Marijuana: Neglected science?

1108811He begins to smoke marijuana at the age of 13, for the euphoric effect, for the detachment from reality and sources of daily anxiety. Its consumption becomes regular, almost compulsive. Psychotic symptoms increase, the motivation decreases. He isolates himself, loses control of its consumption, leading to the hospital repeatedly. He suffers from schizophrenia.

This patient profile, psychiatrist Didier Jutras-Aswad knows him well. Clinical and scientific director of the psychiatric unit and Addiction Hospital of the University of Montreal and researcher at the Research Center, Dr. Jutras-Aswad followed and treated many patients suffering from a disorder related to the use of cannabis.

Spontaneously, one would assume that it opposes the idea of ​​changing the legal status of cannabis, as intends to do the federal government. (When reading the throne speech Friday, the Governor General, David Johnston, confirmed that Canada would adopt legislative measures “that legalize and regulate marijuana use and limit access to this substance.”)

This is not the case.

“I probably biased in favor of changing the legal status of cannabis, if only because the current situation [prohibition] does not work and we have examples around the world changing legal status no negative effect, “says Dr. Jutras-Aswad.

“But as long to do as it should,” he adds.

Consider science

The change of the legal status of marijuana – decriminalization or legalization – could be the opportunity, according to Dr. Jutras-Aswad, to make things better protect the population. Empower citizens in relation to consumption. And better control what is found in the substance.

“But it will depend on how it is done, he insists. If we do it anyhow – besides, if you want my opinion, there are worrying signs for this purpose now – we could change the legal status without there being any impact species on the health of the general population. ”

Currently, he noted, the record is rife with some drift. On one hand, the scientific data used to demonize marijuana. And at the other end of the spectrum trivializes the potentially harmful effects of the substance for some people, such as teenagers or pregnant women.

Most discussions and policies on cannabis are without much consideration of scientific data, wrote Dr. Jutras-Aswad and three colleagues in an article published in 2013 in the journal Neuropharmacology.

Medicinal cannabis: too fast?

Although this is a different folder than the legalization of the medical marijuana case illustrates, according to Dr. Jutras-Aswad, the lack of consideration towards science when discussing the use of marijuana.

Since the changes to the Health Canada regulations, in April 2014, is asking Canadian doctors to prescribe their own cannabis to their patients.

Since cannabis has not been the subject of scientific research “advanced enough” (indications, dosage, side effects and benefits), the Quebec College of Physicians has ruled that doctors who want to prescribe may do so only in the part of a research protocol.

At present, the benefits of cannabis have been scientifically proven for only eight major diseases (see separate tab), according to the Health Canada website. However, Health Canada publishes an exhaustive list of conditions for which cannabis may be an eligible treatment of post-traumatic stress Crohn’s disease through the inflammatory bowel disease.

According to Dr. Jutras-Aswad was “completely retracted” the process by which it must first prove that a drug is effective and safe before putting it on the market.

Didier Jutras-Aswad also found a “great confusion” over therapeutic uses of cannabis. An example: flyers pharmaceutical companies that produce cannabis have been left in the waiting room … a clinic that treats drug addiction.

“It’s crazy like that,” he said, nevertheless adding that doctors who use cannabis for therapeutic purposes do things seriously, like Dr. Mark Ware, director of clinical research unit pain management Alan Edwards of McGill University Health Centre.

Dr. Ware agrees that, “unfortunately, the rule changes are not related to scientific data.” “It is rather due to pressure from patients and lawyers, pressure classes,” he says.

Ideally, he said, the regulations must be supported by scientific data.

When we address the issue of legalization, Dr. Jutras-Aswad hope we take into consideration the data we have, in science as in social sciences. In its field – neuroscience – will be determining what’s missing in the literature to see, for example, if certain populations should be targeted for preventive intervention.

“I think we really lucky with cannabis do things in advance to avoid ending up in 20, 30 years with various problems associated with cannabis could have been better prevent,” he concludes.

Cannabis and brain maturation

In adolescence and early adulthood, brain functions refine. Cannabis target the endocannabinoid system, which is involved in brain development. “If you use cannabis, illustrates Dr. Didier Jutras-Aswad, it is as if we had weighed on the accelerator and stimulate so absolutely normal or physiological neurotransmission this system. “In some people – including teens – the brain gets used and finds a state of homeostasis. But for others, brain maturation is thereby disturbed. Anomalies are sometimes not very important, but they can also lead to various problems, such as developing a psychotic illness and cognitive problems (learning ability, memory, impulsivity, decision making, intelligence quotient).

Risk factors

Age: Young people under 14 or 15 years are considered in an area clearly at risk, while 14 to 18, they are in a buffer zone.

Intensity: Studies suggest that the risk increases if the substance is consumed once a week, or more than 50 times in life.

Heredity: If family members of consumers with mental health problems, the risk that also develops is higher.

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