Easily the coolest college professor you could ever hope to have.

Every Wednesday on NORML SHOW LIVE, Dr. Mitch Earleywine joins us to discuss the latest research in cannabis and to take live calls and chat questions from listeners on marijuana culture, history, medicine, and science.  He is a member of the NORML Advisory Board and his research has been published in over fifty scientific journals on drugs and addiction.  He is the author of Understanding Marijuana, Pot Politics, and Parents’ Guide to Marijuana, and a professor of psychology at SUNY Albany.  We asked Dr. Mitch his opinions of the latest meta-analysis on cannabis and schizophrenia.

Download full interview at http://audio.norml.org/events/Dr. Mitch Earleywine – Latest Cannabis Psychoses Bunk.mp3

NORML SHOW LIVE: The headlines are out there – CNN, WebMD, NPR, every little bit of alphabet soup out there on the cable channels and the news – is trumpeting this headline, this study – Matthew Large, I believe, is the lead researcher on this – from Prince of Wales Hospital in New South Wales Australia says quote:

“It is increasingly clear that marijuana is a cause of schizophrenia and that schizophrenia caused by cannabis starts earlier than schizophrenia with other causes.”

DR. MITCH EARLEYWINE:  Alas, no.  There are no new data – I want to emphasize that – this is a meta-analysis, which means it takes the studies that were already out there and tries to combine them mathematically to make sense of it all.  What you’re not hearing in the media is that in fact, this is probably early-onset folks self-medicating.

You can imagine somebody who is experiencing some symptoms of psychosis, particularly folks with less access to medical care, or folks who are already a little bit paranoid because of the disorder and they’re unwilling to go to a physician.  They hear their friends are using cannabis and enjoying it.  They do it, too, they notice some mild improvements in their symptoms, they turn to it later when they have a psychotic break.   What a surprise, [the researchers] say, “they smoked cannabis first, that’s the big issue.”

What burns my ass is that this same journal a month before had another article failing to replicate this data where we find folks with a special genetic risk and if they’re heavily involved with cannabis early in life they’re more likely to develop schizophrenia.  So all this malarkey about, “oh, if you’re a genetic risk then you’re really gonna get it” isn’t showing up in other data sets.  The media isn’t covering that in the least.

The other finding in this big meta-analysis is that early onset of psychosis showed up for folks who were using drugs more generally – not just cannabis – and this makes much more sense pharmacologically.  When you think about cocaine, amphetamine, and other drugs that work directly in the dopamine system, that’s the system that schizophrenia is all about.  And what a surprise, these folks are more likely to have an early onset.

I’m concerned that the cannabis-related studies are really spurious and they’re compounded by  use of amphetamines, Ritalin, Adderall, all these other stimulant drugs that people were – particularly in Australia – unwilling to fess up to, but more than willing to say they used cannabis.  We’ve got a big problem here.

As we’ve seen time and again none of us want children to have access to cannabis. And the way to get that access limited is, of course, not an underground market that never cards anybody, but a taxed and regulated one, where folks that are too young to be experimenting with this and folks who have psychosis in the family can be markedly more advised and essentially educated before they even purchase the plant.

NSL: Matthew Large, this researcher here, even addressed what we just discussed about the self-medication; he said, quote:

“There is not so much evidence for the widely-held view those patients self-medicate with marijuana.  Marijuana smoking almost always comes before psychosis and few patients with psychosis start smoking marijuana for the first time.”

Is this a case then where they’re just defining psychosis as their starting point of looking at these people rather than the onset of symptoms that would pre-date or pre-sage the psychosis that’s about to come?

DR. MITCH: That’s it exactly, Russ, and as we’ve mentioned in the past what often happens is they find a big record of people who’ve had psychotic breaks and then go back and see if they’ve reported cannabis earlier.  But we have very poor assessments of these potential psychotic symptoms before these people used cannabis and the few studies that do do that, the measures are slightly biased against cannabis users.

I’ve pointed out in the past one of the big questionnaires for this – a schizotypal personality questionnaire – has an item that says “I use words in strange and unusual ways.” Well, sure, schizophrenics certainly do that.  They make words up; that’s part of the way that you manifest the diagnosis.  But we also have a whole subculture here where people are “kickin’ back with the chronic at 420.”  Well, what a surprise, people who do that may say “I use words in a strange and unusual ways.”  In my dataset when you drop that item out, suddenly the link between schizotypy and cannabis use disappears. I’m concerned there are comparable problems in these other datasets.

