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Cannabis Campaigners' Guide News Database result:
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UK: If cannabis is safe, why am I psychotic? Steve Boggan The Times Wednesday 07 Jan 2004 Weeks before the drug is downgraded from Class B to Class C comes new evidence that cannabis-induced psychosis is the bigest problem facing inner city mental health services THERE WAS SOMETHING horribly fast and terribly chilling about the onset of Steve Hammond's psychosis. His father Terry remembers feeling a shiver down his spine when, sitting in front of the television, Steve turned to him with a strange look in his eyes and said: "Why did you ring up the BBC?" "Of course, I told him I hadn't," Terry recalls. "But then Steve said: 'Yes you did. You rang them up and told them I'm a lazy, useless bastard. And they've been broadcasting it all day.'" This was the start of three years of hell for the Hammond family; three years during which Steve, a bright, handsome and popular 22-year-old, descended into madness and despair. For Terry it was the moment when he first saw the illness for himself. For Steve it was a frightening repeat of an episode a few days earlier when, with no papers to roll a joint, he ate a chunk of cannabis resin and collapsed in a nightclub toilet. "When I woke up I heard someone saying: 'It's OK Steve, you can get up now, you're all right'," he recalls. "When I looked around, there was no one there. "That's when my voices started and I've had them ever since. I was so scared you can't imagine. I had voices coming from everywhere - the ceiling, the floor, in my head. It was the most frightening nightmare you could imagine, except I was awake." Steve is one of 210,000 people in the UK who suffer from schizophrenia, and one of a growing number who believe cannabis caused their condition. Ten years ago psychiatrists would have disagreed with him. But three weeks before the Government is due to reclassify cannabis from a Class B to a Class C drug, that view has changed dramatically. Some of Britain's most senior psychiatrists say the drug is now the "No 1 problem" facing mental health services. Psychiatrists in inner-city areas speak of cannabis being a factor in up to 80 per cent of schizophrenia cases, and mental health specialists are bracing themselves for an increase in the problem as reclassification is misinterepreted as an assurance that the drug is safe. For years psychiatrists have noticed a high level of cannabis use among people with psychosis, a generic term for schizophrenia, delusional episodes, manic depression and so on. But it had always been regarded as a chicken and egg problem; sufferers tended to have behavioural problems as adolescents and were more likely to use drugs to counter their often miserable lives. But all that changed two years ago when a group of researchers had the idea of relating cannabis and psychosis to the Dunedin group, a continuing long-term study of 1,000 children - now adults - in New Zealand. They found that those who used cannabis by the age of 15 were more than three times as likely to develop illnesses such as schizophrenia. Since then, other control groups - including a 1987 survey of 50,000 conscripts in the Swedish army and another study in Amsterdam - have been examined again with the drug in mind, and they have all shown that cannabis use increases the likelihood of psychosis by up to 700 per cent. Robin Murray, a professor at the Institute of Psychiatry and a consultant psychiatrist at the Maudsley Hospital in South London, took part in the groundbreaking research that first solved the chicken-and-egg problem. His co-authored report, published a year ago, concluded: "Although most young people use cannabis without harm, a vulnerable minority experience harmful outcomes. A tenth of the cannabis users by age 15 in our sample developed schizophreniform disorder by age 26 compared with 3 per cent of the remaining cohort. Our findings suggest that cannabis use among psychologically vulnerable adolescents should be strongly discouraged by parents, teachers, and health practitioners. Policy makers and lawmakers should concentrate on delaying onset of cannabis use." In an interview with The Times, Professor Murray adds: "Unfortunately there were no experts in psychosis on the committees (the Home Affairs select committee and the Advisory Council on the Misuse of Drugs) that advised the Government on re-classifying cannabis. That's not a criticism - at the time, no one thought there should have been. Since then there have been at least four studies that show the use of cannabis can significantly increase the likelihood of the onset of psychosis. "I would say this is now the No 1 problem facing the mental health services in inner cities. In south London the incidence of psychosis has doubled since 1964. There is a terrible drain on resources. Not only are there people suffering from psychosis who would not be in in-patient beds if they were not using cannabis, but use of the drug also drastically reduces the chances of recovery. People who do improve go out on the streets, meet their old dealer, begin using the drug again and relapse. We're not saying that the Government shouldn't reclassify cannabis - for most people it causes no problems - but I am saying that if they're going to do it they should warn people of the possible downside." The downside for Steve Hammond, now 25, was three months in a psychiatric ward and the loss of a promising future. After three years of treatment, he lives with his parents at their home in Southampton. His paranoia is controlled by drugs but he still hears