The Mental health debate

Over the past few years there have been a lot of reports in the media about cannabis and its effect on mental health problems, especially schizophrenia. Despite the simplistic and often frankly alarmist reports in sections of the media, politicians and some ill-informed campaigners, it's a complicated and very real issue.

Information on this page has been compiled with the help of the mental health charity RETHINK

Other sections

Risks of getting stoned
Risks caused by how you get stoned
Risks caused by the law
The ins and outs of surviving prohibition - risks summary

UKCIA runs a mailing list for the discussion of cannabis and mental health - click to subscribe

Brain care

You get stoned because of a combination effect of several active chemicals which we call drugs, they're "active" because they do things in the brain.

By design or accident some of the chemicals in cannabis are the same shape as chemicals which occur in the brain that regulate the way the brain works.

Most drugs used for fun or escapism - perception changing - work in something like this way, so if you don't like the idea of altering the way your brain works, don't do drugs - simple as that...

It's not so much the altering of perception that's potentially harmful to developing teenagers, it's the constant, unrelenting alteration of perception. We're still learning to be "us" at that age, we're not yet who we are destined to become, and it's probably not a very good idea to derail that process by getting hammered every single day.

You can't learn to be "you" if you never get the opportunity to be "you", you can't forge your adult links with consensual reality if you're never in touch with consensual reality. You can't get a handle on your own personal perception of the world if that perception of the world is always altered.

Cannabis isn't a problem in itself, but heavy and habitual use of any substance that alters your perception of reality during the late developmental stage of the minds growth cannot be anything but a bad idea.

You've got to anchor the good ship 'Mind' before you go diving to explore the depths.

Is cannabis a drug?

Cannabis is a plant that contains many different chemicals, some of which are drugs. When people talk about "drug use", they usually mean one specific chemical such as Ecstasy, LSD, cocaine, nicotine, caffeine or alcohol. Cannabis isn't like that, getting stoned isn't the effect of just one active chemical.

It's important to understand that cannabis can have very different effects depending on the variety or "strain" of the plant because of the ratio of active chemicals which that particular strain contains.

Different types of cannabis are different and hash is different to weed.

So with cannabis there are two important things to be aware of: how strong and what variety it is - but because of prohibition, there's no way of knowing either for most users.

Cannabidiol

Cannabis is famous for containing a chemical called Tetrahydrocannabinol - THC. This is the one which gives the stoned feeling. It's less well known for containing another substance called CBD or cannabidiol.

CBD seems to have good anti-psychotic properties and, although it doesn't make you stoned, it does affect the way THC works.

This is just one example of why cannabis is a complicated substance which needs to be understood, it's not just "dope".

What is mental illness?

Mental illness is a wide term meaning illness that affects the mind.

1 in 4 of the population experience some kind of mental health problem of one kind or another at some time in their lives, although for most it's a minor thing.

One thing that ill people do have in common is that they often experience an irrational stigma from a lot of people. Mental health is still a subject many people don't like to talk about, which is the fear the press played on.

Mental health care for seriously ill people is covered by the mental health act and in extreme cases ill people can be taken into hospital for compulsory treatment, this is called "sectioning".

This is different from physical illnesses, in that
people can't be treated for any physical illnesses (even contagious ones) if they don't want to be.

Support is mostly offered through community care but the mental health services in the UK are grossly under funded and this is one reason why, shockingly, a significant number of mentally ill people are caught up
in the prison system.

Are there links between cannabis and mental health problems?

The discussion about links between cannabis and mental health aren't new but it wasn't until 2004 - when cannabis was reclassified to class C - that the issue started to hit the headlines.

Mental health campaigners who wanted to raise the issue were concerned that the risks are not known and were not considered adequately when reclassification happened.

Unfortunately the issue was been taken up by tabloid press as a campaign to increase punishments for cannabis use, rather than to help understanding.

