read the research to. It makes me giggle that so much is on delta-9-THC.
This iss what everything focuses on. When they injected people with
cannabis it was this compound dissolved in alcohol.
It means the majority of the research has little value. There are two
other isomers of THC. There are CBDs. There are a range of other
chemicals involved. There is also the effect of smoking with tobacco
which is often ignored. So when I have a joint it reduces my anxiety but
the delta-9THC resaerch says it can increase anxiety. It might do but I
puff with rolling tobacco and all the other chemicals in natural cannabis.
The most amusing thing is considering the RCT evidence to the
observational stuff. So there's a lot of evidence pointing to an
assocation between cannabis and mental illhealth (casuality evidence is
still limited and it's studies like the one where they injected people
that are used to say there is a casual element). It has been noted that
the quality of street skunk has gone up significantly in the last three
decades if the measure was delta-9-THC content. There shoud have been an
equivaent rise in cannabis-induced psychosis hospitalisations. As far as
I am aware there hasn't been.
Most people who smoke cannabis don't snmoke every day. Those who do
don't smoke pure delta-9-THC rich joints every day. If anyone gets hold
of the super strong skunk they'll put less in because it'll blitz them
too much. A handful of people may wnat to get that blitzed but they'll
do harder drugs anyway. The majority of peoople who have used cannabis
at least once in their life have never suffered any adverse effects,
apart from a whitey perhaps, and have enjoyed the experience rather than
experienced it as the psychiatric research might lead a person without
experience of cannabis to believe.
What amsues me most is the users themselves. Those who, like me, smoke
cannabidol-rish versions such as commercial weed or hashish. These are
essentially antipsychotic but street users wouldn't use them if they
knew they were antipsychotic. In fact CBD is as effective as atypical
antipsychotics (RCT from South America linked to somewhere on this
blog). It has fewer side effects. It is also very rapid acting if inhaled.
This is the thing about cause and effect. Do people with mild
experiences of psychosis (schizotypy) self-medicate naturally by chosing
to consume an antipsychotic? Cause and effect are hard to work out.
People pick sides on the drugs argument and selecti9vely usse the
evidence. I remember well having to respond to an enquiry about cannabis
and mental health. I checked the internal information directory at work
and it said that cannabis users had a higher level of hospitalisation
with a secondary diagnosis that alcohol users. But I knew the dataset.
It was the hospital episode statistics. The hospitalisations with a
cannabis-induced conditioin as a secondary diagnosis were slightly
higher than the alcohol ones. However the primary diagnosis figures
showed a significantly higher number of people hospitalised with alcohol
problems as the primary diagnosis.
This is why I like the idea of bringing the adversarial system from law
to mental health research. Bias is the bane of all research apart from
qualitative stuff. Publication bias is well known in medication research
but it happens in psychlogical therapies research too. In a paer
published earlier this year that used about 1,000 psychological
therapies papers it found the effect of publication bias - where terials
with negative results aren't published - accounted for the third of the
effect usize when meta-analytical technqnes were used. It happens at
campaigning charities too.
In the legal system (in criminal law I think) the theory is to have two
opposing lawyers: the prosectuion and the defence. They take adversarial
stancdes to ensure they prove that their client is totally guilty or
totally innocent based on the same set of evidence. The judge and the
jury make a decision based on those arguments. If this were applied to
research questions in reviews and even in studies with two teams, one
trying to prove and one trying to disprove based on the same
information, then there's a hope that the science of mental health may
step a little bit closer to be being a true science rather than the
pseudosience it is periodically noted to be by significant authors like
Szasz and Bentall. Of course there is still the problem of bias in the
judge/jury role.
If this happened mental health truths would dissolve quicker than a
chocolate teapot full of tea. It's necessary though. The pursuit of
truth needs it in mental health. I carefully stop myself from attacking
bias too much because it's loved by qualitiative researchers and I like
qualitiatve research because it leads to some good truths as well
compared to the quantitative stuff.
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