January 7, 2019

"When it comes to cannabis, the best-case scenario is that we will muddle through, learning more about its true effects..."

"... as we go along and adapting as needed—the way, say, the once extraordinarily lethal innovation of the automobile has been gradually tamed in the course of its history. For those curious about the worst-case scenario, Alex Berenson has written a short manifesto, 'Tell Your Children: The Truth About Marijuana, Mental Illness, and Violence.' Berenson begins his book with an account of a conversation he had with his wife, a psychiatrist who specializes in treating mentally ill criminals. They were discussing one of the many grim cases that cross her desk—'the usual horror story, somebody who’d cut up his grandmother or set fire to his apartment.” Then his wife said something like “Of course, he was high, been smoking pot his whole life.'...  The first of Berenson’s questions concerns what has long been the most worrisome point about cannabis: its association with mental illness. Many people with serious psychiatric illness smoke lots of pot. The marijuana lobby typically responds to this fact by saying that pot-smoking is a response to mental illness, not the cause of it—that people with psychiatric issues use marijuana to self-medicate.... [Berenson] sits down with Erik Messamore, a psychiatrist who specializes in neuropharmacology and in the treatment of schizophrenia. Messamore reports that... he has begun to see a new kind of patient: older, and not from the marginalized communities that his patients usually come from. These are otherwise stable middle-class professionals. Berenson writes, 'A surprising number of them seemed to have used only cannabis and no other drugs before their breaks. The disease they’d developed looked like schizophrenia, but it had developed later—and their prognosis seemed to be worse. Their delusions and paranoia hardly responded to antipsychotics.'"

Writes Malcolm Gladwell in "The Return of Reefer Madness"... [just kidding!!] I mean "Is Marijuana as Safe as We Think?/Permitting pot is one thing; promoting its use is another."

You know, "Tell Your Children" — Berenson's manifesto title — is the original title of the movie we know as "Reefer Madness." I think it's very strange that Gladwell never mentions that in his article (which appears in The New Yorker).

41 comments:

Kevin said...

Wait, the words “taxed and regulated” don’t make it incumbent on the government to magically solve all the issues?

Darrell said...

We'll have to pass it (legalization) before we find out what's in it.

Nancy is back!

wild chicken said...

All I can say is, I had a couple scary "breaks" on the stuff, and it was nothing like being very drunk. I felt I was losing control of my mind, and doubted my own sanity. A little wine would have been a blessing.

I don't know how people can smoke or eat the quantities they do. They seem very, very anxious for some reason.

tim maguire said...

Is there a "correlation does not equal causation" tag?

Lots of people smoke pot. Some of them have mental health issues. Even if it's shown that a higher percentage of pot smokers have mental health issues than does the population as a whole, the point is far from proven.

stevew said...

Allowing something isn't the same as promoting it, but a lot of the stuff I've read from advocates of changing the legal standing of marijuana could be understood as boosterism. Studying use (has consumption increased with decriminalization?) and its effects will be a lot easier now that it is legal. The chicken & egg argument of whether the mental disorder results in marijuana use, or the other way round seems to be anecdotal to this point. Here's another anecdote: I consumed my share in my youth but eventually gave it up (more like just stopped consuming) because caused me to feel anti-social. Many of my friends stopped for the same reason.

Sydney said...

I have had middle aged patients give it up suddenly after a psychotic type experience while high. It scared the shit out of them. These were heavy life time users with no prior history of mental illness. Today’s marijuana is much more potent than it was 30 years ago, so there’s also that factor.

Kevin said...

“Studying use (has consumption increased with decriminalization?) and its effects will be a lot easier now that it is legal.”

And a lot harder to change once state and local governments become dependent on the tax revenues.

David Begley said...

Since the Dems love science I imagine that they will now stop the legalization push.

rehajm said...

Correlation vs. causation?

Embrace and.

Fernandinande said...

"Reefer Madness."

Story by Lawrence Meade.

Anecdotes by Malcolm Gladwell.

iowan2 said...

Love me some correlation science in the morning. Anecdotes rule!

I got one. A family that our family grew up with,oldest son was (is?) a pot user. He worked as a hard hat building bridges, during college in the late 60's. by 1985 he was VP and eventually CEO. he visited the farm one weekend in 85 and said he wanted to go look at the barns we spent so many hours playing in. He just wanted to smoke a joint. He said he smoked daily. So if you want to be CEO of an international company that operates on 4 continents. Pot is the answer. Anecdotal correlations don't lie.

iowan2 said...

Another? No I couldn't, well if you insist.

