The health impact of smoking ganja
Jamaica's leading addiction psychiatrist, Dr Winston De La Haye, believes many persons do not fully understand the impact smoking ganja has on the body.
That realisation has especially been brought to the fore by the Dangerous Drugs (Amendment) Act 2015 (also referred to as the Ganja Reform Law), which was passed into law in February and took effect on April 15. Under the new regulations, the personal use of up to two ounces of marijuana is now decriminalised.
The law now allows persons to legally inhale the drug in the privacy of their residence, not being used for commercial purposes.
Additionally, members of the Rastafarian faith are allowed to smoke ganja for religious purposes in locations registered as places of Rastafarian worship.
The smoking of marijuana is also legally permitted in places licensed for the smoking of the substance for medical and therapeutic purposes.
De La Haye, who has spent the past 12 years as a trained addiction psychiatrist, said it was important that persons understand that the positive benefits found in cannabis was from the extracted compounds, and not the smoked product - 'spliff'.
Cannabis (more popularly known as marijuana, ganja or weed) contains approximately 500 compounds, of which about 85 are used for medicine and science.
Cannabis has two main components: cannabidiol (CBD) and tetrahydrocannabinol (THC).
The CBDs are the compounds with great medicinal value and are seen as the future of medical marijuana. THC, on the other hand, contains the compounds responsible for the psychoactive effects of the plant, causing the negative effects persons experience from using cannabis.
"It is important that persons understand how cannabis affects the body, the compounds and uses of the substance, and separate the benefits from the dangers. And since the ganja law was relaxed, I am coming across some very serious cases of psychotic episodes from ganja smoking," De La Haye told Health.
"You just can't use smoked products to get the benefits. You can't say let me smoke two spliffs a day to treat my glaucoma. You need the specific products with specific concentration. In other words, the specific extracts with a dosage in order to really capitalise on the positive effect."
He said there was no doubt that cannabis is a well-studied plant. In fact, there are a large number of areas of research proving that cannabis has potential and positive influences, including anti-cancer properties, treatment of certain ocular problems, asthmatic remedies, among others. In fact, the internationally popular Canasol (the glaucoma medical marijuana eye drops) was developed in Jamaica by a Jamaican. And there are other products and ongoing studies for other benefits.
"But, then comes a whole slew of negatives. And that is the real issue we need persons to understand. And for them to especially understand that when persons smoke ganja and become psychotic, it would be because of the THC properties in the plant," said the clinical director of the Addiction Treatment Services Unit at the University Hospital of the West Indies.
"So, it is really important that persons understand that the positives we are discussing relates to the extracts of cannabis, specifically, especially the CBDs, and not of the smoked product. Because in the smoked product, you can't separate the CBD from the THC.
"So, when you smoke ganja, you are getting everything. You are not able to determine that the cannabis I am smoking will help my eyes because I have glaucoma, because it may help your eyes, but can also impact your brain and other areas."
SLEW OF NEGATIVES
De La Haye, who is also the deputy chairman of the National Council on Drug Abuse (NCDA), outlined the major negative impact of smoking ganja and the challenges, stating that it impacts wide areas of the brain.
"Pure cannabis can make you psychotic. The reality is that there are some acute and chronic effects from smoking it," he warned.
He said the well-documented negative impacts include: impaired memory, coordination and driving skills (drug driving).
He said when a person is under the influence of ganja, it can result in decreased reaction time, "so, for instance, when you think you are applying your brakes quickly you really end up taking a longer time. And these are things that can be measured on any given day with anyone who consumes cannabis. These are what we call perceptual distortions".
He said studies show that addictive substances attach themselves to areas of the brain known as the reward pathways. And ganja smoking can impact not just those reward pathways, but also the areas associated with memory, such as the cerebellum, which is responsible for motor activity.
"So, for instance, persons who operate heavy machinery or drive and find that their coordination is impacted when they smoke it, it is because cannabis interferes with those areas in the cerebellum," De La Haye said.
IMPACT ON YOUTH MEMORY
De La Haye said another important finding was the impact ganja smoking had on the memory of youth.
