Category: Drugs

A growing body of scientific studies suggest that marijuana use increases the risk of developing psychotic illnesses such as schizophrenia.  There is an ongoing debate among scientists regarding the exact nature of the risk, including whether the risk is largely confined to those who are already genetically predisposed to these illnesses.  But many scientists have raised the concern whether legalization of marijuana might lead to increases in these illnesses.

Which leads me to the current issue of JAMA Psychiatry, with the viewpoint article Balancing the Public Health Costs of Psychosis vs Mass Incarceration With the Legalization of Cannabis.  In essence, the article argues that marijuana prohibition is a unique risk factor for the development of psychotic illness.  How so, you may ask?   Let’s take a look.

First the authors make the observation that legalization of marijuana is a trend among the states.  They then make the very reasonable claim that marijuana use is associated with an increased risk of psychotic illness.  Then the authors state:

The US has the world’s highest incarceration rate, at 655 per 100 000 adults (followed by El Salvador at 590 per 100 000) and the world’s largest total prison population, at 2 121 600 (followed by China at 1 700 000), according to the World Prison Brief database. The criminalization of cannabis is a significant contributor with approximately 8 million cannabis-related arrests between 2001 and 2010, most owing to possession. Cannabis possession accounts for 36.8% of all drug use arrests in the US according to 2018 US Federal Bureau of Investigation data.

So, as written, the reader is to believe that many marijuana users are languishing in jail for mere possession.  If we dig into the some of the latest DOJ data, however, we learn that about 14% of the state prison population are serving time for drug offenses — and that includes both possession and distribution offenses.   To be sure, it is a nontrivial number of citizens, but anyone who works in the trenches knows that personal possession of small amounts of marijuana does not lead to a lengthy (if any) prison sentence.

Which matters as the authors then state:

Although psychosis is not the only form of psychological distress that may result from incarceration, it is worth considering the consequences of incarceration as a potential trauma or stressor that may contribute to the onset or exacerbation of psychosis given that psychosis risk is a primary argument raised against the legalization of cannabis.

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An article by Joe Nelson of The Press-Enterprise from last week, highlights a few of the policy responses by California counties in regards to fentanyl-related overdoses. Mike Hestrin, district attorney of Riverside County explained, “In the last five years, the number of fentanyl deaths has doubled every year.” This increase is alarming, and is cause for immediate action to punish the drug dealers that are selling this lethal drug with the knowledge that it is deadly.  “During a Feb. 22 press conference, Hestrin announced Riverside County’s first Fentanyl-related murder charge…[for a man] who in October allegedly sold Fentanyl-spiked drugs to [an] 18 year old.” Hestrin is responding to the spike in deaths by attempting to deter the sale of drugs containing Fentanyl by charging the sellers with murder if an individual has a fatal overdose due to the ingestion of the drug. 

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