentration of THC (the chemical that gives a ‘high’) than imported ‘hash’ (cannabis resin). The other product, now much less commonly found, is ‘herbal cannabis’ – chopped up leaves and seeds.

The Forensic Science Service (FSS) say THC content of skunk has increased from six percent in 1995 to 10-11 per cent today (8). The THC potency of most cannabis resin samples in 2005 was between two and six per cent (9). But FSS sources use no common standards for testing THC content and are vague about the term ‘street seizures’ and whether that refers to final product or raw materials and whether the claimed THC levels are in oils or dried samples (10).

Individuals and criminal gangs now grow most of the cannabis consumed in Britain. Like all good small businesses, they have improved their product over the years and their plants, indeed, produce higher levels of THC. However, also like good small businesses, they do not give away more than they must. The extremely high levels of THC reported in sinsemilla ‘skunk’ are not necessarily found in seizures on the street, but in samples from plants found in cannabis ‘factories’. By the time ‘skunk’ reaches the street, it is almost certainly adulterated with leaves and twigs to bulk up the content.

Casual users – like casual drinkers – probably adjust their usage anyway. Everyone but alcoholics drink vodka at a much slower rate than they drink beer. The same is likely to be true of cannabis users, who will simply use less of a potent product in a joint.

Schizophrenia

Schizophrenia is the most feared psychiatric diagnosis, thanks to media portrayals of psycho-killers, institutionalized zombies and aggressive tramps who shriek at invisible tormentors. Far from the Jekyll and Hyde caricature, schizophrenia is a ‘split’ in the normal ‘internal monologue’ with which we talk to ourselves, work things out, think happy thoughts and express inner doubts.

Another voice appears, at first infrequently. It can offer a running commentary, be full of praise, or be ‘the voice of God’ – Joan of Arc was probably at this stage in schizophrenia. The voice may be barely noticed in the pre-teens and only become regular during puberty – provoked by hormonal surges and personal and educational stress. Over years, the voice can further split into different ‘characters’ and become insulting and hostile; rarely, it urges suicide, even more rarely, violence.

Along with auditory hallucinations often come delusions of being watched, persecuted or controlled and seeing hidden messages in anything from television programmes to song lyrics. Depression and paranoia may go on for years before they become too much to bear and disturbed behaviour attracts attention – commonly between 19-25 years of age.

Well before diagnosis, people often find that self-medication with alcohol or drugs can temporarily quieten or calm the voices. It is unusual for an untreated schizophrenic not to abuse alcohol, nicotine and/or other illegal drugs. Because schizophrenia and intoxicants go together and cannabis use is now so widespread it is extremely difficult to determine whether cannabis has caused the disease or is a symptom of the pre-existing mental disorder.

If there is a strong causative link between smoking cannabis and schizophrenia, there would have been an epidemic of the disease that followed the large increase in consumption of cannabis over the last 30 years. But there has been no such increase; the prevalence of schizophrenia has not increased. What has increased is the number of people admitted to hospital with cannabis intoxication – which mirrors the number of people admitted to hospital with alcohol intoxication.

Schizophrenia – early factors

There is a large genetic component: if a parent is schizophrenic, a child’s risk is 10 times greater; if one identical twin has schizophrenia, the other’s risk is 50 times greater (11).

Many fetal/birth factors double the hazard (as much as is claimed for cannabis use): maternal diabetes or exposure to famine or viral infections; emergency caesarean section; premature birth, low birth weight, oxygen starvation, birth complications, needing an incubator; being an unwanted child or father dying before birth; being born or brought up in a city; below-normal IQ and autistic spectrum disorders.

Migrating to a new country increases the risk 18 times; a mother who doesn’t understand you increases the risk 5.8 times; being in an ethnic minority carries a sliding scale – the more of you there are, the better your chance of avoiding the disease.

There are some very early indicators of risk (12): delayed speech and motor development; late learning to stand, walk or potty-train; poor motor function, autistic spectrum disorders, being kept back a year at school, attention defecit, poor verbal memory. In one study, it was possible for researchers to spot which individuals went on to develop schizophrenia from home movies of very young children – simply from their behaviour.

In a three- or four-year-old, it is perfectly normal to have an ‘invisible friend’ or stuffed toys that ‘talk’, but in a nine- or 10-year-old these could be a risk for later psychotic disease. One in seven ‘normal’ children and teenagers may hear voices occasionally, be paranoid, or feel ‘controlled’ and that something is wrong with their minds. In later childhood, behavioural disorders, family breakdown, loss of attachment to key adults, abuse and neglect all increase the risk for schizophrenia.

Modern studies attempt to identify children with such very early signs of the potential to develop schizophrenia and exclude them from analyses of teenagers who use cannabis, to correct for those who might have taken up cannabis to deal with early symptoms. So far, studies have excluded patients with possible psychotic symptoms occurring after 11 years of age, but not before.

Of course, all those risk factors for schizophrenia are also risk factors for alcohol, cannabis and drug misuse, smoking, depression and criminality.

Conclusion

In conclusion, it is still not possible to say whether cannabis use causes schizophrenia or is an early sign of the disturbed mental state.

Cannabis is not a benign substance for the developing adolescent brain but there is no convincing evidence that smoking a few joints will inevitably cause psychotic disease. ‘Old-fashioned mellow hash’ has not been swept aside by ‘genetically-modified super-skunk’ with astronomically high levels of THC.

The argument about cannabis and schizophrenia reflects the modern view of children. In the memories of the 1968 generation, the ‘mild and gentle weed’ they smoked and made them mellow has been replaced by ‘skunk’ which turns today’s children into aggressive and anti-social monsters. So these anti-social, destructive, feral youth can be pathologised and medicalised out of the way.

All these myths play into the hands of the government, ever-wary of upsetting its cosy relationship with the most reactionary elements in the press.

Rob Johnston is a freelance writer on the environment, health and science.

(1) Superskunk me: What happened when one woman smoked dope daily for a month for a BBC documentary, Daily Mail, 25 March 2008

(2) Smoking just one cannabis joint raises danger of mental illness by 40%, Daily Mail, 25 July 2007

(3) One spliff can mean lifelong mental illness, Daily Telegraph, 9 March 2007

(4) Smoking just one cannabis joint raises danger of mental illness by 40%, Daily Mail, 25 July 2007

(5) Schizophrenia: what causes schizophrenia? Mental Health Information leaflet, Royal College of Psychiatrists

(6) ‘Scared Straight’ and other juvenile awareness programs for preventing juvenile delinquency, Cochrane Reviews, 22 April 2002

(7) One spliff can mean lifelong mental illness, Daily Telegraph, 9 March 2007

(8) Use of extra strong ‘skunk’ cannabis soars, Daily Telegraph, 7 February 2008

(9) Rising potency of street seizures of cannabis, Association of Chief Police Officers in Scotland

(10) The ‘Skunk’ panic. Cannabis strength/potency – what does it actually mean?, UK Cannabis Internet Activists.

(11) Schizophrenia: what causes schizophrenia? Mental Health Information leaflet, Royal College of Psychiatrists

(12) Tonya White et al. The Schizophrenia Prodrome, Treatment in Psychiatry, 3 March 2006