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V A COMPARISON OF CANNABIS AND OTHER DRUGS
Cannabis has intrinsically different effects from most other drugs. As with most
other drugs its effects are very variable, and depend not only on the substance
consumed but on the person and his social setting. To this extent it is not easy
to make any close comparison between cannabis and other drugs in common social
use. Nevertheless, science, the law and social attitudes tend to create a common
frame of reference for all drugs and. provided the risks of oversimplification
and borne in mind, comparison of cannabis with other substances that affect the
mind is relevant to our study even though it must necessarily be in broad terms.
Unlike the "hard"drugs. such as heroin, cannabis does not produce tolerance.
Consuming the same, sometimes even a smaller, amount of cannabis continues to
produce the original effect. Unlike heroin, cannabis does not cause physical dependence
and withdrawal effects do not occur when its use is discontinued. The majority
of users regard cannabis as pleasurable and so continue its use, but if they decide
to give it up they do not usually experience difficulty. Here it might be said
is a form of psychological dependence, but it is of a different order from the
intense psychological dependence which normally follows the use of the "hard"drugs.
The "hard"drugs are also physically dangerous: the direct result of
over-dosage may be death, and possible indirect results are ill-health and even
death, from pneumonia, malnutrition and infection due to dirty syringes. The social
effects of taking opiates and cannabis are very different. The opiate-user frequently
gets drawn into a "junkie" sub-culture where obtaining the drug and
all that goes with it becomes a way of life, and this inexorably leads to gross
deterioration. This is not true of cannabis, the use of which by itself does not
appear to impair the subjects efficiency. In Western society it is clear
that some adolescents form aberrant social groups around cannabis-taking; but
where these are personally or socially deleterious it is not clear that the cannabis
itself is primarily to blame. The use of other drugs as well as cannabis is often
to be found in such groups and the social implications of adolescent alienation
are probably of greater significance than the actual drugs.
In this country the barbiturates and the so-called minor tranquillizers such as
meprobamate and chlordiazepoxide are widely prescribed by doctors and are all
capable of producing varying degrees of tolerance and physical and psychological
dependence. Over the last ten years the death rate from barbiturate poisoning
(both accidental and suicidal) has doubled and cases of self-poisoning necessitating
hospital admission have trebled. The amphetamines are also widely prescribed.
and tolerance, psychological dependence and psychosis have become increasingly
recognised as a consequence of their excessive use. Misuse of intravenous methylamphetamine
(Methedrine) and related compounds carries with it the same risks of syringe-transmitted
infections as are associated with heroin. No similar hazards have been observed
to result from the use of cannabis.
We shall in due course be submitting a report on our study of L.S.D. and therefore
do not propose to deal with it at length here. Suffice it to say that L.S.D. and
other hallucinogens have for some while had a limited role in research and in
experimental psychiatry. It is only in the last few years that these drugs have
been used illicitly. It is still not easy to reach a clear assessment of their
effects and dangers in this context, and it is therefore extremely difficult to
make a clear comparison between them and cannabis. The subjective reports of those
taking hallucinogens, both in clinical and in illicit conditions. suggest a response
that is very much more intense. Under the influence of L.S.D. subjects may be
so dangerously deluded that serious, even fatal, accidents occur, but there are
no reliable reports of similar episodes among those who have taken cannabis alone.
Cannabis is often described as an "intoxicant" and frequently compared
with alcohol. Both produce relaxation and euphoria; both, taken in excess, impair
judgment, speed of reaction, and co-ordination. Cannabis more readily distorts
perception of time and space. Unlike alcohol, cannabis is not known to enhance
the effects of certain other drugs, induce a limited degree of tolerance or, over
the long term, cause physical damage to body tissues directly or by dietary deficiency.
