'Cannabis Abuse': Causation or Correlation?

‘Cannabis Abuse’: Causation or Correlation?

A new study from Columbia University has attracted a great deal of press coverage in the past week. Published in the journal JAMA Psychiatry and authored by Carlos Blanco, MD, PhD, et al, you would be forgiven for thinking it was actually two separate studies, given the way in which it has been reported.

The reason for this is that the study looked at two different outcomes related to cannabis use, and made two distinct conclusions. In doing so, it highlighted brilliantly the biases and agendas of the news outlets who covered it.

On the one hand, there were the scare stories. These focussed on the finding of the study that is indeed cause for some concern – that cannabis users are more likely to abuse other substances, most notably alcohol, in later life. Naturally enough, many have been quick to conclude that since the statistics don’t lie, it must be the case that cannabis causes alcoholism.

It’s an example of a problem that has plagued research (or rather, interpretation of research) into cannabis for decades – the problem of causation vs. correlation.

The simplest way of interpreting the results of the study is to presume causation, but a more nuanced and thoughtful analysis provides serious food for thought. To do this means taking a look at the wider issue of addiction.

It is well established that as much as 90% of all drug use is non-problematic, meaning that it is not classed as ‘abuse’, and does not cause any real harm to the user. It is also well established that if someone is prone to an addiction of one kind, they are more likely to become addicted to, and to abuse, something else. In this context it is hardly surprising to hear that there are a certain number of cannabis users who will develop an addiction to alcohol, because we already know that there are a certain number of cannabis users who develop an addiction to cannabis.

Which brings us on to the other point about addiction. Many scientists and so-called experts will tell you that addiction is a ‘brain disease’, but this is wrong. It’s far better to view addiction as a symptom of a far wider problem.

Consider this: If you’ve suffered childhood trauma, you’re 4600% more likely to become an injecting drug user than if you haven’t. What this tells us is that addiction isn’t about the drug, it’s about the individual. Most addicts are using drugs to protect themselves from the pain of a childhood trauma, and treating them as ‘diseased’ instead of looking at, and treating, the underlying causes of addiction which pervade the whole of society, is treating the symptom rather than the cause. It’s marginally better than locking them up, but it still places the blame at the feet of the drugs themselves, and suggests that getting rid of drugs would get rid of the problem.

So despite much hand-wringing at the prospect of legalised cannabis leading to a surge in alcoholism, there is no need to panic. The statistics may not lie, but they don’t tell the whole story of addiction.

The second finding of the study, which was reported on more enthusiastically by supporters of reform and, bizarrely, the Daily Mail, was that contrary to popular belief, cannabis use does not increase your chances of mental health problems in later life.

There’s not much to say on this issue that hasn’t already been said, other than that those who reported it without mentioning the apparently negative findings of the study, are just as guilty of cherry picking as those who only mentioned the negatives. Or at least almost as bad, since those who led with ‘cannabis causes alcoholism’ failed to point out the apparent contradiction in reporting ‘proof’ of a causal link between cannabis use and what they consider a ‘brain disease’, and the part of the study which concluded that cannabis use doesn’t lead to mental ill-health.

Study Reveals New Findings Concerning Cannabis and IQ

Study Reveals New Findings Concerning Cannabis and IQ

One of the most prevalent cliches and stereotypes cannabis users get labelled with is that they’re stupid. That they’re less intelligent than the general population. “It’s called dope for a reason”, detractors often say, “smoking dope will make you dopey”.

Back in July 2012, a study was published in the scientific journal Proceedings of the National Academy of Sciences of the United States of America which seemed to back up those claims.

Researchers followed individuals from the age of 13 to 38, performing a series of interviews in which they asked participants about their use of cannabis, and used IQ tests to determine the level of ‘intelligence’ of those people who had been regular cannabis users, both before and after the onset of use. They found that in 5% of those participants, their use of cannabis seemed to have had a negative effect on their scores. The results suggested that the heaviest users could lose as many as 8 IQ points.

Newspaper reports at the time were typically hyperbolic, with the Telegraph declaring that “Teenagers who regularly smoke cannabis are putting themselves at risk of permanently damaging their intelligence”. Even as recently as last year, articles were still appearing in widely-read publications, using this research as proof of the claim that cannabis makes you stupid.

In February 2015, Forbes ran an article which reiterated the claims of the Telegraph, and warned that adolescent use of cannabis, by lowering IQ, would not only make you stupid, but poor as well – “…individuals with an IQ of 110 have an average net worth of $71,000 and individuals with an IQ of 120 have an average net worth of $128,000. It looks like smoking pot can lower your tax bracket.”, they claimed.

