What's the harm in a puff?

New Zealanders are among the highest users of cannabis in the world, and the debate over whether it should be legal continues.

“What’s your personal history with cannabis?” ask a group of Auckland University of Technology students doing vox pops at the New Zealand Drug Foundation’s cannabis and health symposium. Participants either eagerly tell their story, or look like a deer caught in headlights, nervously inching away from the camera.

In 2008, about 14 per cent of New Zealanders had used cannabis, the Ministry of Health’s alcohol and drug use survey reports. According to the United Nation’s World Drug report, that puts us up there as one of the highest-using countries in the world. A Christchurch Health and Development Study estimates that nearly 80 per cent of young people have used cannabis on at least one occasion:

And 10 per cent have developed a pattern of heavy use consistent with a diagnosis of cannabis dependence. Heavy cannabis use is more common in males and amongst Māori. These findings have been based on South Island samples recruited in Dunedin and Christchurch but it is likely that the patterns of use found in these samples will apply to North Island settings.

Ngatokorima Lamkum, 16, says while it’s different for each area in Auckland, in his social circle, there are people whose parents grow pot. “It's families who are doing it, and everyone networks through that.”

Agnes Wong, 22, says some schools in Auckland are well known for dealing, but most of the people she knows are recreational users. She has spent time in the United States, where she saw people dealing on the street in Venice Beach, but she doesn’t see the same drug culture in Auckland. 

“The effects on conversation are fantastic. What could be a normal conversation is transformed into something hilarious and complicated” – Frederick*, 28

Flora Apulu, 22, does community work with young offenders and says she sees it a lot. “A lot of them, if it’s not alcohol that’s led to their offending, then it’s cannabis,” she says. “It’s just not being able to think properly, not having the right state of mind or being in a good head space to make decisions.”

One regular user, who asked to be called Frederick James Jnr, 28, believes most of the population is aware that weed isn’t the same kind of drug as ‘P’(methamphetamine), or heroin. “I think there is acceptance [of pot smoking], just not enough people willing to talk about it.”

Smoking cannabis, he says over email, both “simplifies and intensifies everything”. “You feel a heaviness, which might be immobilising for some and motivating for others. You are able to experience things like music and film with a heightened sensitivity and appreciation. Great cinematography is a real treat. It may sound cliché but the BBC’s Life documentary in full HD while high is mind-blowing.”

Frederick wants it known that he’s a productive young professional, and that smoking weed regularly has “not, in any way, affected my productivity over the last four years”. He only worried about pot smoking to the same degree as he would be about drinking alcohol or smoking cigarettes. “At the end of the day inhaling any kind of smoke is gonna be detrimental to your health, but cannabis contains none of the poisons that tobacco contains, so we good.”

Another user, James*, 28, says he thinks it is obvious he smokes cannabis, and he never denies it. “Even though many people disapprove, none have ever attempted to have me arrested. I have also been offered plenty of good career opportunities by people who are perfectly aware that I am a smoke cannabis,” he writes.

“I try to live an otherwise healthy life – eating, sleeping and exercising well – mainly so that I can get away with regular drug use without screwing up my body. However, I imagine my lungs and throat will suffer horribly for it in a couple of decades.”

The Christchurch Health and Development Study has been following 1265 people born in Christchurch in 1977. Its founder, Professor David Fergusson, says the findings of the study are clear: Cannabis use is related to a series of harmful areas, including negative impacts on education outcomes, the development of psychosis and depression, increased risk of car accidents, and transition to other illicit drugs.

He says most people who smoke cannabis won’t suffer from psychosis or psychotic-like symptoms (which include delusions, hallucinations, and “disordered thought processes”) – but some will. In fact, young people who use cannabis regularly have rates of these psychotic symptoms that are between 1.5 to 2.5 times higher than those not using cannabis.

