'REEFER MADNESS' CLOSE TO TRUTH WORLDWIDE EVIDENCE SUGGESTS

Bummer news. Marijuana, it turns out, doesn't just get you high -- it
can contribute to serious psychosis.

This potentially explosive topic will be explored Thursday during a
public lecture at the Royal Ottawa Mental Health Centre, entitled
Cannabis and Psychosis: the Untold Story.

Dr. Robert Milin, a psychiatrist and substance-abuse expert, will
provide an outline of the theory that has gained much credence in the
last decade -- that marijuana use increases by two-or three-fold the
risk of a "psychotic outcome," such as schizophrenia.

"I laugh," Dr. Milin said in a light aside this week, "that Reefer
Madness thing that you heard about is not that far off."

The physician was careful to warn about jumping to conclusions. So
far, the relationship between smoking weed and developing a psychotic
disorder is not, as scientists like to caution, a "causal" one.
Evidence from studies around the world, however, points to a link or
an association, possibly after a single use.

Dr. Milin compared it to the link between cholesterol and heart
disease. Alone, high cholesterol does not "cause" heart disease, but
is widely considered a contributing factor, like smoking or obesity.

It is more than guesswork. One study in Australia was based on
interviews with 3,800 young people. Other literature reviews have
traced the evidence to the 1850s.

Dr. Milin is co-authoring a chapter on the issue for an American
academic publication and says a great deal more knowledge has been
gathered only in the past couple of years.

There is also evidence that a heavy intake of marijuana further
magnifies the risk of a psychotic disorder or brings out, for those
pre-disposed, an earlier onset of mental illness.

Adolescence seems a particularly vulnerable age, said Dr. Milin,
because the brain is still changing. This is also the age when the
first onset of schizophrenia, for example, will often occur.

Taken together, these pieces of information mean marijuana use is
often suspected when young people appear at hospitals suffering their
first psychotic episode.

"The evidence now tells us we should be following these patients to
see how they progress."

Some recover with no other ill effects, others don't -- but the
episode stands as a red flag.

"The trick is, how do we identify that vulnerable patient?"

A young man named Matt, now 22, is one of them.

Well-spoken, musical, a good student from a good family, he began
smoking pot regularly when he was 15, mostly after school.

By the time he began his first year of university, he was smoking
daily. His friends could see he was changing. His mind, for lack of a
scientific description, was racing. He began, for instance, to attach
great meaning to mundane things. He was parsing his every word.

He slept and ate at odd times. He was having feelings of
"grandiosity" with regard to his place in the world. He berated his
friends over trivial things, like what they wore and ate. He had a
vague notion of himself as some kind of prophet.

At the end of his first university year, at age 19, he went to see a
doctor who noticed he would not answer a simple direct question. He
admitted to having a vision of himself as a moviemaker, putting to
film his deep, philosophical thoughts.

He needed help.

He was sent to an Ottawa Hospital clinic that determined he was
suffering from drug-induced psychosis. Medication was prescribed and
it soon began to help.

Now off marijuana for more than three years, he believes the drug is
linked to his mental crisis.

"If there were environmental stresses that brought me to the edge of
that cliff, then weed pushed me over."

He also thinks marijuana is a "far greater hazard" than many people perceive.

Matt was asked about whether he has advice for parents with teenagers.

"You know, a lot of parents I knew were really vigilant and I don't
think that helped very much," he said Tuesday. "I think it produced
an atmosphere of shame. Just as I don't think people should be
ashamed of being psychotic or taking medication, I don't think they
should be ashamed of the choices they've made."

Embarrassed, yes, but not ashamed, he explained.

Keep the lines of communication open with your children, he urged.
"An atmosphere of shame only begets more insecurity."

He speaks frequently to high school students. His message is that
drug-induced psychosis is treatable and support is available. "I'm
not there to preach, but be careful. You just don't know how damaging
it can be."

The lecture begins at 7 p.m. in the Associates in Psychiatry
Auditorium at the Royal Ottawa Mental Health Centre on Carling
Avenue. Doors open at 6:30 p.m.