What’s interesting is that even before the Forbes article, other researchers had already begun to question the validity of the conclusions drawn by the original study. In August 2012 (just one month after the study was published) Time Magazine interviewed Dr Carl Hart, associate professor of psychology at Columbia University, as part of an article on the subject. Already, he was doubtful. He pointed out that “when you compare these people’s scores to a normative database on a wide range of domains including executive function, memory and inhibitory control, they score dead smack in the middle, in the 50th percentile.”

There were also questions as to why the original study did not include data on whether the participants were employed, and whether they were able to function normally in their families and in society – factors which are important to give context to the study and to show whether the apparent drop in IQ had real-world implications.

“There are also other factors”, Time pointed out “such as child abuse or other trauma — that might lead people to seek escape in heavy marijuana use and could also affect brain function.” These factors were not examined by the authors of the study.

So, as usual, opinions varied. Now though, there has been a fresh look at the issue. Published in the Journal of Psychopharmacology, this new study took essentially the same approach as the one published in 2012, but with a few key differences. Firstly, the sample size was larger – 2,235 compared to 1,037. The participants had also taken an IQ test at age 8, 5 years before those in the original study and, importantly, before any of them had tried cannabis.

The initial findings seemed to reinforce those published in 2012 – those teenagers who had used cannabis even infrequently scored lower on subsequent IQ tests than was predicted by their score at age 8. They even performed worse in their GCSEs. Crucially though, the research team didn’t stop there. They went back to the data and examined factors other than cannabis use. Once they had statistically adjusted their findings to account for differences such as alcohol use, tobacco use, childhood behavioural problems, and mental health symptoms, cannabis use no longer predicted lower IQ scores. It would appear, then, that cannabis use doesn’t make you stupid after all.

It’s worth pointing out though, that whilst the new study improves on the first in key areas, it also has its own limitations. The subjects of the first study were followed up well into their 30s, where this one only had data on its subjects up to the age of 16. So it could be that the decline in IQ starts later in life, although this seems unlikely.

It’s also clear that a drop in IQ did take place, even if that drop can’t be attributed to cannabis use alone. This study does not attempt to provide an answer as to why that is the case, and should not be taken as proof of anything. As we have seen, one of science’s greatest strengths is its ability to review and re-examine, and we could be back here in another 4 years looking at another study with more concrete conclusions, be they similar or completely different to those drawn by this one.

There is one thing that definitely can be taken from this new research, though, and it was elucidated perfectly by Claire Mokrysz, a PhD student at University College London who was involved in this study. Writing for the Guardian last week in the wake of the results being published, she said:

“Our study is by no means definitive, but it does highlight that we should all be more cautious when jumping to conclusions about the harms of a drug before we have strong evidence either way. Overly forceful conclusions about the potential negative effects of cannabis are unscientific and based on an incomplete evidence base. This can lead to the unfair marginalisation of teenagers who use cannabis, which is the last thing we would want, given that this group is likely to include some of the most vulnerable in society.”

French Drug Trial: A Tragedy We Can All Learn From

French Drug Trial: A Tragedy We Can All Learn From

Late this morning reports began to surface of a tragedy in France. A drug trial in Rennes had gone horribly wrong, leaving at least one person in a coma and others in critical condition. Some reports suggested one person had died. The drug in question remains unknown, as do pretty much all of the details of the incident, although a press conference has been scheduled for 16:30 local time.

Despite the lack of any solid evidence and the number of wildly differing claims swirling around the internet in the immediate aftermath of this story breaking, all of the mainstream media reports had one thing in common. They had all latched onto one apparently key factor – that the drug being trialled was a cannabis-based analgesic.

As it turned out, it wasn’t long before the French Health Ministry stepped in to debunk this claim. Unsurprisingly to anyone with even the most basic knowledge of cannabis and cannabinoids, whatever this drug was that had such disastrous effects, it wasn’t cannabis-based.

It’s not yet clear where or how this rumour started, but the speed with which it was picked up and presumed to be true was staggering. Especially when you start to dig a little deeper behind the headlines and translate the statement, given by the Ministry of Social Affairs, which brought the story to the media’s attention. Here it is in full:

“The minister responsible for social affairs, health and rights of women was informed last night of a serious accident during the carrying out of a phase one clinical trial of an orally administered medicine in the process of being developed by a European laboratory.

This trial had been carried out in an authorised private establishment which specialises in clinical trials, with the aim of evaluating the safe use, tolerance, and pharmacological profile of this substance on healthy volunteers.

This accident resulted in the hospitalisation of six of the volunteers at the University Hospital of Rennes. One of them is in intensive care, and is brain dead.

The company informed the Agence française de sécurité sanitaire des produits de santé (MSNA) of the interruption of the trial and currently is recalling all the volunteers who participated.

