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And the few studies we do have were done mostly in the nineteen-eighties and nineties, when cannabis was not nearly as potent as it is now. It’s hard to study a substance that until very recently has been almost universally illegal.
Are users smoking less, to compensate for the drug’s new potency? Is high-potency cannabis more of a problem for younger users or for older ones?
Because of recent developments in plant breeding and growing techniques, the typical concentration of THC, the psychoactive ingredient in marijuana, has gone from the low single digits to more than twenty per cent—from a swig of near-beer to a tequila shot.
It contains no bombshells or surprises, which perhaps explains why it went largely unnoticed. But he has a reporter’s tenacity, a novelist’s imagination, and an outsider’s knack for asking intemperate questions. The first of Berenson’s questions concerns what has long been the most worrisome point about cannabis: its association with mental illness.
It simply stated, over and over again, that a drug North Americans have become enthusiastic about remains a mystery. Many people with serious psychiatric illness smoke lots of pot.
Risk of bronchitis and respiratory diseases, lung cancer...
Loss of inhibition which may increase risk taking behaviour.
For example, smoking pot is widely supposed to diminish the nausea associated with chemotherapy. The marijuana lobby typically responds to this fact by saying that pot-smoking is a to mental illness, not the cause of it—that people with psychiatric issues use marijuana to self-medicate. In some cases, heavy cannabis use does seem to cause mental illness.
But, the panel pointed out, “there are no good-quality randomized trials investigating this option.” We have evidence for marijuana as a treatment for pain, but “very little is known about the efficacy, dose, routes of administration, or side effects of commonly used and commercially available cannabis products in the United States.” The caveats continue. As the National Academy panel declared, in one of its few unequivocal conclusions, “Cannabis use is likely to increase the risk of developing schizophrenia and other psychoses; the higher the use, the greater the risk.”Berenson thinks that we are far too sanguine about this link.
A few years ago, the National Academy of Medicine convened a panel of sixteen leading medical experts to analyze the scientific literature on cannabis. His wife’s remark alarmed him, and he set out to educate himself.
The report they prepared, which came out in January of 2017, runs to four hundred and sixty-eight pages. 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.