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marijuana-suicide-risk

The Common Element in These Suicides: Marijuana

The common element in all these suicides or self-inflicted deaths was marijuana.   Marijuana was the factor, not alcohol or other drugs…………in all cases.  (Read Part 1 and Part 2)

Marc Bullard, 23      Colorado

Brant Clark, 17        Colorado

Tron Dohse, 26        Colorado

Luke Goodman, 23      Colorado, traveling from Oklahoma

Daniel Juarez, 18     Colorado

Shane Robinson, 25      California

Rashaan Salaam, 41      Colorado

Levy Thamba, 19         Colorado, traveling from Wyoming

Hamza Warsame, 16       Washington

Andy Zorn, 31          Arizona

marijuana-suicide-risk
These four young men died in marijuana-related suicides. Clockwise from left, Daniel Juarez, Colorado, (photo, CBS News), Shane Robinson, California, Hamza Warsame, Washington (photo, Seattle Times, from the family) and Andy Zorn, Arizona.

Four of these victims — Warsame, Thamba, Juarez, Clark — had experienced pot-induced psychosis during the period leading to their deaths.  Juarez was an outstanding soccer player who got very high with a friend the night he stabbed himself 20 times.   The suicide report showed he had 38.2 ng of marijuana in his blood, eight times the limit for Colorado drivers. Toxicologists tested him for methamphetamine and other substances, but the results turned out to be negative. Although the death occurred in 2012, CBS News obtained the police report in 2015 and made it public at that time.  Juarez´s sister claims he would not have killed himself had he not gotten stoned that night.

Suicidal thoughts can come on very quickly while under the influence in individuals who were not previously suicidal. The suddenness of suicidal ideation means that intervention may be impossible. 

Dohse’s death was determined to have been an accident. Unable to find his keys, Dohse climbed up the apartment building and fell.  The toxicology report 27.3 ng. of marijuana in his blood, but no other drugs or alcohol in his system.  As his sister told CBS, she believes marijuana impairment led her brother to make poor decisions the night of his death.  (Read Part 1 for more background on Warsame, Dohse, Juarez and Clark)

Levy Thamba, left, and Kristine Kirk, right. Both died shortly after marijuana edibles went on sale in Colorado.

The story of Levy Thamba is particularly tragic since he was on a student visa to this country.  He came from the Democratic Republic of Congo to study engineering in Wyoming.  While visiting Denver with friends, he tried a marijuana edible for the first time.  It was a pot-infused cookie, the effects of which don´t appear immediately. About two hours later, he became acutely psychotic, thinking pictures were jumping off the wall. The friends calmed him down before going to sleep, but his psychosis returned.   He ran from his room to the sixth floor balcony, jumping to his death.

Thamba’s death is often described along with the death of Kristine Kirk.  She called 911 because her husband, Richard Kirk, wanted her to shoot him, after he ate a marijuana candy.  By the time, help came, he shot Kristine, mother of their three children, instead.

Bullard, Salaam and Robinson appear to have been suffering from depression as a result of heavy and/or extended pot use.  Marc Bullard was “dabbing.”  Andy Zorn, a veteran who had been taking medical marijuana, knew he had to quit marijuana to survive.  But he couldn’t quit and so took his own life. (Many people begin smoking pot after being told “it’s not addictive.”)

Marijuana Withdrawal is a Risk, Too

Although Shane Robinson had experienced two periods of pot-induced psychosis, he was having marijuana withdrawal syndrome at the time of his death.   According to a program of Dr. Drew Pinsky back in 2003, there is “an extraordinarily high incident of suicide in the first six months of marijuana abstinence.”

Most striking about the youths we describe is that they did not begin pot use because of depression.  All of these deaths occurred in marijuana-friendly states where the social situation was an influence on their pot use.  Lori Robinson, Shane’s mother, warns that educating against drugs and modelling a healthy lifestyle without drug use doesn’t work today.  It is no match for current  cultural trends and government policy which normalizes pot use.

Most who die in marijuana-related suicides are male, but women and girls are still at risk.  One of our supporters attempted suicide in her 20s after years of daily pot use, failed relationships and domestic violence.  Her attempt was not successful.  Today she is 29 years sober and her survival is a blessing.   Not all people will be as lucky. Males are generally more successful in suicide attempts, because their methods are often more efficient.

