Genetics Could Explain "Marijuana Psychosis"

Categories: Health, Marijuana
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Is it the devil or the doctor?
Science can be tricky thing, and particularly so when discussing the cannabis plant.  Laymen -- and your average Internet expert -- often sum up complex studies involving biochemistry and neurology in overly simplistic and often misleading bromides. "Cannabis may have antitumor effects" becomes "pot cures cancer."

Examining the magic plant or any other complex psychoactive compound requires both restraint and nuance. But that's boring. Why bother when there's the drama of 21st century reefer madness? "For cannabis it is the tobacco moment,'" is Patrick Cockburn's breathless opening salvo in a four-part series running this week in the UK Independent. For the veteran foreign correspondent -- whose 30-year-old son has been in and out of mental hospitals for the past decade after spending much of the '90s stoned off his ass -- studies suggesting a possible link between marijuana use and psychotic episodes are akin to the revelation that tobacco smoking leads to a host of deadly maladies.

It's poppycock -- but also not entirely. Some studies suggest when coupled with a genetic defect, cannabis use can trigger psychosis in adolescents. But other studies suggest certain marijuana use can defuse schizophrenia. It makes you crazy and it makes you uncrazy?

First, the science. Researchers led by Dr. Marta Di Forti, a genetic expert at the King's College London Institute of Psychiatry, published a study Nov. 14 that suggests a link between a particular gene and the possibility of psychosis. Specifically, a "risk gene for cannabis psychosis." Study participants with a variation in the AKT1 gene, which is involved in dopamine signaling, were twice as likely to develop psychosis than the control group if they smoked pot, and seven times as likely if they used marijuana every day. Not exactly "pot makes you crazy."

But the makeup of marijuana varies from plant to plant, and sometimes from harvest to harvest. Cockburn warns of the dangers of "skunk cannabis," which is anything with a THC level of 15 percent or more -- pretty much everything on the shelves of most California medical marijuana dispensaries. But there's another compound in cannabis called cannabidiol, or CBD. Cannabidiol has been linked to shrinking tumors -- and it's also been linked to a decrease in psychotic episodes.

Most mental health professionals and doctors agree that marijuana isn't a great thing to give to a developing brain -- and while marijuana advocates will rightly claim that it's impossible to fatally overdose from cannabis, physicians likewise won't advise you to smoke seven joints a day, as Henry Cockburn is purported to have done.

Cockburn, it should be noted, is hardly an unbiased observer. What parent, who learns that his pothead son is becoming unhinged -- news he received while on assignment in Afghanistan in 2002 -- could be? There's also the book, published last year, that the two Cockburns penned about their journey through psychosis and the world of mental health institutions, a read that's all the more intriguing with a scientific news hook.

Which the Independent article series doesn't have. Maybe it's not his fault. Maybe it's the newspaper's. But to kick off an article comparing marijuana to tobacco, and to imply that it's the reefer that turned his son batty -- with the epitaph-like opener of "Henry Cockburn was diagnosed with schizophrenia in 2002 at the age of 20. Before that he was a heavy cannabis user" -- is irresponsible. And it's too bad; part two in the series, which ran Tuesday, is a measured and vital examination of the shortcomings of the mental health system.

The problem is that nearly every scientific study ends with a call for more research. That's not the kind of thing that engages casual newspaper readers, or advocates for or against the Drug War. So does cannabis indeed cause psychosis, or fight it? Until the scientists can agree -- and it's going to be a while -- it depends on what you want to believe.

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Once we regulate cannabis, we can enforce rules regarding the minimum percentage of Cannabidiol (CBD)  (for a start, maybe 2-5%).  It is clear that cannabis low in CBD is associated with more problems(1-3).  One thing all current studies miss is regulated cannabis - for example, one study(4) stipulates that cannabis is half as harmful as alcohol.  The flaw in this study is that one drug is regulated, the other is not - cannabis will be much safer when regulations around minimum CBD are met and age limits are enforced.





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