Getting soft on dope, or just taking the soft option?

By JAN CORBETT

Talking to Tom Claunch on the telephone makes you think immediately of Bill Clinton. First there is the seductive southern drawl. Then the rapturous descriptions of Queenstown, where he is holidaying. And lastly the topic: cannabis - although we're not here to find out if he has in fact inhaled.

Yet it's worth remembering Clinton feared losing the presidency if he admitted breathing more deeply.

Here, when asked the question, Helen Clark slid skilfully around it, leaving us to wonder about the reaction had she answered either way.

Would the electorate have cared?

Tom Claunch might say no, and that's what bothers him.

A native of Alabama, USA, Claunch has been in New Zealand for six years working with drug and alcohol abusers. He hit the news this week after Karina Hazel, the Child, Youth and Family-appointed Christchurch caregiver, was jailed for supplying cannabis to two teenagers in her charge.

A horrified Claunch declared that is what you get in a country woefully soft on this drug, even though its use and possession are still criminal offences.

Claunch remembers being shocked at how prevalent cannabis was when he came to New Zealand.

The soils and climate that make us good at sheep, cows and forests also make us good with cannabis crops. Not only did it seem to grow everywhere, it seemed to be smoked everywhere, too. He claims a higher rate of use among high school students here than in the USA or Canada.

So he cannot understand why cannabis has never been the subject of a this-will-kill-you campaign like tobacco has. He bemoans the "harm minimisation" policy that goes all the way to the World Health Organisation. He thinks it's a "give-up attitude" based on the idea that "kids will do it anyway".

Are we soft on cannabis? Or are we and the rest of the world coming around to the idea that it's okay for consenting adults.

After all, it took a complaint from New Zealand First MP Craig McNair to rouse police into investigating the cannabis use of Green MP and Rastafarian Nandor Tanczos, who has never made a secret of it.

At the same time comes news from England that the world's oldest euphoric drug is in line for its first return to the medicine cabinet since 1971.

Long noted as an effective pain reliever, cannabis is now under a £1.2 million Medical Research Council trial for its benefit to sufferers of chronic disease, particularly multiple sclerosis.

Indeed, last year Britain relaxed its cannabis laws to the level of traffic infringements, and last week Canada's Liberal Government announced its plans for decriminalisation.

Here, the parliamentary select committee, which met last year under Green Party pressure to consider the drug's public health effects and legal status, has yet to report.

Since then, and for the purposes of coalition building with United Future, Labour has promised not to fiddle with the laws. The retail market, valued at an estimated $84.3 million, remains illicit.

In the meantime, the boom in methamphetamines has dwarfed cannabis as a social and medical concern. Police tend to prosecute only a fraction of cannabis users.

So it seems timely, 2000 years after its first recorded use for medicinal purposes and 40 years since it became the defining substance for the hippie generation, to ask what do we really know about cannabis and do we care?

Unlike those others of life's great indulgences - alcohol, tobacco and chocolate - the public knows little about the health hazards of cannabis.

It tends to exist in a haze of mythology and becomes entangled with alcohol and tobacco. Dope is seldom used in isolation from these other legal vices.

What we believe about it - and this is also true among scientists and health professionals - tends to be coloured by whether we have inhaled and want to again. Or, as has been said of much of the anti-drug studies coming out of the USA, whether we suspect research funded by a government with a moral-majority style anti-drug policy is tainted.

In assessing cannabis risk, the benefit today's parents have over those of a generation ago is that they probably tried it themselves and see it as a normal part of teenage rebellion or a rite of passage.

But things have changed.

First, thanks to improved plant breeding and hydroponic cultivation, dope can be considerably more potent than it was three decades ago.

The essential euphoria-inducing element - tetrahydrocannabinol (THC) - in a joint can range from 1-10 per cent. One per cent is the equivalent of a glass of low-alcohol beer, 10 is more like a mug of rum. Yet there is no way of telling how strong a joint is until you've finished it.

Second, as rural New Zealand was hit by increasing unemployment and deprivation, the dope culture moved in not only as an economic alternative, but a social ameliorative.

The effects of cannabis are seldom discussed without emphasis on its social impact.

Certainly cannabis is the third most widely used drug, behind alcohol and tobacco, and the most popular illegal drug.

According to the most recent drug use survey of 5500 respondents, 52 per cent have tried it at some time and 15 per cent described themselves as current users. Men tend to use it more than women, although the rate for women is increasing, particularly in the 15-to-19 age group.

Usage is highest among the late teens to mid 20s, tailing off in the late 30s to early 40s. There is an increase in those using skunk - the more potent, hydroponically grown plant.

In the same survey, 30 per cent thought most people would think it acceptable to smoke dope at a party and 18 per cent at the beach, but only a tiny number thought it was okay to do it around a child, before driving or before work.

The perception among respondents was the more you used, the greater the risk of harm.

When the Ministry of Health waded into the topic back in 1996 under then health minister Jenny Shipley, it produced a synthesis of the international research on cannabis harm.

Among risks of heavy use listed were acute and chronic bronchitis, and an increased risk of lung, mouth and respiratory tract cancer. It found indications of subtle long-term cognitive impairment (as opposed to the short-term impairment known as getting high), and the possibility of long-term dependence the more you used it. It also found a strong correlation between heavy, long-term use and mental illness, especially among those predisposed to schizophrenia.

More recent studies here and in Australia are showing a strong correlation between heavy cannabis use and depression in young people. The trouble is it can be argued that depressed teenagers turn to cannabis. hard to separate.

The same can be said of the relationship between cannabis use and paranoid schizophrenia. Enough to say that both Dr Sandy Simpson, clinical head of the Mason Clinic, and Dr Peter McGeorge, clinical spokesman for the Mental Health Foundation, agree there is a strong relationship, and not a happy one.

Dr McGeorge says the recent shift in medical understanding of the drug has been the recognition that cannabis makes paranoid schizophrenics more violent.

Dr Simpson notes that people who go on to develop a psychiatric illness report higher levels of cannabis use earlier in life. It seems to precipitate mental illness among the predisposed, "but the nature of that process is not clear".

Similarly, people with mental illness who continue using cannabis - and schizophrenics often favour it for self-medication to avoid the hideous side effects of conventional treatment - have worse outcomes than those who abstain.

In Australia, where cannabis use is reportedly higher than New Zealand, there has been increased discussion of the role of drugs in their increased rate of psychosis and suicide in young people.

Although Dr Simpson says no one is keeping figures here on changing mental illness rates among the young, he and his colleagues have noticed the enormous increase in the number of mentally ill who are also substance abusers, something they seldom saw 15 to 20 years ago. He says psychiatrists are struggling to deal with the combination, and now fear the onslaught of methamphetamine abuse, which can create an intoxication indistinguishable from acute psychosis lasting for days.

Police, psychiatric and counselling services agree that the cannabis battle must be about delaying the age people start using.

Dr McGeorge, a child and adolescent psychiatrist, says because cannabis promotes apathy and impairs judgment, it is particularly detrimental to teenagers who tend to lose the ability to complete tasks and the drive to succeed at school or in a career.

Tom Claunch says this is why adolescents are more difficult to treat for drug abuse.

Adults have successful lives to go back to, teenagers don't. "So you can't rehabilitate them, you have to habilitate them." He laments a lack of decent residential treatment programmes for young abusers.

Of course many of these claims can also be made about alcohol.

Dr Simpson agrees "it's all stuff with risk attached. It's how society deals with that risk.

"The important thing is that we don't get romantic about cannabis."

Further reading
nzherald.co.nz/health