A recurring question in the prohibitive cannabis debate is 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 cure for it. One of the key constituents of cannabis, tetrahydrocannabinol, can sometimes induce “psychotic” effects, such as anxiety and transient paranoia, but this 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 someone with schizophrenia, but there is no evidence that it can cause psychosis.
The rise and fall of cannabis prohibition
However, the key constituents of cannabis possess potent antipsychotic and anxiolytic properties, so effective that they "may constitute a future therapeutic option in psychosis, in general, and in schizophrenia, in particular ”. This could explain why people with schizophrenia or predisposed to psychotic symptoms report relief after using cannabis.
Although the number of consumers has increased considerably and the power cannabis average has increased significantly, the number of people diagnosed with schizophrenia has remained stable over time. This does not mean that cannabis is completely harmless, but the alleged harms are temporary, exaggerated and other environmental factors, like alcohol and tobacco for example, are often overlooked.
A systematic review of the epidemiological evidence on cannabis 'addiction' (1990-2008) indicates that the modest increase in risk and low prevalence of schizophrenia means that regular cannabis use represents only a very small proportion of the disabilities associated with schizophrenia. From a population health perspective, this raises doubts as to 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 insanity, has triumphed despite lack of evidence.
This position has prevailed to support the claim which outweighs the significant doubts about the relationship that had existed since the start of the debate. One of the earliest surveys, conducted by the colonial government of India in 1872, did conclude that habitual consumption of ganja tended to induce insanity, but careful examination of the evidence presented in the reports underlying this conclusion shows that the alleged relationship lacked "firm or solid foundation" and that its accuracy was often disputed by military doctors.
However, "bad news, administrative expediency and colonial misunderstandings of a complex society" turned into statistics, and statistics provided "proof" that cannabis caused mental illness. In 1894, the Indian Hemp Drugs Commission was established following allegations that insane asylums in India were filled with ganja smokers. After extensive research into the nature of asylum statistics, the majority of Commission members agreed "that the effect of hemp-based 'drugs' had hitherto been greatly exaggerated".
Most of the doctors involved were convinced that cannabis use did not cause insanity, but rather stimulated a mental illness that "was already present in the mind of the individual" and that alcohol played a role in the process. less equal, if not more important. This finding seems to sum up current views on the relationship between cannabis and psychosis.
The dramatic announcements about the mental health implications of cannabis use made by Egyptian delegate Mohammed El Guindy at the Geneva conference had a significant impact on deliberations to include cannabis in the 1925 Convention. El Guindy produced statistics to back up his claims that 30 to 60 percent of insanity cases were caused by hashish. In a later memorandum referring to hashish in relation to Egypt, submitted by the Egyptian delegation in support of El Guindy, the figure was even more alarming, claiming that "about 70% of lunatics in insane asylums in Egypt are hashish eaters or smokers ”.
In the 1920-21 annual report of the Abbasiya asylum in Cairo, the larger of Egypt's two mental hospitals attributed only 2,7% of its admissions to cannabis and even that modest number represented "no, strictly speaking. talk about the causes but conditions associated with mental illness ”.
El Guindy's figures were likely 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 shown by Historian James Mills, Warnock 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 whether this was an accurate picture of cannabis use in Egypt. Other Egyptian statistics showed a very big difference
The tendency of some physicians to extrapolate their experiences in mental health services to society at large was common in many studies in many countries and resulted in 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 statements about the overall harmful effects of cannabis.
The directors of psychiatric hospitals have not all come to the same conclusions. Mexican psychiatrist Leopoldo Salazar Viniegra, for example, who has made a name for himself through his work with drug addicts at the National Hospital of Mental Health, has refuted the existence of psychosis due to “marijuana”. In an article from 1938, entitled " El mito of marihuana (The Myth of Marijuana), he maintained that the assumptions of public and scientific opinion were based on the myth. The link between this substance and insanity, violence, and criminality, which dominated public discourse in Mexico since the 1850s, was the result of sensational media reports and, later, US anti-drug authorities. According to Salazar, at least in Mexico, alcohol played a much bigger role in the onset of psychosis and social problems. Soon after being appointed head of Mexico's Federal Narcotics Service, he told US officials that the only way to stem the flow of illicit "drugs" was through government-controlled distribution.
Due to the ban on cannabis in Mexico in 1920, around 80% of drug law violators were cannabis users. He argued that Mexico should repeal the prohibition on cannabis in order to reduce illicit trafficking (which it felt could not be abolished in Mexico due to widespread corruption) and focus on the much more serious problems of alcohol and drugs. opiates. In 1939, he started a clinic program distributing one month of opiates to drug addicts through a state monopoly. According to Salazar, traditional perceptions of drug addicts and addiction needed to be revised, including “the concept of the addict as a blameworthy and antisocial individual”. In doing so, Salazar not only made himself the enemy of the powerful US Narcotics Commissioner Anslinger, who used the alleged relationship to pass the prohibitive marijuana tax law, but he also went against it. opinions of established medical opinion in Mexico.
Leopoldo Salazar Viniegra "had the audacity to point out some facts which are now virtually acquired in the literature on 'drug' policy that prohibition simply created a black market whose results were far worse than drug use. itself, The prohibition of “marijuana” led to the harassment and imprisonment of thousands of users who posed only a very low threat to society. Although historians have rightly considered that Salazar was the victim of an increasingly imperialist US "drug" policy, it has not been sufficiently emphasized that he was also a victim of anti-Mexican ideology. -drug ".
As a delegate to the League of Nations Advisory Committee and attending its meeting in Geneva in May 1939, he found that intolerance and demands for a ban on Cannabis had increased exponentially under the leadership of delegates and American allies. He returned Anslinger furious with his proposal to treat drug addicts inside and outside prison with a morphine phase-down project. In Mexico, in an article in Gaceta Medica de México, he challenged the validity of 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 opposed Washington's punitive approach to supply-side "drug" control, and he stepped on too many feet nationally and internationally. The United States Consul General in Mexico suggested that ridicule would be the best way to put an end to Salazar's "dangerous theories". After a concerted campaign in which American and Mexican officials set out to destroy him 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 as head of the Federal Narcotics Service and was replaced by someone more obliging in the eyes of the US State Department and the FBN. Not surprisingly, Salazar's work was rejected by Pablo Osvaldo Wolff in his pamphlet Marihuana in Latin America. Wolff, who claimed that cannabis caused psychosis, was much more astute in assuring that his views were dominant in relevant UN agencies. However, after the adoption of the Single Convention of 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 Cannabis-induced psychosis from other acute or chronic psychoses, and many suggest that Cannabis is the only relatively unimportant precipitating agent."
He clarified that "cannabis probably produces a specific psychosis, but this must be quite rare, since the prevalence of psychosis in cannabis users is only a guess in relation to that of the general population." The debate continues and opinions about the link between cannabis use and psychosis and schizophrenia still spark debate among medical observers today.
An editorial published in the International Drug Policy Journal in 2010 calls for a more rational approach, denouncing “ the overemphasis placed on this issue by policy makers who have diverted attention from more pressing issues And concluding that they should give more weight to the risks and harms associated with certain policies relating to cannabis and the evaluation of alternative regulatory frameworks. Given the decades of research and experience in cannabis banning, it seems reasonable to reorient the cannabis policy debate based on the known damage attributable to policies rather than continuing to speculate on questions of cannabis. causality that will not find a definitive answer anytime soon.
Extracted and adapted from: The Rise and Decline of Cannabis Prohibition