The MSNA has decided to conduct a technical inspection of the site of these clinical trials. As soon as she was informed, Marisol Touraine, Minister of Social Affairs, Health and Women’s Rights, took the General Inspectorate of Social Affairs (IGAS) to conduct an inspection of the organisation, means, and the conditions of intervention of this institution in the realisation of the clinical trial.

Marisol Touraine wants to share with the families of patients her solidarity and her deep determination to get to the bottom and establish all responsibilities in this tragic accident. She will travel to Rennes today; she will hold a press briefing.”

As you can clearly see, there is no mention of cannabis, and certainly not of the drug being cannabis-based. And yet the media, in the UK at least, seized on this unsubstantiated rumour and turned it into a headline that was soon being shared worldwide.

What can be learnt from this? Firstly, those responsible for such irresponsible headlines should take a long, hard look at themselves. Professional journalists should know better than to take rumours at face value. They should have reported the facts about the tragedy that was unfolding and left the speculation to those not in a position of influence.

In fairness to those media outlets and journalists, the references to cannabis in their articles were quickly discarded following the Health Ministry’s rebuttal. However, they should never have been there in the first place. Rather than turning this into yet another cannabis scare story, they should have focussed on the real questions raised by accidents such as this – Why do these appalling events occur? And what can be done to prevent them happening again? Ben Goldacre, ever a source of enviable clarity on these matters, spelt these issues out in a tweet referencing a passage from his book Bad Pharma.

What of the rest of us? What can we learn? Well, for one, we should also be heeding Dr. Goldacre’s words. Clinical trials are necessary, and whilst undeniably risky, those risks can and should be minimised. But perhaps just as importantly, if we are to take one thing away from this episode, it should be this: If the media are reporting on a breaking story, especially one that is science-related, it is never safe to presume that they’ve got it right. That goes for every media outlet. From the BBC, to the Guardian, to Russia Today and even Cannabusiness. We’re all fallible. We shouldn’t be, but we are.

We don’t yet have all of the facts in this case, but the eagerness with which certain sources leapt to implicate cannabis threatened to turn this story away from the human tragedy and scientific embarrassment that it is, and turn it into an anti-cannabis scare story with which to beat legalisation advocates.

Hopefully, now that the Health Ministry has refuted those cannabis-based claims, and with the full press conference scheduled for this afternoon, the memory of those headlines will fade and the serious ethical questions raised will be looked at in detail. Not just by the media, but by those in a position to make sure that such a tragedy doesn’t happen again. Our thoughts are with those for whom that international conversation may have come too late.

Hemp Oil vs. CBD-Rich Cannabis: The Need for Clarity

Hemp Oil vs. CBD-Rich Cannabis: The Need for Clarity

Type ‘CBD Oil’ into amazon.co.uk today and you will be met with nearly 200 results over 13 pages. The majority of these results will be for small quantities of oil obtained from industrial hemp, with a few waxes thrown in and even one seller offering 50g of hemp ‘bud’, supposedly for making tea with.

It seems the explosion in popularity of these hemp-derived products, which has ramped up due to increased public knowledge of the medical benefits of cannabinoids, is unlikely to slow down any time soon. But is ingesting an oil made from industrial hemp the same as ingesting cannabis? Is it even beneficial at all? These and others are questions that you should be asking yourself before parting with your hard-earned cash, and luckily we’re here to help cut through the confusion.

Firstly, it’s worth quickly covering what CBD is, and why it has grown in popularity to such a huge extent over the past few years. Cannabidiol (CBD) is typically the second most abundant cannabinoid found in plants of the genus Cannabis Sativa L. (i.e. cannabis and hemp).

Decades of selective breeding for higher levels of THC (the main psychoactive cannabinoid) meant that until fairly recently it was difficult to find strains of ‘recreational/medicinal’ cannabis (as opposed to hemp) containing much more than 1-2% CBD. In stark contrast to that, industrial hemp cultivars were selectively bred to reduce the amount of THC present, and ended up, in some cases, with considerably higher levels of CBD than their recreational/medicinal cousins, although there still wasn’t much of it.

Now though, thanks in large part to the efforts of companies such as the CBD Crew, it is easy to get your hands on strains of cannabis which contain both THC and CBD in reasonably high quantities, with most strains containing a 1:1 ratio of the two.

The reason why these strains were developed is down to much medical need and a little bit of economics. As more research has been conducted on CBD its potential medical applications have constantly amazed.

It is perhaps best known as an anticonvulsant, which makes it excellent at treating seizures. This was brought to the public’s attention back in 2013 in CNN’s documentary ‘Weed’, with Dr Sanjay Gupta. In the documentary Gupta interviewed the Figi family, the joint-youngest member of which, Charlotte, suffers from a rare and extremely serious form of epilepsy called Dravet’s Syndrome. To cut a long story short, the only medicine which controlled Charlotte’s seizures was high-CBD cannabis oil, and she’d tried everything.

