7 ms·

> Several limitations must be considered when interpreting the evidence reviewed in this paper. First and foremost, medical and recreational use of cannabis are

> Several limitations must be considered when interpreting the evidence reviewed in this paper. First and foremost, medical and recreational use of cannabis are not the same and their effects on cognition should not be assumed to be equivalent. Adding to this variability are the different constituents of cannabis studied, including whole plant cannabis and isolated compounds. So much this. You need three way split studies (And perhaps different category naming). - +50 year varieties of cannabis - medical cannabis (Higher CBD, lower THC) - Modern dispensary cannabis (high THC) We keep selling the idea that bud is natural but ask anyone older than 60 who smokes and they will tell you 'modern' cannabis is absolutely wild compared with what existed a few decades ago. Anecdata I personally know someone in their early 20 who experienced a major psychotic event following regular heavy use of cannabis. The mental health and neural maturation of 13 to 25 yr old while consuming cannabis is something that also needs very urgent studying.

InSteady 3y ago
I am not an "older person" and I was smoking bud a few decades ago, thank you very much. Some of the stuff I got back then was categorically better than a great deal of the dispensary bud found today. Some of the cannabis cup winning strains from the mid 90's to mid 2000's would beat the pants off of the vast majority of mega-THC, mass produced strains sold in your average pot shop in terms of pleasant qualitative effects. It's wonderful to be able to take a few hits and hit the perfect high.. you smoke less bud, experience more of the pleasant effects with less of the mind-numbing, paranoia, and other unpleasant side-effects. In the 70's (and still today with trash-tier cannabis) people had to smoke tons to get any effect. I have done this with Mexican brick weed (purchased in Mexico). It is just straight up an inferior experience, there is nothing more safe or beneficial to smoking a butt load of crappy weed in order to get high. Also, it's kind of a myth that cannabis was terrible back in the 70's. A lot of it was, don't get me wrong. But selective breeding and sophisticated indoor growing techniques were developing at that time, so it was possible to get pretty damn good bud if you happened to know the right people. There is still plenty of outdoor 'Mexican brick weed' going around these days just like it was back in the 70's, and it's pure trash. And there is plenty of mediocre bud masquerading as "top shelf" going around today (including strains in dispensaries advertising astronomical and dubious THC percentages). As ever it takes a lot of time, expertise, equipment, and capital to produce truly great bud. Now if you start talking about distillates and concentrates, that is one area in which I agree there is a notable difference in usage patterns and negative effects. It's kind of comparable to turning cocaine into free-base IMO. >I personally know someone in their early 20 who experienced a major psychotic event following regular heavy use of cannabis This is the classic timeframe for psychosis to develop. Despite millions of gov dollars spent trying to prove a connection, there is no evidence that cannabis causes psychosis: Cannabis and Psychosis: a Critical Overview of the Relationship https://pubmed.ncbi.nlm.nih.gov/26781550/ https://pubmed.ncbi.nlm.nih.gov/26781550/ >Evidence reviewed here suggests that cannabis does not in itself cause a psychosis disorder. Rather, the evidence leads us to conclude that both early use and heavy use of cannabis are more likely in individuals with a vulnerability to psychosis. I don't use at all anymore, btw, so I'm definitely not a cannabis evangelist or any such. Just throwing in my two cents.
- arp242 3y ago
  The link between cannabis use and psychosis is very real, although it's less clear if cannabis causes the psychosis. Other people have come to different conclusions than the paper you linked. At this point there it's hard to be sure one way or the other, but all things considered I feel there's enough to warrant some caution (also wrt. dependency and some other issues).
  - dackerlunghack 3y ago
    [dead]
  - bregma 3y ago
    Correlation is not causation. There are plenty of other drugs (especially alcohol) used for self-medication that are also linked to psychoses, as well as non-drug behviours that are strongly correlated to psychoses. The immediate jump to causation is mostly politically-based and not scientifically-based.
    - arp242 3y ago
      > Correlation is not causation. Yes, I believe I said this: "it's less clear if cannabis causes the psychosis". But thank you for your platitude. The only answer which can be given with any certainty at this point is "we don't know", which may optionally be followed by "but I think that [..]". There is no "immediate jump" to causation; the only such jump I see here is dismissing things out of hand on account of allegedly being "politically-based".
      - trevwilson 3y ago
        > The only answer which can be given with any certainty at this point is "we don't know" It might be a little more convincing if you shared whatever studies you're referencing to form this opinion, because while I don't have access to the paper linked above the abstract pretty definitively seems to be saying that we do know with some certainty: > Evidence reviewed here suggests that cannabis does not in itself cause a psychosis disorder. Rather, the evidence leads us to conclude that both early use and heavy use of cannabis are more likely in individuals with a vulnerability to psychosis. >Future research studies that focus exclusively on the cannabis-psychosis association will therefore be of little value in our quest to better understand psychosis and how and why it occurs.
theshackleford 3y ago
Medical cannabis doesn’t mean higher CBD lower THC at all as a blanket rule. It all depends what it’s intended to treat. For ongoing complications relating to a SCI for instance, they prescribe a high THC low CBD offering as higher THC is shown to be more effective for what they are trying to impact.
- InSteady 3y ago