“I withdraw into myself and experience everything as being more striking than it would otherwise be. This is useful when I need to conceptualise projects but problematic when I want to socialise” – James, 28

“It’s not massive – it’s misleading to say cannabis will create an epidemic of psychosis – but it looks like being a contributing factor,” says Professor Fergusson. The study found that the association between cannabis use and psychosis was most marked among young people who are pre-disposed to the illness.

It also found that there is growing evidence to suggest a link between other mental illness – depression, anxiety and suicidal thoughts – among those who use cannabis heavily, and those who use it early in life.

Matt*, who has been smoking cannabis since he was 15, worries about the effect it has on his mind, but has read a lot of conflicting information. “I don’t feel like it has in a long-term sense but sometimes after smoking my brain doesn’t feel as quick as when I haven’t been.”

Though Diana*, 27, smokes every other day, she doesn’t see herself as having a dependency. “This time of year it is harder to source ... we’ve not been able to purchase any since Christmas, but that’s no drama,” she says. “I don’t ‘need’ it, and can and have gone long periods without it. I was a smoker for many years and giving up cigarettes was horrendous; I would not have coped if I couldn’t buy them for weeks back then.”

She says she’s aware of the health impacts of short-term memory loss, anxiety and depression, but she’s not worried about any impact on her health, though she discourages people under 20 from smoking it.

“I believe it has harmful impacts on younger, forming brains, and as a more personal tale, I have a 24-year-old brother who is in and out of jail as a result of his addiction and related illegal activity,” she says. “He started smoking at 11 or 12.”

Dunedin Longitudinal Study director Professor Richie Poulton told the Drug Foundation’s drug policy symposium last year that about 10 per cent of people who start smoking by the age of 15 will develop a disorder, compared to about five per cent of those who use by age 18.

He also points out that anything you smoke and inhale, if you do it often enough, is going to be bad for your lungs, gums and teeth, but cannabis has a different effect to tobacco. Plus, starting smoking early in life could make you more stupid: Professor Poulton’s study found that people who started using cannabis in adolescence and used it heavily for a long time showed an average eight-point decline in IQ.

The University of Wollongong’s Nadia Solowij says that long-term or heavy cannabis use results in “cognitive dysfunction” beyond the initial high. Most people who smoke a lot (“heavy use” is understood to mean daily use, of as many as seven joints a day, for several years) will develop schizophrenia-like symptoms: impaired cognition, memory deficits, and changes to the brain. She told the Drug Foundation conference that the jury is out on whether those changes are permanent.

It’s easy to dismiss these findings, especially if you’ve experienced few consequences of smoking regularly. After all, eight IQ points aren’t a lot, and 10 per cent of people doesn't mean you've been affected. It’s easy to ask what comes first: psychotic symptoms or heavy cannabis use. After all, couldn’t people be self-medicating?

But Professor David Fergusson says, in short, to trust him and the findings of his study. “We knew what these kids were like before they started smoking cannabis, so we can ask the question did they change before or after they smoked cannabis.”

The University of Queensland’s Professor Wayne Hall told the Drug Foundation conference observational studies always present a challenge, but insofar as they can, both the Christchurch and Dunedin studies have been controlled for the effects of other risk factors – “And [they are] pointing very strongly to cannabis playing a role in combination with other forms of disadvantage and adversity in producing these outcomes.”

“There have been no reported deaths from cannabis use, and it is used around the world for a large array of conditions (including depression, which I am a sufferer), so why should I be worried about it harming me?” – Richard*, 23

Cannabis has a number of compounds that interact with the brain, including Tetrahydrocannabinol (THC) and Cannabidiol (CBD). THC makes people anxious, paranoid and impairs cognition. CBD is understood to have anxiety-reducing and anti-psychotic properties, but it has largely been bred out of the weed you’d buy on the street.

The Australian Cannabis Prevention and Information Centre’s Dr David Allsop told the symposium that, in an examination of more than 200 cannabis seizures in New South Wales carried out by of the Australian Cannabis Prevention and Information Centre, less than five per cent of them showed CBD, indicating a trend towards high-potency cannabis.

