At a time, as now, when the interests of big business coincide with those of major media outlets and the known preferences of ensconced liberal academics, it behoves us to consider seriously the debate on the legal status of cannabis. There comes a time in the life of democracies where the voice of the masses, the “vox populi” driven by the herd instinct can endanger or at least drown out the voice of Science and Reason.
It is therefore very refreshing, and in terms of its pertinence to the current debate, of great importance, that a confluence has been struck between the world’s top addiction researcher, Dr Nora Volkow, the Director of the Nationals Institutes of Health Institute devoted to the research and care into drug addiction, with the world’s undisputed leading medical a journal, the New England Journal of Medicine. Dr Volkow overseas the distribution of around USD$1 Billion in research funds to addiction researchers globally, and funds an estimated 85% of addiction research around the world. She is an eminent and well published researcher in her own right, with a recent search of the National Library of Medicine Catalogue, known as PubMed showing 603 peer reviewed papers published in her name, along with doubtless countless monographs and book chapters which are not listed on this famous international database.
Dr Volkow’s recent piece in the New England Journal of Medicine was entitled “Adverse Effects of Marijuana Use”, and may be found in volume 370, No. 23, pages 2219-2227, and was published on 5th June 2014.
It cannot be stressed to members enough that her piece was written specifically to counterbalance the implicit presumption which underlies much of the liberalist position that marijuana is essentially harmless, and that all those who seek to restrict its use are nothing more than kill-joys and party poopers. Dr Volkow’s paper makes the point successfully that the reason the legal drugs alcohol and tobacco are associated with more disease and death than the illicit drugs, lies not in their intrinsic toxicity, but in the wider availability of the legal drugs. Since the pro-cannabis lobby seek to increase the availability of cannabis, its measured toxicities will inevitably increase. This is the inevitable conclusion presented by the thoughtful authors of this paper. Indeed the documented trend in cannabis potency in the US from 1975-2013 has been an strictly inverse relationship between perceived harm and teenage smoking trends now for forty years. This is in the context of a four-fold monotonic rise in cannabinoid content from 3% in the 1980’s to 12% in 2012.
To the liberalist perspective the findings in the paper are devastating. The researchers document that cannabis is addictive. Whilst rates of cannabis addictoin in the general community are reported at 9%, it rises to around 16% when use commences in adolescence, and up to 50% in those who smoke daily. Cannabis addiction can cause a recognized withdrawal state. Because the brain develops and matures until the end of the third decade of life, there are grave concerns related to the exposure of young people to it. It has been shown to interfere with the circuits and wiring of the prefrontal executive centres, and in the critical hippocampal formation which is pivotally involved in the formation of new memories, attention, and emotionality. It damages the precuneus which is a key integrative area. Moreover these effects last not only during cannabis intoxication, but also, because it is fat soluble, for days afterwards. Because of its effect on the brain’s dopamine-dependent reward pathways, it increases the use of other drugs in later life. Cannabis damages memory, cognitive function and attention systems. Cannabis, tobacco and alcohol all act as gateway drugs and prime the brain to the use of harder drugs in later life.
Cannabis therefore has the not surprising effect of reducing:
- school performance,
- school grades achieved,
- school retention rates,
- IQ,
- income attained,
- employment rates, and
- life satisfaction
and increasing criminality rates.
Mental illness is also elevated by cannabis. Increased rates of anxiety, depression, psychosis inlcuding schizophrenia have all been observed across the board, not just in those who may be considered to be predisposed. Moreover known schizophrenia is exacerbated by cannabis exposure. Car crashes including fatal car crashes are elevated. Cannabis-related emergency room visits have risen. Drivers can be intoxicated with both cannabis and alcohol which are cumulatively toxic, dangerous and lethal.
Since cannabis is immunosuppressive real concerns exist about its use in HIV/AIDS patients, or its administration to patients with respiratory conditions.
Cannabis smoking has been shown to increase lung secretions and suppress respiratory immunity. It is associated with chronic bronchitis, lung hyperinflation, and increased airways resistance. Whilst its affect on lung cancer is uncertain at this time, a negative result was reported in a single US study examining only very low level cannabis exposure – a mere 30 joint years (one joint daily for 30 years). However serious cause for concern has been raised by studies of its cardiovascular effects, showing associations with stroke, heart attack, and transient ischemic episodes.
There are real concerns about the use of cannabis in pregnancy which require further study. The authors also note that because of the dramatic rise in potency in cannabis, older studies showing a lack of effect may be falsely reporting negative results, given the increased potency of the preparation available in modern times. The effect of second-hand smoke and passive smoking also needs careful research.
In conclusion this lengthy and exhaustive report from the world’s leading researchers in addiction medicine strikes a very sombre and sobering warning note to any sane parent, and any members of this Honourable House who are contemplating having grandchildren. Devastating effects on maturating brain function, mental illness, gateway effects for other drugs, lifetime educational achievement, poverty, employment rates, driving, respiratory and cardiovascular effects have all been demonstrated beyond reasonable doubt in a context where the potency of the available preparations has risen by four-fold. Passive smoking effects and effects on pregnancy are likely but as yet not proven. Increased availability is necessarily associated with increased morbidity and mortality.
There is enough material here to give serious pause to any members tempted by alleged tax revenue streams to succumb to the siren song of the seduction of “the weed.”
We have been warned most soberly and most sombrely. It will be up to us to heed this eminent warning and to act accordingly and appropriately.
Adverse Health Effects of Marijuana Use, Volkow, NEJM, June 2014