For the sake of scientific accuracy, it is important to note that not all scientists are convinced, as yet, of CBD’s efficacy as an epilepsy drug, but with Charlotte at least it seems to have worked wonders.

At the time of ‘Weed’s airing, there was a growing market for high-CBD flowers and oils, and stabilised genetics were already available, but after the story went out on CNN there was an explosion of interest. Most of this came from people suffering various forms of epilepsy, or their friends and family, but the film also spiked interest in the other qualities of CBD.

Not only is CBD an anticonvulsant, it is also an antiemetic, anti-inflammatory, and is even showing promise as an antipsychotic. In other words, far from causing ‘reefer madness’, it seems that CBD could well be an effective treatment for psychoses.

Naturally, whilst people in more enlightened parts of the world were able to legally obtain CBD oils, flowers, edibles, etc., in order to find out whether they could benefit from using them, most could not. And since high-CBD cannabis is rarely, if ever, being sold by the local neighbourhood dealer, desperate people were forced to look elsewhere. What emerged was an untapped market with no supplier.

That wasn’t the case for long though, as into that void stepped companies like Medical Marijuana Inc., owners of one of the first and most popular brands of ‘CBD Hemp Oil’ on the market: Real Scientific Hemp Oil.

These companies offered people the chance to buy oil marketed as containing as much as 24% CBD or higher, for often extortionate amounts of money – 60g of RSHO Gold Label will set you back $1,999 – and whilst the price has come down in many cases, many have been worried from the beginning about the quality, safety, and efficacy of these products.

That’s because ‘CBD Hemp Oil’ is not the same as cannabis oil properly produced from a cannabis plant containing the full spectrum of cannabinoids and terpenoids. And since the market operates in a grey area, the safety standards cannot necessarily be trusted. The oil being purchased and ingested may contain CBD, but that doesn’t guarantee a thing.

Which is a problem where sick people are concerned, because they need to know exactly what they’re consuming. If the oil helps them, they need to know they can get another batch of exactly the same purity and potency. And if it doesn’t, it needs to be because CBD simply isn’t effective for them, not because they’ve actually eaten a syringe full of something barely resembling quality, full-spectrum, cannabis oil.

Unfortunately for everyone, there isn’t much that can be done to ensure the safety of what you’re buying. Which isn’t by any means to say that all hemp-derived CBD oils are dangerous, a lot of them now will show you test results and do genuinely have strict safety protocols in place. I have no doubt that some, probably most, of the oils on the market are in some way capable of helping people, but it’s hard to know which without trying, which is always a risk.

Luckily, there are people out there doing the leg work and testing samples of hemp oil to find out what’s really in them. On October 14th, 2014, projectcbd.org released a report into Medical Marijuana Inc., Kannaway and others. As they put it themselves in their press release at the time:

“A six-month investigation by Project CBD has revealed potentially serious quality control issues in products marketed by Medical Marijuana Inc, (MJNA) and questionable financial dealings between MJNA and its affiliates and subsidiaries.”

The ‘financial dealings’ in question don’t need to be gotten into now, but the ‘serious quality control issues’ most definitely do.

Project CBD commissioned lab tests on samples of RSHO Gold, at least one of which was found to contain “significant levels of toxic solvents”, namely hexane. The samples they used were donated to them by parents of children who became violently ill after consuming the oil. As well as potentially extremely dangerous adulterants, lab tests carried out on RSHO samples found massive variation in the levels of both CBD and THC – many samples tested at far above the legal limit of 0.3% THC, meaning not only were these oils potentially toxic, they were also illegal in most of the world.

The point of bringing all of this up is not to make all hemp-derived CBD products and the companies who produce them out to be evil, or to scare anyone off trying CBD, but to point out that in a largely unregulated market it is vital to understand the difference between cannabis oil and hemp oil, and to do as much research as possible before spending money on anything.

Aside from the fact that the biggest hemp oil producers of them all have been shown to be selling an inferior and potentially harmful product, Project CBD list a few other reasons why hemp should be a last resort on their website:

• Industrial hemp typically contains far less cannabidiol than CBD-rich cannabis strains so a huge amount of industrial hemp is required to extract a small amount of CBD. This raises the risk of contaminants as hemp is a “bio-accumulator”—meaning the plant naturally draws toxins from the soil.

• Hemp-derived CBD and refined CBD powder lack critical medicinal terpenes and secondary cannabinoids found in cannabis oil. These compounds interact with CBD and THC to enhance their medicinal benefits.

