People who smoke skunk 'are 18 times more likely to develop psychosis'

Embargoed until Wednesday, July 02, 2008

People who smoke skunk, the extra strong cannabis grown in hothouse conditions, are 18 times more likely to develop psychosis that those who take the milder forms such as hash (cannabis resin), a new study has found. 

 

The study, which was carried out at the Institute of Psychiatry and presented this week to delegates at the Annual Meeting of the Royal College of Psychiatrists, looked at the links between cannabis use of psychosis.

 

Psychiatrist Dr Marta Di Forti, as part of the GAP (Genetics and Psychosis) Study led by Professor Robin Murray, compared the pattern of cannabis use between 112 patients with first episode psychosis and 75 healthy ‘controls’ screened for psychosis. Both groups came from the South East London area. 

 

The researchers found that people who had a psychotic episode were twice as likely to have used cannabis for longer, three times more likely to have used it every day and 18 times more likely to use skunk.

 

The cannabis plant is "a rich treasure trove of pharmacology" and contains 60 cannabinoid molecules, said Dr Paul Morrison, a senior researcher working with Prof Murray and presenting at the meeting as well. The one that has attracted the most publicity is THC Delta-9- tetrahydrocannabinolwhich is responsible for the psychotic symptoms and the cognitive deficits induced by cannabis.

 

But cannabis also contains another molecule, CBD or cannabidiol, which seems to protect users from the psychosis and impaired   cognition induced by TCH. CBD seems to counteract the effect of THC. 

 

The potency of THC in cannabis has increased steadily over the last decade due to higher concentrations of the drug and its formulation, delegates at the Annual Meeting heard.

 

In 1995, skunk had 6 per cent THC; now that figure is nearer 16 -18 per cent. Skunk not contains only high levels of THC, but contains no or very little CBD, so there is nothing to protect users against its power.

 

In contrast with skunk, hash contains much less THC and an almost equal amount of CBD, which might contribute to further reduce the potency of its adverse effectFor example, Savitex, the cannabis drug, used to treat multiple sclerosis, has equal amounts of both THC and CBD.

 

Dr Di Forti used an analogy comparing users of cannabis to drinkers. Like the drinker who starts off on half a pint of lager and ends up drinking a bottle of vodka a day, cannabis users might start with a weekly joint of hash or grass and graduate to smoking skunk every day, she said.

 

Because of the difference in strengths of cannabis formulations, Dr Di Forti urged psychiatrists to question their patients on their drug habits in a more detailed way. "We should have more data on cannabis exposure. We should take a cannabis history in a more detailed way, like we do when we take a history of cigarettes smoking to establish risk of lung cancer. But it would be naive to say that smoking a joint is safe as we do not have enough data to reach such conclusion,” she said.


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References:

Annual Meeting of the Royal College of Psychiatrists, Imperial College, London, 1 - 4 July

 

© 2008 Royal College of Psychiatrists