A recurring question in the prohibitive cannabis debate about whether there is a supposed link between cannabis and madness
Since the 1840s, cannabis has been accused of triggering madness and has been hailed as a remedy for it. One of the key components of cannabis, tetrahydrocannabinol, can sometimes induce “psychotic” effects, such as anxiety and transient paranoia, but it is not schizophrenia. Persistent use of cannabis (or any other “psychoactive” substance) can precipitate psychosis in genetically predisposed people and complicate or worsen symptoms in a person with schizophrenia, but there is no evidence that it can cause psychosis.
The rise and fall of cannabis prohibition
However, the key components of cannabis have potent antipsychotic and anxiolytic properties, so effective that they “could be a future therapeutic option in the psychosis, in general, and in schizophrenia, in particular ”. This could explain why people with schizophrenia or those predisposed to psychotic symptoms declare themselves relieved after using cannabis.
Although the number of consumers has increased considerably and the power average of cannabis has increased significantly, the number of people diagnosed with schizophrenia has remained stable over time. This is not to say that cannabis is completely harmless, but the alleged harms are temporary, exaggerated, and other environmental factors, such as alcohol and tobacco, for example, are often overlooked.
A systematic review of epidemiological data on cannabis “dependence” (1990 - 2008) indicates that the modest increase in risk and the low prevalence of schizophrenia mean that regular cannabis use represents only a very small proportion of the disabilities associated with schizophrenia. From a population health perspective, this raises doubts about the likely impact of preventing cannabis use on the incidence or prevalence of schizophrenia. However, the goal here is not to review all of the often conflicting evidence on the relationship between cannabis and psychosis, but to see how such an argument, that cannabis causes madness, triumphed despite the lack of evidence.
This position prevailed to support the assertion that prevails over the significant doubts about the relationship that has existed since the start of the debate. One of the earliest investigations, conducted by the colonial government of India in 1872, did conclude that the habitual consumption of ganja tended to cause madness, but a careful examination of the evidence presented in the reports underlying this The conclusion shows that the alleged relationship lacked “solid or solid foundations” and that its accuracy was often contested by military doctors.
However, “bad information, administrative expediency and colonial misunderstandings in a complex society” turned into statistics and the statistics provided “evidence” that cannabis caused mental illness. In 1894, the Indian Hemp Drugs Commission was established following allegations that the insane asylums in India were filled with ganja smokers. After extensive research into the nature of asylum statistics, the majority of the members of the Commission agreed "that the effect of hemp-based" drugs "had hitherto been greatly exaggerated".
Most of the doctors involved were convinced that the use of cannabis did not cause madness, but rather that it stimulated a mental illness which “was already present in the mind of the individual” and that alcohol played a role. less equal, if not more important. This conclusion seems to sum up current opinions on the relationship between cannabis and psychosis.
The dramatic announcements on the implications of cannabis use for mental health made by Egyptian delegate Mohammed El Guindy at the Geneva conference had a significant impact on the deliberations to include cannabis in the 1925 Convention. El Guindy produced statistics to support his claims that 30 to 60% of the cases of insanity were caused by hashish. In a later memorandum referring to hashish in relation to Egypt, submitted by the Egyptian delegation to support El Guindy, the figure was even more alarming, claiming that "about 70% of the insane in the insane asylums in Egypt are hashish eaters or smokers ”.
In the 1920-21 annual report of the Abbasiya asylum in Cairo, the larger of the two Egyptian psychiatric hospitals attributed only 2,7% of its admissions to cannabis and even this modest number represented “not, strictly speaking talk about the causes but the conditions associated with mental illness ”.
El Guindy's figures were probably based on observations by John Warnock, the head of the Egyptian lunation department from 1895 to 1923, published in an article in the Journal of Mental Science in 1924. However, as the Historian James Mills, Warnock has made broad generalizations about cannabis and its users, despite the fact that those he saw were only the small proportion of them in hospitals. It did not seem relevant to him to know whether this was an accurate picture of cannabis use in Egypt. Other Egyptian statistics have shown a very big difference
The tendency of some physicians to extrapolate their experiences in mental health services to society in general was common in many studies in many countries and had the consequence of ignoring the fact that the vast majority of cannabis users did so. no problem. Studies have often generalized the cases of a few individuals with personality disorders to make general claims about the overall harmful effects of cannabis.
