The Washington Post has an article up about the odd thing about cannabis use - it can be relaxing for some, but anxiety producing for others. And (I didn't really realise) its effects can vary even in the same experienced user:
The effects of weed can even vary with each experience and may be influenced by how anxious you are when you ingest the drug. A person could smoke or ingest the same amount of cannabis on two different occasions and have two completely different experiences, said Ryan Vandrey, a professor of psychiatry and behavioral sciences at Johns Hopkins Medicine.
“A lot of it could be the baggage you’re carrying into the situation,” Vandrey said. “It’s really hard to predict.”...
Sariyah, a 20-year-old who lives in Georgia, used to smoke cannabis every day when she got off from work. She said she felt like the weed helped her unwind. But then, a few months ago, cannabis started making her feel worse.
“Eventually, over time, it started making my heart race,” said Sariyah, who asked that her full name not be used because her family doesn’t know she uses cannabis.
Sariyah said weed often enhances her “deepest thoughts.” If she’s sad or anxious, she feels more so when she smokes. Sariyah said she has cut back and wants to find the dose of weed that reliably works to soothe her anxiety.
Now, she smokes about twice a week. “A majority of the time, I’m not anxious when I smoke, but sometimes it’s there,” Sariyah said. “Sometimes it just comes out of nowhere.”...
Decades of clinical research has found THC can negatively effect the developing brain, and regular cannabis use in the teen years is associated with a higher likelihood of developing anxiety and depression later in life.
“Smoking early can catalyze anxiety and depression,” Grisel said. “It’s not exactly clear how that happens but the evidence for it is very strong.”
The article sounds reasonably balanced to me, and doesn't even touch the area of increased risk of schizophrenia, at least for teenage users.
But go to the comments, and you get the typical pot-head "how dare you criticise our habit" contributions:
There is, I should note, another WAPO article up which is an outright cautionary one about the potential bad effects of marijuana use on teenagers and young adults:
Parents are not ready for the new reality of teen cannabis use
Wow, the comments on this one are going to be "good":
Again, some pushback:
And finally: I will repeat my (very reasonable) position on this:
* how any drug use and availability affects society and communities depends on a lot of factors, and you can't really prescribe universal rules very helpfully. For example - alcohol is cheap and abundant in Japan, and its overuse can be a real problem, but visit the place and no one would think it is making it unpleasant to live in, or causing widespread economic harm. In Russia, or Alice Springs, or a wide variety of other remote indigenous communities around the world, it's a completely different story. The easy availability of marijuana in a place like Amsterdam might have little effect on residents, given their general work ethic and community attitudes (in fact, the country has low usage rates); but no one is likely to argue that widespread use is harmless in a community that has high unemployment already and is economically struggling.
* Obviously, banning and criminalising use of a drug that some use with pleasure can have its own negative consequences, and profit a criminal underworld. Yet bans work in some places with no great disaster on a societal level (see Japan, Singapore with marijuana, for example. Depends on how you feel about capital punishment though - I don't think Singapore is the perfect example.)
* Given the situation with Mexico and crime syndicates, as well as the lack of wisdom of filling jails in the US with drug users, I can see the benefit of decriminalising and perhaps even legalising use in the USA.
But: the social background for legalisation in the US makes it a dangerous experiment on a societal scale, and one which I think will only be averted by increased governmental role in standards being set for the products.
Thus - as someone in the comments sections said, there really is a case for nation wide legislative control, as to the strength of THC in products, and (probably) the type of product can even be sold.
But there is no real push for that at the moment, and I think the US is going to regret the current haphazard path it is taking on this.
The article sounds reasonably balanced to me, and doesn't even touch the area of increased risk of schizophrenia, at least for teenage users.
ReplyDeleteBecause the latest analysis dismissed the argument. In most studies the argument is that in those so predisposed the risk in increased. I'm not convinced either way. The data dances too much.
why THC would alleviate someone’s feelings of anxiety or stress. Instead, people may feel a calming or relaxing effect because the drug can enhance how you’re already feeling.
One way to approach that is that the CB 1 receptor occupation can act as a "retrograde inhibitory neurotransmitter", possibly reducing excitatory activity. That's like the current antidepressant ketamine, which has a similiar effect. I'm concerned about both because that inhibition can potentially reduce connection formation(synapses).
The reason CBD has a calming effect is twofold. It is a potent antioxidant and anti-inflammatory. Inflammation is implicated in anxiety. CBD also boosts the same inhibitory neurotransmitter as anxiolytic drugs. Fear conditioning is boosted by a key inflammatory mediator. 20 years ago an Australian psychiatrist argued that CBD acts as an antipsychotic. That highlights the problem with modern strains of cannabis. The THC/CBD ratio has hugely increased, making psychotic episodes and anxiety attacks far more likely. The cannabis strains today are much more potent. In past decades I could smoke with little effect on my cognition. Today's strains knock me for 6 and that isn't just age.
I wish newspapers would stop using anecdotes to make a point. That's completely unacceptable.
There is some interesting research highlighting how a "strong" endocannabinoid network can prevent the damaging effects of childhood maltreatment. However childhood maltreatment can also reduce the strength of the endocannabinoid network. That is another reason why simply using an anecdotal example, without knowing the personal history, is fraught with problems. It would be interesting to see a study on those with cannabis use disorder and their personal history.
Teenagers using cannabis is far too dangerous because it may inhibit maturation of the frontal lobes by decreased connectivity. A previously mentioned study highlighted how in those with childhood maltreatment but were resistent to addiction, anxiety, and depression, there was increased frontal lobe function, which plays a key role in regulating emotions. There are contradictions in these analyses that remain unresolved.
Contrariwise a recent analysis found that in adults there was no cognitive dysfunction(upon cessation, long washout time for cannabinoids). Another study found that alcohol consumption was associated with white matter damage, a key marker for cognitive decline and latter dementia, but cannabis users showed no signs of white matter damage. Both results are consistent with the pharmacology of alcohol and cannabinoids.
I checked, there is evidence for teenage use and frontal lobe dysfunction. That is extremely worrisome.
https://pubmed.ncbi.nlm.nih.gov/24592665/
I will note that there is a bit of irony in your giving your own anecdote about changes to cannabis, while getting very upset with a newspaper story passing one on...
ReplyDeleteOverall, though, do you agree with my complaint that if you're going to legalise such a product, do it thoroughly and with a view to maximising safety in use?
I mean, my impression is that in most US states, it's left up to salespersons to recommend different cannabis products on a very subjective basis. And as with alcohol, at least in Australia, it would seem to make sense to me to structure tax on the products so as to make those which are in stronger concentration higher, so as to encourage lower dosage products.
Teenagers accessing the products is a legal problem that should be addressed, regulating potency is the wrong target. I suspect the real problem is with edibles. It can take .5 to 1 hour for the effect to kick in, which is annoying. Teenagers will keep consuming thinking it will come on quicker because, well, teenagers using any drug are stupid like that.
ReplyDeleteFor adults it doesn't matter. In Australia the price of cannabis has fallen in real terms, unchanged for 20 years despite higher potency. There is no need for Mexicans to maintain the black market, it is alive and well in Australia. The problem for cannabis users is that those who drink alcohol which is more dangerous and causes more social problems then complain about cannabis users. There is an old saying, give 5 men alcohol and they'll start fighting, give them cannabis and they'll start a band.