Marijuana use is associated with an increased risk of prescription opioid use. The National Institute on Drug Abuse analyzed data from the National Epidemiologic Survey on Alcohol and Related Conditions and found respondents who reported past-year marijuana use in their initial interview had 2.2 times higher odds than nonusers for having a prescription opioid use disorder and 2.6 times greater odds of abusing prescription opioids.[i]
Marijuana use seems to strengthen the relationship between pain and depression and anxiety, not ease it. A recent study that surveyed 150 adults receiving MAT examined whether marijuana use diminishes the relationships between pain, depression, and anxiety and whether self-efficacy influences these interactions. The study concluded that marijuana use strengthens the connection between feelings of pain and emotional distress. Marijuana use was also associated with a low sense of self-efficacy, making it harder for them to manage their symptoms.[ii]Continue reading Big Marijuana moves to exploit the Opioid Epidemic→
Anthony Bourdain. Kate Spade. You know their names and you know the unfortunate circumstances surrounding their untimely passing. Bourdain, 61, and Spade, 55, took their lives in suicides by hanging. Their deaths marked an immediate response from mental health advocates while pushing mental illnesses such as depression and anxiety to the forefront of the news cycle.
Prior to their deaths the CDC’s (Center for Disease Control), Vital Signs report found that suicide rates have been rising in nearly every state. In 2016, nearly 45,000 Americans age ten or older died by suicide. Even more alarming, suicide is now the 10th leading cause of death and is one of three leading causes that are on the rise. But what does this mean for states where drug use runs rampant? Colorado saw a 34.1 percent increase in suicides while Washington and Oregon saw increases by 18.8 percent and 28.2 percent. Take into consideration that these states have legalized marijuana for recreational and/or medicinal use and it’s clear that mind-altering drugs can aggravate those with and without mental health conditions.
Bourdain was a long time pot smoker and made countless marijuana jokes, often alluding to smoking weed in the restaurants he visited. The “Anthony Bourdain: Parts Unknown” Twitter account once tweeted an elaborate illustration detailing “how to roll a joint.”
Did copious amounts of THC play a part in Bourdain’s death? At this point we don’t know for sure, but we do know that his weed addiction began in his younger years right before the publication of his best-selling book, “Kitchen Confidential,” in 2000. “Weed was a major expense. Before I reached the point where weed made me paranoid and agoraphobic, it was costing me a few hundred dollars a week,” the chef recalled. Fast forward to becoming a successful star, and Bourdain was using cocaine to offset the effects of weed. It’s important to note that cannabis is playing a role in many suicides by causing mental health disorders, including depression and psychosis. One has to wonder if a cocktail of drugs played a part in his untimely death.
Kate Spade suffered from mental illnesses for several years. She was seeking help during the last five years, “seeing a doctor on a regular basis and taking medication for both depression and anxiety,” widower Andy Spade said in a statement. It’s worth nothing that we don’t know if any drug use triggered her problems. The CDC’s Vital Signs report found many factors contributing to the various suicide cases across the country. It’s eye-opening that more than half of people who died by suicide did not have a known diagnosed mental health condition at the time of death.
What a shame it is that thousands of Americans are advocating to legalize a drug with the potential to severely damage the brain? There’s absolutely no sense in burdening our country with a mental health crisis.
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
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.
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.