• It’s against federal law to use hemp leaves and flowers to make drug products. Hemp oil entrepreneurs attempt to sidestep this legal hurdle by dubiously claiming they extract CBD only from hemp stalk before importing it to the United States, a grey area activity at best.

Clearly then there is an urgent and vital need for clarity when it comes to the difference between cannabis oil and hemp oil, and perhaps an even more urgent need for vigilance and caution when it comes to buying either.

My advice is not to never use hemp oil, I know people personally who have experienced benefits from it, but if you have no way of obtaining full-spectrum oil from the cannabis plant itself and do decide to go down the hemp route, do your research. And if you’re not sure, don’t take unnecessary risks.

Did the National Cancer Institute Say That Cannabis Helps Treat Cancer?

Did the National Cancer Institute Say That Cannabis Helps Treat Cancer?

Back in August of this year the USA’s National Cancer Institute quietly released a document entitled ‘Cannabis and cannabinoids – for health professionals’. As they stated themselves in the opening line of said document, its intention was to “provide an overview of the use of Cannabis and its components as a treatment for people with cancer -related symptoms caused by the disease itself or its treatment.”

It didn’t cause too much of a stir in the mainstream press, but was latched onto by the slightly more hysterical sections of the internet. As you might expect, this led to endless variations of the same headline: GOVERNMENT ADMITS TRUTH CANNABIS KILLS CANCER.

But did they?

Not really. What they did do was provide a useful overview of the research, and a handy guide to what we already know – that cannabinoids can kill cancer cells in a lab, but that (mainly due to difficulties in being granted permission to carry out clinical trials), the research is not yet at the point where we can say for sure that cannabis is an effective cancer treatment for humans.

So it was nothing particularly new, but that’s not to say it should be dismissed entirely. The fact that the National Cancer Institute felt comfortable in stating that cannabinoids kill cancer cells at all is a pretty big step.

Plus, what the shouty headlines tended not to point out, was all of the other great bits of information contained within the document. For example, in the section on human/clinical trials, there are a plethora of studies mentioned into the use of cannabis and cannabinoids to treat nausea, vomiting, appetite loss, pain, anxiety, and insomnia.

Not all of the outcomes of those trials were positive, as is often the nature of these things. But what becomes pretty clear when reading the document is that the medical and therapeutic nature of cannabis and cannabinoids are no longer in any doubt. We can use it to reduce nausea, or stimulate appetite in patients undergoing chemotherapy – the important questions which are being asked now are more about how we do that.

What combinations of cannabinoids, and at what dose are they most effective? What are the differences when using a synthetic version of a cannabinoid like Dronabinol, compared to delta-9-THC from the cannabis plant, or an endogenous cannabinoid like Anandamide or 2AG?

What I’m trying to say is this: The document released by the National Cancer Institute was important, but not for the reasons a lot of people tried to claim. It’s not an admission that cannabis cures cancer. What it is, is a fascinating insight into where cannabinoid research is right now. What it shows us (and this is really important, if not as eye-catching as ‘cannabis kills cancer’) is that science is moving on from the question of whether or not cannabis can be used medically. That is now accepted for the most part. What we’re seeing now is a shift in research priorities over to ‘how do we utilise this medicine in the most effective way?’.

That’s a big step, and as interest in the topic grows and countries such as the USA begin to loosen the absurd, Kafkaesque bureaucratic nightmare that scientists are forced to navigate in order to carry out the necessary research currently, we should begin to get a clearer picture of whether or not cannabis really can be a safe and effective cancer treatment for humans. But before that happens, the sad truth is that the research just isn’t there to back up the claims, and all the anecdotal evidence in the world won’t change that from a scientific viewpoint.

The 11 Most Important Cannabis Studies of All Time

The 11 Most Important Cannabis Studies of All Time

Cannabis has been used as a medicine for thousands of years by everyone from the ancient Romans, Greeks, and Egyptians; to Indians, Assyrians, and the ancient Arab world more generally. Whilst these ancient cultures were obviously aware of the therapeutic potential of cannabis, they existed before the dawn of modern science, and so obviously could not have had any real understanding of what it was about cannabis that helped them.

Nowadays, we are learning more and more all the time about what cannabinoids are, how they work, and the potential benefits and down-sides of their use as medicine. Interestingly, we have got to this point by taking our cues from ancient civilisations. For example, a folk story of an Arab leader who suffered from epilepsy and was cured by cannabis prompted early cannabinoid researchers to carry out experiments on people with epilepsy, to see whether cannabis could indeed help them.

