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UK: One in four at risk of cannabis psychosis

Mark Henderson

The Times

Tuesday 12 Apr 2005

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ONE in four people carries genes that increases vulnerability to psychotic
illnesses if he or she smokes cannabis as a teenager, scientists have found.

A common genetic profile that makes cannabis five times more likely to trigger
schizophrenia and similar disorders has been identified, increasing pressure on
the Government to reverse the drug's reclassification from Class B to Class C.

The increased risk applies to people who inherit variants of a gene named COMT
who also smoked cannabis as teenagers. About a quarter of the population have
this genetic make-up, and up to 15 per cent of the group are likely to develop
psychotic conditions if exposed to the drug early in life.

Neither the drug nor the gene raises the risk of psychosis by itself.

The study, led by Avshalom Caspi and Terrie Moffitt, of the Institute of
Psychiatry at King's College London, offers the best explanation yet for the
way that cannabis has a devastating psychiatric impact on some users but leaves
most unharmed. Scientists had suspected that genetic factors were responsible
for this divide, but a gene had not been pinpointed.

The findings, to be published in Biological Psychiatry, also reinforce a
growing consensus that nature and nurture are not mutually exclusive forces but
combine to affect behaviour and health. The King's team has previously
identified genes that raise the risk of depression or aggression, but only in
conjunction with environmental influences.

Mental health campaigners said that the results vindicated their concerns about
the decision last year to downgrade cannabis to a Class C drug, which means
that possession is no longer an arrestable offence.

Marjorie Wallace, chief executive of the mental health charity Sane, said that
it was becoming clear that cannabis placed millions of users at risk of lasting
mental illness. About fifteen million Britons have tried cannabis, and between
two million and five million are regular users, according to the Home Office
British Crime Survey. The research suggests that a quarter could be at risk.

The evidence will be considered by a review of the drug's classification
announced last month by the Home Secretary. It may be possible to develop a
test for genetic susceptibility to cannabis. "If we were able genetically to
identify the vulnerable individuals in advance, we would be able to save
thousands of minds, if not lives," Ms Wallace said.

Dr Caspi, however, rejected the idea of screening based on the COMT gene. "Such
a test would be wrong more often than it is right. Cannabis has many other
adverse effects, especially on developing teenagers, on respiratory health and
possibly on cognitive function. Effects may be pronounced among a genetically
vulnerable group but that doesn't mean we should encourage others not
genetically vulnerable to use cannabis."

The King's team tracked 803 men and women born in Dunedin, New Zealand, in 1972
and 1973, who were enrolled at birth in a research project. Each was
interviewed at 13, 15 and 18 about cannabis use, tested to determine which type
of COMT genes they had inherited, and followed up at 26 for signs of mental
illness.

COMT was chosen as it is known to play a part in the production of dopamine, a
brain-signalling chemical that is abnormal in schizophrenia. It comes in two
variants, known as valine or methionine, and every person has two copies, one
from each parent.

Among people with two methionine variants, the rate of psychotic illness was 3
per cent, the background rate for the general population, regardless of whether
they had used cannabis as teenagers.

Among those with two valine variants the rate was 3 per cent for non-users but
15 per cent for those who had smoked cannabis in their teens.

Dr Caspi said research had shown that the valine gene variant and cannabis
affect the brain's dopamine system in similar fashion, suggesting that they
deliver a "double dose" that can be damaging. The work needs to be replicated
by others to confirm the findings, Dr Caspi said. It also is possible that the
gene involved is not COMT but a neighbour.

THE DRUG OF CHOICE FOR MILLIONS

Cannabis was reclassified from a Class B to a Class C drug in January 2004.
Possession remains illegal, but is not an arrestable offence. The Home
Secretary has asked for a review by November

The Home Office estimates that fifteen million people have tried cannabis, two
million to five million are regular users and reclassification has saved
199,000 hours' police work

Liberalisation campaigners argue that millions smoke the drug with fewer
ill-effects than others suffer from alcohol or tobacco

A recent study at Maastricht University found that cannabis doubles the risk of
schizophrenia, hallucinations and paranoia among a genetically susceptible
group

 

 

 

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