HAZE OF CONFUSION HANGS OVER DANGERS TO HEALTH

From the End of This Month Cannabis Will Be Reclassified As a Class C
Drug, Alongside Tranquillisers and Steroids. But Does Anyone Really
Know What the Dangers of Smoking Dope Are? Jason Burke and Anushka
Asthana Report

Steve, 25, Jamie, 23, and Amit, 30, all liked, or like, a smoke.

Steve tried cannabis at school and was smoking 10 to 15 joints every
evening by the time he was at college. He lost his job and started
behaving erratically. One night, drunk and stoned in a club, he ate a
lump of hashish resin and woke up hearing voices. He is still being
treated for schizophrenia.

For several years Jamie had smoked 20 joints, often of powerful skunk,
a week. He holds down a well-paying office job and says that he has no
problems with motivation or concentration. He says he has never
suffered any adverse effects, let alone mental health issues, and
describes his consumption as a 'positive lifestyle choice'.

Amit smoked 15 joints a day for six years. 'My life was like something
from The Office,' he said last week. 'I had an undercurrent of
depression throughout that time. Without cannabis, it would have been
much worse.' Amit has a new job and stopped using cannabis six months
ago. But he admits it was hard to break his habit. 'There is no doubt
I was addicted,' he said.

All three men were heavy users. According to the Independent Drugs
Monitoring Group, a typical user consumes more than seven grammes (a
quarter of an ounce) of average-strength cannabis a week. This year an
estimated one in 10 Britons aged between 16 and 59 - about 3.3 million
people - will use the drug. Few of them will smoke as much as Steve,
Jamie and Amit ever did. Instead it will be a quiet spliff on a park
bench outside school, or with coffee after a dinner party, or while
watching a video on a Sunday evening when the children have gone to
bed.

The amount of cannabis smoked in the UK is unprecedented. But for an
activity that has such mass appeal - one in four 15- to 24-year-olds
smoked it in 2002, according to the British Crime Survey - very little
is known about the effects of such broad consumption on people, on
health, on society.

At the end of this month, cannabis will be reclassified from a class B
to a class C drug - putting it on the same level as steroids and
tranquillisers. The effect of the change, and the police guidelines
issued along with it, will make it extremely unlikely that anyone
consuming cannabis in private will be arrested. Smoking pot in your
own home will, in practical terms at least, be legal. Offend
repeatedly or smoke in a public place or outside a school and the
consequences could be severe, however. Under-18s, say the guidelines,
should be arrested, although in reality it is unlikely that the police
will always follow the law to the letter. Possession can still result
in a two-year prison sentence. There are also increased penalties for
dealing.

The changes, recommended first in a report by the Police Foundation, a
council of scientific experts and the Commons Home Affairs Select
Committee, regularise the reality of the enforcement of soft drugs
law. In much of the country, police rarely arrest and prosecute
'personal users'. None the less, in 2000 there were 70,000 convictions
for possession of cannabis.

The changes are controversial. Some criticise any move to liberalise
drug laws, others criticise the confusion surrounding the new policy
and many say the changes don't go far enough.

The debate grew more heated again last week when new research by
leading psychiatrists pointed to a strong link between mental illness
and cannabis use.

Professor Robin Murray, a psychiatrist at the Maudsley hospital in
south London, published findings stating that cannabis both increases
the risk of serious mental illness and exacerbates existing psychotic
conditions.

Murray's conclusions were controversial. His research was not
published in time to be presented to the council of experts consulted
by the Home Office when it decided to go ahead with the
declassification. Critics of Home Secretary David Blunkett's decision
seized on it as evidence that the Government's drugs policy is, in the
words of the Daily Mail's Melanie Phillips, 'reckless'. The
Conservative Party accused the Government of 'mixed messages' and
vowed to reverse the move.

In fact, the situation is more nuanced. Murray cited research in
Sweden and Holland that confirmed the link between cannabis and
psychosis. Research at Yale Medical School showed that
tetrahydrocannabinol (THC) - the active ingredient in cannabis - can
produce a psychotic reaction. The studies confirmed that no one could
sensibly say that cannabis was 'harmless'. However, they did not prove
that cannabis was necessarily dangerous for everyone.

According to Paddy Power, a consultant psychiatrist with the Lambeth
Early Onset Service in south London, 70 per cent of the 170 people
referred to the clinic each year take cannabis. 'A proportion of the
population is certainly at risk of psychosis from heavy use of
cannabis, but they are a minority and it is possible that they are
already at risk of psychosis for a variety of other factors,' he told
The Observer last week.

And, to many, this is key. Power likens the connection between
cannabis and psychosis to the link between cigarette smoking and lung
cancer and heart disease. 'It does not mean one leads inevitably to
the other. The more you do, the more you are at risk,' he said.