Those early researchers, most notably Professor Raphael Mechoulam, drew on ancient knowledge to kick-start a proper scientific understanding of cannabis and cannabinoids which continues to expand and develop to this day. What follows is a brief timeline of possibly the most important studies undertaken into cannabinoids since Professor Mechoulam first isolated THC.

1964 – ‘Isolation, Structure, and Partial Synthesis of an Active Constituent of Hashish’
Delta-9-Tetrahydrocannabinol is first isolated, and its structure examined, by Professor Raphael Mechoulam and Dr Yechiel Gaoni at the Weizmann Institute of Science, Israel. According to Professor Mechoulam, the hashish he and his team used was obtained from the police, at first illegally and without the correct permits. Luckily he was not punished for this, as this discovery marks the beginning of modern cannabinoid research.

1980 – ‘Chronic administration of cannabidiol to healthy volunteers and epileptic patients’
Undertaken by Professor Mechoulam and his team, this is the study that drew on the old Arabian story of the leader who was cured of his epilepsy by taking cannabis. It was admittedly only a small study, but it is still the only clinical trial conducted on humans into the effectiveness of CBD as a treatment for epilepsy. Out of 8 patients involved in the trial, 4 remained almost or completely seizure free, 3 saw some improvement, and 1 saw no effect. No dangerous side-effects were noted.

1986 – ‘Cannabinoids as Therapeutic Agents’
Edited by Professor Mechoulam, this important work pulled together the known research into cannabinoid science at the time and posed an important question – “Are we missing something?”
At this point, the scientific world had still only studied the effects of phyto-cannabinoids (from the cannabis plant), and had not yet worked out how or why they produced the effects that they did, or whether there was an endogenous version of these molecules at work within the human body. This was soon to change…

1990 – ‘Stereochemical effects of 11-OH-Δ8-tetrahydrocannabinol-dimethylheptyl to inhibit adenylate cyclase and bind to the cannabinoid receptor
Professor Allyn Howlett et al discover, for the first time, CB1 receptors in humans. This momentous discovery showed the system in the human body which cannabinoids act upon, and triggered a race to discover endogenous cannabinoids which act on the same system, since it could not be the case that humans (and all mammals as it transpired) have a biological system designed to be triggered only by molecules found in cannabis, outside of the human body. This partly answered the question of ‘are we missing something?’, but not fully.

1992 – ‘Isolation and structure of a brain constituent that binds to the cannabinoid receptor’
Mechoulam, Lumir Hanus, Roger Pertwee, Bill Devane, and others discover Anandamide, the first known endogenous cannabinoid. After years of trying, and worries about being beaten to it by other labs, Anandamide was finally discovered by Bill Devane. At the beginning of their search Raphael Mechoulam had told Devane that if he discovered the endogenous cannabinoid, he would get to name it. So rather than sticking with the actual chemical name – Arachidonoyl Ethanolamide – Devane named the molecule Anandamide, after the Sanskrit word Ananda, meaning bliss or happiness. Six years after Mechoulam first asked the question, scientists finally knew what we had been missing.

1993 – ‘Molecular characterization of a peripheral receptor for cannabinoids’
The discovery of CB2 receptors. A group of scientists from Cambridge discovered a second type of cannabinoid receptor which, unlike CB1 receptors, is found throughout the body rather than being restricted to the brain. The discovery of this receptor helped provide a molecular explanation of the established effects of cannabinoids on the immune system, which had previously been a mystery.

1995 – ‘An efficient new cannabinoid antiemetic in pediatric oncology’
Raphael Mechoulam & Aya Abrahamov decided to test the anti-nausea (antiemetic) effects of cannabis, which had been documented throughout history but never scientifically tested, on children undergoing treatment for cancer. The side-effects of such treatment include severe nausea and are often hugely traumatic for anyone receiving the treatment, but especially so in children. The study was initially a double-blind study, with a control group of children who were not receiving THC along with their cancer treatment. After one week however, it was decided that it was so obvious which children were receiving THC, and the effect it was having on them was so positive, that they began administering it to all of the children in the study. They found that 2-3 doses per day stopped nausea completely, and without any psychoactive effects.

2004 – ‘Amyotrophic lateral sclerosis: delayed disease progression in mice by treatment with a cannabinoid’
Amyotrophic Lateral Sclerosis, more often known in the UK as Motor Neurone Disease, is an incurable disease which always takes the life of its victim, and for which the treatment options available are severely limited. It must be stressed that this study was carried out on mice, and is in no way suggestive of a cure for ALS, but the results were promising. Mice which received THC lived longer and fared better than those which did not, due to THC’s neuroprotective qualities.

