|
|
House of Lords
HOUSE OF LORDS
SELECT COMMITTEE ON SCIENCE AND TECHNOLOGY
SUB-COMMITTEE I
CANNABIS
------------------------------------------------------------------------
PURITY AND DOSAGE
IN THE RECREATIONAL AND THERAPEUTIC USE OF CANNABIS
Neil M. Montgomery FRSA FRAI
Department of Social Anthropology
The University of Edinburgh
May, 1998
1. Introduction
1.1 In assessing issues of 'purity and dosage' I will separate cannabis users in the UK into four distinct groups, three of which apply to recreational use (Casual, Regular and Heavy users) and one to therapeutic use. Certain notable aspects, particularly those of purity, will be pertinent to all four groups while others, mainly related to dosage, will be specific to each group. Let me begin by describing the four groups:1.2 The Casual user is one who indulges in cannabis use for recreational purposes on an irregular basis, consuming no more than one ounce of cannabis resin (28.4 grams) in any one year. They require very little cannabis - less than 0.1 grams - to become 'stoned'; that is, to experience the drug's psychoactive effects 1. They may consume up to one gram over a six hour period, remaining 'stoned' but still functioning; however, the consumption of any more than one gram, within such a period, will inevitably cause the user to 'whitey'; a disturbing episode of nausea, dizziness, immobility and general unpleasantness which will last anywhere between a few minutes to an hour.
1.3 The Regular user exemplifies the average cannabis user in the UK and will consume, for recreational purposes, one eighth of an ounce (3.5 grams) of cannabis resin 2 per week. They usually 3 require more than half a gram to become 'stoned' but after 0.1 grams will begin to feel a mild psychoactive effect which they will maintain throughout, most commonly, an evenings consumption. The Regular user may consume cannabis throughout the day, whether they are working or not 4 . Having experienced 'whities' in the past, they will regulate their consumption to avoid the experience again. Most experienced Regular users - those who have been using cannabis for more than two years - are likely to have gaps of several years between 'whities'; perhaps only experiencing a few 'whities' in their life.
1.4 The Heavy user is in a minority 5 among recreational cannabis users, consuming up to and beyond one ounce (28.4 grams) of cannabis resin per week. These are people who have become dependent on cannabis; they are psychologically 6 addicted to the almost constant consumption of cannabis. The Heavy user will consume more than the Regular user's weekly amount in one day; more than one eighth of an ounce (3.5 grams). Becoming 'stoned' and remaining 'stoned' throughout the day is their prime directive. A heavy user would need to consume a considerable amount of cannabis, at least one quarter of an ounce (7 grams), within a short period of time (perhaps two hours) before encountering the 'whitey' experience; if at all.
1.5 The Therapeutic user belongs to a group which is formed from a complex mixture of recreational and non-recreational users suffering from a wide range of ailments that appear to demand various levels of dosage which relate to both their experience with cannabis as a recreational drug and their therapeutic needs. An increasing trend within this group is to abandon the illicit market and grow their own cannabis at home 7 ; primarily, to avoid problems of impurity.
2. Purity
2.1 There has been no scientific survey of the purity of cannabis resin being consumed in the UK 8 . The most common form of cannabis used in the UK is imported cannabis resin and there are two specific causes of its contamination: a) substances, like boot polish, treacle, wax, henna, soil and glue are added to cannabis resin before importation to increase its weight, thus artificially increase its value; b) blocks of cannabis resin may be secreted for importation in petrol tanks, immersed in diesel, or packed closely with other particularly pungent substances to disguise its own distinct aroma and thus is contaminated through absorption. To properly assess health risks associated with the consumption of cannabis resin within the UK it is absolutely crucial that we have a clearer picture of what exactly is being consumed along with the cannabis.2.2 Quality control is not completely non-existent because the market tends to regulate itself (nobody wants to buy a substandard product) however, the control only extends to that which is so obviously contaminated that it is not sellable. There are no guidelines, regulations or inspections to maintain control over the quality of a substance which is being consumed by a sizeable minority of the population (7.5 million) 9 . Control over the quality of products in an illicit market cannot be maintained. The argument for proper quality control is an obvious one when we discuss cannabis as a therapeutic agent (it is inconceivable that the medical profession would proceed on any other basis); the consequences of extending such control become a serious and complex issue if we want to be equally concerned about the health of recreational users.
