CANNABIS IN THE UK –
IS A PERSISTENT CULTURE OF DENIAL LEAVING TREATMENT NEEDS HIDDEN AND PRIMING A PUBLIC-HEALTH TIME BOMB?
The level of public understanding about cannabis risks remains inadequate, states a research analysis by Kathy Gyngell in the Journal of Global Policy & Practice (vol 6 #2).
The analysis in full:
Download Gyngell – Jnl Global Drug Policy & Practice – cannabis
Cannabis is still the most commonly used illicit substance in the UK and the one most widely used by adolescents. But it continues to be exempt from the hazardous reputation held by other illicit drugs, recognised by government as posing a serious public health risk.
Many view cannabis as non-problematic. This is in the face of evidence that shows that first episode psychosis is associated with the use of higher potency cannabis, and that it is linked to increased relapse and problems with nonadherance to medication in patients with schizophrenia. Adolescent use significantly increases risks for dependence, other substance-abuse problems, mental-health problems and poor emotional, academic and social development - symptoms that adolescent addiction psychiatrists routinely note. But it is still viewed by many policy makers, advisers and commentators as a benign drug.
The UK has one of the highest rates of cannabis use in the developed world, one third of all UK adults have tried it and about 2.2million people used it ‘last year’ – 6.8% of the population. The evidence that this level of use is already damaging public health is powerful.
First, it is the drug of the young and the drug of initiation. 17.1% of British 16-24 year olds reported using it in the last year and 9% in the last month. Early initiation into cannabis use turns out to be almost uniquely British. The typical starting age is much younger than in other European countries – 9% of British schoolchildren use it by the age of 13. In Sweden, the number is just 2%. Young adults are the most dependent on this drug, too: 13.3% of users aged 16-24 and 9% aged 25-34 are judged to be dependent.
Yet the numbers of individuals in treatment with cannabis disorders are disproportionately low. In the Netherlands, in contrast, cannabis is the primary drug for which treatment is sought: 38.4% in 2009 were in treatment for cannabis, followed by 31.4 % for cocaine and 18.2 % for opioids.
Recent studies throw claims for medical efficacy into doubt. Its negative impact on cognition, memory and academic outcome, explored by Thomas Lundquist in his study of the cognitive damage acquired by some 400 of the long-term cannabis abusers who had sought treatment at his outpatient clinic, is regarded
as seminal. New research underscores the multiple health consequences of smoking cannabis, yet there is still a dangerous lack of public awareness of how harmful this drug can be.
The CEO of the British Lung Foundation, Dame Helena Shovelton, said recently that "Young people in particular are smoking cannabis unaware that each cannabis cigarette increases their chances of developing lung cancer by as much as an entire packet of 20 tobacco cigarettes". She has called for a public health campaign to "dispel the myth that smoking cannabis is somehow a safe pastime.
Professor Peter Jones of Cambridge University, one of Britain’s leading psychiatrists and an expert in schizophrenia, addressing an Institute of Psychiatry (London) Conference as long ago as 2005, noted that “Cannabis is a huge issue for psychiatric services at this moment. I work in a first contact schizophrenia service and it might as well be a Cannabis Dependency Unit”.
Though the current Home Secretary, Theresa May, has tough views on drugs, a gap between rhetoric and practice from earlier years persists.
Given the scale of current use, the high potency of the drug, and the ever earlier age of initiation into cannabis, harm reduction services for adolescents, in most of which continued cannabis use is tolerated, are inadequate. Inaction in the UK is priming a public mental-health and treatment time bomb.