"People who take cannabis to treat PTSD are like a man who uses a cane. This prevents them from moving on to psychotherapy," Professor Yifrah Kaminer, a senior Israeli physician who has studied the effect of drugs on society, warns. Kaminer, who lives in the US, has tried for many years to put a mirror in front of us so that we won't fall into the trap of legalizing marijuana, despite the growing trend to decriminalize recreational use.
Kaminer, whose expertise on this topic extends three decades, has seen how the drug can affect people. He believes that if you prescribe it to people suffering from mental issues just so they could use it as a walking cane, this would ultimately backfire and worsen their situation, and adversely impact society.
Kaminer has witnessed the results with his own eyes in the US, where about 20 states have already legalized recreational use, including his home state of Connecticut.
"We have seen how teens in junior high school use this drug, and the younger the starting age is, the greater the risk of developing serious issues down the road, including psychosis," he warned in an interview with Israel Hayom.
"The second group is people who suffer from depression and anxiety, which comprises some 15-20% of the population. Studies show that using cannabis may help them in the short term, but then it begins to give them repeated depressive episodes that only get worse; we have seen a dramatic increase in suicidal tendencies [in the wake of legalization]."
According to Kaminer, the voice of those two groups – teens and those with mental struggles – has been drowned out by the pro-legalization camp, in part because of interest groups that eye windfall profits.
"I have been studying the treatment of adolescent substance abuse for over 30 years. I have studied more than 2,000 teens over the course of my research and what I see is that the age is getting lower and lower. And my colleagues have also noticed that teens are becoming more psychotic at a younger age, even without any familial history of psychosis," he laments.
Not like cigarettes
Kaminer adds that many have overlooked the big difference between cigarettes and marijuana because they don't realize that it's a matter of concentration of the substance. Legalization would make it part of people's daily lives and in high concentrations. Many also believe the drug can help cope with mental issues, but the effect has not been proved.
"A study conducted among US veterans who were using the drug to deal with PTSD shows that those who believed that it was helping them, saw gains in the short term. Those who said they did not believe it could help them, did not see this. But both groups had experienced the same kind of PTSD, so it's very much a placebo effect. Also, those who truly believe this is a magic bullet cannot easily transition into psychotherapy and can't properly function without cannabis, and this is one of the challenges facing the healthcare professionals," he said.
Kaminer believes that approving the recreational use of marijuana has unintended consequences. "When you smoke a cigarette, the amount of nicotine is about 0.5%. As for cocaine, the ranchers in the Andes chew on leaves that have only about 0.5% of the drug, which does not lead to addiction. But cocaine on the market is about 30% or even 60%. This is what is beginning to happen with cannabis. Cannabis products on the street can have a concentration of about 20%, which can lead to a euphoric state of mind. In oils and pastes, this can be as high as 80% or 90%. Teens who use this get psychotic."
Just recently, with the swearing-in of a new government in Israel, the effort to legalize marijuana has picked up steam. A new Knesset committee is about to be formed on this matter and even though the coalition has failed to muster enough votes in the Knesset plenum, the proposed legislation has been moving forward and could result in people being able to sell and use the drug in small quantities. Kaminer believes that there is not enough data that would justify such a measure, especially in light of the effect this could have on at-risk populations such as adolescents.
"To slow this train, I tell lawmakers: Before you pass such legislation, add a few amendments to control the concentration of the substance in products and to ensure vendors can only sell it at a safe distance from public buildings. Also, add a mechanism that would help keep it away from teens. It's like having a new road paved in a neighborhood but without any traffic lights, asphalt, or speed limits and then asking the public to cross it at their own risk. That is just beyond the pale.
"If the Knesset proposal sees the light of day, we have to include various amendments that would impose certain restrictions and allocate resources for enforcement of road traffic violations. In Washington and Colorado the number of deaths among drivers who had been using marijuana has doubled since legalizations in those states," he said.
Kaminer is a psychiatrist and a senior physician at the University of Connecticut and has been at the forefront of the effort to counter the growing trend in the US to legalize the substance, and even around the world. He believes that ultimately it is the American taxpayer who would have to pay the price for the adverse effects of the move because it would hurt the development of youngsters and because it would only make PTSD patients feel worse in the long run.
Kaminer believes that marijuana is not a gateway drug. "Those who are going to cash in from all this are the stockholders and former officials who are eager to make money off of this," he warned.
Kaminer stresses that those who want to adopt the Dutch liberalization model of cannabis use are misguided because the substance is only legal in regulated "Coffee Shops" and generally banned in the Netherlands. About 60% of cases of drug-addiction therapy in that country are a result of cannabis use.
Mitigate the damage
Those who believe the legalization train has already left the station claim that Kaminer is out of step with the global trend, but he believes that things are not as clear-cut. He notes that not a single country in Europe has legalized recreational use nationwide. He and others have been sounding the alarm on the impact on teens, stressing that there are not enough studies on this. "Lab mice's teenhood is just two weeks," he says. This, he claims, makes it all but impossible to extrapolate findings on human teens.
Kaminer is on the board of the Smart Approaches to Marijuana (SAM), an advisory group that seeks to inform lawmakers of the ramifications of legalization. Its experts, including Kaminer, testified in the Connecticut State Senate and most likely helped water down some of the provisions of the law they recently passed, by imposing restrictions on the how and where the drug can be sold. For example, some of the restrictions deal with keeping it away from schools or on how it can be advertised.
As an Israeli, his focus now is on making sure Knesset members hear expert advice before moving forward with legalization. "Every such bill must include a budgetary estimate on the cost this could have on the economy and how to fund it, and I believe this could total some NIS 4 billion ($1.3 billion).
"We must take into account the expected rise in car accidents and the collateral damage: loss of days of work, treatment for psychiatric disorders that could come up or get worse, including psychosis, more enforcement, and prevention efforts that would target children as early as elementary schools."
He is particularly interested in having limits imposed on the concentration of the substance on the products that would be sold if cannabis is approved, especially food products. He also seeks to close the loophole on the use of substances in vaping. "The work is cut out for us; we must engage in rigorous planning and preparations so that we don't make an unwise dash toward legalization," he warns.