The campaign for information and further research about cannabis and mental health has been led by the mental health charity RETHINK, some of whose members have direct experience themselves either as ill people or
carers of people with mental illness.

A lot of people with mental health problems use cannabis. In some cases it seems to help but in others this use makes the illness worse. In addition to this complicated situation, some of the effects of
cannabis which many people enjoy seem similar to the symptoms of some illnesses, but in fact aren't

Questions...

Are there links between cannabis and mental health?

Does cannabis cause mental illness?

Does it have any effect on existing mental illness making it worse or better?

These are important questions and the answers aren't as simple as the more rabid tabloid press would like you to believe.

Where to get help and
what to do

RETHINK give advice on what to do if you think you or someone you know is developing a mental health problem. Download "Cause for concern" here (pdf document)

Never be afraid to talk to people about your feelings - especially if you feel scared or frightened when you get stoned.

If these feelings keep coming back never keep it a secret, don't ignore them and don't carry on getting stoned, hoping they will go away.

Cannabis isn't for everyone, never feel forced to use it just because all your mates do

Schizophrenia.

Perhaps the worst of the brain problems, it's often called a "split personality" but that's wrong. It's better to think of schizophrenia as meaning "split from reality", ill people hear voices which aren't there, suffer hallucinations and, put simply, don't always experience the real world around them correctly.

People can suffer degrees of the illness and no two people's illness are the same

Many people recover from schizophrenia, but others do not get the help they need and have a low quality of life, are socially excluded or find their symptoms unmanageable.

The symptoms of schizophrenia are called a "psychosis", which means ill people experience paranoia attacks, sometimes feeling they are being watched and people are talking about them.

For more information on what Schizophrenia is, see the RETHINK site:
Schizophrenia

The charity "mind" also has a page:
"Understanding schizophrenia"

UKCIA looked at some of the research in our section
Cannabis and mental health .

Does cannabis make mental illness worse or does it help?

For those who have schizophrenia cannabis is extremely
likely to make the condition worse and delay recovery

But like many of the issues about cannabis and mental health, it's complicated and some people with certain conditions insist cannabis helps them cope.

People who have schizophrenia are more likely to use cannabis than the population in general, in spite of advice not to do so. This might be because use of cannabis gives temporary relief from the voices, but the evidence seems to be that they use cannabis and other drugs pretty for much for the same reasons as anyone else - not just enjoyment, but relaxation, to socialise and so on.

There is also recent research that suggests that CBD (a chemical in cannabis) has antipsychotic benefits, although THC (the main active ingredient) is generally accepted is harmful to people with schizophrenia. Studies are underway to see if medicines can be made from cannabis, but these are early days.

Does cannabis cause schizophrenia?

Cannabis isn't a cause of psychotic conditions like schizophrenia in the sense that it directly leads to psychosis. That's obvious - we all know people who've smoked for years and haven't got schizophrenia; we also know people who have psychotic symptoms who haven't used any drugs..

But this is a hot potato of a question because it depends on what's meant by "cause". There are no specific causes as no single cause has been identified -
even genes only carry a 50% risk. it's better to think of "risk factors" - factors which increase the risk of it developing. Some people put birth complications as the main causal factor in about 40% of cases of schizophrenia.

But that doesn't mean that cannabis definitely has no causal role. No single cause for psychosis has ever been identified - it's almost always a bit of a melting pot of risk factors like genes, birth complications, racism, living in cities, trauma, the list is almost endless. The thing is that if more than one risk factor is present, the chances of developing a psychotic condition goes up exponentially, or as researchers put it, the risk factors interact.

Cannabis use might be one of these risk factors, especially for children or young teenagers and especially if they use a lot of it - the more smoked, and the younger the user - the bigger the risk.

Cannabis, drugs and young people

Some research seems to show that perhaps cannabis and certainly other drugs may be a significant risk factor in the development of schizophrenia in young people.

