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UK: Junk Medicine: Cannabis

Mark Henderson

Times Online

Saturday 08 Jul 2006

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Science is no czar

Fashionable opinion has long held that cannabis is a soft drug with few
risks to health. Its use has become so commonplace that even those who
have not tried it usually have friends and relatives who have done so
without ill effects. Such widespread personal experience did much to
drive the successful campaign to downgrade it from a class B drug to
class C.

There is, however, significant scientific evidence that cannabis is not
always benign. A study from the Karolinska Institute in Sweden this week
found that when rats were exposed to THC — its main psychoactive
ingredient — during the equivalent of adolescence, their brains became
more sensitive to heroin. In subsequent experiments, animals with
experience of THC took much more heroin.

The findings lend biological support to the “gateway theory” of drug
abuse, that early cannabis use makes people more susceptible to heroin
addiction later in life. Social factors, and perhaps a genetic
propensity to risk-taking, probably also explain why most heroin users
have experimented with cannabis first. But the notion that neurological
changes in the brain are also important cannot be dismissed.

This is far from the only way in which cannabis can be harmful. It is
estimated that smoking three joints a day carries the same risk of
cancer as 20 cigarettes. More serious still is a link to mental illness:
schizophrenia, bipolar disorder and psychosis.

Scientists have built a compelling case that cannabis can trigger or
worsen these psychiatric disorders. While most people’s mental health
will be unaffected by the drug, for some it can have catastrophic
consequences. Robin Murray, of the Institute of Psychiatry, estimates
that as many as 10 per cent of schizophrenia diagnoses can be attributed
to cannabis. The risk may be partly genetic; research by Avashalom
Caspi, a colleague of Murray’s, has found that a gene variant carried by
one person in four multiplies the risk of cannabis- induced psychosis
fivefold.

It is no longer possible to contend that cannabis is a safe or mild
drug. Critics of the Government’s liberal stance are increasingly
claiming that the science is on their side and they are right that it
gives cause for concern. It does not necessarily follow, though, that
ministers were wrong to reclassify cannabis. Science can offer valuable
guidance, which should always set the baseline for policy decisions. But
though it has a critical place in any sensible debate, it can contribute
only so much.

Science has no view on the most appropriate use of police time and
resources, the chief reason that was advanced for reclassification.
Medical evidence also reveals nothing about the legal strategies that
best dissuade young people from taking cannabis. As Murray says, few
teenagers know whether the drug is classified as class B or C, and fewer
care. And there is a reasonable if unproven argument that legalisation
for adults might be a better way of keeping the drug out of young hands
than giving criminals a monopoly on its sale.

Such a policy might make cannabis less attractive to dealers who would
sell to teenagers, or send a dangerous message that it is safe, but
medical research cannot say which. Evidence suggests that the young,
with still developing brains, are most at risk. That, however, could
support two different approaches: tough age restrictions and education
campaigns about its dangers, or a blanket ban designed to keep it off
the streets.

The choice is ultimately a matter of politics. It is essential that
rigorous, up-to-date research be taken into account when formulating
drug policy, so that risks are considered appropriately. Risks, however,
do not automatically require regulation: they must be weighed against
the costs and benefits of the measures proposed to control them. Science
can inform, but it cannot always decide.

Mark Henderson is Science Editor of The Times
http://www.timesonline.co.uk/article/0,,8123-2259203,00.html

 

 

 

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