It was the usual horror story

Friday, January 25th, 2019

I can’t say I know much about Mother Jones, but I was surprised to see them publish a “scary” look into the science of smoking pot:

It’s been a few years since Alex Berenson has “committed journalism,” as he likes to say. As a New York Times reporter, Berenson did two tours covering the Iraq War, an experience that inspired him to write his first of nearly a dozen spy novels. Starting with the 2006 Edgar Award-winning The Faithful Spy, his books were so successful that he left the Times in 2010 to write fiction full time. But his latest book, out January 8, strays far from the halls of Langley and the jihadis of Afghanistan. Tell Your Children is nonfiction that takes a sledgehammer to the promised benefits of marijuana legalization, and cannabis enthusiasts are not going to like it one bit.

The book was seeded one night a few years ago when Berenson’s wife, a psychiatrist who evaluates mentally ill criminal defendants in New York, started talking about a horrific case she was handling. It was “the usual horror story, somebody who’d cut up his grandmother or set fire to his apartment — typical bedtime chat in the Berenson house,” he writes. But then, his wife added, “Of course he was high, been smoking pot his whole life.”

Berenson, who smoked a bit in college, didn’t have strong feelings about marijuana one way or another, but he was skeptical that it could bring about violent crime. Like most Americans, he thought stoners ate pizza and played video games — they didn’t hack up family members. Yet his Harvard-trained wife insisted that all the horrible cases she was seeing involved people who were heavy into weed. She directed him to the science on the subject.

We look back and laugh at Reefer Madness, which was pretty over-the-top, after all, but Berenson found himself immersed in some pretty sobering evidence: Cannabis has been associated with legitimate reports of psychotic behavior and violence dating at least to the 19th century, when a Punjabi lawyer in India noted that 20 to 30 percent of patients in mental hospitals were committed for cannabis-related insanity. The lawyer, like Berenson’s wife, described horrific crimes — including at least one beheading — and attributed far more cases of mental illness to cannabis than to alcohol or opium. The Mexican government reached similar conclusions, banning cannabis sales in 1920 — nearly 20 years before the United States did — after years of reports of cannabis-induced madness and violent crime.

Over the past couple of decades, studies around the globe have found that THC — the active compound in cannabis — is strongly linked to psychosis, schizophrenia, and violence. Berenson interviewed far-flung researchers who have quietly but methodically documented the effects of THC on serious mental illness, and he makes a convincing case that a recreational drug marketed as an all-around health product may, in fact, be really dangerous — especially for people with a family history of mental illness and for adolescents with developing brains.

A 2002 study in BMJ (formerly the British Medical Journal) found that people who used cannabis by age 15 were four times as likely to develop schizophrenia or a related syndrome as those who’d never used. Even when the researchers excluded kids who had shown signs of psychosis by age 11, they found that the adolescent users had a threefold higher risk of demonstrating symptoms of schizophrenia later on. One Dutch marijuana researcher that Berenson spoke with estimated, based on his own work, that marijuana could be responsible for as much as 10 percent of psychosis in places where heavy use is common.

These studies are hardly Reagan-esque, drug warrior hysteria. In 2017, the National Academies of Sciences, Engineering, and Medicine issued a report nearly 500 pages long on the health effects of cannabis and concluded that marijuana use is strongly associated with the development of psychosis and schizophrenia. The researchers also noted that there’s decent evidence linking pot consumption to worsening symptoms of bipolar disorder and to a heightened risk of suicide, depression, and social anxiety disorders: “The higher the use, the greater the risk.”

Given that marijuana use is up 50 percent over the past decade, if the studies are accurate, we should be experiencing a big increase in psychotic diseases. And we are, Berenson argues. He reports that from 2006 to 2014, the most recent year for which data is available, the number of ER visitors co-diagnosed with psychosis and a cannabis use disorder tripled, from 30,000 to 90,000.

Legalization advocates would say Berenson and the researchers have it backwards: Pot doesn’t cause mental illness; mental illness drives self-medication with pot. But scientists find that theory wanting. Longitudinal studies in New Zealand, Sweden, and the Netherlands spanning several decades identified an association between cannabis and mental illness even when accounting for prior signs of mental illness. In an editorial published alongside the influential 2002 BMJ study on psychosis and marijuana, two Australian psychiatrists wrote that these and other findings “strengthen the argument that use of cannabis increases the risk of schizophrenia and depression, and they provide little support for the belief that the association between marijuana use and mental health problems is largely due to self-medication.”

One of the book’s most convincing arguments against the self-medication theory is that psychosis and schizophrenia are diseases that typically strike people during adolescence or in their early 20s. But with increasing pot use, the number of people over 30 coming into the ER with psychosis has also shot up, suggesting that cannabis might be a cause of mental illness in people with no prior history of it.”