NSL: One of the things we’ve always said in these pieces with you and I talking about this is how worldwide the rates of schizophrenia and psychosis seemed to stay stable at about 1% of the population, even if that population starts smoking a whole lot of weed – if a lot of them start smoking or if they start smoking a lot of it – doesn’t matter is still stays the same.

But one of the hypotheses they have here is that, “Yeah, sure, there’s a certain 1% that are gonna get psychosis but these 1% are gonna get it earlier and then they’d have these extra two or three years of psychosis-free functioning that they would be losing out of because of their use of marijuana.”

My first thought on that is if this were the case, wouldn’t we see a lowering of the median age of psychosis onset when we have higher use of cannabis in a society?

DR. MITCH: In fact, Wayne Hall in Australia has made this same suggestion and they have yet to detect this change in the median age of first onset. But he’s suggesting that some new data are going to reveal that in the current younger cohort, this is the case.  I haven’t seen those data yet and I’m a little concerned.  In part we go to so much effort now to try to identify psychosis earlier that it seems like if that is the case, it may be simply that we are better at identifying psychotic disorders than we were 20 years ago, so we have this other potential confound.  And as Paul [Armentano] has emphasized time and again, we do have a subset of folks who really respond well to cannabis-based medicines in controlling psychotic episodes, and I think it may be a cannabidiol issue where Project CBD may be able to help us isolate who might be helped and who might not from this.

And then, of course, that fits that self-medication hypothesis better.  I feel like the critique of that self-medication that they offer in this meta-analysis is premature, in part because of how poorly we assess psychotic symptoms prior to anyone’s cannabis use.

NSL: What is the actual risk to people who have a history of mental illness or who feel they may have a certain mental illness and how they should entertain the notion of using cannabis to treat themselves?

DR. MITCH: In fact, cannabis is rarely my first choice for any of the more common mental illnesses. So we’ve talked before about depression, anxiety, and PTSD.  With depression, cannabis may help a subset of folks.  A number of my friends who’re in clinical practice say that the people who are using it are having more troubles in their practice.  But that may be a different subset.

But my first line of defense – it really sounds corny – but kind of a bibliotherapy.  Educate yourself about depression. If you have a mental health center that you appreciate, 12 weeks of good hard work, of taking a look at your own faults, how you behave during the day, the way you frame the events in your life; that can last a lifetime in the treatment of depression.  And then cannabis is just to enjoy, not something you have to lean on in order to make sure you have a happy day.

With anxiety, I’ve done this both on Facebook to some of our friends and repeatedly in emails and my published work.  Anxiety is one of the psychological disorders that psychology really has mastered. If folks again are willing to go see a therapist for a good couple of months and really put some effort in, you can literally tame this kind of thing and make it so anxiety is no longer debilitating, and then suddenly your cannabis again is just for fun.  The idea that cannabis is actually going to help anxiety is very dose-dependent, very strain-dependent, and not the most efficient way to get at this.

PTSD, I just got those new data on that.  A ton of people think that cannabis helps some of the symptoms of PTSD.  I completely believe them.  But compared to these exposure-based treatments – which I know are a drag – [cannabis] is not going to last a lifetime the way that that kind of treatment can, and then again cannabis is just for fun.  It doesn’t have to be for medication and you’re less likely to have these lingering symptoms of the emotional numbing, the distancing from your family, or these kind of freaking-out experiences when you’re in a big crowd.  And then, what a surprise, you basically worked hard for three months and kicked this disorder rather than felt like “I have to lean on cannabis for the rest of my life.”

Such is the case with a pair of just-published studies slated to appear in the journal Schizophrenia Research. The first study, conducted by a team of researchers at various New York state hospitals, the Yale University School of Medicine, and the National Institutes of Mental Health assessed whether there exists a causal association between cannabis use and the age of onset of psychosis in patients hospitalized for the first time for an episode of schizophrenia.

Despite previous media claims to the contrary, researchers concluded:
“Although the onset of cannabis use disorder preceded the onset of illness in most patients, our findings suggest that age at onset of psychosis was not associated with cannabis use disorders. Previous studies implicating cannabis use disorders in schizophrenia may need to more comprehensively assess the relationship between cannabis use disorders and schizophrenia, and take into account the additional variables that we found associated with cannabis use disorders.”