One of the biggest pot heads in highschool took the military instead of jail option. He ended up in Clandestine spook work. After his 20 years, he went private doing the same stuff. His sister, my classmate, shared that she went to DC to visit him. Decided to see a movie. He drove...to a parking ramp where he switched cars and left thru an exit not availible to the public. On to the movie.
Pot is the go-to for people doing deep spook work.

Sebastian said...

"Is Marijuana as Safe as We Think?/Permitting pot is one thing; promoting its use is another."

The fatal flaw of libertarianism is that people's "individual" choices always have massive social ramifications. Not only does your "voluntarily" induced psychosis put me at risk, in the therapeutic welfare state your breakdown is my problem.

Of course, that doesn't decide the policy issue, since the costs of prohibition may be higher still. But we usually don't get a fair accounting of all the relevant costs.

gilbar said...

this is Why is it So Important that we keep marijuana as a Schedule One drug
research Can NOT be conducted on Schedule One drugs, which allows pro pot people (ppp) to say:
there has Never been a study showing Any Actual harm from marijuana!

IF we remove pot from Schedule One, researchers will be able to show that pot causes GOD Know what

mccullough said...

Just tax pot companies for their treatment and institutionalization.

Gretchen said...

I have said this for a while. As soon as marijuana is legal in all of the US, the media will declare it to be the greatest public health threat.

While I don't think it is harmful to many people who use it occasionally, it is now extremely strong and obviously has negative psychoactive effects, as well as cannabinoid hyperemesis syndrome for heavy users.

gilbar said...

Fetchin Gretchen said.. As soon as marijuana is legal in all of the US, the media will declare it to be the greatest public health threat

That's why The Plan is to leave it illegal (but unenforced) at the Federal level. All the states will legalize it; with the Feds essentially saying that The Crime is to study it

bagoh20 said...

We were once very close, but now rarely see each other. We just grew apart.

Lucien said...

Funny how many of the same people who have made medical research on marijuana next to impossible also claim that the War On Drugs must go on because “we don’t know enough” about it. Well, we know enough about militarized police breaking into people’s homes at 3:00 a.m. and shooting their dogs in the hope of finding some weed.

buwaya said...

I almost hired (out of a contract gig) the biggest pothead I ever knew, almost 20 years ago. A very talented, hard working fellow and a daily, out and proud user.

Unfortunately he started showing disturbing signs of the schizophrenia he was later diagnosed with. This was long before the official pot-schizo connection was made. I thought at the time that his habit may have had something to do with his illness. He descended into near-complete self destruction, was in rehab/NA eventually.

I dont know how he eventually turned out.

So another anecdote.

Mr. Groovington said...

I’ve smoked pot lightly or moderately for 30 years, possibly like many of us here.

If you write, drinking moderately is better. The proof of this is observing the sanity of the little darlings you strike out in the morning.

It’s a shitty drug really. Used as a tool, for sex, or for a mild high before a long walk, it’s ok. But sitting around stoned is wasted living time.

Mr. Groovington said...

Fernandistein said...
"Reefer Madness."
Story by Lawrence Meade.

Yup, I can see Meade being a user. A toke before heading out into the garden would be proper usage.

Amadeus 48 said...

A bunch of people are whistling past the graveyard about pot. Don’t sugarcoat it, Althouse.
Why would you purposely impair your mental faculties?

Fernandinande said...

Gladwell is not a serious author, but I went looking for numbers anyway.

The book "Tell Your Children"

Trends in Emergency Department Visits, 2006-2014
(Marijuana/Cannabis not mentioned)

ED visit rate increased 7.4% for total population; 4.7% for men, 9.8% for women.

Lowest quartile income (by zip code) increased 23.%; everyone else (3 of 4 quartiles) increased only 1.5% (=ED visits only increased for poor people, pretty much).

Reasons:
Injury admissions decreased 13%.
Mental health/substance abuse +48%
Maternal/neonatal increased +26%
Abdominal pain +32%

These conditions had the highest increases:
Alcohol-related 76.3
Mood disorders 33.5
Anxiety disorders 37.2
Schizophrenia 54.2
Substance-related disorders 73.7
Early or threatened labor 63.4
Normal pregnancy 56.8
Hypertension complicating pregnancy 94.9

The 56% increase in normal pregnancy (among poor people!) is disturbing....

Some oddments -
We also observed that odds of in‐hospital mortality were significantly reduced among marijuana users compared with non‐users in all hospitalized patients as well as cancer patients. ... Our finding of an inverse association between marijuana use and in‐hospital mortality deserves further study.

Conclusions:
"Patients with SSD [schizophrenia] and BPD [bipolar] who have comorbid MUD [smoke pot] do not have increased risks for readmission or suicide attempt and may, for BPD patients with comorbid anxiety disorder, have a lower risk. Further research on the underlying mechanisms lowering risks for patients with comorbid MUD would be of interest."

n.n said...

