My rating: 5 of 5 stars
“Should psychiatrists speak out about what they were seeing to discourage cannabis use, I asked? Simpson said that in Colorado, psychiatrists had tried and failed. ‘We’ve put it out there, and the community is not receptive.’ At this point, his job as a physician was to try to deal with the wreckage, ‘treat what comes in the door.’
“What did he think would happen in five years, I asked? What would the Denver Health emergency room be like, especially if cannabis continued to grow in popularity?
“Simpson had a three-word answer: ‘It’ll be busier.'” (page 139)
This passage comes a little more than halfway through the narrative of Tell Your Children: The Truth About Marijuana, Mental Illness, and Violence, a poorly named book that should nonetheless be required reading for lawmakers considering full legalization of recreational marijuana and parents who think their kids smoking weed is no big deal. The book makes its case primarily with data and studies from around the world that evidence a tie between marijuana use and psychosis, and between psychosis and nightmarish violence. The author, a former New York Times reporter, doesn’t avoid stepping on toes or burning sacred cows, and that’s because he’s convinced of the connection between marijuana, psychosis, and violence. The evidence he presents is both convincing and alarming.
“Based on his data and later findings, Andreasson says he believes that cannabis is responsible for between 10 percent and 15 percent of schizophrenia cases. Few people develop schizophrenia solely because of smoking, he thinks. But many who would not have become sick do so because marijuana pushes their vulnerable brains over the edge.
“‘Without cannabis, few people would develop the disorder,’ he says.” (page 56)
Before going any further, it’s important to understand where Alex Berenson is coming from in writing this book. In the introduction, he tells us how he has always held a more liberal stance on marijuana, didn’t think of it as a dangerous substance—if you want to use it, go ahead. But then he had a conversation with his wife, a psychiatrist, about a frightening case of violence and she commented on the fact that the perpetrator was “of course” high and had been smoking pot for much of his life. This comment caught Berenson off-guard, and the subsequent conversation led him to start digging into the scholarship around marijuana use and mental health. He didn’t set out to write a book. What he found in the process of research convinced him to write a book.
It turns out that the connection between marijuana use (especially if started young or done frequently over years) and psychosis has been well-documented—to the point that ethical standards prevent researchers from testing the effects of cannabis on people with a history of psychotic disorders because of “the known link between the drug and psychosis” (page 171).
There is a lot of information in this book. Berenson goes through study after study, many of them from Europe. He points out the work that has been done in the UK, where marijuana is hardly used compared to in the US and Canada. He touches on the chemical and brain science aspects, the distinction between CBD (non-psychoactive) and THC (what gets you high), and explains the problem with the term “medical marijuana”. He points out that the concentration of THC in today’s marijuana is much higher than it was in the 60s or 70s, and that through other cannabis products like edibles, users are often consuming straight THC, so they’re getting even higher doses of the chemical than they would from smoking it.
Most of the book is data reporting and science, but in the last few chapters, he focuses primarily on examples of horrifying violence carried out by people in some state of psychosis who either had a history of near constant marijuana use or had just ingested more THC than they ever had before. He waits until the end of the book to tell those stories, because he knows the typical response would be something like, “That’s a freak case. That’s not typical.” Berenson is convinced if marijuana use continues to increase, this sort of violence will become typical.
Whether or not he’s entirely right, I think he’s onto something. I’ve always had philosophical and theological problems with getting high (1 Corinthians 6:19–20), and with my base-level understanding of brain science, I’ve also thought: if something gets you high, that’s probably because a chemical is getting past the blood-brain barrier that isn’t supposed to, so you’re probably doing damage to your brain.
I read about half of this book on my daily commute through Denver, on a bus where the stench of weed is almost constant and it’s common to encounter people who couldn’t exactly be described as lucid. I know at least two people personally who have had psychotic breaks while using, though none to the extremes described in this book (thank God). A lot of what Berenson wrote rings true and makes logical sense.
I gave the book five stars because I really do think it should be required reading—maybe for everyone. It’s a necessary check against the “marijuana is harmless” message that we hear all the time. But this book really, really, really needs a bibliography and the title is terrible. If they republish it under a new name (which they should), they need to go with something like “Seeing Through the Smoke.”