Mental illness implications of cannabis use must not be ignored

For California voters, recreational marijuana legalization was sold as a win-win-win: billions of dollars in new tax revenues, a chance for law enforcement to focus on more serious crimes, and the societal acceptance of a relatively low-risk alternative to alcohol.

But as the state stumbles through its second year of fully legalized cannabis, the reality appears to be more lose-lose-lose.

Tax revenues have fallen far short of expectations, as the state’s heavily regulated and high-cost legal industry struggles to compete with dealers and illegal dispensaries. California earned about $345 million in cannabis taxes in 2018, half of earlier projections.

In fact, excise taxes on sales actually fell in the fourth quarter, as overall legal sales dropped. Now the industry is asking regulators for help cracking down on the black market, a development that may mean law enforcement will become more aggressive about pursuing marijuana-related crimes.

At the same time, evidence of dangers that cannabis and THC pose – especially to mental health – has mounted.

I examined those risks in detail in my new book, “Tell Your Children: The Truth About Marijuana, Mental Illness, and Violence,” which details a generation of scientific studies linking cannabis to psychosis and schizophrenia, a devastating brain disease which causes sufferers to have hallucinations, delusions, and paranoia.

(THC is the chemical in cannabis primarily responsible for its psychoactive effects and psychiatric risks. Cannabis sold for recreational use today contains up to 30 percent THC, compared 1 to 2 percent when the drug first became popular in the 1970s. Users today also commonly consume edible products laced with near-pure THC oil; smoking near-pure THC extracts called “wax” or “shatter” is also common.)

Peer-reviewed medical journals all over the world have published disturbing new studies about the drug’s dangers.

A paper in February connected teenage cannabis use to depression and suicidal thinking in adulthood. Another in mid-March showed that teenagers who use marijuana daily were five times as likely to develop psychosis. Still more recently, emergency room physicians in Colorado reported that marijuana-related visits have soared since voters approved recreational legalization there in 2012.

Further, suicide data from Colorado shows that suicides in which people had THC in their blood increased roughly four-fold between 2006 and 2016. Fatal driving accidents in which people had THC in their blood have risen sharply.

Alongside the mental health, suicide, and driving risks of cannabis, real-world evidence that the drug may drive violence has also mounted. While cannabis makes some users euphoric and relaxed or even lethargic, it makes others paranoid. The risk is so well-known that dispensaries advertise some cannabis strains as less likely to produce paranoia than others.

But people with psychosis are at a high risk to commit violent crimes, especially homicide. For them, the paranoia that marijuana provokes can be more than unpleasant; it can lead to sudden and devastating violence.

Aggravated assaults and murders have soared in the first four states to legalize since recreational dispensaries began to opened in 2014. No one can say for certain at this point that legalized marijuana has driven the crime increase, but police and media reports show a clear nexus between cannabis use – or dealing – and crime in many cases.

In California, the drug has been legal for recreational use for just over a year, not long enough for even the most basic crime trends to become apparent.

Even so, the drug has been linked to high-profile homicides recently, including the cases of Camden Nicholson and Kevin Douglas Limbaugh. Nicholson, 27, allegedly killed his parents and their housekeeper at their Newport Beach home in Feburary; a civil lawsuit filed on behalf of the housekeeper claims that Nicholson abused marijuana and steroids before committing the crimes. Limbaugh, 48, murdered Davis Police Officer Natalie Corona in January before killing himself; a toxicology report showed he had THC and alcohol in his blood.

With evidence of marijuana’s risks mounting, California badly needs to compile more data on the health risks of the drug.

But it is not. In fact, the state’s Cannabis Advisory Commission said in its 2018 annual report that cannabis regulators had “not implemented” their recommendation to “collect data and report yearly on youth and adult cannabis use and overuse; ER visits and treatment episodes; DUI and poison control calls related to cannabis.”

So why haven’t you heard about any of these problems?

Backers of legalization – and their supporters in the media – have successfully cast marijuana legalization as a racial and social justice issue, although almost no one is in prison for cannabis possession. And they have vastly oversold the potential medical benefits of the drug, while understating its risks.

I have seen the aggressiveness with which they attack anyone who dares criticize cannabis for myself. I am a former New York Times reporter who spent years investigating the pharmaceutical industry, but some have called me a shill for Big Pharma, which they seem to believe wants to keep cannabis illegal.

The attacks on me don’t bother me. But the media’s reluctance to discuss the risks of cannabis does–especially now, with use in the United States soaring, led by the states that have legalized.

Data from the early legalization states show that legalization causes adult cannabis use to rise, in part because prices fall. Even in California, where legal prices remain high, use will likely go up in the next few years, as legal dispensaries and delivery services openly advertise.

Legalization makes people believe that cannabis is safe, and encourages some people who otherwise would have stayed away from an illegal drug to try it.

The promised benefits of legalization have so far been mostly illusory for California. But the harms are real–and if the scientific studies and data from Colorado and other early legalization states is any guide, they are only going to grow.

Alex Berenson is a novelist, journalist, and author of “Tell Your Children: The Truth About Marijuana, Mental Illness, and Violence,” alexberensonauthor@gmail.com. He wrote this commentary for CALmatters.