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30/07/2007 00:00:00

Reefer Inanity: Never Trust the Media on Pot

Watching the media cover marijuana is fascinating, offering deep insight
into conventional wisdom, bias and failure to properly place science in
context. The coverage of a new study claiming that marijuana increases
the risk of later psychotic illnesses like schizophrenia by 40% displays
many of these flaws.

What are the key questions reporters writing about such a study needs to
ask? First, can the research prove causality? Most of the reporting
here, to its credit, establishes at some point that it cannot, though
you have to read pretty far down in some of it to understand this.

Second -- and this is where virtually all of the coverage falls flat --
if marijuana produces what seems like such a large jump in risk for
schizophrenia, have schizophrenia rates increased in line with marijuana
use rates? A quick search of Medline shows that this is not the case --
in fact, as I noted here
earlier, some experts think they may actually have fallen. Around the
world, roughly 1% of the population has schizophrenia (and another 2% or
so have other psychotic disorders), and this proportion doesn't seem to
change much. It is not correlated with population use rates of marijuana.

Since marijuana use rates have skyrocketed since the 1940's and 50's,
going from single digit percentages of the population trying it to a
peak of some 60% of high school seniors trying it in 1979 (stabilizing
thereafter at roughly 50% of each high school class), we would expect to
see this trend have some visible effect on the prevalence of
schizophrenia and other psychoses.

When cigarette smoking barreled through the population, lung cancer rose
in parallel; when smoking rates fell, lung cancer rates fell. This is
not the case with marijuana and psychotic disorders; if it were, we'd be
seeing an epidemic of psychosis.

But readers of the AP, Bloomberg, The Washington Post, and Reuters were
not presented with this information. While CBS/WebMD mentioned the
absence of a surge in schizophrenia, it did so by quoting an advocate of
marijuana policy reform, rather than citing a study or quoting a doctor.
This slants the story by pitting an advocate with an agenda against a
presumably neutral medical authority.

Furthermore, very little of the coverage put the risk in context. A 40%
increase in risk sounds scary, and this was the risk linked to trying
marijuana once, not to heavy use. To epidemiologists, however, a 40%
increase is not especially noteworthy-- they usually don't find risk
factors worth worrying about until the number hits at least 200% and
some major journals won't publish studies unless the risk is 300 or even
400%. The marijuana paper did find that heavy use increased risk by
200-300%, but that's hardly as sexy as try marijuana once, increase your
risk of schizophrenia by nearly half!

By contrast, one study (
) found that alcohol has been found to increase the risk of psychosis by
800% for men and 300% for women. Although this study was not a
meta-analysis (which looks at multiple studies, as the marijuana
research did), it certainly is worth citing to help readers get a sense
of the magnitude of the risk in comparison with other drugs linked to

Of course, if journalists wanted to do that, they would also cite
researchers who disagree with the notion that marijuana poses a large
risk of inducing psychosis at all, such as Oxford's Leslie Iversen,
author of one of the key texts on psychopharmacology, who told the Times
of London that

"Despite a thorough review the authors admit that there is no conclusive
evidence that cannabis use causes psychotic illness. Their prediction
that 14 per cent of psychotic outcomes in young adults in the UK may be
due to cannabis use is not supported by the fact that the incidence of
schizophrenia has not shown any significant change in the past 30 years."

Such comments don't help the media stir up reefer madness, which they've
been doing, quite successfully, for the last few decades. Perhaps
covering the marijuana beat makes you crazy.

Author: The Huffington Post via UKCIA

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