"Smoking cannabis can cause youth not to be able to recall things they knew before. So, let's say, last year this time you would have known a chapter from something you studied in school, and after consuming cannabis for a period of time, you find that you are not able to recollect as you did then, or you find you are unable to concretise new material you are now reading from short-term into long-term memory," said the addiction psychiatrist.
"Even if you are smoking weed and not becoming psychotic, but you are doing studies and want to perform well in your examination, you may not want to smoke weed because it will impair your memory."
He added: "There are clear studies showing that the scholastic achievement of persons who smoke cannabis over time compared with those who don't is much less. So, ultimately, persons who smoke cannabis do worse, compared with those who don't."
He also noted that the cerebral cortex, which is involved with decision making, is also impacted.
De La Haye said well-known physiological effects of smoking ganja include: depersonalisation; paranoia; derealisation; an anxiety state causing persons to have panicked reaction; and decreased libido.
He said smoking cannabis can also cause disturbance in time perception, where a person thinks they are engaged in an activity for a longer time than they actually are. It can also lead to alteration in mood; restlessness; excessive thirst; and constipation.
Another causal effect, the doctor said, was apraxia, which is the inability to maintain a steady gait, "meaning you are kind of bobbing and weaving when you walk".
"There is what the average Jamaican would call madness. There are persons, who had they not smoked cannabis would not have become psychotic. Would not have started hearing voices, seeing things, feeling paranoid," he said.
"Persons need to understand that because psychosis is a genetic immediate illness, if you have it in your family, then there is a great chance if you smoke weed, you will become psychotic, too."
He added: "And for those who are bipolar or schizophrenic and are managing and stable, we are almost sure that if you start smoking weed, it is going to disrupt your stability and have you succumb to exacerbation, and a resurgence of symptoms."
The fact is, De La Haye said, smoking anything at all is hazardous for a person's health.
"We can't lose sight of the fact that even if you smoke crushed paper or wood chips, because of the tar in any smoked or lit product, it is dangerous to your health. This is why there are several studies showing that the prevalence for cancer of the lung also increases in persons who smoke cannabis. But again, it would still be hazardous even if you smoke lettuce leaves everyday of your life," he said.
DIFFERENT EFFECTS ON PERSONS
He said smoking ganja affects each person differently, based on a number of factors, such as age, sex, health status, body mass index, metabolic rate, mental and physical strength, how often it is smoked, how much is inhaled, and how deep a person is inhaling.
"The earlier you start to smoke ganja is the more likely you are to have a greater impact, especially if you had the vulnerability for mental illness, which is a genetic predisposition," De La Haye said.
"Overall, when you start using it as an adolescent, the likelihood of having a psychotic episode increases anywhere to times three to times six, as various studies have indicated."
He pointed out that ganja remains in a person's system for four to six weeks after smoking it and is detectable by urinalysis, hair analysis or saliva tests.
ABILITY TO DO JOB
"These are the well-known negative effects of smoking cannabis, which certainly does not allow someone employed in sensitive areas to be able to conduct their activities in a normal manner," stated De La Haye.
"Undoubtedly, working in certain professions like law enforcement, you can't smoke ganja, period, because it will impact your aim in using your weapon because of impaired coordination."
De La Haye said a critical area that needs to be examined is drug driving, as smoking ganja does impact a person's driving ability.
He continued: "The reality is that there are certain jobs, irrespective of your religious conviction, that you just can't smoke it, because there is no doubt that cannabis can definitely impair a person's ability to do their job. The protection of citizens comes first and foremost over your right to exercise those rights," said the doctor.
He stressed that once a person has tested positive, it means they were using the substance, noting that it was highly unlikely that anyone could claim they tested positive because they were among persons smoking ganja.
SOME CASES REVERSIBLE
The addiction psychiatrist said in some cases, the negative effects were reversible once a person stopped smoking the substance. But, because of their vulnerability, there were others that once they start using cannabis and it triggered a psychotic episode, they never recover and they will always be on medication. And, there are some who don't do very well after they stop, as they keep relapsing.
"It is a big game of Russian roulette. You are really not sure what the outcome will be once you start using it," De La Haye pointed out.
"However, luckily for the youngster who smokes, becomes psychotic and comes to us early, the earlier the better. We are able to manage that, once they discontinue using. Those are able to eventually recline and come off medication and remain stable. But there are also many who never come back."