An eminent professor of psychopharmacology defined a drug as “something a politician once used but now regrets”.

This does not seem to be far off from the local situation when it comes to marijuana. And unsurprisingly so.

Cannabis is a substance that primarily alters mood and cognition and, unlike most of its purported therapeutic effects, has garnered solid scientific evidence for disrupting a multitude of physical and mental functions.

Understandably, no one’s political career is likely to prosper by divulging regular hashish consumption for cheering oneself up or for promoting cannabis use to voters.

The targeted brain receptor of marijuana is linked to key brain and body functions, ranging from learning, memory, cognition and mood regulation to appetite control, fertility regulation, cardiac function, gastrointestinal motility, insulin resistance and others.

Disrupting the delicate balance of such an important receptor through external overstimulation is conceivably not without risks.

Psychosis, mood disorders, mental slowness through impaired learning and memory, accentuation of anxiety and depression as well as increased heart rate and breathing problems have all been evidenced in relation to cannabis use, especially in those predisposed.

More so, the sought-after hedonic effects occur through the sabotaging of the brain pleasure centres, rendering them less responsive to normally satisfying behaviours. This results in less motivation to engage in activities that tend to characterise our human existence.

Cannabis ticks all the boxes defining addictive drugs. They include rapid onset of reinforcing effects, tolerance with repeated exposure, resetting of the reward system, relief from distressing emotional states and, with heavy use, withdrawal and cravings on abrupt cessation.

Tolerance, which necessitates consumption of higher doses to achieve the same level of sought-after effects, does not occur to marijuana’s devastating effects and, compounded with the unusually slow elimination of the same drug from the body, culminates in escalating harm with elevated dosing.

Addiction is characterised by an increased motivation to engage in a particular behaviour as a result of repetition and despite the occurrence of unintended but unavoidable harm.

I witness its deleterious effects on human life incessantly through my work

Cannabis use is no different. I witness its deleterious effects on human life incessantly through my work, as do the families of those afflicted by cannabis use disorder. A momentous shift in the legal landscape of the most popular, currently illicit, mind-altering substance is unlikely to be devoid of consequences.

Though unintended and largely unavoidable, these complications can be predictable from high-level research evidence of cannabis-induced harm and the experience from countries that have normalised marijuana consumption.

The main factor in the overall equation of regularising marijuana consumption for enjoyment is the provoked change in exposure to the drug in the population and the level of consumption across different age groups.

This is associated with a number of factors including the altered perspective and evaluation of cannabis risks, especially by the younger generations, the commercial availability and preference for more potent cannabis products, relatively novel modes of consumption such as vaporisation, changes in patterns of use and the interaction between evolved cannabis use and consumption of other intoxicating substances.

Most worrisome is the possible diversion of legally manufactured marijuana products and home-grown sativa plants to adolescents and older children.

From a public health perspective, these factors are expected to culminate in an unprecedented “disease burden” of increased cannabis prevalence in the future, unequally targeting the most vulnerable.

This increased opportunity of exposing the brain to a toxic chemical, together with increased prevalence of consumption, culminates in increased opportunity of harm at the population level.

The possible ramifications of accelerated marijuana use on sub-populations at elevated risk is more than enough to annihilate any argument that prioritises convenience and perceived harm reduction for the less vulnerable who choose to “recreate” themselves.

It would be naïve to expect the criminal marijuana enterprises to automatically give up their considerable profits as a result of a legal cannabis market.

It is most likely that, through corruption and advantageous pricing of cannabis and other drugs targeting specific age groups, they will ensure a major market share at the expense of increased criminality and more damage. This is what reportedly happened elsewhere.

The most relevant aspect of the whole argument is the shift in focus on what’s harmful.

It seems that the inefficiencies of the laws that prohibit cannabis use became the main source of harm to humanity while cannabis has been laundered to innocuous and promoted to the status of drug of choice for various conditions, including cancer and chronic illnesses, to the point of being curative. It has even been advocated for enhanced athletic performance.

The “medical” label assigned to cannabis for a multitude of conditions, through political procedures that replaced strict medical research studies, contributed significantly to the process of cannabis normalisation.

Even if there is some evidence it can alleviate a few symptoms in very limited conditions, cannabis medicalisation in the absence of strict evidence has managed to catalyse this shift in perspective.

Objectively, we cannot say that prohibition has been all bad and did not contribute anything to reduce and control consumption.

For example, there is data from studies showing that a proportion of non-users would choose to consume cannabis if they no longer risk prosecution.

On the other hand, it is human nature to go to extremes to engage in a desired activity despite risk of legal sanctions and, in the process, expose oneself to added risks.

Most laws are not perfect, people tend to find loopholes and, in so doing, create complications.

Understandably, those who blame criminalisation for most of, if not all, the harm associated with cannabis are pushing for freedom to consume without legal complications rather than reviewing current laws in the context of changing circumstances and the real harm caused by the drug.

Decriminalisation has already brought about a better balance.

Another factor is the widespread consumption of the drug.

To what extent can marijuana consumption contaminate the user’s views on legislation of the same “mind-altering” drug?

I wonder what drives certain politicians to vehemently deny or dissociate themselves from cannabis use while favouring a shift to free consumption with life-destroying potential, especially to the most vulnerable of our society.

Anthony Dimech is a Consultant Psychiatrist with dual accreditation in General Adult and Addiction Psychiatry from the UK. He is reading for a PhD in comprehensive individualised assessments and interventions for addiction behaviours.

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