Not surprisingly, misinformation continues to threaten the medical marijuana industry, a major concern for doctors and patients alike. When statements are intentionally crafted using cherry-picked and misinterpreted conclusions such that they demonstrate clear bias, the underlying concepts become as dangerous as they are unscientific. When these opinion-fueled ideas are then published by outlets as influential as the Wall Street Journal, legitimate, licensed medical cannabis professionals and researchers are forced to brace against the coming waves of misconception, social stigma, and uncertain legislative status.
Claims that cannabis use, whether medical or recreational, can cause or increase rates of mental illness and violent crime outright only serve to instill fear in the minds of the public. Doing so at such a critical tipping point for medical patients in the U.S., who could experience significant relief from a wide range of physical and mental medical conditions threatens to slow the progress of this industry that focuses solely on providing effective treatment. These types of misinformed and biased articles serve as little more than scare tactics and are incredibly irresponsible.
Cannabis and Mental Illness
Perhaps the most offensive concept presented by Alex Berenson’s recent Wall Street Journal op-ed, titled “Marijuana Is More Dangerous Than You Think”, is an association between cannabis legality and mental illness. But don’t be fooled–as any good statistics student knows, correlation does not imply causation. In other words, just because two things may appear related, it doesn’t mean that one causes the other, or vice versa.
Berenson’s claim that “for centuries, people all over the world have understood that cannabis causes mental illness and violence” is in fact categorically untrue. Quite the contrary, ancient uses of cannabis and hemp aimed at treating symptoms now recognized as anxiety, depression, mania, and paranoia. In today’s evidence-based medical arena, decisions on medical therapies are and should remain driven by preclinical and outcomes-based clinical research. We simply do not understand enough about the endocannabinoid system and its therapeutic manipulations to make blanket statements or assumptions on disease processes or side effects.
The article makes a point of referencing survey data from September 2018 that points to a rise in U.S. mental illness rates; up to 7.5% of Denmark and Finland’s young adults reported serious mental illness in 2017, nearly twice the rate reported in 2008. Interestingly, any evidence linking marijuana to this increase is absent from Berenson’s op-ed.
Yes, it is fair to point out that cannabis use can result in paranoia. And of course, cannabis users are quick to make light of the effect, but it’s also important to acknowledge that different patients are affected by different types of marijuana in a variety of ways, and the “paranoid stoner” trope of film and television is mostly just that: a stereotype proliferated for entertainment purposes.
Cannabis ≠ Crime
Berenson’s op-ed cites statistics dating back to 2014 and 2015 for Colorado, Washington, Alaska, and Oregon–the first four states to legalize recreational marijuana; Berenson compared the states’ murder and aggravated assault rates to those from 2017 and identified increases, making no small effort to imply that legalization of marijuana could be a cause.
However, research on marijuana use in addition to regularly analyzed crime statistics in legalized states has repeatedly shown a nearly complete lack of violent tendencies in marijuana users, recreational or medical. In fact, according to a study published in The Economic Journal in June 2017 titled “Is Legal Pot Crippling Mexican Drug Trafficking Organizations? The Effect of Medical Marijuana Laws on US Crime,” the introduction of medical marijuana laws in US states bordering Mexico has led to a “sharp reduction in violent crime”–a 13% decrease on average.
Economist and study author Evelina Gavrilova explained further: “Whenever there is a medical marijuana law we observe that crime at the border decreases because suddenly there is a lot less smuggling and a lot less violence associated with that.” In fact, researchers from the study found the following after legalization of medical marijuana in states bordering Mexico:
- Violent crime in California decreased by 15%
- Violent crime in Arizona dropped by 7%
- Robbery dropped by an average of 19%
- Murder rates decreased by an average of 10%
- Homicides specifically related to the drug trade fell by an astonishing 41%
The Focus On Opiates
Berenson’s op-ed does get one thing right: opiates (and many prescription medications, for that matter) can be far more dangerous than cannabis, and as such both government and public parties have given those drugs the most attention. It’s unfair to mention both cannabis and opiates in the same breath, however, as the two could not be more different from each other. Furthermore, a significant amount of research exists that shows that areas surrounding legal marijuana dispensaries actually benefit from reduced opioid overdose rates.