Cannabis may well, however, be at least as dangerous as alcohol as an influence
on driving or other responsible activity. This sharpness of similarity and contrast
is considerably blurred by the effects of very different social settings. Alcohol
in our culture is in general use and not illegal. Cannabis is used by a minority,
and mostly against the law. Drinking patterns vary widely by country and by social
class. Though many drinkers, particularly those who can be regarded as alcoholics,
drink to get drunk, alcohol-users normally take a small amount, seeking only mild
effects and a little social relaxation. The patterns of cannabis-smoking are more
obscure. Experienced cannabis-users often smoke cannabis for a mild intoxication
that they feel will improve their performance in a particular social setting or
activity, e.g. playing jazz. Many smokers, however, take the drug in anticipation
of a few hours of intense mental elation without the aggressive impulses often
associated with taking large amounts of alcohol. All in all, it is impossible
to make out a firm case against cannabis as being potentially a greater personal
or social danger than alcohol. What can be said is that alcohol, with all its
problems, is in some sense the "devil we know"(1); cannabis, in Western
society, is still an unknown quantity.
Tobacco-smoking is, of course, the most widespread "drug-addiction"
in our society. The immediate effects are well known and substantially harmless.
Physical dependence does not appear to occur, but habituation is intense, and
people find great difficulty in giving up smoking. The long-term dangers of smoking
in inducing cancer of the lung, in exacerbating chronic bronchitis and in contributing
to coronary thrombosis are great. Nevertheless the danger that smoking may produce
lung cancer was for a long while not apparent. It is not possible to say that
long continued consumption, medically or for pleasure, of cannabis, or indeed
of any other substance of which we have not yet had long experience, is free from
To make a comparative evaluation between cannabis and other drugs is to venture
on highly subjective territory. The history of the assessments that have been
given to different drugs is a warning against any dogmatic judgment.
Tobacco was once the object of extreme judgments. In the 17th century
a number of countries attempted to restrict or forbid its use, but without success.
In 1606 Philip 111 of Spain issued a decree restricting its cultivation. In 1610
in Japan restrictions were issued against planting and smoking tobacco, and there
are records of at least 150 people apprehended in 1614 for buying and selling
it contrary to the Emperors command, who were in jeopardy of their lives.
At the same time, in Persia, violators of the laws which prohibited smoking were
tortured and in some cases beheaded. The Mogul Emperor of Hindustan noted "as
the smoking of tobacco has taken a very bad effect in health and mind of so many
persons I order that no person shall practice the habit". Smokers were to
have their lips slit. In 1634 the Czar of Russia forbade smoking, and ordered
both smokers and vendors to have their noses slit, and persistent violators to
be put to death. Medical reports of the period are full of accounts of its deleterious
effects on mental and physical health.
Even non-alcoholic beverages that are now in common use have, in their time, been
regarded as gravely dangerous. As late as the beginning of this century the Regius
Professor of Physic at Cambridge along with the most distinguished pharmacologist
of the time described in a standard medical textbook the effects of excessive
coffee consumption: "the sufferer is tremulous and loses his self-command,
he is subject to fits of agitation and depression. He has a haggard appearance....
As with other such agents. a renewed dose of the poison gives temporary relief.
but at the cost of future misery". Tea was no better. "Tea has appeared
to us to be especially efficient in producing nightmares with ... hallucinations
which may be alarming in their intensity.... Another peculiar quality of tea is
to produce a strange and extreme degree of physical depression. An hour or two
after breakfast at which tea has been taken . . . a grievous sinking ... may seize
upon a sufferer, so that to speak is an effort.... The speech may become weak
and vague.... By miseries such as these, the best years of life may be spoilt".
With such earlier judgments in mind we do not wish to make any formal or absolute
statement on a comparison of cannabis and the other drugs in common social use.
All we would wish to say is that the gradations of danger between consuming tea
and coffee at one end of the scale and injecting heroin intravenously at the other,
may not be permanently those which we now ascribe to particular drugs.
In 1996, 66,468 males and 4,031 females were convicted of offences of drunkenness