Some drugs such as alcohol, speed (amphetamine) and cocaine are known to be very significant risk factors, but all drugs can have some effect including cannabis.

No-one knows who is vulnerable to developing schizophrenia before they get it and if cannabis could be a trigger it makes sense not to use it when you're young and your brain is still developing. In short, the harder, the younger, the stronger you cane it, the greater the potential risk.

Of course it would make sense to use laws to protect young people from these potential dangers, but this isn't possible whilst cannabis remains illegal.

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People with bipolar (manic) depression can swing from moods of deep depression to periods of overactive, excited behaviour, this is called "mania".

Between these severe highs and lows there may be relatively stable times, although this isn't always the case. Some people also see or hear things that others around them don't (known as having visual or auditory hallucinations or delusions).

One form of treatment for this illness is to use antipsychotic drugs, so it's no surprise that cannabis can have quite an effect on depression.

But, despite the scare stories in the papers, far from making things worse there are many sufferers of depression who claim cannabis helps their condition.

The fact is, there are different types of depression and cannabis may help with some, but not others.

The thoughts of Boojum
a sufferer from depression and a cannabis user

I think until more is known about mental illness itself it's difficult to isolate the role that any single factor plays. I do know that there is a lot said about cannabis and mental illness by people that neither smoke cannabis nor suffer from mental illness, and I do wonder to myself precisely what gives these people the idea that they are qualified to comment on something that they themselves have never experienced. Then of course there is the use of this umbrella term 'mental illness' to describe a number of conditions ranging from the relatively minor to the life destroying, I don't think that does the cause of debate any favours. To kinda highlight those points I am a cannabis smoker and I suffer from mental illness, type 1 bipolar disorder, so I feel qualified to offer an opinion about cannabis and manic depression and depressive illness, but I cannot offer any informed opinion about cannabis and schizophrenia, because I do not suffer from schizophrenia.

I can offer an opinion, but not an informed one - that's kinda my point, there's lots of opinion floating around (much of it wearing the thin guise of scientific research when it is nothing of the sort). My informed opinion regarding cannabis and manic depression/depressive illness is that it generally improves my mood if I am in a depressive phase, but smoking strains with high THC and low CBD when I am towards the manic side of my cycle can make me edgy and anxious. I do not believe that smoking cannabis in any way led to my illness (I was diagnosed, wrongly, with simple depression years before I started smoking, if anything I started smoking to try and find answers for my condition, which I did in the sense that cannabis puts me in a more contemplative frame of mind), and I am convinced that without cannabis I would be less able to live a 'normal' life than I am now, since it also enables me to deal with my alcoholism.

My uninformed opinion of cannabis and schizophrenia is different, however. I do not believe it is a good idea for schizophrenics to smoke cannabis. I do not think there is a causal link, but I suspect that if you have schizophrenia cannabis could conceivably exacerbate the symptoms, and if you are in the early stages of undiagnosed schizophrenia I suspect smoking cannabis may increase your awareness of the symptoms thus speeding the onset. Which again goes back to this umbrella term 'mental illness', looking at cannabis and mental illness is a nonsense, because mental illness is just a convenient term to link otherwise unrelated conditions of the mind. With some forms of mental illness I believe cannabis - the right strains, selected for THC to CBD ratio, can be beneficial. With other forms of mental illness I believe cannabis can be detrimental. I do not believe, however, that cannabis is causal, with any form of mental illness.

Tobacco

The vast majority of people with mental health problems are also heavy tobacco smokers. Because tobacco seems to relieve some of the symptoms in ill people, it isn't generally seen as a problem.

However, illnesses such as schizophrenia are thought to be linked with the regulation of a brain chemical called dopamine and tobacco is known to disrupt that balance.

If you smoke a lot of cannabis with tobacco, you're also going to be smoking a lot of tobacco. We strongly advise you not to smoke cannabis with tobacco.

RETHINK website
mind website