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The Second Cannabis and Mental Health Conference - a review

May 1st - 2nd 2007
King College London

Review

The second "Cannabis and mental health" conference hosted by Robin Murray and Zerrin Atakan at Kings College, near Waterloo Station took place at the start of May. I had attended the first conference in 2004, so this was very much a chance to catch up on developments. As previously it was a very interesting and revealing event, albeit very dry academic stuff and at times difficult to really understand what point they were making if any. Most of it made sense though and a lot of it was riveting stuff.

The first, and perhaps most important thing to be explained was that there is no single substance called "cannabis". Now that's not news to some of us because we know there's lots of different types with very different effects,
but it was made clear right at the start of the conference that no blanket statements such as "cannabis causes so and so" can be made, you have to know what type you're talking about. There's a very simple if maybe unexpected reason for that: Cannabis contains quite a few active substances, but in particular two - THC and CBD.

THC does seem to have a very active role in the mechanism of schizophrenia but CBD has an opposite, anti psychotic role. The good old cannabis that Rosy Boycott has told everyone about that she smoked up her tree in the 60's - such stuff as Red Leb (oh fond memories) was absolutely soaked in CBD apparently. CBD acts on a different part of the brain to THC, but of course the brain being the brain the two "network" with each other. CBD reduces anxiety and is the brain care "good guy" in this debate.

The speakers came from Germany, Holland, Israel, USA, the UK of course, but mostly Australia and New Zealand. One from the USA was in fact a British (I think) Asian and made it clear he wasn't American. These antipodean guys were of a type though, well known for their "cannabis makes you mad, progress to other drugs and give you cancer" research, not really found anywhere else apart from maybe the USA. They were all very anti legalisation, but oddly not pro prohibition either, it's just they thought people should be drug tested and locked up for using cannabis... hmmm indeed.

One presentation indeed - from an American Prof. Yasmin L Hurd of the USA claimed to demonstrate that cannabis is a gateway drug by carrying out some unsettling animal experiments on rats. It's this sort of study that gives researchers a bad name frankly. The study involved giving young rats doses of THC and then later in life enticing them to self administer heroin. The claim was that the rats exposed to THC were more likely to self administer heroin therefore cannabis is a gateway drug to addiction. Quite why this was presented at this conference wasn't entirely clear to me frankly.

The German - Markus Leweke - presented the CBD study on the second day. I had seen an earlier version of his work and this was an update of it. CBD seems to be stunning, showing better results than the normal anti psychotic
medication with none of the side effects such as obesity. He was difficult to follow though, presentation skills and mic technique not being his strong points and English not being his first language. Zerrin Atakan talked about
brain scans showing how THC and CBD act on the brain, explaining how the one moderates psychotic effects of the other.

The British lot - principally Zerrin but also Robin were quite outspoken in their desire to see cannabis properly regulated, despite the way they're reported in the media. This has to be stressed given some of the claims made
by certain "news" papers, they do not support prohibition. The reason being they want to see the ratio of THC to CBD regulated. They claim that what's been happening over reecnt-ish years is the THC has been increased at the
expense of CBD, hence the observed growth in problems. Brain care specialists, to be fair to them, are not very good at getting their message across to the media dogs who write what they want to anyway.

It's not as simple as that though, there's an interesting complication I'd not heard mentioned before. The anti psychotic medications used in the treatment of such conditions as schizophrenia aren't neutral in what they do
to brain chemistry - obviously not, it's how they work. Concerns were expressed about the way people come off these drugs, leaving them more vulnerable to the effects of THC if they revert to using cannabis, which
many do. The reason many ill people continue to use cannabis may be because THC has some beneficial effects on schizophrenia, helping people to manage the voices, coupled with the anti psychotic effects of the CBD. But the changes the anti psychotic drugs make in the brain mean reverting to cannabis use destabilises things further. Better management of patients coming off anti psychotics would may reduce the problems being seen with cannabis.

We heard loads about Anandamide and 2A-G, the natural brain chemicals which THC mimics. Again, interesting if weird stuff. It's the development of this system in young people which is disrupted by THC and is the reason we need effective controls to keep kids away from it. This bit of the brain is a dynamic system which varies according to need - ie the brain makes these chemicals when it needs to which in itself make them a bit special apparently. The present prohibition policy has seen a reduction in use in recent years, but also a constant lowering of the age of first use.

Coffee and dinner was the time we had to chat to each other, and I got hold of Marj Wallace from SANE and had a good long talk about how to communicate with cannabis users (ie not the way she does it). Not sure she had her ears turned on though.

One thing I did find odd was that this was two days of talking about something very familiar to me but in an abstract academic way. None of the speakers had any first hand experience of cannabis or the culture behind it - at least that they would admit to! Apart from the Dutch guys of course who knew all about it. They all seemed unaware of the grit weed issue that's dominated the news this year, or indeed the wider contamination problems incidentally, again apart from the Dutch people.

One interesting point was the way they used the term "potency", it wasn't at all the way the Home Office has explained it. They agreed that the only meaningful way to measure it is in terms of Mg/gram sample. "The Home office is wrong" was one comment, for some reason that is something I can well believe. Potency has increased by a factor of perhaps 2 or 3 times incidentally, not the 25 - 30 fold increase claimed by a certain newspaper.

The debate at the end was "which country has the best regime for cannabis" - from the countries represented by the speakers. Holland won by a clear majority in the vote at the end. The Dutch speakers explained how
psychiatrists there are vocal in calling for proper legalisation whilst the Aus and NZ contingent seemed to have no overall strategy along with the Germans. The present UK position was ridiculed by Terry Hammond, ex of RETHINK who took the strange position of both opposing prohibition but not wanting legalisation, he favoured decriminalisation, which to my mind is odd because it's simply tolerating things as they are, something he's outspoken against.

I think the big problem we have is the reporting in the media, which is heavily affected by groups with a vested interest. Simply, the studies concerning cannabis and mental health are not being properly reported and
the conclusions are being twisted. Add to that the fact that these guys are academics, albeit working with real people. They speak in tongs with their academic language and their chosen subject scares people. All that adds up to a dangerous combination.

Lots more to say about all this, but leave with two thoughts:

The risk from cannabis is low apparently, even for those at most risk (val-val COMT gene combination for what it's worth - most of us are met-met or met-val of course - yeah , right, you knew that didn't you....). The
percentage of cannabis users at risk is tiny, almost but not insignificant. The problem is the illness is particularly nasty and even this small percentage means thousands of people in total because there's a lot of us, it's highly visible and very distressing for people involved and very scary for everyone else.

Most of the risk could be greatly reduced if the THC/CBD levels in cannabis were regulated in some way though, if only to allow people to chose the type of cannabis they enjoy most. It probably wouldn't have happened had cannabis not been prohibited, but we've spent the past 30 odd years eradicating the strains which have been used for thousands of years and the folklore which regulated its use, a true own goal for the drug war if ever there was one.

Whatever this debate is, it is not one for the prohibitionists though, the mental health risks are perhaps the biggest reason for a regulated legalised regime there could ever be.

Derek
UKCIA
May 2007

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