  Yeah, they really don't know what they are talking about it seems. High CBD strains are relatively new to the scene, at least in popular adoption. Medical cannabis has been around since the 90's, and it was mostly potent strains that were preferred and shared among cardholders. High CBD strains may be helpful for anxiety in some people, and are amazing for epileptic seizures. However, medical cannabis is prescribed for many other conditions as well. The pain relieving effects of cannabis are multifaceted, but generally speaking, strains with a higher ration of THC:CBD are going to perform better here (that doesn't at all mean higher THC = more pain relief, though).
- DoingIsLearning 3y ago
  You are correct. Again comes back to the need for better naming, I meant variants intended for seizure control in Epilepsy.
  - theshackleford 3y ago
    That makes sense. I only added my experience because I must admit that as a new patient, I went in asking for a "High CBD/low THC" option because I was under the impression early on that CBD was the more important therapeutic component and I didn't "want to be high" but was sadly informed that for pain, that was not particularly an option, which was very much new to me to learn.
- adr1an 3y ago
  I assume SCI == Spinal Cord Injury
guerrilla 3y ago
Exactly. It's only "natural" if you think dogs, cabbage and corn are natural. I think that's besides the point though. It's fallacious thinking. Wild tobacco is not what you want. Not that any tibacco is, but you get the point.
pipes 3y ago
Did the person recover from the event? I'm genuinely interested. I knew someone who seemed to have suffered something catastrophic from regualy ecstasy use. (this was twenty years ago, I haven't seen him since). Personally I think weed is the most underestimated of all drugs. I smoked it for a while when I was a teenager and I think it left permanent bad effects. But I can never be sure.
- wolfpack_mick 3y ago
  What permanent bad effect do you think it has left? I do wonder about this too. I binge drank between 14-16 years old, started smoking weed around the same time - and smoked daily from 20-25. After that I did a short bout of therapy and walked away from it. I'm now 40 and I do often wonder what damage might have been done. If I'd have to guess how damage could materialise i'd point to the fact that my thinking was polarised for a long time and I had trouble controlling my emotions. But those traits could easily be attributed to verbal aggression and a lack of trust and empathy in my childhood - which most likely contributed to the substance abuse in the first place (1) Or it could even just be attributed to the male brain taking a little more time to mature. (1) https://www.theguardian.com/society/2023/oct/02/shouting-at-children-can-be-as-damaging-as-physical-or-sexual-abuse-study-says https://www.theguardian.com/society/2023/oct/02/shouting-at-...
  - pipes 3y ago
    I skateboarded, drank and smoked with this guy when I was about 15/16 (he was just part of our little group that skated etc, not a close friend, more just someone I knew). He was really out going, funny, confident. Whatever happened I didn't see him for another five years or so. Then at about 21/22 years old, me and another mate met him randomly on the bus... Right away it was obvious that something had gone badly wrong for him. He seemed jittery and withdrawn. We all laughed at a joke together, ten minutes later he asked if we'd been laughing at him, it was so surprising. He explained he was no good at doing jobs and had failed at chefing. He also explained he'd been living in a house were they were they had been doing Es everyday (he'd moved out and stopped that). Some of his house mates I knew of vaguely, I knew them mostly as dodgy bastards that should be avoided at all costs. Anyway he seemed to be a wreck of a person. Judging the character change I doubt it wasn't permanent damage, but I'm no expert. Bizarrely this encounter was 20 years ago, and I remember it clearly because it was so utterly shocking to me. Thanks for the link by the way. Ever since my daughter was born I've been stopping my wife from shouting at her or labelling her something negative, because I know all too well what it did to me (it was totally minor for me, but it's there). My wife has finally accepted this and it's stopped. Hrm, one positive impact I've had on the world I guess :)
thedaly 3y ago
> We keep selling the idea that bud is natural but ask anyone older than 60 who smokes and they will tell you 'modern' cannabis is absolutely wild compared with what existed a few decades ago. To be fair, this is true of all drugs across the board, most notably alcohol.
- johnea 3y ago
  As a daily weed smoker, over 60, who's not a fan of alcohol, I still have to disagree with this. The strain selection that's gone on since cannabis was legalized has led to massively more potent strains. But alcohol products, measured in "proof" equal to 2x the percentage of alcohol in the product, has been stable since before my lifetime. Alcohol hasn't changed it's potency at all. However to support your point (maybe), then and now, alcohol causes MUCH more social and medical harm than cannabis.
  - thedaly 3y ago
    I should be more clear, I mostly mean alcohol in the time since the industrial revolution, after breakthroughs were made in the yeast technology. Prior to the developments, there was a limit to how potent we could brew alcohol before it poisoned the yeast. Although, IPAs are one example of alcohol potency increasing over the last few decades. Perhaps the better comparison to cannabis is nicotine, which has also exploded in potency over the last 50 years. Anecdotally, this trend seems to be ingrained in human nature. We like are drugs and we like them as strong as we can make them.
    - flextheruler 3y ago
      We’ve had liquor for nearly as long as we’ve had alcohol. How has the potency of alcohol products increased? Yes there are stronger IPAs but they’re a small minority of alcohol products who are still well below the alcohol percentages of liquor or wine. Also I don’t see how nicotine product potency has increased either. There’s just salt nicotine vapes now and they often still pale in comparison to strong tobacco in terms of nicotine concentration. And trust me the tobacco are ancestors had was just as strong if not stronger as what we have. We figured out selective breeding of plants a long time ago and tobacco has been openly grown for centuries.

