Pubdate: Sat, 03 May 2014
Source: Montreal Gazette (CN QU)
Copyright: 2014 Postmedia Network Inc.
Contact:  http://www.montrealgazette.com/
Details: http://www.mapinc.org/media/274
Author: Charlie Fidelman

POT BAD FOR YOUTHS WITH PSYCHOSIS, STUDY SAYS

Marijuana Found to Slow Recovery

Drug abuse really does have a negative impact on youth with 
psychiatric disorders, and at least one illicit drug, marijuana, 
should be raising alarms bells, researchers warn after presenting 
preliminary results Friday from a two-year Montreal study.

A hands-on team, created by the Centre hospitalier de l'Universite de 
Montreal 15 years ago to help troubled youth with psychosis, held a 
conference at Notre-Dame Hospital to present treatment innovations.

Psychosis is described as a loss of contact with reality. Symptoms 
include visual and auditory hallucinations, confusion, delirium, 
bizarre thoughts and these are often accompanied by anxiety and panic attacks.

The team, led by psychiatrist Amal Abdel-Baki, head of the CHUM's 
psychosis services program for youth, followed 212 young adults, 
average age 23, many with drug abuse issues - once they had been 
hospitalized for an episode of psychosis.

Those who managed to quit using alcohol and drugs improved, 
Abdel-Baki said. They had fewer symptoms, reduced their use of 
hospital emergency rooms and tended to return to school or work at 
the same pace as young adults without a history of substance abuse.

"The impact of what we saw is that they functioned socially as well 
as those who never took drugs and better than those who continued to 
abuse drugs," Abdel-Baki told The Gazette.

Those who remained drug abusers continued to have psychotic symptoms 
and show up at the ER, and had difficulties finding work or returning 
to class. However, a striking finding is that one group did worse 
than all others - the pot users.

Alcohol and other substance users improved much slower than those who 
stopped using drugs, but they still showed some improvement, Abdel-Baki said.

"What we realized, is that young adults who use cannabis continued to 
deteriorate with time, despite treatment," Abdel-Baki said. "We asked 
ourselves, 'Are all drugs equally bad?' "

Researchers noted that in their study, the most harmful effects were 
seen in people who used cocaine, speed and crack. Initially, the 
stimulant users appeared to be struggling with more problems than the 
pot users. They had more psychotic symptoms, more violence and a much 
harder time quitting than the pot users.

They were targeted from the get-go for intensive therapy. "It was the 
way we took charge of them. We brought out the canons, the most 
intensive treatment that we have for them. We tended to treat them 
more aggressively," Abdel-Baki said, by seeking court-mandated 
therapy to provide anti-psychotic medication by injection. "And these 
youths improved, there were fewer relapses."

In contrast, perhaps researchers trivialized the effect of cannabis 
because, in the beginning, users' symptoms were less severe, she said.

"Perhaps they deteriorated because we didn't treat them aggressively enough?"

In fact, the research suggests that problems of mental health and 
drug abuse, regardless of the substance that is being consumed, 
should be taken seriously, Abdel-Baki said.

Those who treat addictions demand patients go for mental health 
services first; and mental health sends them to detox centres, she added.

"We know that the two issues - mental health and addiction - should 
be treated at the same time, and by the same team," Abdel-Baki said.

Apart f rom medication, participants in the CHUM clinics also had 
group therapy and were paired with social workers to help them find 
lodgings and improve social reintegration.

Previous studies have linked early cannabis use among some teens with 
increased risk of developing addiction and mental health problems as adults.

Last August, a review of 120 studies examining cannabis and teenage 
brain development by researchers from UdM and New York's Icahn School 
of Medicine at Mount Sinai Hospital concluded that there's strong 
evidence that early pot use can interfere with the development of the 
adolescent brain.

"What we know is that the younger the exposure, the higher the risks 
for negative outcomes for cognitive problems and psychos is as 
opposed to the 40-year-old who uses cannabis," said Didier 
JutrasAswad, a CHUM psychiatrist and researcher, and one of the 
authors of the study.

"Generally, cannabis is not a problem but that depends on who is 
using because individual factors can modify the risk," Jutras-Aswad 
said. "The question is not about whether cannabis is good or bad, but 
who is more likely to suffer from problems?"

The teen population at risk that should be monitored includes those 
with a genetic predisposition or a family history of mental illness 
as well as behavioural traits like, for example, being impulsive, 
anxious and easily depressed.

[sidebar]

Short video offers glimpse into life of psychosis sufferer

"Psychosis is a meticulously planned attack inside the head, which 
suspects nothing."

Susanne Serres, 23, wrote those words after she was hospitalized last 
year following an episode of psychosis. On Friday, Serres, who is 
enrolled in creative writing at Universite du Quebec a Montreal, 
presented a short film at a conference on psychosis.

The film featured a few moments in the life of a young man named 
Adrian who mistakenly believed he was being followed home. It 
captured his ragged breathing, the voices he was hearing, the odd 
things his eyes were seeing. And it conveyed his distress and panic 
at not knowing what was real and what was coming from inside his head.

The film and her writing, which Serres said was inspired by her stay 
at the hospital, proved therapeutic for her and her family.

"I didn't know what psychosis was - until I was treated at the 
hospital," said Serres, one of many young Montrealers to benefit from 
early and intense treatment provided at JAP, an outreach mental 
health clinic of the Centre hospitalier de l'Universite de Montreal 
for youth with psychosis.

Cynthia Sanon, 27, recalled her first episode, at age 23, after 
smoking a joint with her friends.

"It's very scary. You feel like you are in some movie and most of it 
doesn't make sense. Your mind spins stories, wild stories," Sanon said.

She went to a hospital emergency room, but was sent back home because 
doctors believed she would improve once the effect of the pot wore 
off. She didn't.

Sanon said she was highly stressed at the time, trying to pay her 
bills by working at two jobs while also going to school. She lost her 
jobs, quit school and had two more relapses (with trips to the ER) 
linked to drug and alcohol use.

Sanon, who is studying nursing, thanked the JAP team, especially her 
social worker, for the unfailing support that helped her remain 
psychosis-free for two years.

Serres's video is expected to be posted soon on the clinic's website: 
http://premierepisode.ca/capsules-video/
- ---
MAP posted-by: Jay Bergstrom