A separate study slated for publication in the same journal assessed the cognitive skills of schizophrenic patients with a history of cannabis use compared to non-users. Authors reported that patients with a history of marijuana use “demonstrated significantly better performance on measures of processing speed, verbal fluency, and verbal learning and memory” compared to abstainers. Marijuana use was also associated with better overall GAF (Global Assessment of Functioning) scores compared to those of non-users.

Authors concluded: “The results of the present analysis suggest that (cannabis use) in patients with SZ (schizophrenia) is associated with better performance on measures of processing speed and verbal skills. These data are consistent with prior reports indicating that SZ patients with a history of CUD (cannabis use disorders) have less severe cognitive deficits than SZ patients without comorbid CUD. … The present findings also suggest that CUD in patients with SZ may not differentially affect the severity of illness as measured by clinical symptomatology.”

Both study’s findings are in line with previous (though virtually unreported) research indicating that marijuana is unlikely to instigate incidences of schizophrenia in the general population, that cannabis use among patients with the disease is associated with higher cognitive function, and that at least some schizophrenics find subjective relief from symptoms of the illness by using pot. Nonetheless, odds are the nobody from the mainstream media will be champing at the bit to report on them.

Bottom line: marijuana’s complex relationship with schizophrenia is far from understood, and likely won’t be for some time. But that doesn’t give the MSM a free pass to only promote one side of the story.

To add insult to injury, this latest dose of reefer rhetoric comes only days after investigators in the United Kingdom reported in the prestigious scientific journal Addiction that the available evidence in support of this theory is “neither very new, nor by normal criteria, particularly compelling.” (Predictably, the conclusions of that study went all together unnoticed by the mainstream press.)

Yet today’s latest alarmist report, like those studies touting similar claims before it, fails to account for the following: If, as the authors of this latest study suggest, cannabis use is a cause of mental illness (and schizophrenia in particular), then why have diagnosed incidences of schizophrenia not paralleled rising trends in cannabis use over time?

In fact, it was only in September when investigators at the Keele University Medical School in Britain smashed the pot = schizophrenia theory to smithereens. Writing in the journal Schizophrenia Research, the team compared trends in marijuana use and incidences of schizophrenia in the United Kingdom from 1996 to 2005. Researchers reported that the “incidence and prevalence of schizophrenia and psychoses were either stable or declining” during this period, even the use of cannabis among the general population was rising.

That said, none of this is to suggest that there may not be some association between marijuana use and certain psychiatric ailments. Cannabis use can correlate with mental illness for many reasons. People often turn to cannabis to alleviate the symptoms of distress. One study performed in Germany showed that cannabis offsets certain cognitive declines in schizophrenic patients. Another study demonstrated that psychotic symptoms predict later use of cannabis, suggesting that people might turn to the plant for help rather than become ill after use.

Of course, even if one takes the MSM’s latest ‘sky is falling’ scenario at face value, health risks connected with pot use — when scientifically documented — should not be seen as legitimate reasons for criminal prohibition, but instead, as reasons for the plant’s legal regulation.

For instance, as I told AOL News earlier today: “We don’t outlaw peanuts because a small percentage of people have allergic reactions. We educate the community, we regulate where and when peanuts can be exchanged. That seems like it ought to apply to marijuana, too.”

To draw another real world comparison, millions of Americans safely use ibuprofen as an effective pain reliever. However, among a minority of the population who suffer from liver and kidney problems, ibuprofen presents a legitimate and substantial health risk. However, this fact no more calls for the criminalization of ibuprofen among adults than do these latest anti-pot allegations, even if true, call for the current prohibition of cannabis.

Placed in this context, today’s warnings latest do little to advance the government’s position in favor of tightening prohibition, and provide ample ammunition to wage for its repeal.

Clinical evidence indicating that marijuana use may be casually linked to incidences of schizophrenia or other psychological harms is not compelling, according to a scientific review published online by the journal Addiction.

Investigators at the University of Bristol, Department of Social Medicine assessed the potential health risks of cannabis, particularly whether use of the drug may be causally linked with mental illness.