Steve, quoted above, is certain that cannabis triggered his psychosis.
Trying cannabis since developing his condition set off an immediate
reaction. 'It made me feel instantly crazy,' he said. 'It was like
turning on a switch.' But Steve may have been vulnerable already,
backing up the general consensus that cannabis can make mental illness
worse or increase the risk, but does not cause it. Steve's father,
Terry Hammond, now works for the mental health charity Rethink. He
agrees that, though cannabis had 'hurled [his son] over the edge,
Steve had previously showed signs of vulnerability'.

But no one knows how many might be vulnerable. Some talk of as many as
one in seven or in 10. Yet Les Iversen, professor of pharmacology at
Oxford and a House of Lords adviser on drugs misuse, said the fraction
was 'tiny'. Harry Shapiro, of the independent research centre
Drugscope, referred to a 'handful out of millions' being affected.

The issue of psychosis touches on many key debates within the broader
argument over the legalisation of cannabis and, more generally,
society's approach to other drugs.

Is the risk of exposing a vulnerable minority to possible psychosis
outweighed by the harm done to society by criminalising millions of
people who safely enjoy cannabis? Is it even correct to lump cannabis
with other controlled drugs such as heroin or crack that are far more
dangerous to individuals and to society? What about the differing
strengths of cannabis? What would happen if cannabis supply was
controlled by the government? Is it not irrational to focus on
cannabis when alcohol, almost all health professionals agree, is a far
more harmful drug and is misused far more widely?

Despite decades of debate, there is little clear consensus over the
way forward.

Peter Coker, who has worked with drug users for nearly 20 years and
currently runs the National Drug Prevention Alliance, opposes the
reclassification, let alone any further liberalisation. 'Blunkett
thought that, if he gave this concession to the liberalising lobby, it
would be satisfied. Instead it has just been encouraged,' Coker said.
'The reclassification is being read [by potential users] as a signal
that there is a more relaxed attitude to all drugs, and that is very
dangerous.'

Bob Carstairs, of the Secondary Heads Association, is also concerned
about the message sent to children by the reclassification. His
organisation, which represents headteachers at more than 4,000
schools, has recommended that they maintain a policy of suspending
first offenders and of expelling those who sell cannabis to their
school mates, or who otherwise encourage consumption of the drug.

'The majority of heads are disappointed at the confused message that
is being sent,' Carstairs said last week. 'There is a huge amount of
confusion. There are eight-year-olds trying cannabis. They are simply
too young to make a mature judgment.' But predictably others criticise
the policy for not going far enough.

Francis Wilkinson, a former chief constable of Gwent, says the
cannabis laws discredit all drug laws. 'Children experiment [with
cannabis] and find it is not harmful. They then think that all the
laws are wrong, even those dealing with drugs that are very damaging.'
He says cannabis and heroin have a completely different impact on the
individual and on society. 'For example, people who smoke cannabis do
not commit crime to get more,' Wilkinson, who claims widespread
support within the police force, said.

'If there is one thing that would substantially reduce crime, it is
government regulation and control of the supply of both cannabis and
heroin.'

Another supporter of the reform is Mike Trace, the Government's former
deputy drug tsar from 1997 to 2002. He said that, in 1999 and 2000, he
and his staff calculated that 'in the realms of UKP100 million' would be
saved by the criminal justice system if cannabis was legalised. He
blames fear of a 'Middle England' backlash for politicians' failure to
push through radical measures. 'There is a fear of being portrayed . .
. as soft on drugs,' he said.

Some, such as Professor Iversen, advocate a 'coffee shop system' like
Holland's. 'We need to separate the supply of cannabis from those
drugs that are more harmful.'

However, major change in drugs legislation is unlikely in the short
term, not least because Britain is bound by a series of United Nations
conventions to keep cannabis use illegal. Policy is likely to come
from the broad moderate consensus represented by drugs professionals
such as Power and others working on the front line of drugs and mental
illness in Lambeth. Despite his concerns on health issues, Power backs
reform. 'The main risk is the extremely detrimental effects on
youngsters of being caught up in the criminal justice system simply
because of the recreational use of a drug that has relatively limited
adverse health effects compared to other drugs and alcohol,' he said.

Most health professionals see education as the critical issue. The
Home Office officials say they are sensitive to the need for teaching
people about health risks and are investing UKP1 million in a campaign
to educate the nation about the new legal situation regarding cannabis
use and about the impact smoking the drug can have on bodies and
minds. Campaigners such as Hammond say that much more effort is needed.

What no one denies is that millions in Britain will continue to use
cannabis - whatever the legal situation and whatever the health advice.

Alex makes UKP50,000 a year selling cannabis and cocaine to mainly
middle-class clients. 'Even if they legalise cannabis, it would be
taxed and we could undercut it,' he said. 'The really low-quality
goods would be taken off the market and some street dealers would go
out of business. But I'd carry on. There is a huge demand for
cannabis. That's capitalism. Where there is demand, there will always
be a market.'