So, who is paying the price? Everyone, but no more devastatingly than our emerging generation!
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“We do need to worry about young people”: Doctors reveal surge in psychosis linked to cannabis
The number of Scots suffering mental illness linked to cannabis has surged since use of the drug was effectively decriminalised.
Figures reveal the number of users being hospitalised because of psychiatric issues has climbed by 74% since 2016 when police began warning those caught with the drug for their own use.
The admissions data has prompted experts to call for a reassessment of the risks posed by cannabis in comparison to Class A drugs and alcohol and urgent action to bolster support for users trying to give up.
Professor Jonathan Chick, medical director of a world-leading rehab clinic in the Borders, said the figures confirmed his experience, adding: “The eye has been taken off the ball with cannabis. We do need to worry about the numbers of young people presenting with psychosis and schizophrenia because of it.”
In January 2016, Police Scotland changed the guidance to officers, advising that simple possession of cannabis could be dealt with using a warning rather than a report to the Fiscal and possible prosecution.
Comparing the data from 2015/16 to the latest figures reveals the number of prosecutions has more than halved from 1,809 to 877 in 2019/20. However, drug-related hospital stays due to mental or behavioural problems linked to cannabis use rose by 74% from 1,191 to 2,067 last year. And in 2020/21, a record 1,263 new patients sought hospital treatment for a range of psychiatric disorders blamed on the drug, including schizophrenia.
A recent report by Public Health Scotland states: “There has been a notable increase in the percentage of [psychiatric hospital] stays attributed to cannabinoids in recent years, increasing from 9% in 2014/15 to 18% in 2019/20.”
He said: “We’re dealing with both dependence and psychosis. Often, where there has been a second or third psychotic breakdown, there has been hospital or police involvement because of incidents of self-harm or harm to others. These patients have terrifying thoughts.
“It is a paranoid psychosis where they can’t even go into the street without misinterpreting thoroughly innocuous cues as malevolent. It is a horrible experience.
“In some cases, people have used cannabis for 20 years and got by up till that point, but, typically, psychosis will occur within the first three to four years.
“Sometimes the damage is permanent in which case the treatment for schizophrenia involves living and working in safer environments and medication – though there is no medication that doesn’t come without effects such as weight increase, mental slowing and involuntary movements.”
Researchers in the US have bolstered the link between cannabis and mental illness. Recent analysis by McLean Hospital, Massachusetts, found that admissions due to cannabis-associated psychosis are up to 2.5 times higher in parts of the country where the drug has been legalised.
Meanwhile, Harvard Medical School studied 246 new psychosis patients aged 16-35 and discovered that a total of 78% had used cannabis. In all, 47% were currently or had been dependent on the drug – compared with 5% in the general young population.
The onset of the damage caused by cannabis was often swift. The typical age of first use was 15 with symptoms appearing between 17 and 19 and psychosis setting in between 19 and 21.
Annemarie Ward, chief executive of the charity Faces & Voices of Recovery, said: “We’re still in the grip of this really worrying narrative that cannabis is about peace, love and opening your mind with no harm done. In fact, the current type is addictive and psychoactive with horrendous consequences.
“The cannabis myth has to be challenged but the preventive messages to children and young people are not loud or clear.
“Every warning handed out should come with a referral to a local drugs centre where that person is assessed and given help where it’s needed – before it ever gets to the stage where they have to be admitted to hospital.”
CBD is another – though this is far more benign, the one that is the focus of medicinal cannabis. However, research shows that THC damages the crucial links between brain cells.
These bridges in the brain’s neural network are burnt temporarily, potentially causing the classic hallmarks of psychotic episodes: hallucinations, delusions and voices in one’s head. But, over time, the damage can become permanent and the spells of detachment from the real world longer-lasting and more frequent.
Last year, German research also found a link with lung cancer, separate to the risk posed by tobacco smoke. Munich’s Ludwig-Maximilian University looked at those with a genetic liability to lifetime cannabis use and found that their risk of developing squamous cell carcinoma is 22% higher.
Police Scotland Chief Inspector Anton Stephenson said: “Recorded police warnings in cases involving a single charge of possession of a controlled drug gives officers another tool to support those at risk of becoming vulnerable in our communities.
Issuing such a warning is not the only option available to officers dealing with people in these circumstances and officers can use their discretion to determine the best course of action.”
He added: “Our advice is simple: there is no safe way to take drugs, there is always a risk, and the only way of staying safe is to avoid drugs altogether.”
My happy, lovely son is gone. We only have a shell of him now and my heart is breaking
Alexander was 12 when he first smoked cannabis and by the time he was 14 he was undergoing psychiatric care after suffering hallucinations and threatening to kill
His descent into serious mental illness came after he was first given the drug by friends, before buying it online from dealers and eventually selling it himself to fund his own habit.
Today, Alexander is 19, does not have the capacity to live alone and probably never will, says his mother. “He is so damaged by cannabis that he will not likely hold down a job, get married, drive a car or live independently and will miss out on all the lovely life events most of us will take for granted,” she said.
“Before he started smoking cannabis he was very keen on sports at school and would go running and swimming with his brothers.
“But within a few months of smoking cannabis he had become secretive, would go out as soon as he came home from school, spent a lot of time in his room and became isolated from us all.
“The happy son who had been open and sharing became a recluse, hiding a drugs habit from me.
“I discovered it all by finding drugs in his schoolbag and confronted him with it. Of course, he promised to give it up but only became more secretive and I could still smell it on him, and his behaviour worsened.”
It was only when Michelle, who lives in the Central Belt, accessed his social media accounts that she realised how bad his habit was.
“He was selling the drug to others so he could afford to buy it for himself. When he didn’t smoke cannabis or skunk, he would buy powerful cannabis oil to get the same or a stronger effect, which I feel triggered the psychosis,” she added.
“Alexander was so disturbed and psychotic at times he would think the dog was speaking to him. It all got too much when he wakened me one night threatening me with a glass. I had reached the end of coping with this on my own.”
Attempts to seek help from the family GP only resulted in assurances that many teenagers dabble in drugs but that it rarely led to long-lasting problems. “I could not get anyone to take us seriously and in desperation went to A&E at hospital where the consultant confirmed my son was mentally ill and needed to be admitted – sectioned under the Mental Health Act.
“After he was sectioned he spent almost two years in a psychiatric unit where he underwent drug treatment for psychosis. I visited him every day because it was so important to let him know we still cared for and loved him – and always would.”
“Alexander left hospital during the first wave of the Covid pandemic and has been living at home since, totally dependent on his family.
“When I asked the police to investigate the amount of drugs sold online they refused, and only seemed interest in what we all might think as bigger drugs. The son I had has gone, dead, killed by cannabis. He has been replaced by a shell and my heart breaks for him.”
Names have been changed.
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Communications Team - Dalgarno Institute