The directors of psychiatric hospitals have not all reached the same conclusions. Mexican psychiatrist Leopoldo Salazar Viniegra, for example, who has made a name for himself through his work with drug addicts in the national mental health hospital, has denied the existence of psychosis due to “marijuana”. In an article from 1938, entitled “El mito of marihuana”(The Myth of Marijuana), he argued that the assumptions of public and scientific opinion were based on the myth. The connection between this substance and the craziness, violence and crime, which has dominated public discourse in Mexico since the 1850s, was the result of sensational media reports and, later, by American "drug" authorities. According to Salazar, at least in Mexico, alcohol played a much more important role in the onset of psychosis and social problems. Shortly after being appointed head of Mexico's Federal Narcotic Service, he told US officials that the only way to stem the flow of illicit “drugs” was through government-controlled distribution.
Because of the cannabis ban in Mexico in 1920, about 80% of drug law violators were cannabis users. He argued that Mexico should repeal the prohibition of cannabis in order to reduce the illicit traffic (which it considered impossible to suppress in Mexico due to widespread corruption) and focus on the much more serious problems of alcohol and alcohol. opiates. In 1939, he launched a program of clinics distributing a month of opiates to drug addicts through a state monopoly. According to Salazar, the traditional perceptions of drug addicts and dependence needed to be revised, in particular “the concept of the drug addict as a blameworthy and anti-social individual”. In doing so, Salazar not only made himself the enemy of the powerful American narcotics commissioner, Anslinger, who used the alleged relationship to pass the prohibitive marijuana tax law, but he also went against opinions of medical opinion established in Mexico.
Leopoldo Salazar Viniegra “had the audacity to point out certain facts which are now virtually acquired in the literature on“ drug ”policy that the prohibition simply generated a black market whose results were much worse than the consumption of drugs The prohibition of “marijuana” itself has led to the harassment and imprisonment of thousands of users who posed only a very slight threat to society. Although historians have rightly considered that Salazar was the victim of an increasingly imperialist American drug policy, it has not been sufficiently emphasized that he was also the victim of Mexican anti-ideology. -drug “.
As a delegate to the Consultative Committee of the League of Nations and participating in its meeting in Geneva in May 1939, he observed that intolerance and requests for the prohibition of Cannabis had increased exponentially under the direction of the delegates and American allies. He returned Anslinger furious with his proposal to treat drug addicts in prison and outside with a project to gradually reduce morphine. In Mexico, in an article in the Gaceta Medica de México, he challenged the validity of the data relating to hashish and schizophrenia in a report from Turkey submitted to the committee. Salazar considered that the international drug control conventions then in force were “practically ineffective”. His views were opposed to Washington's punitive approach to supply-side drug control, and he has trod on the feet of too many people nationally and internationally. The US Consul General in Mexico has suggested that ridicule is the best way to put an end to Salazar's “dangerous theories”. After a concerted campaign in which American and Mexican officials undertook to destroy it personally, the Mexican press portrayed him as a madman and a “marijuana propagandist”.
Due to intense diplomatic and public pressure, he was forced to resign from his post as head of the Federal Narcotic Service and was replaced by someone more accommodating in the eyes of the United States Department of State and the FBN. Not surprisingly, Salazar's work was rejected by Pablo Osvaldo Wolff in his brochure Marihuana in Latin America. Wolff, who claimed that cannabis causes psychosis, was much more astute in asserting that his views were dominant in the relevant United Nations agencies. However, after the adoption of the Single Convention 1961, the United Nations Bulletin on Narcotic Drugs published in 1963 a review which cast significant doubt on the relationship and, if there was one, on its relevance. In this review, Canadian psychiatrist HBM Murphy concluded "It is extremely difficult to distinguish psychosis caused by Cannabis from other acute or chronic psychosis, and many suggest that Cannabis is the only relatively minor precipitating agent".
He said that "cannabis probably produces a specific psychosis, but it must be quite rare, since the prevalence of psychosis among cannabis users is only a guess in relation to that of the general population". The debate continues and opinions on the link between cannabis use and psychosis and schizophrenia still arouse debate among medical observers today.
An editorial published in 2010 in the International Drug Policy Journal calls for a more rational approach, denouncing “excessive emphasis on this issue by policy makers who diverted attention from more pressing issues”And concluding that they should give more weight to the risks and harms associated with certain cannabis policies and the evaluation of alternative regulatory frameworks. In light of decades of research and experience in the prohibition of cannabis, it seems reasonable to redirect the debate on cannabis policy based on the known harm caused by policies rather than to continue speculating on questions of causality that will not find a definitive answer anytime soon.
Extracted and adapted from: The Rise and Decline of Cannabis Prohibition