Fact test: How harmful is hashish, actually?

For years, discourse — each on-line and off — surrounding hashish legalization has been steeped in mistruths and claims that, when positioned below scrutiny, cannot be confirmed. DW’s fact-checking staff took a take a look at the analysis and spoke with specialists to make clear a few of the hottest myths.

Is hashish a gateway drug?

Claim: Cannabis is “a gateway drug” in keeping with, for instance, German politician Markus Söder.

DW reality test: Unproven.

The principle that utilizing hashish results in the usage of more durable and extra harmful medication might be one of the crucial widespread instances made towards legalization, in addition to one of many oldest. Söder and his colleagues lately used the argument in an interview with the German tabloid newspaper Bild, accusing opposition events of “trivializing” the drug.

On social media, supporters of legalization typically oppose the declare.

Fact: There is a correlation between hashish use and later use of more durable narcotics, research have proven. The earlier and the extra ceaselessly folks use hashish, the upper the probability of later use of different illicit medication.

But correlation isn’t causation

“If you look at how someone became a heroin user, you are very likely to find cannabis use along the way,” mentioned Dr. Stefan Tönnes, head of forensic toxicology at Frankfurt University Hospital. “But if you look the other way around, how many cannabis users go on to use heroin afterwards — it’s very, very few.” This reveals {that a} correlation alone isn’t proof of a causal relationship.

The gateway drug principle can’t be utterly disproved, mentioned Dr. Eva Hoch, a psychologist within the psychiatry division of the University Hospital in Munich. She has been finding out the consequences of hashish for about 20 years.

“Cannabis naturally stimulates the reward center in the brain and could pharmacologically promote drug affinity,” she mentioned.

But there are additionally many different threat elements for illicit drug use that must be thought of, she added. The National Institute on Drug Abuse within the US says so, too, including that extra analysis is required on the query of hashish as a gateway drug.

For the time being, the declare that hashish is a gateway drug stays unproven.

Is alcohol extra harmful than hashish?

Claim: Alcohol is “over 100 times more dangerous than cannabis”, in keeping with tweets like this one.

DW reality test: Misleading.

It is commonly claimed — particularly by these advocating for legalization — that alcohol is much extra dangerous than hashish. Several social media posts and newspaper articles point out a examine that claims alcohol is 114 instances extra harmful than hashish.

This declare doesn’t maintain up — the determine is nowhere to be discovered within the cited examine, which solely reveals that the chance of a deadly alcohol overdose is bigger than that of a deadly hashish overdose.

Since its impact begins shortly after being smoked, the power of intoxication attributable to hashish will be higher in comparison with alcohol, Tönnes mentioned, thereby decreasing the chance of an overdose. However, “when cannabis is consumed as a pastry, overdoses can occur as well.”

With that mentioned, the damaging results of each medication do not begin with overdose. But the examine referenced in these posts would not handle the nonfatal penalties.

The totally different intoxicating results of alcohol and hashish include their very own risks, Tönnes mentioned, including that it is essential to have in mind the consequences on the consumer’s social surroundings and psychological well being.

“Alcohol has a very significant effect, which is disinhibition and increased risk-taking,” he mentioned. “This is actually less the case with cannabis. But here we have the unpredictable paranoia risk, and that’s where individual sensitivity to cannabis effects can vary.”

The damaging results of alcohol consumption on the physique have lengthy been proved. “Alcohol has a high organ-damaging effect and causes more health damage than cannabis,” Hoch mentioned. But “it also depends on the intensity of use, not just the substance.”

It’s laborious to obviously assess the well being dangers of hashish due to its numerous types of use, Hoch mentioned. In Europe, for instance, hashish is commonly smoked with tobacco, which is well-known to have dangerous carcinogenic results — that is thus not directly associated to hashish use.

So alcohol overdoses are extra seemingly than hashish. But each medication can endanger the bodily and psychological well being of customers and have a damaging impression on their surroundings, even in small portions. This hazard can hardly be in contrast with one quantity — the declare that alcohol is 114 instances extra harmful than hashish is due to this fact deceptive.

Can you die from extreme hashish use?

Claim: According to this tweet, there was “no recorded death due to cannabis overdose.”

DW reality test: True.

According to NIDA, no single overdose dying that has occurred thus far has been attributed solely to hashish. The US Centers for Disease Control and Prevention additionally states that “a fatal overdose is unlikely.”

Despite this, hashish use as a explanation for dying stays below dialogue and the topic of scientific research.

In the Seventies, checks had been carried out on canine and monkeys to find out what dose of hashish might be probably deadly. The animals had been administered a excessive oral dose of tetrahydrocannabinol (THC). They confirmed signs equivalent to drowsiness, tremors and vomiting, however all survived the involuntary excessive.

Animal research are tough to switch to people, however Hoch mentioned “the lethal dose for cannabis is very, very high. It’s very unlikely that a human would ingest that much.”

Cannabis: Death not dominated out

Researchers at King’s College London have been attempting to retrospectively decide whether or not hashish will be lethal to people by reviewing all cannabis-related deaths that occurred in England between 1998 and 2020.

In nearly all instances, hashish was not the one drug — on common, three to seven different substances had been additionally detected, equivalent to opiates, alcohol or medication equivalent to tranquilizers or sleeping drugs.

