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Cannabis kills

Thomas Stuttaford

The Times

Tuesday 31 Jul 2001

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One of the social paradoxes of the 21st century is that the more
environmentally friendly and green a person's lifestyle, the more likely he
or she is to discuss the evils of pollution, carcinogens, the dangers of
DNA research and questions of genetic make-up - while enveloped in the blue
haze of cannabis smoke.
The youthful protesters against global industry and the pharmaceutical
industry (which has revolutionised medicine and agriculture, helping to
prevent mass starvation in the developing world), are also those who
advocate the taking of a drug, cannabis, that would fail its safety tests
at the animal stage of testing, let alone unrestricted use in human beings.
This is why I do not support its legislation.

Few doctors have not seen the sudden mental changes that can follow
intoxication with cannabis. In the short time that I was involved with
large numbers of drug-dependents - mainly, but not exclusively, young
people - it was a comparatively common occurrence. The argument always
deployed to belittle the importance of this well-known phenomenon is that
the personality of many of those who are apt to become cannabis-dependent
is essentially a flawed one, and that the easygoing, hearty rugby or hockey
player with an outlook as phlegmatic as that of his or her parents would
not be affected in the same way.

Even if this were true, it ignores the obvious truth that there is a large
and important minority of people, often clever and aesthetic, but with a
vulnerable personality, who might have had happier and more productive
lives if they hadn't smoked pot and developed one of the psychological
conditions associated with it.

The ability of cannabis to change the slightly bizarre behaviour of a young
person carrying a genetic disposition to schizophrenia, from that described
as being characteristic of a schizotypal personality disorder, to the
disordered thought and behavioural pattern of someone with a frank
psychosis is now accepted. The ability of cannabis to cause other psychotic
and neurotic conditions, as well as precipitating schizophrenia, is well
documented. Likewise, its deleterious effect on short-term memory, with all
its attendant disadvantages, is well known.

The physical disadvantages of cannabis are less well described. Young
people rarely think about mortality: death is for older age groups. They
may worry, or claim to worry, about the long-term effects of pesticides,
food additives, exhaust pollution and eating the right sort of fat (in the
more extreme cases, no fat at all), but they prefer to ignore that even in
the short term, cannabis can be a killer.

Twenty years ago M.B. Holmberg presented statistics based on a study of
1,000 16-year-olds that showed that those who had been regular cannabis
smokers at that time were five to eight times more likely to have died over
the following ten years. Not only were they more likely to have ended up at
the undertakers but there was a greater probability that they had spent
time in hospital or under the care of doctors or social workers. They had a
greater incidence of disease and social problems.

In Holmberg's study 10 per cent of the regular cannabis smokers at the age
of 16 were recognised as suffering from a psychosis during the ten-year
follow-up period. Much of the excess mortality in young cannabis-takers
occurred among the psychotic patients who obviously were prone to suicide
and accidental death. A study has shown that even in the early 1980s, when
cannabis wasn't as strong as it is now, someone who smoked cannabis once
every ten days ran nearly two-and-a-half times the risk of being involved
in a road accident.

A later survey has put the risk of road accidents greater than this. D.H.
Gieringer, writing on marijuana, driving and accident safety in The Journal
of Psychoactive Drugs, suggests that the true figure of accident-proneness
in driving is three to five times that of those who do not use cannabis
regularly. This was demonstrated to me many years ago when I was working
with drug-dependent patients. I was to speak in a debate opposing the
legalisation of cannabis. My opponent, a university lecturer of great
charm, offered to give me a lift to the debating hall because he wanted to
demonstrate how cannabis-smoking did not affect driving. After a
terror-inducing drive, which could compete in the nonchalance stakes with a
French taxi driver's, he abandoned the car - parking would not be the right
word - feet from the pavement.

He was happy with his performance. "There you are, Tom," he said, "I told
you it would be nothing like driving with someone who has been drinking."

Not all the excess deaths of regular cannabis-takers, as opposed to
non-smokers, can be attributed to suicide and accidents. Cannabis has been
commonly smoked in Western society for only the past 40 years or so. So its
long-term effect as a cancer inducer has until recently been conjectural.
It is known that there is twice as much tar in cannabis as in tobacco, and
there is evidence that this tar is carcinogenic. Tests have shown that most
cannabis smokers - President Clinton is the obvious exception - aim to
inhale deeply and to retain the smoke for as long as possible.

