Thursday, May 31, 2012

Cannabis, teenagers and schizophrenia

cannabis-stash

Cannabis or marijuana use by teenagers and adolescents is highly associated with the onset of psychosis and schizophrenia. Cannabis goes by many names including hash, pot, grass, weed, or ganja. This gateway drug is falsely thought to be innocuous and as having no lasting effects. Cannabis use by teenagers is often not recognised as a problem. Cannabis is cheap and easily accessible in most student populations. Pune is a major hub for the cannabis drug trade. This week a quarter tonnne of ganja was found dumped in a well. Cannabis use is rampant in Pune colleges and hostels, where students assiduosly guard and maintain their 'stash'. During the 57th National School Games the highest number of students testing positive for marijuana came from Maharashtra.

Regular cannabis use increases the risk for schizophrenia and psychosis by upto 4 times. There is increasing evidence that cannabis use can precipitate schizophrenia in vulnerable individuals. This is especially so with early onset use of cannabis. Cannabis also exacerbates symptoms of schizophrenia in those who have already developed the disorder. Psychotic disorders like schizophrenia involve disturbances in the dopamine neurotransmitter systems of the brain. Δ9-tetrahydrocannabinol (THC) - the key neurochemical in cannabis - interacts with dopamine to adversely affect its functioning by multiple mechanisms.

Teenagers are especially vulnnerable to the schizophrenia-inducing effects of cannabis. Cannabis like substances (anandamide) called endocannabinoids, produced by the body, play an important role in several processes of brain maturation. Regular marijuana use affects this process of brain maturation in teenagers. Schizophrenia is also a disorder of brain maturation. Disruption of the endocannabinoid system in the adolescent brain by exposure to cannabis interferes with brain maturation. This provides a mechanism to increase the risk for development of schizophrenia in adolescence.

How to cut down and stop cannabis use

  1. Write down a list of reasons for wanting to stop - you will need to review this at times when you are feeling low or experiencing craving.
  2. Tell someone you trust that you are quitting
  3. Get rid of the paraphernelia for smoking cannabis - the stash, wrappers, lighters, matches. You may be surprised at the number of places where small amounts are hidden. Get rid of it all.
  4. Take measures to prevent fresh procurements - avoid places and people associated with replenishments
  5. Make a list of things to do to occupy the time freed-up from procuring and using cannabis.
  6. Review your list of reasons and things to do when you feel low and when craving is intense.
References
  1. Paola Casadioa, Cathy Fernandesb, Robin M. Murray, Marta Di Forti. Cannabis use in young people: The risk for schizophrenia.  Neuroscience & Biobehavioral Reviews. Volume 35, Issue 8, August 2011, Pages 1779–1787. doi:10.1016/j.neubiorev.2011.04.007
  2. Degenhardt L, Hall W. Is cannabis use a contributory cause of psychosis? Can J Psychiatry. Aug 2006;51(9):556-65.
  3. Deepak Cyril D’Souza,Richard Andrew Sewell,and Mohini Ranganathan. Cannabis and psychosis/schizophrenia: human studies. Eur Arch Psychiatry Clin Neurosci. 2009 October; 259(7): 413–431. Published online 2009 July 16. doi: 10.1007/s00406-009-0024-2

Saturday, May 26, 2012

Alcohol and Happiness - do they mix?

Alcohol and happiness don't mix - definitely not when taken in excess, and definitely not in the long term. The relationship between adverse alcohol use and unhappiness is reciprocal - unhappy people tend to drink hazardously, and vice versa. This effect increases over time as demonstrated by a 15-year study that followed-up adult twins in 1975, 1981, and 1990.

alcohol blackouts unhappiness
Passing out while drinking is significantly more likely in dissatisfied people

Blackouts or passing out while consuming alcohol is an indication of unhappiness.


binge drinking unhappiness
Dissatisfied people are more likely to have a pattern of binge drinking.

Binge drinkers are more likely to be dissatisfied with life. A pattern of binge drinking on weekends negates any beneficial effects of moderate alcohol use.


alcohol excess unhappiness
Excessive alcohol use increases overr time especially in dissatisfied people

Excessive alcohol use increases dissatisfaction and unhappiness. Alcohol, even in moderation does not reinforce feelings of well being, pleasure, happiness or joy. Moderate drinking does not reduce unpleasant feelings.
Don't drink alcohol to regulate your mood, it leads to more grief.
References
  1. H. Koivumaa-Honkanen; J. Kaprio; T. Korhonen;, R.J. Honkanen; K. Heikkilä; M. Koskenvuo. Self-reported Life Satisfaction and Alcohol Use: A 15-year Follow-up of Healthy Adult Twins. Alcohol and Alcoholism. 2012;47(2):160-168.
  2. R. Curtis Ellison, Marjana Martinic. The Harms and Benefits of Moderate Drinking: Findings of an International Symposium. May 2007 supplement to Annals of Epidemiology.
  3. Gustafson R. Does a moderate dose of alcohol reinforce feelings of pleasure, well-being, happiness and joy? A brief communication. Psychol Rep. 1991 Aug;69(1):220-2.