Tolerance, normalization, or rejection. Suddenly, the choice matters.

Known Unknown said...

"These are otherwise stable middle-class professionals. Berenson writes, 'A surprising number of them seemed to have used only cannabis and no other drugs before their breaks."

Middle-class professionals

Hmmm ... what else could be a driver for their psychotic issues?

stevew said...

"And a lot harder to change once state and local governments become dependent on the tax revenues."

So true. Just look at the state run lotteries.

TreeJoe said...

There are numerous problems with studying pot today and then applying that research. Let me draw a comparison to alcohol.

Alcohol is fairly well studied. First, there is a consistent use of measurement as it relates to ethanol. You can reliably dose someone with ethanol (i.e. 1 ounce of 40% ethanol x 4 in 2 hours) and then easily measure it's impact in the bloodstream concentration. It also very quickly metabolizes. Those dosages are then commercially shared.

Marijuana is very different. There is no standard unit of measurement and metabolism for THC - and that's just one component of marijuana. Most studies will reference a unit of pot consumed - but smoking it has inconsistent consumption and different people MAY metabolize it substantially differently. Does once ounce of THC Oil baked into a brownie survive the baking in full potency, get metabolized at 70% of volume, and is it equivalent to smoking one ounce of marijuana leaves. Of what strain? etc.

I read alot of pro-marijuana people claiming it's health benefits and I always ask the simplest of questions:

1. At what dosages and of what strains?
2. At what dose is it clinically effective? At what dose does it become toxic? At what dose do side effects start to increase dramatically?

This is basic clinical pharmacology stuff - but THC/Marijuana is being pushed bigtime without any understanding of the physiology.

Murph said...

Saw this on Reason mid-2018.

Do not just look at the chart - read the piece as it's got some "reasonable" points to make.

https://reason.com/blog/2018/08/27/cannabis-involved-traffic-fatalities-fal

Infinite Monkeys said...

ED visit rate increased 7.4% for total population; 4.7% for men, 9.8% for women.

Must be from edibles. They have one and wonder if it's working. They have another and think that, maybe, it just doesn't affect them. They have a third and by that time the first two have kicked in and start wanting to call an ambulance.

I didn't click through, did they say whether these schizophrenic breaks came after smoking legal marijuana? If they were in states that still practice prohibition, I would question whether the marijuana had been adulterated with other drugs. Are they blaming Mary Jane when the real culprit is Molly?

William said...

I'm reading the Simon Schama book on Holland in the 16th century. The Dutch Calvinist preachers fulminated against tobacco usage. They claimed it led to torpor and licentiousness. It's possible to be right about something for the wrong reasons. If pot usage turns out to be a mood altering drug with no harmful side effects for anybody at any time, it will be the only one......We'll never be able to fully learn of the harmful effects of this substance until rich white men find a way to become richer by packaging and selling it.

Char Char Binks, Esq. said...

I'm sure we'll have all the answers 10,000 hours after we legalize it.

Howard said...

The dose makes the poison and your mileage may vary rule this issue. Life is one big experiment with the same final answer.

Howard said...

Haha CharChar. Gladwell is the most overrated of the overrated class of social influencers.

glenn said...

As long as it isn’t anyone I love WFC.

Yancey Ward said...

I favor the decriminalization of pot, but I am under no illusions about its safety. I have known literally dozens of long-term users of pot over the course of my life, and none of them are upstanding, productive people- I wouldn't trust any of them with any critical task, and I would definitely count the spoons and forks after they left the house. The best I can say about the drug is that it seems to cause fewer health problems than a similar level of alcohol abuse, but even that might not be true in the long run.

Yancey Ward said...

"I have spent the last several years building up an immunity to THC."

BJM said...

We were shown Reefer Madness at school in the 7th grade. It was a "Hello, fellow kids" moment...this was far scarier.

Abuse/addiction occurs in every society/culture and shaming or prohibition isn't an effective deterrent. Recovery/rehab has limited value, it will have to sort itself out. How and what that looks like is impossible to predict.

FullMoon said...

Carbohydrates is the problem.
Stupid tokers get high on the evil weed, over indulge in cookies ,cake and satanic rituals, leading to mis behavior and obesity.

gerry said...

I won't be here, probably (I'll likely be dead), but I'll bet in a couple of decades the citizenry will be bombarded by tales of horror about the lies and manipulation of Big Marijuana. Big Law will take it down and everyone will cheer.

ccscientist said...

I used to smoke a lot. There is a reason that Cheech and Chong was so funny--it was true. Stoners are useless. Stoner surgeons? I sure hope not.