Author Alex Berenson chose to give his
latest book a provocative title, one that played off the 1936 film “Tell
Your Children” — later known as “Reefer Madness.”
The former New York Times reporter and
author of award-winning spy novels settled on “Tell Your Children: The
Truth about Marijuana, Mental Illness and Violence” (Free Press, $26).
But researchers and medical clinicians say the science doesn’t support
his premise: that marijuana use can cause schizophrenia and violence.
“The title is sort of twofold,” the New
York-based Berenson says. It reflects the controversy that he knew would
come from his book. “But it also is meaningful.
I wanted people to be
able to talk to their kids about the evidence, and if they’re honest
with kids, that can change their behavior, like changing behavior about
cigarette smoking,” he says.
The seeds of an idea
The book’s genesis lay in a conversation
with Berenson’s wife, a forensic psychiatrist, about someone who had
committed an act of violence. His wife, Berenson writes in the book,
“said something like, ‘Of course he was high, been smoking pot his whole
life.’ “
“She saw a lot of these cases,” he says. “I
was skeptical. I probably said it sounds like ‘Reefer Madness.’ ” But
after looking at the evidence, “I found it to be overwhelming. I had
covered the drug industry and had written about drugs for mental health,
and yet I didn’t really believe until I looked at the science.
“Dozens of well-designed studies have linked
marijuana with psychosis and schizophrenia,” Berenson says. While most
people never will have a psychotic episode from smoking marijuana, he
writes, some will experience temporary episodes and “an unlucky minority
of users will develop full-blown schizophrenia.”
“Start with the fact that psychosis is a
serious risk for violence,” he says. “If they are taking their
anti-psychotic medications and are being healthy and not using
recreational drugs, most of that risk goes away. … The flip side is if
those people are using recreational drugs, their risk is off the
charts.”
He says cannabis is a drug that can provoke paranoia and delusions even in healthy people.
Berenson cites a 2017 report by the National
Academies of Sciences, Engineering and Medicine that reviewed thousands
of cannabis studies. According to that report:
“There is substantial
evidence of a statistical association between cannabis use and the
development of schizophrenia or other psychoses, with the highest risk
among the most frequent users.” The report offers the caveat that “the
relationship between cannabis use and cannabis use disorder, and
psychoses, may be multidirectional and complex.”
A key distinction
Critics of Berenson’s book argue that he
confuses association with causation. One of the authors of the 2017
Academy of Sciences study tweeted that “We did NOT conclude that
cannabis causes schizophrenia. We found 1) an #association between
cannabis use and schizophrenia …”
It’s a key distinction, says Carl Hart,
chairman of the psychology department at Columbia University, whose
research includes studying the effects of psychoactive drugs on humans.
Berenson’s “point is that cannabis causes psychosis disorder.
There is
absolutely no evidence to show that,” Hart says.
Of Berenson’s linkage of cannabis and
violence, Hart says, “I have never seen it, frankly, and this is me
studying people day after day, year after year.”
Dr. Dale Carrison, a former FBI agent,
sheriff’s deputy and former head of the ER department at University
Medical Center in Las Vegas says, “If you have some mental illness
lurking in the background, even if it’s not active, and take any kind of
drug, there is that potential for that drug making mental illness
worse.” But in all his years as a police officer and an ER physician,
Carrison says, “I haven’t seen anybody on marijuana get violent.”
As states continue a nationwide push toward
legalizing medical and recreational marijuana use, medical professionals
wrestle with what is and isn’t known about its effects. In May, 43
doctors, psychiatrists, mental health organizations and practitioners in
Massachusetts signed a “statement of concern” about “how marijuana
policy is shaped” in that state. The Massachusetts Prevention Alliance,
which promotes “laws and policy that support prevention measures to
reduce substance abuse and addiction,” coordinated and supported
drafting of the statement.
The letter cites as potential negative
effects of legalization, addiction and “increased risk of serious mental
health problems, including acute psychosis… paranoia, schizophrenia,
depression, anxiety and suicide.” It notes that “just as not all tobacco
use causes cancer, not all marijuana/THC use causes the negative
effects.
However, the risk is substantial enough to require policies
which discourage use.”
More research needed
A January study published in The Journal of
Neuroscience concluded that even a small amount of cannabis use by
teenagers is associated with changes in their brain, especially the
amygdala, which handles “emotion-related processes” and in the
hippocampus, “involved in memory development and spatial abilities.”
Another study by Canadian researchers
published in 2018 in the American Journal of Psychiatry found that the
effects of marijuana on teenagers’ ability to reason appear to be
stronger than the effects of alcohol.
Many agrees that more studies on marijuana
would be beneficial. But research is hampered in the U.S. because
marijuana is classified as a Schedule 1 drug, meaning it has “no
currently accepted medical use” under federal law.
“It’s just very hard for us to get good data
on anything because of the Schedule I issue,” says Sarah Feldstein
Ewing, professor of psychiatry at Oregon Health & Science
University, and a committee member of the 2017 report. “No other country
has this limitation. It’s something that’s really hamstringing us.”
Meanwhile Berenson continues to argue that
the risk is real and that consumers — particularly adolescents, those
who suffer from paranoia, panic attacks or schizophrenia or those with a
family history of mental illness — “probably should not use it.”
No comments:
Post a Comment