Malcolm Gladwell wrote a similar piece in the New Yorker, emphasizing how little we know about marijuana compared to legal drugs, and Berenson himself has an opinion piece in the New York Times, where he points out that many of the same people pressing for marijuana legalization argued that the risks of opioid addiction could be easily managed.


  1. Felix says:

    On the subject of Mother Jones and surprising articles (like a pro-Trump article on CNN), look up their stuff on “mass shootings”.

  2. Bruce says:

    Patrick Cockburn wrote about his son, a schizophrenic. He said that there’s a pattern of schizophrenics being treated, cured, released, smoking a celebratory blunt, batso again.

  3. McChuck says:

    Marijuana is much stronger these days. Some strains are well over 20% THC content. Don’t forget that THC is a hallucinogen.

    The 420 people also don’t like to talk about the number of traffic fatalities dramatically increasing (double or more) after legalization.

  4. Alistair says:

    This is a relatively sober take. There’s an emerging science showing that Marijuana use can cause schizophrenia of varying degrees of severity. It seems dose-dependent, and it also seems that (as always) some people are much more vulnerable. In risk terms it seems like a single-digit percentile of users are going to have severe problems (partly dosage, partly bad genetic luck)

    But how much is this in the big societal picture? The 10% increase in schizophrenia baseline is plausible (I did some fairly pessimistic estimates off the studies a year or two back and got a 25% schizophrenia increase for full legalisation). That’s obviously not great, but in context may not be so bad, compared to the total mental health budget and the value of marijuana market. Especially if MJ use displaces some alcohol abuse (anything displacing alcohol abuse is generally a good trade).

    In short “Yes…but”….This effect looks bad, but it’s not yet selling me as big enough to panic about. As always, open to more and better data….

  5. Graham says:

    It seems balanced to me as well.

    I’m conscious that I’ve always been biased on the file, but with biases that point in both directions-

    I’m of the view that any society gets to prioritize its traditional intoxicant or none on historical, familiarity or cultural grounds, so I’m not necessarily persuaded it has an obligation to treat them all the same on purely rational or egalitarian grounds. The latter seems as alien an argument to me as the former seems to many.

    I’ve never been a fan of 70s-80s stoner culture, the tropes and mannerisms of which seem to animate a lot of the movement for recreational cannabis even now.

    For me, the former seems a satisfactory reply to calls for equality, the latter admittedly just a personal motive. I don’t think the latter alone is cause for prohibition, but since hardly anyone on any cause is not arguing from personal taste deep down, I feel no guilt.

    I’ve also managed to drink recreationally for 25 years without being drunk in any meaningful sense, beyond awareness that reflexes would not be up to operating a vehicle, and that one can drink for other qualities than pure mind alteration, or for a rather modest level of mind alteration. Some chance encounter with one of the classical Greeks put in my head the notion that too much mind alteration for its own sake is bad. I can’t pin that down from memory.

    I’m OTOH conscious that prohibition was once a radical reformist scheme anyway, as it was with booze, so there’s that.

    So all in all, I’m probably down with legalization, which my country is even now implementing in it’s usual top down way, although I suspect it will mean more users than would have been the case a hundred years ago.

  6. Graham says:

    One question I have not seen answered: When advocates observe how many more people per year are killed by alcohol, have they normed these figures to allow for what I would presume to be a vastly larger installed user base for alcohol? That would seem obvious, but I’ve never seen it mentioned.

  7. Abelard Lindsey says:

    I’m not convinced pot makes you crazy. But I am absolutely convinced it makes you stupid and lazy. Every pot smoker I’ve known personally who has smoked it regularly over a multi-year period has serious problems with short-term memory recall. Often, it is serious enough that it is a pain in the ass to deal with such people because they are so forgetful. Pot also makes you lazy, too.

  8. Bruce says:

    I don’t think pot makes normal people crazy, but if you are already on the edge I think it will push you over. Lots of people are on the edge of being stupid and lazy and forgetful.

  9. Harry Jones says:

    One size does not fit all. Different people react to mood altering substances in different ways.

    I say if the effects are the problem, then outlaw the effects. Have tests to measure objectively when someone’s judgment is impaired, then prosecute only those instances.

    The trouble with marijuana and mental problems is the correlation-causation fallacy. Maybe they’re all self medicating?

    Likewise alcohol abuse. There are two kinds of problem drinkers: those who have problems because they drink, and those who drink because they have problems. The only sure way to tell these two apart is to know a problem drinker from childhood.

  10. Bruce says:

    Maybe they’re all self-medicating, but nobody medicates for sloth, inattention, and a habit of being spacey with pot. An old meth cook did once tell me that meth makes you go out and take two jobs, cocaine makes you think you are a genius, and crack makes you bop your nearest and dearest on the head to get twenty bucks for another rock.

    It is pretty hard for the law to tell if drink and drugs are the skidmarks in front of the accident or the reverse, and the law is an ass.

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