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The herb ain’t organic – Marijuana Psychoses

“When you smoke the herb, it reveals you to yourself.” That’s a quote from Jamaican musician Bob Marley, well known for seeking musical and spiritual inspiration from a spliff. But smoking the herb can reveal much more, as writer/copy editor SIMONE DELOCHAN found out.

A young man in his late teens/early twenties, in a group on the street, as I was passing by said with a grin: “We could bun it anywhere now”. He was lighting a roll-on (when cigarette paper and marijuana is attached to a normal cigarette). I told him it was illegal to smoke it in public spots and they would be arrested. “Not if de police doh catch we…,” he laughed.

On November 22, 2019, Attorney General Faris Al Rawi, proposed an Amendment Bill to decriminalise the use of marijuana. Under the Bill:

  • A person will be allowed to lawfully grow no more than four cannabis plants at his/her residence and without a license
  • A person can be in possession of 30 grammes of cannabis or less with no arrest
  • The tiered possession scheme proposes the abolition of the present regime whereby possession of any amount is an arrestable offence

Government also proposed to impose an upper limit—30 grammes—for lawful possession of cannabis or cannabis resin products. The proclamation of the legislation occurred on December 23, 2019.

Around the world, Canada has legalised recreational use in full; in Belize a person can have up to ten grammes in possession without being arrested. Other countries are Jamaica (decriminalised in 2015); Uruguay (but you must register with the government first), Portugal (all drugs were decriminalised in 2001), The Czech Republic (decriminalised for amounts up to 15 grammes) among others.

In the United States, decriminalisation varies from strictly for medicinal use to both recreational and medicinal. In some other countries, while usage and possession may be illegal, the general culture is not punitive to recreational use.

Among usage benefits listed are alleviation from chronic pain; alleviation from certain types of seizures; and relief of insomnia, anxiety, depression and Post Traumatic Stress Disorder (PTSD) symptoms.

In September of last year, while there were still rumblings of the need to decriminalise marijuana in various quarters, Catholic News interviewed Dr Joni Lee Pow, psychologist at the School of Medicine, University of the West Indies, St Augustine and one of the researchers in a project called Intrepid II.

Intrepid II (International Research Programme on Psychoses In Diverse Settings) “is a 5-year research programme that investigates the incidence, presentation, outcomes and impact of psychotic disorders in three countries: India, Nigeria and Trinidad” (intrepidresearch.org).

Professor Craig Morgan of King’s College, London is the principal investigator of the project and Professor Gerard Hutchinson the principal investigator for Trinidad.

Cannabis-induced psychosis is part of the research area, and as yet, as the programme is now going into its second year, there are no numbers “because we want to be very, very sure that these diagnoses are correct,” said Dr Lee Pow.

Genetically modified marijuana

To quote comedian Louis CK when he had his own bizarre experience when sharing a joint with a group of young adults: people have been working on marijuana like it is the cure for cancer. Marijuana now, Lee Pow says, is not the same as that in our grandparents or parents’ time.

Genetic modifications have been made to the plant resulting in a higher THC to CBD ratio. Analysis in the US for the period of 1995–2014 indicated that “Today’s cannabis is not natural. Over two decades, THC concentrations in retail marijuana rose dramatically, while CBD levels declined, with THC:CBD ratios now eight times greater than before (‘Changes in Cannabis Potency over the last two decades’, www.sciencedirect.com).

THC is the compound in marijuana which results in the ‘high’ in users. CBD provides the palliative benefits of the herb, the much-touted medicinal advantages of using marijuana.

In another study Dr Lee Pow cited, higher concentrations of THC are associated with psychotic symptoms: “Limiting its therapeutic potential, THC in marijuana acutely elicits psychosis, anxiolysis, intoxication, cognitive impairment”. Prolonged use is “likely to increase the risk of developing schizophrenia and other psychoses…” (‘Tinkering with THC-to-CBD ratios in Marijuana’, Madras, BK (2019); www.nature.com).

“Obviously,” says Dr Lee Pow, “if you tamper with something so that the THC:CBD ratio is higher, so disproportionate, it will yield results in the people that use marijuana.”

The above-quoted study goes on to say: “High concentrations of THC and high ratios of THC:CBD in marijuana are associated with more robust euphoria, anxiety, and psychotic symptoms in otherwise normal people…most retail marijuana strains contain immoderately high concentrations of THC and scant CBD levels.” (‘Tinkering with THC’).

Marijuana Psychoses

Another recent study which looked at about 900 patients who suffered psychosis across 11 sites in Europe, showed a definite link between cannabis use and psychotic disorders.

The data was collected between 2010 and 2015, following up on the 900, examining their cannabis use, psychotic symptoms, and to date it is the most conclusive study. The study showed that use of high-potency cannabis daily had five times increased odds of having a psychotic disorder.

People who have a family history of any kind of mental illness are at risk, but even “if you don’t have that family history, it could still happen. You could still have psychotic reactions; you could still have bad experiences,” Dr Lee Pow commented.

How do marijuana psychoses present themselves? Symptoms of marijuana psychosis can include any of the following: hallucinations (which are false sensations and can occur with senses of sight, hearing, touch and smell), delusions (which are false beliefs), disassociation (feeling disconnected), disorganised thoughts (which may result in the person speaking nonsense) and pronounced mood and behavioural changes (such as unexplained aggression or appearing unemotional).

Psychotic symptoms are debilitating says Dr Lee Pow, and patients are treated with anti-psychotics. Once a psychotic episode has been experienced, she describes it as “almost like breaking a threshold”. The chances of having another episode are increased, as well as developing schizophrenia.

She continued: “The truth is we don’t actually know enough about the cannabinoid receptors, about how marijuana works, about THC and its specific interactions with brain chemicals. We simply don’t understand it enough yet….We are seeing so many detrimental effects.”

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