Authors wrote: “We continue to take the view that the evidence that cannabis use causes schizophrenia is neither very new, nor by normal criteria, particularly compelling. … For example, our recent modeling suggests that we would need to prevent between 3000 and 5000 cases of heavy cannabis use among young men and women to prevent one case of schizophrenia, and that four or five times more young people would need to avoid light cannabis use to prevent a single schizophrenia case. … We conclude that the strongest evidence of a possible causal relation between cannabis use and schizophrenia emerged more than 20 years ago and that the strength of more recent evidence may have been overstated.”

In 2007, an analysis in the British medical journal The Lancet estimated that experimenting with marijuana could increase one’s risk of developing a psychotic illness later in life by some 40 percent. Following this report, Parliament in 2008 voted to reclassify marijuana as a Class B substance, making its possession punishable by up to five years in prison.

University of Bristol researchers also criticized Parliament’s reclassification of the drug, which took effect earlier this year. They concluded: “The only important possible benefit of prohibition is prevention of cannabis use. There is little or no evidence that it effectively achieves this benefit. Patterns of cannabis use in the population appear to be independent of the policy surrounding use, and criminalizing individual cannabis users does not appear to modify their use in a healthy way.”

Overall, investigators determined that marijuana’s most significant health risk was its association and reinforcement with tobacco smoking.

Doubt cast on cannabis, schizophrenia link
via CBC

A British study has cast doubt on the supposed link between cannabis use and schizophrenia.

… This latest study, led by Dr. Martin Frisher of Keele University, examined the records of 600,000 patients aged between 16 and 44.

… Frisher and colleagues compared the trends of cannabis use with general practitioner records of schizophrenia and psychosis.

They argue that if cannabis use does cause schizophrenia, an increase in cannabis use should be followed by an increase in the incidence of schizophrenia.

According to the study, cannabis use in the United Kingdom between 1972 and 2002 has increased four-fold in the general population, and 18-fold among under-18s.

Based on the literature supporting the link, the authors argue that this should be followed by an increase in schizophrenia incidence of 29 per cent between 1990 and 2010.

But the researchers found no increase in the rates of schizophrenia and psychosis diagnosis during that period. In fact, some of the data suggested the incidence of these conditions had decreased.

Over the past few years the mainstream media, as well as federal politicians, have enjoyed promoting the notion that smoking pot induces mental illness. Perhaps most notably, in 2007 the MSM touted that cannabis “could boost the risk of developing a psychotic illness later in life by about 40 percent” — a talking point that was also publicly promoted US anti-drug officials. Similarly, Canadian bureaucrats alleged — just two weeks ago — that marijuana users have a “seven-fold increase” in risk of developing schizophrenia.

Given this environment, I held little hope that anyone in the MSM would bother to report on the Keele University study — which initially appeared online on the website of the journal Schizophrenia Research in late June and was reported on by NORML on July 2 — despite its obvious newsworthiness.

And for nearly two months no one did. But kudos to the Australian Broadcasting Corporation and a handful of British tabloids for just now bringing these findings to light (and even acknowledging that the MSM would have arguably provided far more prominence to this story had the findings demonstrated the opposite result.)

For now, let’s score one for the good guys, and cross your fingers that the American press will also eventually take notice.

Most notably perhaps, a team of researchers writing in the July 28, 2007 edition of the prestigious scientific journal The Lancet, boldly proclaimed that smoking cannabis could boost one’s risk of a psychotic episode by 40 percent or more.

Naturally, this alarmist rhetoric received wall-to-wall coverage by the mainstream press. Even more troubling, the supposed ‘pot-and-schizophrenia’ link was one of the primary reasons cited by British PM Gordon Brown, ex-Home Secretary Jacqui Smith and others as the impetus for reclassifying cannabis (from a verbal warning to a criminal offense punishable by up to five years in jail) in the United Kingdom.

Of course, there was a fatal flaw with The Lancet‘s argument — one that, oddly enough, every single MSM outlet failed to mention. Empirical data did not support the investigators’ hypothesis that smoking marijuana was associated with increased rates of schizophrenia or other mental illnesses among the general public — a fact that even the authors begrudgingly admitted when they declared, “Projected trends for schizophrenia incidence have not paralleled trends in cannabis use over time.”

Which brings us to 2009.