Pot is the Common Element, not an Underlying Mental Health Issue

These youths banish the claim that mental health problems always come before the marijuana use.   (A strong misconception is that mental illness after using pot only affects those with previous mental health issues.)  The deaths described here include active psychotic reactions at the time of marijuana use, as well as depression from long-term use.

The lives of these young men need to be a warning to states trying to legalize marijuana.  Suicide rates in Colorado have reached all-time highs and each one of Colorado’s 21 health regions had a suicide rate higher than the national average, according to a February report by the Colorado Health Institute.

When the pot industry tells us that “no one ever died from marijuana,” they’re lying.   Maybe it is time for the CDC to start tracking marijuana-related deaths.

These 10 deaths are just a few of the many self-inflicted deaths related to marijuana use.  Lori Robinson has assembled more stories of marijuana-related deaths and psychosis on the website of Moms Strong.  Read these stories on momsstrong.org.

Is Marijuana a Safe Drug?

By  Christine Miller, Ph.D., for Moms Strong.  Dr. Miller was one of many speakers at a rally in front of the state capital in Sacramento, Oct. 4, 2016.  She  also wrote Ten Myths Marijuana Advocates Want You to Believe.

We all know individuals who have been able to use marijuana and be happy, successful and productive members of society. The precise proportion of users who fall into this category is not known, but what is clear is a substantial percentage of people cannot use marijuana with impunity. Unfortunately, you can’t tell ahead of time who that is going to be. There is no genetic test, no psychological profile, no family history screening that is reliable.

The question becomes not how many fatalities does use of marijuana cause, but can a young person use it occasionally, i.e. “responsibly,” like having a single beer once a month or once a week, and be sure that they’ll be O.K.? The answer is no, particularly in regards to psychotic outcomes. Some individuals experience acute psychosis after their first use.

1) Psychosis: hundreds of peer-reviewed, scientific articles show a correlation between marijuana use and psychotic outcomes such as schizophrenia, too numerous to list here. The question of whether marijuana is causal for psychosis has been answered in the affirmative by applying standard principles of causation used in pharmacological and epidemiological research:

  •  Dose response effect, so that heavier use of more potent product results in more users developing schizophrenia(Zammit et al., 2002; van Os et al., 2002; DiForti et al., 2009; DiForti et al., 2015)
  •  Administration of the active ingredient (∆9-THC) in the clinic under controlled conditions causes psychotic symptoms (D’Souza et al., 2004; Morrison et al., 2011; Bhattacharyya et al., 2011; Freeman et al., 2014).
  •  Self-medicating is not that likely, because many will try to quit to avoid the psychotic symptoms before they become too impaired (Fergusson et al., 2005), e.g. comedian Seth McFarlane; but for others it may be too late (as seen in The Other Side of Cannabis, Heartsgate Productions, 2015).
  •  Marijuana use generally comes before the psychosis, not vice-versa (Arseneault et al., 2002; Henquet et al., 2005; Kuepper et al., 2011).
  •  In users who have schizophrenia, the age of onset is earlier than for non-users, similar to the effect of carcinogens in causing an earlier onset of a suite of cancers (Veen et al., 2004; Barnes et al., 2006; Large et al., 2011)
  •  Of all recreational drugs, marijuana use is the most likely to result in chronic psychosis (Niemi-Pynttari et al., 2013).

What percentage experience a psychotic outcome? The low to moderate-strength marijuana available in the last century was shown to trigger single psychotic symptoms (paranoia, racing thoughts, delusions, hallucinations) in 12% to 15% of users (Thomas, 1996; Barkus et al., 2006; Smith et al., 2009). Of those with such “prodromal” symptoms, about 35% can be expected to develop full psychosis, i.e. a constellation of symptoms occurring at once (Cannon et al., 2008). For about half of these individuals, conversion to chronic schizophrenia spectrum disorder occurs irrespective of family history (Arendt et al., 2008; Niemi-Pynttari et al., 2013).

The result for low to moderate-strength marijuana was about a 2.5-fold increased risk of schizophrenia, but for the high strength product available today, the risk for schizophrenia is 5-fold compared to non-users (DiForti et al., 2015). That increase in risk translates into about one out of every twenty users if they don’t quit in time. Is this impact limited to adolescence? Given that the brain continues to develop in males through the late twenties (see figure on back), it seems unlikely that the risk for chronic psychosis is limited to adolescent users. Furthermore, administration of THC to adults in a clinical setting results in psychotic symptoms (D’Souza et al., 2004; Morrison et al., 2011. Bhattacharyya et al., 2011; Freeman et al., 2014).