InSteady 3y ago

I am not an "older person" and I was smoking bud a few decades ago, thank you very much. Some of the stuff I got back then was categorically better than a great deal of the dispensary bud found today. Some of the cannabis cup winning strains from the mid 90's to mid 2000's would beat the pants off of the vast majority of mega-THC, mass produced strains sold in your average pot shop in terms of pleasant qualitative effects. It's wonderful to be able to take a few hits and hit the perfect high.. you smoke less bud, experience more of the pleasant effects with less of the mind-numbing, paranoia, and other unpleasant side-effects. In the 70's (and still today with trash-tier cannabis) people had to smoke tons to get any effect. I have done this with Mexican brick weed (purchased in Mexico). It is just straight up an inferior experience, there is nothing more safe or beneficial to smoking a butt load of crappy weed in order to get high. Also, it's kind of a myth that cannabis was terrible back in the 70's. A lot of it was, don't get me wrong. But selective breeding and sophisticated indoor growing techniques were developing at that time, so it was possible to get pretty damn good bud if you happened to know the right people. There is still plenty of outdoor 'Mexican brick weed' going around these days just like it was back in the 70's, and it's pure trash. And there is plenty of mediocre bud masquerading as "top shelf" going around today (including strains in dispensaries advertising astronomical and dubious THC percentages). As ever it takes a lot of time, expertise, equipment, and capital to produce truly great bud. Now if you start talking about distillates and concentrates, that is one area in which I agree there is a notable difference in usage patterns and negative effects. It's kind of comparable to turning cocaine into free-base IMO. >I personally know someone in their early 20 who experienced a major psychotic event following regular heavy use of cannabis This is the classic timeframe for psychosis to develop. Despite millions of gov dollars spent trying to prove a connection, there is no evidence that cannabis causes psychosis: Cannabis and Psychosis: a Critical Overview of the Relationship https://pubmed.ncbi.nlm.nih.gov/26781550/ https://pubmed.ncbi.nlm.nih.gov/26781550/ >Evidence reviewed here suggests that cannabis does not in itself cause a psychosis disorder. Rather, the evidence leads us to conclude that both early use and heavy use of cannabis are more likely in individuals with a vulnerability to psychosis. I don't use at all anymore, btw, so I'm definitely not a cannabis evangelist or any such. Just throwing in my two cents.

