The Royal College of Psychiatrists has announced that it is to carry out a review into its opposition to the decriminalisation of cannabis.

Traditionally the organisation has resisted calls for its opposition to relaxing laws for the Class B drug to be dropped and this move may signal a shift in the beliefs held by the College’s leading psychiatrists.

Significantly, this announcement comes just a week before cannabis derived medicines will be available on prescription to patients fulfilling strict criteria and after a summer of gathering momentum for campaigns seeking to relax drug laws in the UK.

It is important to note that at this point the Royal College of Psychiatrists will only be reviewing its opposition to the decriminalisation of cannabis and not of the legalisation of the drug. The review will mainly be conceived of an analysis of evidence gathered from countries where cannabis has already been legalised, which will enable it to identify whether decriminalisation and legalisation has an impact on incidences of mental disorders associated with cannabis use.
Royal College of Psychiatrists Head of policy and review chair said “We need to look at it in more detail to get more evidence. One of the arguments for legalising cannabis has been that you will get purer forms of it and you can tax it so governments benefit.”

Irrespective of the scope of this review, it could be a pivotal moment in British drug policy as some of the College’s leading psychiatrists have been involved in research which the government has utilised in its frequent rebuttals of arguments for decriminalisation and legalisation. Additionally, a number of its members occupy powerful positions advising the government, including Dr Owen Bowden-Jones who is the chairman of the Advisory Council on the Misuse of Drugs. Therefore, without the scant backing of a few of the College’s psychiatrists, the governments current position would become increasingly untenable.

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So what evidence is already exists?

From an analysis of Dr James’ interview with the Daily Telegraph it is possible to identify the areas that the review will be delving into.

The link between Cannabis and Schizophrenia

Dr Adrian James reiterated the College’s official view that its opposition to legalisation of cannabis is due to concerns that is can cause psychosis in users.

“Our official view is that we are concerned about the health risks and we are against legalisation of cannabis on that basis but there may be arguments that outweigh the psychiatric arguments”

Despite the numerous headlines each year purporting that a ‘link’ between high-strength cannabis and schizophrenia has been found, there is still no evidence that a causal link exists, instead studies find an association between use and schizophrenia. This is critical as an associative link does not account for other factors in a users life that may have caused the onset of schizophrenia.

It is important to note that this area of debate is highly nuanced and while there is an association between high-strength cannabis or ‘Skunk’ and schizophrenia, there are also a number studies which have found CBD (Cannabidiol) to have anti-psychotic effects and in one study scientists found CBD to protect against the long-term negative psychiatric effects of THC in mice. Therefore it is possible that cannabis strains higher in CBD could reduce the risks of cannabis induced schizophrenia.

Additionally, a number of studies have found an increased association between cannabis use and schizophrenia when consumption was initiated during adolescence. In this regard, legalisation and decriminalisation provide positive policy signals as there appears to be a minor link between legalisation and a reduction in consumption by teenagers.

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Cannabis and Criminal Justice

Dr James also highlights the issue of criminalising an act that is so prevalent throughout the UK.

“As a forensic psychiatrist, the strongest argument is decriminalising behaviour that is widespread and avoiding people getting caught up in the criminal justice system and ending up on a conveyor belt. If you can decriminalise it as an activity, you prevent that and the stigma associated with it”

On this front the panel will be able to draw from an array of data which shows that the criminalisation of consumption of any drug is wholly ineffective in reducing use and such efforts have a negative impact on harm reduction.

Furthermore, while we already know that police are arresting less and less people for cannabis offences – which may be in part due to police prioritising more serious crimes owing to funding cuts. Therefore were the burden of policing cannabis related offences lifted off police entirely it may enable the resources utilised in policing cannabis to be reallocated to areas of greater need and significance.

Vitally, a move to decriminalise cannabis would remove the fear of prosecution for over 7% of the adult population who use the drug.

What does this mean in reality?

Due to The Royal College of Psychiatrists close ties with the government and the use of it’s members’ research by the government in defending the status quo this review could be a defining moment in British drug policy.
It’s possible that a change in the College’s opposition to legalisation of cannabis could be the catalyst for the decriminalisation of cannabis and in-turn potential legalisation. If the College were to publicly withdraw their support for prohibition owing to concerns over how the substance can affect a user’s mental health, it would make the government’s current position on the drug unsustainable.
While scepticism may remain about how independent the review will be due to the College’s links with the government, Dr James has stated that the panel will be looking at research from countries where the drug has been legalised with an “open mind”.

A move to decriminalise the drug would not only help to end the stigma associated with cannabis, following the Spanish model it could mean citizens would be able to cultivate a small amount of the drug without fear of prosecution, while the sale of the drug would remain illegal.

Crucially, such a move would enable researchers to conduct studies on the drugs effect on the brain, free from the constraints and hurdles they can encounter when working with restricted substances and may eventually open the door to legalisation.

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