voices, is unable to work and remains afraid to go out alone. "I can remember it starting as if it were yesterday," he says. "I wouldn't want to wish that on anyone; it was terrifying. The voices got worse and worse as the days and months went by. I became completely paranoid. I was convinced my mind had been taken over by aliens; well, you would - how else could you explain the voices? "My mum and dad were great. They convinced me to go into hospital. There was a bit inside me that said, 'Steve you need help'. When I came out I felt better, although my voices were still there. I tried different medications and eventually the doctors found one that suited me, that did not give me bad side effects. My voices are still there but cognitive therapy has helped me to understand them. It made me realise that they were really my own thoughts. The doctor explained to me about how the communication system in my brain was not functioning correctly. He explained all about neurotransmitters. It seemed to make perfect sense to me. It was a revelation and a fantastic relief that I had not been invaded by aliens. "I didn't have a clue that cannabis could do this; if I had, I may have had second thoughts, or at least not smoked so much. I thought it was perfectly harmless. If it was public knowledge that cannabis can affect your mental health in this way, young people would be more switched on to recognise the symptoms or they might make an informed choice not to start at all. "I have tried smoking cannabis since, but it was terrible. As soon as I took a couple of puffs it made me feel instantly crazy. It was like putting on a switch. I don't touch the stuff now." The voices and hallucinations in schizophrenia result from an excess of the brain chemical dopamine. Drugs such as cannabis, amphetamines and cocaine increase the levels of dopamine in the brain. The Lambeth Early Onset (Leo) service at Lambeth Hospital in south London has a first-onset psychosis ward where the damaging effects of cannabis on dopamine levels are all too easy to see. Young men and women are brought in as early as possible to improve their chances of recovery with anti-psychotic drugs. In a year, as many as 120 patients pass through the ward - the vast majority admitting to regular cannabis use. "It would be wrong to say that cannabis alone causes psychosis," says Paddy Power, a consultant psychiatrist at the unit. "It's a bit like saying someone had a heart attack because of a stressful incident when they also ate too much fatty food, took too little exercise and smoked. In much the same way, using cannabis can be a major contributory factor in the onset of psychosis. You are also at greater risk of developing psychosis from genetic factors, early brain development problems, birth trauma and even migrating to another country. If you add cannabis, then you have a dangerous mix. "Between 70 and 80 per cent of the people who present at our unit have a history of cannabis use that has probably been a factor in the development of their psychosis. I wouldn't say that should prevent a reclassification of the drug, but it would be irresponsible of the Government not to marry that with an educational programme - particularly for parents and young people - so users can be made aware of the risks in much the same way as we are given health warnings over alcohol and tobacco." The Home Office says its "Frank" anti-drugs campaign includes advice on cannabis, but its efforts on education timed for the reclassification of the drug on January 29 could be called into question. It has commissioned the mental health charity Mentor to produce a million leaflets for distribution a month after the reclassification - on a budget of just £50,000. Mentor's chief executive, Eric Carlin, says much more money is needed if the message that all drugs - including cannabis - are potentially dangerous is to get to young people. "The area has been neglected," he says. "We are not yet clearly making the point that if you have a history of mental illness, or if you are pre-disposed to psychosis, you are playing Russian roulette by smoking cannabis. Our job is to try to get that message across." But isn't reclassifying cannabis from B to C sending a message in itself that the drug is safe? The Home Affairs select committee that recommended the reclassification in May 2002 thinks not, even in the light of the new evidence. David Winnick, one of the MPs on the committee, says its members stand by their recommendation. "We would not change our view," he says. "I believe we should be warning people that they should not take any drugs, including cannabis. But we decided that to continue to criminalise everyone who takes cannabis would be wrong. "As opposed as I am to people smoking nicotine, I would not be in favour of banning that. All we can do is warn people of its dangers. There was no evidence to suggest that more people would smoke cannabis simply because we reclassified it, and I don't believe they will." Terry Hammond, Steve's father, disagrees. "Of course it sends a message," he says. "After Steve became psychotic I spoke to a lot of his friends about cannabis and they all thought it was perfectly safe - and they felt that the reclassification confirmed that. Since then I have been contacted by lots and lots of parents who believe cannabis was a major factor in their sons and daughters slipping into psychosis. I have no doubt it caused Steve's. "Most people who smoke cannabis will probably suffer no harm whatsoever. But for some it will be disastrous. They could sink into Steve's world. And I wouldn't wish that on anyone."
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