Many of the people we spoke to didn’t know much about where their pot came from. “In terms of where it’s come from, and what the growers have done with it, I don’t know a lot,” says Frederick*. “This is a major problem and something that could be fixed and monitored if prohibition were ended.”

James says he prefers to buy from people he knows for this reason. “I’m not currently able to buy direct from a grower, which considerably reduces what I know and basically just sucks.”

Professor Fergusson says what is needed now is not further illustration of the harms of smoking cannabis, but a discussion about how it should be dealt with. He is in favour of decriminalisation combined with much social marketing and discouragement of the use of cannabis by minors. 

The drug carries a moderate risk, he says. “It’s wrong to characterise it as a terrible drug, it’s equally wrong to dismiss it as harmless. Most users won’t suffer any harm. A minority of heavy users can suffer severe harm. So how do you manage that legally, socially and clinically?”

As such, cannabis is problematic for policy makers. Professor Poulton says politicians need to treat it as a health issue, not a legal one, and concentrate on delaying the onset of use at least until late adolescence. He told the Drug Foundation symposium that irregular use of small amounts has negligible health effects, but the regular use of large amounts can be fairly significant. The “burden of disease” from regular and heavy cannabis use, he says, is probably under-estimated.

Community worker Flora Apulu sees cannabis use as a contributing factor to a bigger problem. “There’s a good side to it, and there’s a bad side to it. I’d agree that it’s bad for young people, just because we’re the most vulnerable; the younger we’re doing it, the longer-term the effects on our bodies, and our memories, and our brains.

“It is a problem,” she says, “and more young people need to tell each other that. If they learn the bad effects of it, then it could change into peer pressure that it’s not a good thing to do.”

Khylee Quince, the Tumuaki Māori for Auckland University’s Faculty of law, told the Drug Foundation’s conference that cannabis law as it stands discriminates against Māori, as Māori are more likely to be arrested and convicted for cannabis offences than non-Māori. (The criminal justice group JustSpeak found last year that this extends to more than just illicit drug offences.)

Filmmaker Paora Te Oti Takarangi Joseph, who has directed a documentary about the marijuana culture amongst New Zealand youth, says Māori feel the impact of cannabis and its harms much more widely, but Tikanga can be used to help people stop using.

He says many young people are looking for a sense of belonging, and drugs and alcohol have the opposite effect. “If you’re sitting around a campfire, and you pull out a joint, and everyone is smoking a joint, or drinking whiskey…‘We were connected, now we’re all stoned. Now we’re getting disconnected.’”

He says an indigenous framework can be used to bring drug users down to earth. “It’s not about taking off as an individual into the wild blue yonder, and then behind you, everyone else is outside the waka,” he says. “Because then we have to get out all the life jackets, and that’s hard work.”

Reverend Hirini Kaa, an Anglican minister and PhD student, has worked with young people in South Auckland, and says young people who don’t feel part of a community tend to create new networks, which can mean joining a gang.

“Many young people are lost in a range of ways – they get up in the morning, and have no purpose to their lives, no hope,” he says. “I think young Māori, the ones who need help, are conscious of their situation. They know things are challenging ... but it’s really hard to overcome it, especially when you have an exploitative system that kind of wants to keep them there.”

He says society can’t treat drugs and alcohol in a vacuum. “We have a really challenging drug culture amongst our communities. We have pictures of Uncle Bob and Tupac and it’s glorified; it’s seen as something cool.”

Hirini Kaa lost a cousin in car crash in which alcohol and drugs were involved. On the front of the order of service at the tangi was a marijuana leaf. “When they carried him off the marae, a really sacred sad moment, they played [a song by Bob Marley]. There’s a whole bunch of things in there that really disturb me, but I really understand. Our beautiful culture isn’t doing it for us, but Bob Marley sure isn’t going to do it for us either.”

 

* Names have been changed.