Other Adverse Psychological Outcomes

2)  Risks for anxiety, panic, and depression are increased by marijuana use: Zuardi et al., 1982; Thomas, 1996; Patton et al., 2002; Dannon et al., 2004; Hayatbakhsh et al., 2007; Medina et al., 2007; Hasin et al., 2008; Zvolensky et al., 2010; Fairman and Anthony, 2012; Silins et al., 2014; Cougle et al., 2015; with some studies showing that correction for confounding variables lessens the association with anxiety and depression, while others report the effect remains. For a review see: Miller CL, The Impact of Marijuana on Mental Health in: Contemporary Health Issues on Marijuana (Winters KC and Sabet K, eds), Oxford University Press, in press.

3)  Risk for suicidal ideation is increased on average 7-fold: Arendt et al., 2006; Silins et al., 2014; Kvitland et al., 2016 , even after correcting for a prior history of depression: Clarke et al., 2014.  In 2014 (the report specific for 2015 data is not yet available), the 2nd year after legalization of recreational use of marijuana, Colorado experienced the highest suicide rate in state history: “In 2014, there were 1,058 suicides among Colorado residents and the age-adjusted suicide rate was 19.4 per 100,000. This is the highest number of suicide deaths ever recorded in Colorado.” Office of Suicide Prevention Annual Report 2014-2015, Colorado Department of Public Health and Environment.

Particularly alarming, the Colorado media has reported sudden onset suicidal ideation or completed suicide in consumers of commercial edibles: Levi Thamba Pongi, Denver, 2014; Richard Kirk, Denver, 2014; Luke Goodman, Keystone, 2015, but also reported following the smoking of potent marijuana: Brant Clark, Boulder, 2007; Daniel Juarez, Brighton, 2012.  (Editor’s note: In Seattle, 16-year-old Hamza Warsame jumped six floors to his death after smoking marijuana in December, 2015.)   These responses can happen so quickly in individuals who were not previously suicidal that intervention may be impossible. 

4)  Lack of educational achievement and decreases in motivation – after covariate adjustment, the odds for marijuana users completing high school are reduced to about 0.37-fold that of controls (Silins et al., 2014); accounting for demographics and other factors, marijuana use adversely affected college academic outcomes, both directly and indirectly through poorer class attendance (Arria et al., 2015); decreases in motivation with marijuana use have been documented in clinical studies of humans (Bloomfield et al., 2014) and in animal models (Silveira et al., 2016).

5)  Negative impacts on IQ: up to an approx. 7 point drop in IQ from childhood scores by age 38 in marijuana users who have been abstinent for 24 hours prior to testing; but only an approx. 5 point drop in those abstinent for a week prior to testing (Meier MH et al., 2012); a subsequent study of twins by Jackson et al., 2016, yielded mixed results, with an average decline of 4 points in marijuana users by late adolescence, however restricting the comparison to the matched twins (thereby controlling for genetics and a myriad of environmental factors), the effect of marijuana largely disappeared. The limitation of this later study is that brain development is not complete by late adolescence, particularly the wiring of the all-important cortex is still ongoing through the late twenties (see Figure below). There is no controversy, however, about the negative, real-time impact of marijuana use during tests of cognition and memory: Curran HV et al., 2002; Ranganathan and D’Souza, 2006; Morrison et al., 2009; Solowj et al., 2010; Pavisian et al., 2014.

See 10 Myths Marijuana Advocates Want You to Believe for complete information, footnotes and the bibliography

Dr. McKeganey Warned of the Marijuana – Mental Illness Link

PSA Warning Issued in 2005 was Ignored

Eleven years ago the ONDCP and SAMHSA held a press conference to inform of research that confirms what many families already knew–that marijuana use was a trigger for psychosis and mental illness.

The ONDCP is the White House Office of National Drug Control Policy; SAMHSA is the Substance Abuse and Mental Health Services Administration.  Each agency has a crucial role in trying to ascertain usage and reduce demand for drugs.

Specifically, Dr. Neil McKehaney from the University of Glasgow came to the US and spoke at the national Press Club on May 5, 2005. The agencies went to great effort to share important information.  A video was recently found online.