arp242 3y ago
The link between cannabis use and psychosis is very real, although it's less clear if cannabis causes the psychosis. Other people have come to different conclusions than the paper you linked. At this point there it's hard to be sure one way or the other, but all things considered I feel there's enough to warrant some caution (also wrt. dependency and some other issues).
- dackerlunghack 3y ago
  [dead]
- bregma 3y ago
  Correlation is not causation. There are plenty of other drugs (especially alcohol) used for self-medication that are also linked to psychoses, as well as non-drug behviours that are strongly correlated to psychoses. The immediate jump to causation is mostly politically-based and not scientifically-based.
  - arp242 3y ago
    > Correlation is not causation. Yes, I believe I said this: "it's less clear if cannabis causes the psychosis". But thank you for your platitude. The only answer which can be given with any certainty at this point is "we don't know", which may optionally be followed by "but I think that [..]". There is no "immediate jump" to causation; the only such jump I see here is dismissing things out of hand on account of allegedly being "politically-based".
    - trevwilson 3y ago
      > The only answer which can be given with any certainty at this point is "we don't know" It might be a little more convincing if you shared whatever studies you're referencing to form this opinion, because while I don't have access to the paper linked above the abstract pretty definitively seems to be saying that we do know with some certainty: > Evidence reviewed here suggests that cannabis does not in itself cause a psychosis disorder. Rather, the evidence leads us to conclude that both early use and heavy use of cannabis are more likely in individuals with a vulnerability to psychosis. >Future research studies that focus exclusively on the cannabis-psychosis association will therefore be of little value in our quest to better understand psychosis and how and why it occurs.

theshackleford 3y ago

Medical cannabis doesn’t mean higher CBD lower THC at all as a blanket rule. It all depends what it’s intended to treat. For ongoing complications relating to a SCI for instance, they prescribe a high THC low CBD offering as higher THC is shown to be more effective for what they are trying to impact.

InSteady 3y ago
Yeah, they really don't know what they are talking about it seems. High CBD strains are relatively new to the scene, at least in popular adoption. Medical cannabis has been around since the 90's, and it was mostly potent strains that were preferred and shared among cardholders. High CBD strains may be helpful for anxiety in some people, and are amazing for epileptic seizures. However, medical cannabis is prescribed for many other conditions as well. The pain relieving effects of cannabis are multifaceted, but generally speaking, strains with a higher ration of THC:CBD are going to perform better here (that doesn't at all mean higher THC = more pain relief, though).
DoingIsLearning 3y ago
You are correct. Again comes back to the need for better naming, I meant variants intended for seizure control in Epilepsy.
- theshackleford 3y ago
  That makes sense. I only added my experience because I must admit that as a new patient, I went in asking for a "High CBD/low THC" option because I was under the impression early on that CBD was the more important therapeutic component and I didn't "want to be high" but was sadly informed that for pain, that was not particularly an option, which was very much new to me to learn.
adr1an 3y ago
I assume SCI == Spinal Cord Injury

guerrilla 3y ago

Exactly. It's only "natural" if you think dogs, cabbage and corn are natural. I think that's besides the point though. It's fallacious thinking. Wild tobacco is not what you want. Not that any tibacco is, but you get the point.