2005 – ‘Prevention of Alzheimer’s disease pathology by cannabinoids: neuroprotection mediated by blockade of microglial activation’
Anecdotal evidence has long existed regarding cannabis’ effects on people suffering from Alzheimer’s disease. This study, whilst only a first step on the path to fully understanding the relationship between the two, provides strong enough evidence to offer real hope that cannabis and cannabinoids could, in time, help us to combat a disease which is reaching epidemic levels across the world, which will only continue to rise as the population ages.

2006 – ‘A pilot clinical study of Δ9-tetrahydrocannabinol in patients with recurrent glioblastoma multiforme’
Whilst it has been long-established that THC and CBD can both induce apoptosis and cell-death in cancer cells in a test tube, this was the first human trial undertaken to study whether or not THC can be an effective treatment for cancer in the real world. All of the patients involved were suffering from one of the most aggressive and hard to treat forms of cancer – glioblastoma multiforme – and were not expected to survive. The results of the study were mixed, but did suggest that THC can indeed inhibit tumour growth at least temporarily in some patients. As with the Alzheimer’s research, it is very early days and this was a very small study, so despite the many anecdotal stories of cannabis ‘curing’ cancer, the science isn’t there yet. This was a ground breaking study however, and will hopefully pave the way for more clinical trials in the future.

2007 – ‘Cannabinoid receptors and the regulation of bone mass’
Endogenous cannabinoids and CB2 receptors discovered in bones by Professor Itai Bab. This research showed that both the cells which degrade our bones, and the cells which rebuild them, produce Anandamide and express CB2 receptors, suggesting an important role for the endocannabinoid system in regulating bone strength. This is another area, along with Alzheimer’s and similar diseases, in which we must increase our understanding given our ability as a species to live for far longer than our ancestors.

Clearly, there are many hundreds if not thousands of other studies which could be included in this list, but these are in my view the key moments in cannabinoid research so far. Many people will look at some of the claims made by the studies I have chosen and think they are absurd, so I will end with a quote from Professor Mahmoud A. Elsohly. Speaking in a recent documentary about the work of Raphael Mechoulam, he said, in reference to how people scoffed at ancient stories of cannabis’ medical properties:

“[They would say] this is crazy, there is no such plant that can do all of this. And today it’s very easy to really go back to this old literature about the different indications for which marijuana was prescribed and find out that there is justification for that.”

Who knows what discoveries are still to be made, the potential possibilities are mind-blowing.

Cannabis and Schizophrenia: The Debate That Won't Die

Cannabis and Schizophrenia: The Debate That Won’t Die

The debate over whether or not cannabis causes schizophrenia is one that has been raging since the dawn of prohibition. We’ve all seen the ludicrous “this is your brain on drugs” adverts, and heard the stark warnings from politicians about how smoking ‘skunk’ will ‘mess with your mind’. But what is the truth? As always, it’s not easy to say, and certainly can’t be summed up with a media-friendly sound bite.

A recent publication in the journal ‘Nature’ written by Matthew Hill, a cannabinoid neuropharmacologist at The Hotchkiss Brain Institute, University of Calgary, Alberta, Canada, attempted to shed some light on many of the common misconceptions about the issue.

In it, Hill points out that despite what we’re often told “the nature of this relationship [between cannabis use and schizophrenia] is still a matter of debate and is not as clear as some researchers or policymakers would suggest.”

Instead, he argues, the relationship is far more complex and nuanced than if it were simply causal. As he points out, if cannabis were in fact a cause of schizophrenia, then an increase in its use would necessarily have to lead to an increase in diagnoses of schizophrenia. However this simply isn’t the case.

Before the 1960’s, cannabis use in much of Europe and North America was extremely rare, but since that time it has seen an explosion in popularity. In certain regions over 20% of the adolescent population now use the drug. In stark contrast to this, schizophrenia rates have remained stable and in some cases have even declined. Not only that, the rate of cannabis usage in a country doesn’t seem to have any bearing on schizophrenia rates compared to other countries. Broadly speaking, despite wild variations in cannabis usage, schizophrenia rates are fairly regular throughout the world.

What this means is that the idea that ‘cannabis causes schizophrenia’ cannot be true. If it was, there’d be an uptick. However, as Hill points out, it’s not as simple as saying that there’s no relationship between the two either. Studies have suggested that heavy, prolonged use of cannabis (especially in adolescence) does seem to speed up the onset of the disease, but only in those individuals who would have developed it anyway.

However, as is always the case in science, not everyone agrees with Hill’s take on the issue. In response to his article, Matthew Large, Marta Di Forti and Robin Murray have now offered up a rebuttal in the very same journal – Nature – in which Hill’s piece was published.

In their rebuttal, Large, Di Forti, and Murray claim that Hill’s “contention that the increased societal use of cannabis over time is not reflected in increased rates of schizophrenia has been tested only once to our knowledge — and that study came to the opposite conclusion.”