The Reality of Berenson’s Claims
As the opinion piece continues laying its foundation of misinformation, Berenson inappropriately makes the claim that cannabis use causes schizophrenia. He then proposes that cannabis causes psychosis, which causes an increase in violent crime. Unfortunately, because his audience is not a primarily scientific one able to review his assertions and critically analyze and interpret the source literature, his claims, when presented in a widely-respected international publication like The Wall Street Journal, are mostly taken at face value by the readership.
Ziva Cooper, Ph.D., Research Director for UCLA’s Cannabis Research Initiative and Associate Professor at the Semel Institute for Neuroscience and Human Behavior and Department of Psychiatry and Biobehavioral Sciences, is one of the co-authors of the 2016 National Academies of Science, Engineering, and Medicine’s comprehensive report on the state of cannabis research, evidence for use, and recommendations on future research. This report, referred to as the NASEM report throughout this piece, is the main source from which Berenson derives his biased conclusions. Dr. Cooper has commented publicly on his misrepresentation of the report’s findings:
“Mr. Berenson was trying to convey the risks associated with cannabis. But he did so in a biased manner where he only presented data to support his arguments, even though there is very strong data on the other side to disprove his arguments. And so, for instance, he was talking about how cannabis use leads to greater opioid consumption, but there is evidence pointing to the contrary that he failed to raise. So, in that respect it was biased. And then with respect to his misinterpretation of the conclusions of the National Academy of Sciences report stating that cannabis causes schizophrenia, that was a gross misinterpretation of our conclusions in the text. And to make that claim is quite dangerous and it’s misinformed.”
Cooper continues: “I have yet to see scientists strongly support his claims, so that speaks volumes. To misrepresent the scientific findings de-legitimizes the actual research related to the risks that are known to be related to cannabis, such as cannabis use disorder and impaired driving. He’s immediately striking fear in the readers’ minds rather than portraying the data that we have a great deal of information on. My fear is that people really aren’t going to look at our report as a primary source. They’re going to look at his interpretation of our findings.
“With regard to our consensus report and how we synthesize and evaluated available research we all work hard to come to an agreement as to what the conclusions are. What does the data support? Conclusions were that there is substantial evidence to support that cannabis use is associated with developing schizophrenia and other psychotic disorders. Associated. Not causation, but association. And if you look at the report, we also have a conclusion that says that cannabis use history is associated with improved cognitive function in people that have psychotic disorders. So, again there’s an example of bias here. He chose the first conclusion, which says that there’s an association between cannabis use and schizophrenia, but not the second one that shows that there’s clearly a very complex relationship between cannabis use and schizophrenia.”.
The Result of Misinformation
A timely demonstration of the reach of such alarmist and biased writing took place in Florida State Legislature during ongoing debate over amending the state’s constitution to allow for smoking of the cannabis flower. House Speaker José Oliva brought Berenson to speak with legislators of both chambers, and he delivered the following message: “Marijuana is not medicine. Cannabis use is a broad risk. The book has at least a dozen studies from all over the world. The risk for violence among cannabis users is at least the same among alcohol users.”
Assuming that inflammatory remarks such as these, based on faulty, misleadingly biased conclusions, will not have an effect on the future of patients’ lives is pure folly. As further research relating to marijuana medical effects and general properties is produced, one can hope that the cloud of misinformation will clear and negative opinions will become powerless. Until that point, it is best to remain observant, skeptical, and supported by fact when it comes to cannabis topics.
Luis Enrique R. Liogier-Weyback, MD is the founder of Doctor Jane, Florida’s most discreet, professional and convenient concierge medical cannabis practice. Doctor Jane provides South Florida patients and their caregivers with a safe space where they can exercise their right to access medical cannabis therapy in an environment of their choosing, free from stigma and complications. To learn more about Doctor Jane, visit www.DoctorJane.net.