Coverup of the Marijuana – Mental Illness  Risk

At this same Press Conference, a couple who had lost their 15-year-old son to suicide due to the mental health problems arising from marijuana use, spoke.  The Press covered the story, but did not use their considerable investigative skills to probe into what those parents and Dr. McKenagey were describing.  It is true that about one quarter of American high school students are depressed, which points to multiple problems of American culture, not just drugs. However, knowing how vulnerable teens are, and then not exposing the factors that could make their outcomes worse, is lamentable.

In addition to depression, anxiety and suicide, there are the risks of psychosis, bipolar disorder and schizophrenia that arise from marijuana use.  Pot proponents love to state that anyone who has a psychotic reaction to pot already had the problem before they used it.  They tend to blame family members for not  wanting to admit  mental health problems, and argue that pot is used as a scapegoat.

Several studies have shown a link between marijuana and schizophrenia.  Explains pharmacologist Christine Miller, Ph.D:  “No one is destined to develop schizophrenia. With identical twins, one can develop the disease and the other one will do so only 50% of the time, illustrating the importance of environmental factors in the expression of the disease.  Marijuana is one of those environmental factors and it is one we can do something about.”

A Missed Opportunity

One person who worked in the office of ONDCP Director John Walters told Parents Opposed to Pot, “They accused us of being pot-crazy during a time when there was a methamphetamine crisis going on.  Marijuana is almost always the first drug introduced to young people and the evidence for the mental health risks were very strong by 2005.  Although pot was getting stronger as it is today, the warning was falling on deaf ears.  Members of Congress wanted us to focus on the meth crisis, but marijuana was a growing issue and we had a myriad of issues.”

This Public Service Announcement reached audiences in the Press, and some newspapers and magazines reported about it.  Since the Internet and search engines were not as they are  today,  few parents, children,  schools and mental health professionals took notice.   (Did the marijuana lobbying groups bully and try squelch the information?)

Lori Robinson, whose son suffered the mental health consequences of marijuana said:  “I will always deeply regret Shane not hearing this PSA .  Shane was a smart, gregarious and fun-loving young man who naively began using pot never knowing he was playing Russian roulette with his brain in ’05-’06 at the age of 19.   Dr McKeganey so clearly stated that the public views marijuana as harmless, not realizing the potency of THC was rising while the “antipsychotic” property of CBD was being bred out.  Sadly, despite both parents never used an illegal drug in our lives, our son assumed that since a few of his friend had smoked in high school, it was just a “harmless herb.”   Shane’s story is on the Moms Strong website.

Robinson added, “This video is absolutely current TODAY.  Let’s keep this video circulating & it WILL save young brains & families the destruction that lies ahead when marijuana hijacks your kid’s brain.

The research has expanded since that time and scientific evidence on each of the following outcomes from marijuana use is voluminous: marijuana & psychosis, marijuana & violence and marijuana & psychiatric disorders.

Lessons to be Learned

Lives could have been saved, and so many cases of depression, psychotic breakdowns and crimes could have been prevented – if the public had become more aware back in 2005.   Congress, the Press and most of all, the American psychiatric community was wrong to ignore the warnings that were issued with this PSA.

Let’s not continue to ignore  the evidence. Today in the US, mental health is worse than it’s ever been, and the promotion of drug usage may be a huge factor in this problem.  Harm reduction in preference to primary prevention strategies is practiced in many jurisdictions.  Drug overdose deaths have overtaken gun violence deaths and traffic fatalities in the USA — by far — under this strategy.

Today Dr. McKeganey is the Director of the Center for Substance Use Research in Glasgow.

Marijuana-Truth

Filmmaker Explains the Marijuana Truth

Filmmaker Sets Record Straight in Statement About Marijuana

by Jody Belsher, filmmaker, The Other Side of Cannabis

TOP TEN THINGS marijuana enthusiasts say to defend this psychoactive drug:
1. It’s natural
2. It cures cancer, cannabis is good for anxiety and depression
3. It’s never killed anyone
4. I have studies to prove how good it is.
5. The anti-pot people are all prohibitionists, propagandists
6. It’s safer than alcohol
7. What’s the big deal already, let’s just legalize
8. Marijuana will make a lot of money from taxes
9. The Cartel will go away if we legalize
10. We imprison 1000’s of people from marijuana not being legal Continue reading