This is surprising, since these three eminent scientists seem to be conveniently forgetting a study which even I, a lowly writer, am very much aware of. A 2009 meta-analysis undertaken by Keele University found, and I quote, that “In terms of the model set out in the Introduction, the 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 the incidence of psychotic disorders”

The Keele study even goes on to mention 3 other studies which came to the same conclusion, none of which were mentioned by Large, Di Forti, and Murray.

The other ‘argument’ put forward by these three in their response to Matthew Hill which deserves a mention is that “Deaths from cardiac disease are declining in many countries despite increased obesity, but that does not mean that obesity is unrelated to cardiac disease.”

This is a complete red herring and really a distortion of the facts used to serve their own argument. They’re correct that deaths from cardiac disease have fallen, but when looking at schizophrenia’s relationship with cannabis we are not talking about deaths. We are talking about diagnoses. Diagnoses of cardiac disease do, obviously, increase with obesity levels, but the reason deaths do not is that we are getting ever better at treating cardiac disease. Frankly, if I were one of these three scientists I’d probably be pretty embarrassed by what I’d just put my name to.

The point of all of this is not to settle the argument one way or the other. I am certainly not qualified to do that. But what can be taken from all of this is that the cannabis/schizophrenia relationship is a complex one. It is undeniably a relationship that exists, but exactly why and in what sense we don’t yet fully understand.

The problem is, we don’t seem able to extricate ourselves from the stigma and politics which have enveloped the issue to simply focus on the cold, hard, science of it. Even renowned scientists like Robin Murray are guilty of twisting things to suit their agenda, and no doubt scientists on the other side of the argument have done the same. Until we can remove the emotion from the issue we are not likely to get any real answers any time soon, and the great cannabis and schizophrenia debate will continue to rage.

Christian Aid Report Urges New Cures for Global Drugs Trade

Christian Aid Report Urges New Cures for Global Drugs Trade

A new report released by Christian Aid entitled ‘Drugs and Illicit Practices: Assessing their impact on development and governance’ has declared the war on drugs a failure.

The Christian organisation has broken ranks from other charity groups, who have until now largely ignored the issue despite claiming to be campaigning for international development and against human rights abuses.

Referring to the prohibitionist methods of fighting the war on drugs as treating the issue like a “malignant tumour”, the report argues that the reality is that this tumour “has become an almost necessary part of the whole body, rendering conventional treatments ineffective. Removal could cause certain organs to fail.”

This analogy highlights the situation in major drug-producing countries like Mexico. In 2010, a DEA investigation found that between 2004 and 2007, cartels in the country had laundered $378.4 billion through Wachovia Bank; an amount equal to one third of Mexico’s entire GDP at the time.

What this means for Mexico, as well as other countries such as Afghanistan, Tajikistan, and Columbia, is that the removal of this ‘tumour’ through the current tactic of full eradication could prove disastrous to the countries as a whole, rather than just the cartels themselves. The market in illicit drugs is now so deeply ingrained within the economies and cultures of these countries that simply following the same, well-worn path of trying to rid the world of drugs through prohibition can no longer be considered a viable option. A new approach is desperately needed.

As the report makes clear – “the current cure is not working… and despite the hundreds of billions spent on eradication, the illicit drugs industry is bigger than ever”.

Whilst the report stopped short of calling for legalisation, it is clear that its publication has happened as a result of the rapid spread of law reform across the globe. The Supreme Court in Mexico recently ruled that the prohibition of cannabis is an infringement on human rights.

It also serves to highlight the continued hypocrisy of the British government and their refusal to take reform seriously. Decriminalisation and legalisation of drugs, particularly cannabis, has swept away failed eradication approaches in countries as diverse as Mexico, Portugal, much of the USA, and Uruguay, with Ireland seemingly set to follow suit.

Despite this the British government has repeatedly ignored calls for reform from both outside and inside the country – their latest dismissive and scientifically illiterate response to calls for cannabis to be rescheduled being the perfect example of this ‘head-in-the-sand’ mentality.

Christian Aid’s report drives home the devastating effect of prohibition on the most vulnerable in society, and the complexity of an issue too often reduced to empty rhetoric and grand proclamations about being ‘tough on drugs’. It is an issue which demands a more nuanced approach in order to fully understand the reasons why people take drugs, what we can do to best protect those people from harm, and ultimately how we can reshape society so that these problems no longer occur.

Whilst far from ground-breaking – Christian Aid are hardly the first people to realise that prohibition has failed – this report could well be part of an historic change in worldwide drug policy. With UNGASS 2016 just a few months away the timing couldn’t have been better, and will only add to the mounting pressure on global governments to use their time in New York to make a real, meaningful change in the world.