Two years after The Lancet‘s dire predictions, a team of researchers at the Keele University Medical School have once and for all put the ‘pot-and-mental illness’ claims to the test. Writing in a forthcoming edition of the scientific journal Schizophrenia Research, they compare long-term trends in marijuana use and incidences of schizophrenia and/or psychoses in the United Kingdom. And what do they find?

“[T]he expected rise in diagnoses of schizophrenia and psychoses did not occur over a 10 year period. This study does not therefore support the specific causal link between cannabis use and incidence of psychotic disorders. … This concurs with other reports indicating that increases in population cannabis use have not been followed by increases in psychotic incidence.”

Should we expect an apology — or even better, a change in policy — from the Gordon Brown regime any time soon? Or at the very least, will some sort of ‘correction’ be forthcoming from the mainstream news media?

I wouldn’t hold my breath.

Just last week, NORML reported on a BBC television reporter’s absurd ‘documentary’ that purportedly showed the “dramatic” and “unpleasant” effects of marijuana by injecting herself with pure THC on film-a manner of administering cannabis that no recreational user would ever engage in.

With this in mind, we were hardly surprised to see this recent headline from across the Atlantic: Cannabis-smoking mum stabbed herself to death. Never mind that she was on meth and thought her dog was talking to her.

Excerpts after the jump.

A mother driven insane by cannabis stabbed herself repeatedly through the chest with a carving knife after claiming she was spoken to by a dog.

Julie Cross told friends the animal was “trying to tell her something” before picking up the 5in blade and ramming it at least five times into her chest and abdomen.

An inquest was told the former receptionist, from Goring, used speed and cannabis on a daily basis and in the weeks running up to her death had slashed her wrists and smeared her blood across a crucifix and also hung a noose from her attic.

Katie Leason, spokeswoman for mental health charity Rethink, said the case further proved that cannabis causes severe mental illness. “We don’t believe there is any doubt about it now. There is a proven link between the drug and psychosis,” said Ms Leason….

It had led to her spending much of her last year in and out of the Mill View psychiatric hospital. The inquest heard that during what was described as a “very difficult life” Miss Cross had made repeated attempts on her own life, starting at the age of 14.

So here we have a woman who regularly heard voices, had a history of suicide attempts since childhood, who was using methamphetamine regularly (mentioned only ONCE in the article), and who finally, tragically, killed herself. To the British press, this scenario is clear evidence that marijuana will make you commit suicide!

And these are not the only ‘pot will make you nuts’ headlines coming from the UK. Note these other recent headlines and leads, the first of which is from the same publication as the above story:

Cannabis drove Brighton man to kill himself
The Argus (UK), February 22, 2008
“A web designer killed himself after being driven mad by cannabis.”

Cannabis users risk their sanity
Oxford Mail (UK), March 5, 2008
“Oxfordshire’s top drugs officer said the county is on the verge of a mental
health epidemic unless more is done to tackle cannabis abuse.”

Children as young as 10 on cannabis
Daily Post (UK), February 9, 2008

Hmm, so pot will drive us mad, target our children, and make us kill ourselves. Where have I heard this before?

For readers on this side of the pond who have not followed this story, “skunk” is the slang term British prohibitionists have chosen in their attempt to rebrand cannabis as this millennium’s most dangerous drug. (US authorities executed a similar game plan in the early 1900s when they successfully outlawed hemp by rebranding it “marijuana”.) For years now, British police and news reporters have blamed everything from psychosis and suicide to criminal acts like rape and murder on the after-effects of smoking “skunk,” aka allegedly super-potent pot.

Never mind that a recent study reported that so-called “skunk” only comprises a minute fraction of the UK’s marijuana market.

Never mind that teen use of cannabis in Great Britain recently fell to a record low.

Never mind that a legal pill containing 100 percent THC is available by a doctor’s prescription and that its side-effects do not include psychosis, suicide, rape, or murder.

And, most importantly, never mind that — to date — nobody in Britain or anywhere else on the planet is actually “injecting” the “main ingredient” in “skunk” (which, of course, is THC). Let’s not let facts get in the way of a good horror tale.

Of course, this pseudo-documentary — along with the recent rash of alarmist headlines — is all part of a concerted effort to push through PM Gordon Brown’s ill-conceived plan to recriminalize minor pot possession. And there’s no chance of government officials letting truth get in the way of that.