MARIJUANA, THE NOT SO HAPPY HERB

Although he's the Prime Minister's chief drugs adviser, Major Brian
Watters of the Salvation Army usually finds himself out of step with
health and drug specialists. Most people who work in drug treatment
oppose Watters' conservative stance on heroin trials and supervised
injecting rooms.

So it was a little surprising that when Watters maintained this week
that the community's familiarity with cannabis was breeding
complacency and even a generation of apathetic teenagers who drop out
of school and jobs, get involved with "harder" drugs and run the risk
of suffering psychiatric disorders the specialists agreed with him,
albeit cautiously.

Yes, they said, the increasing social acceptability of dope smoking,
coupled with the success of the anti-tobacco lobby and even the
overwhelming focus on "hard" drugs such as heroin, has had the
unintended effect of suggesting, particularly to the young, that
cannabis is safe.

This week Watters, who was handpicked by Prime Minister John Howard to
chair the Australian National Council on Drugs, announced that the
council would put a greater emphasis on cannabis.

The council is also expected to outline a new cannabis strategy in
March. This will include its response to a New South Wales study that
recommends that patients should be able legally to relieve their pain
with marijuana if they have permission from their doctor.

The council's shift was prompted by feedback from rural and regional
forums held by council members last year. Country people
overwhelmingly reported that alcohol was the number one drug issue for
them but that cannabis use by young people was the next biggest area
of concern.

Drug experts are unanimous: cannabis is not safe. While it rarely
kills only one death from cannabis smoking was recorded in Victoria in
1998 and it is unclear how this occurred it is implicated as a risk
factor for psychosis in susceptible young people.

As marijuana has become more socially accepted, researchers report
that the age at which young people begin smoking dope is dropping
dramatically.

Dr Jan Copeland, a senior lecturer at the National Drug and Alcohol
Centre at the University of New South Wales, says cannabis has more
toxins and tar than tobacco but that most people don't smoke 40 joints
a day.

However, Copeland says drug workers on the north coast of New South
Wales are reporting concerns that young people are becoming addicted
to nicotine through cannabis use, as marijuana is commonly mixed with
tobacco in joints.

"They (young people) seem to see it as the 'happy herb'; that it does
no harm. They don't understand that not only is it bad but it can
introduce then to a tobacco habit as well," Copeland says.

Cannabis is the most commonly used illicit drug in Australia,
especially among teenagers. The 1996 Australian School Students'
Alcohol and Drugs Survey found 36.4per cent of 12 to 17-year-olds had
reported using it at least once in the past week and 4per cent of
males reported using cannabis on at least six occasions in the past
week.

Most casual users show no signs of serious damage. Yet Dr Tim Rolfe
the deputy director of the Dandenong Area Mental Health Services says
the research shows an increased risk of schizophrenia for regular
users of cannabis (those who use more than 50 times a year). Still,
cannabis is almost certainly one of many risk factors, he says.

Surveys show that 50 to 60per cent of people with mental illnesses use
cannabis but there is no clear evidence that it marijuana contributes
to mental illness.

A new study in progress by Rolfe and Professor Jayashri Kulkarni,
director of the Dandenong health service and a consultant
psychiatrist, is trying to work out the role cannabis plays in
schizophrenia.

The study follows anecdotal evidence from both doctors who have
treated hundreds of patients with schizophrenia whose symptoms have
abated or decreased when they stopped using cannabis and recurred or
increased when they began again.

'People are worried," says Rolfe. "Carers of people with mental
illness see it (cannabis use) in people with illness such as
schizophrenia and observe it and almost uniformly report that its
consequences are bad."

"That doesn't mean cannabis causes mental illness. We know that it
contributes to the risk of developing a psychiatric disorder but there
are many other risk factors and the majority of users don't develop a
mental illness."

All of which might help explain Watters' stance. In a letter to The
Age this week, he wrote that the regional forums showed that cannabis
problems were far more prevalent than previously thought and that
"even more disturbingly, that young people are starting to believe
that cannabis is a completely harmless drug".

Another council member is Professor Margaret Hamilton, director of
Victoria's Turning Point Alcohol and Drug centre. Hamilton thinks the
debate on whether cannabis should be decriminalised or legalised has
overshadowed the issue of the health risks of smoking marijuana.

Hamilton sees good reasons for cannabis decriminalisation, notably
that it might stop young people from getting caught up in illicit
activities. However, "we have underplayed cannabis as a health risk in
the flurry of debate about its legal status. "There's been very little
debate about the risk associated with its use.

There are people who are more and less vulnerable, so it's a much more
sophisticated story then whether it is legal or not. Certainly there
is strong anecdotal evidence about heavy cannabis use and first
psychosis in young people. There's no strong evidence of a direct
causal relationship but enough anecdotal evidence to be concerned.

"There is a general view that it is harmless. It's not but it's far
less harmful then many things, even perhaps alcohol."

Hamilton says it is also unhelpful to talk about tackling single
drugs, as most people who use one illegal drug also use legal ones,
often at greater detriment to their health.

"If heroin has bumped anything off our agenda it's alcohol," she
says.

Another council member, Professor Wayne Hall of the national drug and
alcohol research centre at the University of New South Wales, says
cannabis isn't killing people as heroin does, but because it is so
widely used there are bound to be problems. However, he cautions
against "alarmist" statements such as "war on cannabis".

Heroin remains the drug that most worries the public, says
Hall.

"It may come down to the differences between rural and urban. In
Sydney and Melbourne it's clearly heroin ... cannabis just doesn't
rate as an issue from that point of view but the anxiety of parents in
the country is cannabis, which is much more available."

Five years ago the Kennett government's Drugs Advisory Council
recommended that marijuana be decriminalised so an effective health
campaign could be mounted. The council argued that while it remained
illegal, young people, in particular, would remain immune to the
dangers of its use.

Professor David Penington, head of Kennett's council and now of the
Bracks Government's Drug Policy Expert Committee, says there is no
doubt cannabis use is a problem.

Nevertheless, "to suggest it is comparable to heroin is absolute
nonsense. Many more lives are lost from alcohol and tobacco than
marijuana. Any education about substance abuse should include alcohol
and tobacco as well as marijuana".