As a result of these two factors, a person who smokes a joint rather than a
cigarette will ingest four times as much tar. It is not therefore
surprising that not only does the tissue of cannabis smokers show
pre-malignant changes but that there is now evidence of an increased
incidence of many cancers. Research workers at New York's Memorial
Sloan-Kettering Cancer Centre, one of the top ten cancer centres in the
world, found that on average regular smokers of cannabis were 30 times more
likely to develop cancer of the neck, throat, mouth and larynx than those
who never inhale marijuana. Other research in the early 1990s demonstrated
that these tumours appear between ten and 30 years earlier than in
non-cannabis takers. These cancers struck more often and at an earlier age
in cannabis smokers than in other people.

The Sloan-Kettering researchers analysed their statistics. The response, as
would be expected, was dose-related. The risk of head and neck cancer was
doubled by smoking any marijuana, and those who smoked more than a joint a
day increased the incidence by five times. If they also smoked cigarettes,
as most did, the incidence of head and neck cancers increased 36 times.
Cigarettes and cannabis are a deadly mixture. The SloanKettering
researchers, like those from the Swedish National Institute of Public
Health, had no doubts about the ability of cannabis to induce cancer of the
lungs, mouth, pharynx (throat) and larynx (voice box). In all probability,
it also increases cancer of the oesophagus.

Workers on psycho-active drugs have also studied the effects of cannabis on
the heart and cardiovascular system. They have shown that when patients are
stoned they suffer palpitations, cardiac arrhythmias and a drop in blood
pressure that may, for instance, induce dizziness when they stand up.

In a fit young person the general view is that these changes are more
likely to be inconvenient and disturbing than dangerous. There have been
one or two cases of heart attacks recorded in young people after heavy
cannabis use, but they were not shown to be necessarily the result of the
heavy cannabis use.

The news is less encouraging for those who smoked cannabis in the 1960s and
1970s and have never given it up. They should not be too sanguine about its
effect on their ageing cardiovascular systems. Older people with heart
disease or high blood pressure have been shown to be adversely affected by
smoking cannabis. Whenever cannabis and hormones are discussed, the story
is usually told of a young Swedish patient who had started smoking cannabis
before he was 12. He was a heavy cannabis smoker by the time he was 16. The
boy was undersized, had no pubic hair, small testicles and an
underdeveloped penis. His testosterone levels were abnormally low for a boy
of his age.

He stopped smoking and it was as if a miracle had happened. He grew, his
testosterone levels returned to normal and once again he could go proudly
into the communal showers after PE. This is only a single case and has
therefore little scientific value, but it is a good illustration of an
extreme example of the changes that can follow heavy smoking of cannabis.

Men who smoke too much cannabis may well, for instance, develop heavy breasts.


When I was working in Whitechapel a Rastafarian told me that he could
notice no difference between alcohol and a spliff. "You drink whisky,
doctor, and become impotent; I take ganga and become impotent. The only
difference is that I get red eyes and you don't." He was right about the
whisky, and the red eyes, but knew nothing about my sex life - it was in
pre-prostatectomy days. To judge from my chats with heavy cannabis takers,
it seems that though they claimed the drug enhanced sexual sensations, in
many cases it also reduced potency.

It is known that heavy doses of cannabis can induce foetal malformations in
animals. There has been much argument about whether it also causes an
increase in stillbirth and foetal abnormality rate in human beings. At
present, the case for this could be described only as unproven, but it
reduces sperm counts, and when there is so much worry from the green
movement about the reduction in sperm counts over the past century, it
would seem a pity to hasten the process.

Most of us with children and grandchildren whose own opinions on the
legalisation of cannabis weren't formed by its widespread use in
undergraduate days will continue to worry about its psychological and
neurological effects (admirably described recently by Professor Susan
Greenfield in The Times). The former has been a source of anxiety for 40
years.

We should never forget that cannabis induces both physical and mental changes.

 

 

 

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