Pubdate: Wed, 11 Jun 2014
Source: New Zealand Herald (New Zealand)
Copyright: 2014 New Zealand Herald
Contact:  http://www.nzherald.co.nz/
Details: http://www.mapinc.org/media/300
Author: Dale Bramley
Note: Dr Dale Bramley is a public health physician and chief 
executive of Waitemata District Health Board.
Page: A29

ADDICTION, PSYCHOSIS, ANXIETY - DOPE IS HARMLESS? YOU MUST BE HIGH

The ban last month of so-called legal highs came as a welcome relief 
to staff at Waitemata District Health Board, particularly our 
doctors, nurses and mental health workers who see first-hand the 
effects synthetic cannabinoids can have.

As the discussion around synthetic cannabinoids evolved in the public 
sphere, it was not unexpected that talk would soon turn to the issue 
of decriminalising cannabis.

As the district health board (DHB) responsible for running drug and 
alcohol addiction therapy services for the Auckland region, our staff 
see the clinical and social impacts of cannabis use on a daily basis.

More than 14,000 clients are seen by our Community Alcohol and Drug 
Services each year. Of these, more than 15 per cent present with 
issues relating to cannabis use.

There may be a perception that cannabis is benign. But staff running 
mental health, addiction and emergency services can tell you beyond 
doubt that it's otherwise.

We see on a daily basis the issues that cannabis use can have for 
people in their daily lives. Our clinicians see how it can exacerbate 
existing issues such as mental illness and dependencies on other 
substances, and how it is associated with poorer overall health.

Cannabis smokers often have the same respiratory problems as those of 
tobacco smokers, such as daily cough, more frequent acute chest 
illness, and a heightened risk of lung infections. Simply put, people 
who smoke cannabis have more health problems and miss more days of 
work than those that don't.

The link between chronic cannabis use and mental illness is 
well-proven. A substantial number of individuals presenting to our 
mental health services have their presenting problem complicated or 
worsened because of the use of cannabis.

Smokers of cannabis are about 2.6 times more likely to have a 
psychotic episode than non-smokers.

High doses of marijuana can produce a temporary psychotic reaction 
and in some users can worsen the course of illness in patients with 
schizophrenia.

Numerous studies following users over time, and through the 
experience of our DHB's own drug and alcohol services, show a link 
between marijuana use and later development of psychosis - those who 
start young and smoke heavily are at an increased risk for later problems.

Marijuana use has also been linked to various mental health problems 
among the young, such as depression, anxiety, suicidal thoughts, and 
personality disturbances, including lack of motivation to engage in 
activities they would usually find rewarding.

While it's arguable that cannabis is already easily available to 
young people in New Zealand, the question we have to ask is: do we 
want to make it more so?

It is an addictive substance. Nine per cent of users become addicted 
to marijuana, but this nearly doubles to 17 per cent for those who 
start smoking young. That's one in every six young adults who use 
cannabis. For those who use it daily, the chance of addiction rises 
to 50 per cent.

Legalising or decriminalising cannabis are not sensible solutions to 
the legal highs problem.

Let's not convey the message - especially to our young - that 
cannabis is harmless. It is not. Any initiative that potentially 
makes cannabis more freely available will only further increase the 
burden of medical, psychological and social problems cannabis use has 
on our health system and our communities.
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MAP posted-by: Jay Bergstrom