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Second Thoughts On Pot

You don’t expect the New Yorker and Mother Jones to be places where you read anti-marijuana articles, but Tell Your Children [1], the new book by former New York Times reporter Alex Berenson is knocking some people flat. The book examines what we know scientifically about marijuana use, and it turns out to be pretty damn scary.

I have never been a pot smoker, though back in my youth, I ate space cake in Amsterdam. Meh. I’ve always had ambivalent views about marijuana legalization. I can’t stand the way the stuff smells, and found the people I hung out with in college who were big fans of it to be incapable of talking about much else. But I accepted the line that pot was largely harmless. I don’t like the fact that it’s being legalized everywhere, but couldn’t come up with a compelling reason to oppose it. I chalked that up to social custom. Frankly, I didn’t much care.

Berenson’s book is a game-changer. In his New Yorker piece, Malcolm Gladwell writes straightforwardly about the overwhelming scientific evidence that marijuana is a hell of a lot more problematic than many of us think.  [2]Excerpt:

Berenson begins his book with an account of a conversation he had with his wife, a psychiatrist who specializes in treating mentally ill criminals. They were discussing one of the many grim cases that cross her desk—“the usual horror story, somebody who’d cut up his grandmother or set fire to his apartment.” Then his wife said something like “Of course, he was high, been smoking pot his whole life.”

Of course? I said.

Yeah, they all smoke.

Well . . . other things too, right?

Sometimes. But they all smoke.

change_me

Berenson used to be an investigative reporter for the Times, where he covered, among other things, health care and the pharmaceutical industry. Then he left the paper to write a popular series of thrillers. At the time of his conversation with his wife, he had the typical layman’s view of cannabis, which is that it is largely benign. His wife’s remark alarmed him, and he set out to educate himself. Berenson is constrained by the same problem the National Academy of Medicine faced—that, when it comes to marijuana, we really don’t know very much. But he has a reporter’s tenacity, a novelist’s imagination, and an outsider’s knack for asking intemperate questions. The result is disturbing.

I’ll say. Read his piece to find out why. [2] Or even better, check out Stephanie Mencimer’s detailed report in Mother Jones [3], the San Francisco-based left-wing magazine. I’m sure it’s going to wind up subscribers. Excerpts:

Berenson, who smoked a bit in college, didn’t have strong feelings about marijuana one way or another, but he was skeptical that it could bring about violent crime. Like most Americans, he thought stoners ate pizza and played video games—they didn’t hack up family members. Yet his Harvard-trained wife insisted that all the horrible cases she was seeing involved people who were heavy into weed. She directed him to the science on the subject.

More:

Over the past couple of decades, studies around the globe have found that THC—the active compound in cannabis—is strongly linked to psychosis, schizophrenia, and violence. Berenson interviewed far-flung researchers who have quietly but methodically documented the effects of THC on serious mental illness, and he makes a convincing case that a recreational drug marketed as an all-around health product may, in fact, be really dangerous—especially for people with a family history of mental illness and for adolescents with developing brains.

2002 study [4] in BMJ (formerly the British Medical Journal) found that people who used cannabis at age 15 were more than four times as likely to develop schizophrenia or a related syndrome as those who’d never used. Even when the researchers excluded kids who had shown signs of psychosis by age 11, they found that the adolescent users had a threefold higher risk of developing schizophrenia later on. One Dutch marijuana researcher that Berenson spoke with estimated, based on his own work, that marijuana could be responsible for as much as 10 percent of psychosis in places where heavy use is common.

These studies are hardly Reagan-esque, drug warrior hysteria. In 2017, the National Academy of Medicine issued a report [5] nearly 500 pages long on the health effects of cannabis and concluded that marijuana use is strongly associated with the development of psychosis and schizophrenia. The researchers also noted that there’s decent evidence pot can exacerbate bipolar disorder and increase the risk of suicide, depression, and social anxiety disorders: “The higher the use, the greater the risk.”

Given that marijuana use is up 50 percent over the past decade, if the studies are accurate, we should be experiencing a big increase in psychotic diseases. And we are, Berenson argues. He reports that from 2006 to 2014, the most recent year for which data is available, the number of ER visitors co-diagnosed with psychosis and a cannabis use disorder tripled, from 30,000 to 90,000.

Mencimer admits that she was red-pilled by Berenson’s findings:

Before talking to Berenson, I didn’t realize it was possible to smoke your way to the ER. I smoked plenty of weed in high school and so did all my friends, and none of us jumped off a balcony or killed anyone—we could barely get off the couch. But the marijuana sold today is not what we smoked, which at 1 percent to 2 percent THC was the equivalent of smoking oregano. Today’s weed is insanely more potent, as are products like “wax” and “shatter”—forms of butane hash oil designed to be vaped or dabbed that come pretty close to 100 percent THC. And these high-potency products usually contain very little CBD oil, the ingredient in cannabis that’s supposed to account for many of its supposed health benefits.

These potent products can cause hallucinations, restlessness, and, as anyone who’s smoked even weak pot is familiar with, paranoia. After reading Berenson’s book, I fact-checked it a bit, and inadvertently discovered all sorts of websites advising pot users on how to manage their paranoia and ride out the psychotic effects. I also found plenty of news stories about bad trips on pot. Such incidents are typically treated jokingly. “But a lot of the time it turns out not to be a joke,” Berenson told me. “A lot of the time it’s a 22-year-old guy who maybe has some history of aggression, and he winds up throwing himself off the balcony or beating up his girlfriend.”

One more passage:

Paranoia and psychosis make people dangerous, so rising use of a drug that causes both would be expected to increase violent crime, rather than reduce it as pot advocates claim. Berenson looked at data for the four states that legalized weed in 2014 and 2015—Oregon, Washington, Alaska, and Colorado—and calculated a combined 35 percent increase in murders in those states from 2013 to 2017, compared with a 20-percent rise nationally. This “isn’t a statistical anomaly,” Berenson writes. “It’s real.”

