THE HASLAM LEGACY: Does mental health block medicinal and recreational cannabis?

March 03, 2015 Matt Noffs Comments

A variation of this blog was also published in The Canberra Times, The Age and The Sydney Morning Herald. Click here to see the original OP ED.

Following the death of Dan Haslam, the man who helped make medicinal marijuana trials a reality in NSW, we should take a moment to reflect on our drug laws.

Dan, with the support of his family, conducted a brave campaign to be allowed to use cannabis to mitigate the worst side effects of his cancer treatment and to lead a dignified life. The introduction of cannabis for medicinal use is an important step in the move away from prohibition towards regulation.

The introduction of cannabis for medicinal use is an important step in the move away from prohibition and towards regulation.

On the other hand it's important not to conflate medicinal cannabis for recreational cannabis use - they are distant relatives who are similarly controlled by outdated drug laws. In fact, it's this conflation which has held medicinal cannabis behind bars for so long.

I think it's important for me to point out that I am not a Cannabis user and had never enjoyed Cannabis when I did try it in my youth. But my personal preferences should not determine our drug laws, especially if our drug laws are hurting the very lives they intend to protect.

I’m a firm believer that the tremendous expense we currently put into drug law enforcement would be far better spent on treatment. That is not to say that all of the money spent on law enforcement is a waste - but some of it is - and many senior level police (ex-police commissioners and drug squad commanders) agree with me on this point.

WHERE ARE WE SPENDING OUR MONEY CURRENTLY?

According to data from 2010, law enforcement accounts for 66 percent of government drug policy expenditure, while treatment accounts for only 21.3 percent. Meanwhile prevention and harm reduction account for a measly 11.3 percent combined:

What are we spending our money on? What are we spending our money on?1

In comparison, as of 2005 mental health spending only accounted for 6.8 percent of health care expenditure in Australia.

That being said, government spending on mental health has increased by almost 100 percent since 1993 – which offers hope for our future but also very sobering look at our past.

DOES CANNABIS CAUSE MENTAL HEALTH ISSUES?

This is a tricky and very loaded question. Yes, it can – BUT current research suggests only if you are genetically predisposed.

Variations in the COMT gene can affect the development of psychosis following cannabis use in adolescence:

The effects of COMT variation The effects of COMT variation2

Symptoms of what is termed “cannabis psychosis”, which can be caused by the COMT gene variation, usually cease once a person has stopped using.

This evidence points to the fact that cannabis usage only induces psychosis in users who already have a genetic vulnerability, so it is not a universally applicable statement that “cannabis usage causes mental illness”.

Cannabis use can also cause depression and anxiety.

There are also a myriad of external factors that trigger mental health issues in individuals – both those with a genetic vulnerability and those without. Something as “simple” as a stressful life situation, like financial problems, unemployment or a loved one’s death, are often a major trigger. Similarly trauma, exposure to substances whilst in the womb or having a history of mental illness in the family are all risk factors that may increase an individual’s likelihood of developing mental health issues.

The main question to ask here is "Is it this fear, primarily, that holds back reform?"

If so, we should take the bull by the horns and start looking into ways that assist people to discover whether or not they have genetic predisposition so it can be detected early - I, for one, would want to know before jumping in. I would also want this for my children, should they choose to use cannabis.

What about a federally subsidised genetic test? It would be idealistic to think that government would pay for the entire test but it would be in their interest to encourage young people to do it - even if cannabis remains on the list of illicit substances.

Surely that would save money and, more importantly, minds.

STEPPING AWAY FROM PROHIBITION

Cannabis is the most commonly used illicit substance in Australia, the UK and the US. Recreational usage was at its peak in the 1970s, and while usage has dropped since then, it remains the most popular recreational drug – particularly amongst young people:

Marijuana use percentages Marijuana use percentages3

Usage of cannabis is already so common and so readily available, that I can’t imagine a move away from prohibition and towards regulation would result in an increase in usage; but even if it did increase usage by some small percent, any increase in mental health spending would still be marginal.

A move away from prohibition and towards regulation would undoubtedly reduce spending on drug law enforcement significantly, which in turn would cover any additional costs needed for mental health spending should it be required - and we could cover those who would be affected by cannabis use. Certainly better than we do now.

I don't believe jumping into regulating any drug is sensible - but by researching regulation in these areas will open up the can of worms that must be opened.

For instance, one important area of research that could be pursued is "Would regulating cannabis help us reach those who are affected by drug-induced psychoses faster?"

If one steps away from the relentless idealism of a "drug free society” and moved toward a more pragmatic approach that looks at how we, as a society, should spend our money on dealing with issues of drug dependence and mental health, then one would sooner come to the conclusion that prohibition is an ineffective way to deal with drugs.

New solutions need to be discussed, proven and then acted upon.

Dan's campaign to allow people to live and die with dignity should not be in vain.

Matt Noffs

 

REFERENCES


1. Government drug policy expenditure in Australia - 2009/10 by Authors: Alison Ritter, Ross McLeod, Marian Shanahan
2. Is there a link between marijuana use and mental illness? by National Institute on Drug Abuse via http://www.drugabuse.gov
3. Teen marijuana use is on the rise by American Psychological Association via http://www.apa.org/

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