pipes 3y ago

Did the person recover from the event? I'm genuinely interested. I knew someone who seemed to have suffered something catastrophic from regualy ecstasy use. (this was twenty years ago, I haven't seen him since). Personally I think weed is the most underestimated of all drugs. I smoked it for a while when I was a teenager and I think it left permanent bad effects. But I can never be sure.

wolfpack_mick 3y ago
What permanent bad effect do you think it has left? I do wonder about this too. I binge drank between 14-16 years old, started smoking weed around the same time - and smoked daily from 20-25. After that I did a short bout of therapy and walked away from it. I'm now 40 and I do often wonder what damage might have been done. If I'd have to guess how damage could materialise i'd point to the fact that my thinking was polarised for a long time and I had trouble controlling my emotions. But those traits could easily be attributed to verbal aggression and a lack of trust and empathy in my childhood - which most likely contributed to the substance abuse in the first place (1) Or it could even just be attributed to the male brain taking a little more time to mature. (1) https://www.theguardian.com/society/2023/oct/02/shouting-at-children-can-be-as-damaging-as-physical-or-sexual-abuse-study-says https://www.theguardian.com/society/2023/oct/02/shouting-at-...
- pipes 3y ago
  I skateboarded, drank and smoked with this guy when I was about 15/16 (he was just part of our little group that skated etc, not a close friend, more just someone I knew). He was really out going, funny, confident. Whatever happened I didn't see him for another five years or so. Then at about 21/22 years old, me and another mate met him randomly on the bus... Right away it was obvious that something had gone badly wrong for him. He seemed jittery and withdrawn. We all laughed at a joke together, ten minutes later he asked if we'd been laughing at him, it was so surprising. He explained he was no good at doing jobs and had failed at chefing. He also explained he'd been living in a house were they were they had been doing Es everyday (he'd moved out and stopped that). Some of his house mates I knew of vaguely, I knew them mostly as dodgy bastards that should be avoided at all costs. Anyway he seemed to be a wreck of a person. Judging the character change I doubt it wasn't permanent damage, but I'm no expert. Bizarrely this encounter was 20 years ago, and I remember it clearly because it was so utterly shocking to me. Thanks for the link by the way. Ever since my daughter was born I've been stopping my wife from shouting at her or labelling her something negative, because I know all too well what it did to me (it was totally minor for me, but it's there). My wife has finally accepted this and it's stopped. Hrm, one positive impact I've had on the world I guess :)

thedaly 3y ago

> We keep selling the idea that bud is natural but ask anyone older than 60 who smokes and they will tell you 'modern' cannabis is absolutely wild compared with what existed a few decades ago. To be fair, this is true of all drugs across the board, most notably alcohol.

johnea 3y ago
As a daily weed smoker, over 60, who's not a fan of alcohol, I still have to disagree with this. The strain selection that's gone on since cannabis was legalized has led to massively more potent strains. But alcohol products, measured in "proof" equal to 2x the percentage of alcohol in the product, has been stable since before my lifetime. Alcohol hasn't changed it's potency at all. However to support your point (maybe), then and now, alcohol causes MUCH more social and medical harm than cannabis.
- thedaly 3y ago
  I should be more clear, I mostly mean alcohol in the time since the industrial revolution, after breakthroughs were made in the yeast technology. Prior to the developments, there was a limit to how potent we could brew alcohol before it poisoned the yeast. Although, IPAs are one example of alcohol potency increasing over the last few decades. Perhaps the better comparison to cannabis is nicotine, which has also exploded in potency over the last 50 years. Anecdotally, this trend seems to be ingrained in human nature. We like are drugs and we like them as strong as we can make them.
  - flextheruler 3y ago
    We’ve had liquor for nearly as long as we’ve had alcohol. How has the potency of alcohol products increased? Yes there are stronger IPAs but they’re a small minority of alcohol products who are still well below the alcohol percentages of liquor or wine. Also I don’t see how nicotine product potency has increased either. There’s just salt nicotine vapes now and they often still pale in comparison to strong tobacco in terms of nicotine concentration. And trust me the tobacco are ancestors had was just as strong if not stronger as what we have. We figured out selective breeding of plants a long time ago and tobacco has been openly grown for centuries.