The role of weed in rising violent crime rates in legalization states is a hotly contested question, especially in Colorado, where murders in Denver are at a 10-year high. Berenson admits he can’t say for sure whether those upswings are due to legal weed, but the raw data, he says, definitely contradicts advocates’ claims: “What I want people to stop saying is that legalization reduces violent crime. It doesn’t.”

Read the whole thing. [3] It’s important that you do.

In his review essay, Malcolm Gladwell compares the laissez-faire attitude we have developed towards pot with the way we regard nicotine. Gladwell talks about how the FDA just announced a crackdown on flavored vape juice, in an effort to discourage vaping among teenagers, who are becoming nicotine addicts because of it. Gladwell writes:

A week after [the FDA commissioner] announced his crackdown on e-cigarettes, on the ground that they are too enticing to children, Siegel [a public health advocate] visited the first recreational-marijuana facility in Massachusetts. Here [6] is what he found on the menu, each offering laced with large amounts of a drug, THC, that no one knows much about:

Strawberry-flavored chewy bites
Large, citrus gummy bears
Delectable Belgian dark chocolate bars
Assorted fruit-flavored chews
Assorted fruit-flavored cubes
Raspberry flavored confection
Raspberry flavored lozenges
Chewy, cocoa caramel bite-sized treats
Raspberry & watermelon flavored lozenges
Chocolate-chip brownies.

He concludes, “This is public health in 2018?”

A lot of people made fun of Tucker Carlson for his seemingly out-of-left-field swipe at how marijuana use affects young people in his famous monologue last week. I too thought it was a bit weird. But based on Berenson’s findings, Carlson was closer to the truth than many of us think.

UPDATE: A reader writes:

I’m a reader of your blog and an ER doctor, now in [small town] but trained and worked primarily in [major city]. I read your post on marijuana and psychosis/violence just before starting my night shift tonight, and my first patient (in [small town], mind you) is a psychotic young woman who recently assaulted her fiancée with a broken shard of mirror. [The patient tested negative for every drug but cannabis.] I can attest that this is quite common.

 

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156 Comments (Open | Close)

156 Comments To "Second Thoughts On Pot"

#1 Comment By Alex (the one that likes Ike) On January 12, 2019 @ 5:34 pm

By the way:

[The patient tested negative for every drug but cannabis.] I can attest that this is quite common.

Bold is the most important moment in that doctor’s story. More important even than the specific details as to how exactly violent that girl became.

#2 Comment By B Topp On January 13, 2019 @ 1:14 am

Generally I have liked some books Gladwell wrote but his career was fostered by right wing and business groups. He also has a history of supporting as a shill Big Pharma and Big Tobacco two industries hurt by the legalization of marijuana. As far as what Berenson said I like to see those studies duplicated. The concept that pot makes you more aggressive than alcohol sounds base on my lifetime experience of observation to be outright ludicrous. Would love to know who financed this article. I’ve got a guess. Gladwell does dispute some points in the below link.
[7]

#3 Comment By Alex (the one that likes Ike) On January 14, 2019 @ 4:50 am

B Topp, care to define what means “more” and “less” aggressive? There are very few *aggressive* alcoholics who, eventually, proceed from the “Gonna kill ’em!” stage to the stage of actually trying to slit someone’s throat like that girl tried either.

As to financing… I would love to know who financed all those articles about the harmfulness of fried foods and caffeine. Or those about healthiness of eating everything raw (yup, try nibbling a raw potato). To be sure, I can fancy some powers’ hidden agendas beneath virtually every article about harmfulness/usefulness of something. And?

#4 Comment By Wayne Lusvardi On January 14, 2019 @ 8:32 am

Omitted from discussion is at what dosage does weed make one psychotic or homicidal? I know people who stay mellow with weed and don’t seem to OD. It is either a choice of weed or some upper drug that is even worse (opioids). At high doses, or consumption of dangerous strains of weed, it can lead to a psychotic break with reality. Weed may just be a lesser evil in most cases but dangerous at high doses or when, say, mixed with alcohol. Never smoked cigarettes let alone weed, but the perfect is the enemy of the good sometimes.

#5 Comment By Hector_St_Clare On January 14, 2019 @ 10:03 am

B Topp, care to define what means “more” and “less” aggressive? There are very few *aggressive* alcoholics who, eventually, proceed from the “Gonna kill ’em!” stage to the stage of actually trying to slit someone’s throat like that girl tried either.

It’s not that most alcoholics or heavy drinkers are violent, it’s that a very high percentage of violent people are using alcohol when they commit their crimes. Cross-culturally, homicide rates seem to correlate well with alcohol consumption. (Again, I’m saying this as someone who quite likes alcohol and would favour liberalizing the laws about it in this country).

Also to state the obvious, and to paraphrase the prosecutor from The Brothers Karamazov, alcohol doesn’t *make* people violent. it’s a disinhibiting agent, so what it does it makes people with pre-existing violent tendencies more willing to follow their inclinations. It also can “free people up” to be more friendly, sociable, promiscuous, or creative depending on the person involved.

#6 Comment By Alex (the one that likes Ike) On January 15, 2019 @ 4:18 am

Certainly, Hector. What I wanted to say is that the same correlation (Denver again) can be traced in regards to marijuana consumption. Thus the idea that alcohol abusers are somehow socially more dangerous than marijuana abusers is weird to say the least. Also, most alcoholics I know just keep on drinking their booze. At worst they get some low-quality spirits when they ain’t got enough money for something better. While people who abuse marijuana seem to be quite prone to trying harder stuffs.