In 4% of the deaths, researchers discovered hashish to be the only real explanation for dying, normally resulting from accidents sustained throughout intoxication. In one case, hashish toxicity may have resulted in dying. Still, it stays unclear whether or not a single dose was the reason for dying or the length of use finally contributed.

Hoch mentioned there have been “other published cases of cannabis-related deaths.” These have been reported in affiliation with accidents, suicides or cardiovascular problems equivalent to coronary heart assault. But establishing the reason for these deaths is tough, she mentioned.

Smoking pot isn’t good in your coronary heart

The NIDA additionally warns of the dangers that may consequence from the elevated coronary heart fee attributable to hashish use. The institute has acknowledged that “marijuana increases heart rate for up to three hours after smoking,” which it says could enhance the chance of coronary heart assault.

“Cannabis definitely has an effect on the cardiovascular system,” Tönnes mentioned. “People who are particularly sensitive, have a predisposition or have previous damage may therefore be particularly sensitive to cannabis.”

Older research additionally recommend a hyperlink between hashish use and an elevated threat of heart problems. “You can’t rule out the possibility that this could become life-threatening,” Tönnes mentioned.

Why is a single overdose (seemingly) not deadly?

The threat of dying from a single hashish overdose is “negligible,” the King’s College researchers concluded.

Apart from the massive quantity of hashish wanted, it is usually thought of physiologically unlikely, Hoch mentioned. The very low presence of cannabinoid receptors within the mind stem explains why hashish — a minimum of in folks with out preexisting circumstances — has a much less potent impact on respiration or different essential bodily capabilities equivalent to blood stress or coronary heart fee. Opioid receptors, however, play a better position within the mind stem, which is why a heroin overdose can result in respiratory failure.

“Alcohol can also have a paralyzing effect on the central nervous system, especially the respiratory center,” Tönnes mentioned, “and therefore lead to death.”

Does hashish kill mind cells?

Claim: “Marijuana doesn’t kill brain cells,” in keeping with some Twitter accounts.

DW reality test: Unproven.

How does hashish or marijuana (because the dried, resinous flowers and the small leaves of the feminine hemp plant close to the flower are referred to as) have an effect on the mind? In the Seventies, the psychiatrist Robert Heath, of Tulane University Medical School in New Orleans, made headlines after conducting an experiment on rhesus monkeys that he mentioned proved that marijuana use kills mind cells.

The qualitative implementation of the experiment was closely criticized, and the outcomes of the examine had been later refuted by researchers on the National Center for Toxicological Research in Arkansas. That was only the start.

Many hypotheses, no readability

To date, research on the long-term results of hashish on mind construction in people have proven conflicting outcomes.

Hoch has lengthy adopted the “explosion of publications” round hashish.

“It’s true that cannabis interferes with neurophysiology,” she mentioned. But she emphasised that even she will be able to’t clearly say how neurotoxic or brain-damaging the principle lively ingredient in hashish, THC, actually is. She mentioned additional analysis was wanted.

More is understood concerning the speedy, shorter-term results. There is nice proof that sure psychological skills are impaired after acute hashish use, equivalent to short-term reminiscence, psychomotor coordination or consideration span. With persistent use, these results can persist for days. However, they seem like reversible after a number of weeks of abstinence.

Young folks in danger

There isn’t any denying that hashish use can harm younger brains specifically, because the mind develops considerably in the course of the transition from childhood to maturity, Hoch mentioned.

The US Centers for Disease Control and Prevention warns that marijuana use earlier than age 18 can have an effect on how the mind builds connections for capabilities equivalent to consideration, reminiscence and studying, but in addition emphasizes that the consequences of marijuana use on the mind depend upon many elements, equivalent to the quantity of THC, how usually it’s used, age at first use and whether or not use is accompanied by different substances, for instance, alcohol or tobacco.

Long-term results on the mind may additionally be attributable to elements apart from marijuana, equivalent to genetics, house surroundings or different unknown elements.

Studies wanted on neurogenesis by means of hashish

A 2019 examine induced a stir when it discovered that after smoking marijuana, youngsters have extra grey matter in sure areas of the mind. But not even the researchers concerned wished to take a transparent place on whether or not the rise in grey matter ought to be seen as useful or quite dangerous. The knowledge must be interpreted with warning.

Hoch mentioned the declare that hashish can develop new mind cells was attention-grabbing and ought to be pursued sooner or later.

Initial animal experiments have centered on the impact of cannabidiol (CBD) on neurogenesis. CBD, together with THC, is without doubt one of the best-known cannabinoids, or chemical compounds present in hashish. But there is a distinction: THC has a psychoactive impact and CBD doesn’t.

Further analysis into the physique’s personal hashish system is required, Hoch mentioned. “When do cannabinoids promote health? When do they pose risks?,” she requested. So far, greater than 140 cannabinoids have been found. For most of them, the consequences haven’t even been studied, she mentioned.

“Cannabis products available on the black market have a completely unclear cannabinoid profile. They usually contain very little CBD, but a lot of the main intoxicating active ingredient THC. Dangerous additives such as synthetic opioids or cannabinoids could also be included,” Hoch mentioned. That’s why her recommendation to teenagers is: “You’re doing your brain a favor by not smoking pot”.

This article was initially written in German.