2.3 The purity of cannabis resin and potency of different types of cannabis (resin or herbal) have direct links to dosage. For those who are applying self-medication, purity is of paramount importance; they are depending on an effect for some form of relief and are likely to consume more 'contaminated' product than their usual dose in an attempt to find that relief. Of course when they next acquire cannabis of a higher quality the processes for measuring out dosage remain the same, at least for the first application. Over-dosage, of this unintentional nature, is likely to cause distress and disruption to daily activity. The result is that the therapeutic user makes attempts at ensuring a continuity of supply either by buying cannabis resin in bulk or by growing their own at home; both activities - the possession of 'more than what might be considered compatible with personal use' and 'cultivation' - are serious crimes that may well result in a custodial sentence.
3.1 The measurement of dosage for the therapeutic and recreational user is a process performed completely by eye and experience. There are a few people who will invest in expensive 'gram scales' (weighing to within on hundredth of a gram) and laboriously subdivide their purchased cannabis into experientially discovered doses, but by far the most common processes lack any kind of accuracy or consistency.3.2 Consistency of dose, however, is effected more by variations in the type of cannabis and potency than by the lack of accurate measurement systems, purity problems or the development of tolerance. Each type of cannabis has a unique psychological and physiological effect; for instance, a dark, malleable, Nepalese hash will produce a 'stone' that swamps the entire body inducing a feeling of extreme heaviness and sluggishness, combined with a dulling of the general senses but tending to focus the mind, concentrating it on one process, one input; whereas, a Thai grass will produce only a slight physiological effect of light relaxation, general senses become alert and will be stimulated by minor changes in surroundings, a feeling of brightness, happiness and contentment will often lead to inexplicable giggling. This startling range of effect offers the recreational user desirable variety but can confuse and distress an inexperienced therapeutic user, perhaps not offering them the relief they expect.
3.3 The examples I have chosen are of course extremes, between which there is a complex mixture of effects; one further example to offer is Durban Poison, a grass which produces an effect similar to Nepalese Black for about fifteen or twenty minutes then the 'stone' changes to a light, 'speedy' effect similar in many ways to a Thai grass.
3.4 As if this were not complicated enough, the effect which one might expect from any one type of cannabis will itself be affected by the mood and actions of the user. If the user is in a mood to relax then they will be assisted; a sense of relaxation will be emphasised - depending on dosage the results can be gently calming or soporific - or, if the user is busy, has things to do, the same type of cannabis will stimulate action, keep them going and concentrate the mind. Because of this particular trait of cannabis I have found it difficult to describe it as a stimulant, or a depressant, or an intoxicant, or a euphoriant; it seems to be able to effect all senses in different ways. I thus suggest that a new description be applied which is less misleading than the others - sensoriant. As a sensoriant, cannabis is quite remarkably flexible with a potential for a broad range of uses and applications as a therapeutic; however, given its obvious complexity, much more research than is currently being conducted needs to be devoted to establishing what components, or more likely, what combinations of components within cannabis are responsible for each notable effect.
3.5 The two principle methods of consumption, eating and smoking, offer slightly different psychoactive effects and very different effect progressions; for the recreational user this is no more than a matter of choice but the differences appear to be very important to the therapeutic user10 . Again, what I offer are two extremes in the scale of needs and applications: The therapeutic user who suffers from chronic pain can be relieved and satisfied through ingestion of solid matter by mouth - often cooked or melted into foodstuffs - however, the Multiple Sclerosis (MS) sufferer who aims to relieve involuntary spasms gains no satisfaction from eating cannabis because after consumption it takes anything up to two hours for the effect to begin; an MS sufferer cannot plan their spasms hours in advance. What the MS sufferer requires is a quick acting palliative, therefore they tend to smoke cannabis rather than eat it. When cannabis smoke is inhaled the effect begins within five seconds.
3.6 Differences in dosage are also apparent in these examples; 'chronic pain' seems to require regular, large amounts of cannabis, leading this type of user to consume almost as much as a Heavy recreational user (up to five grams per day); 'involuntary spasms' require only a small amount, commonly half a 'joint' (approximately 0.1 grams), at the first indication of an impending attack.
3.7 There also appear to be considerable differences in the type of palliative effect in these two different conditions I have exemplified; the users with 'chronic pain' say that the cannabis does not really take the pain away but makes the pain more bearable; whereas, users with MS experience a direct, identifiable intervention on their condition.
4.1 A considerable tolerance is built up when cannabis is consumed on a regular basis; meaning that a Heavy user requires at least eight times as much cannabis as a Regular user to achieve the same effect. A regular user, too, is effected by a build up of tolerance in that while maintaining their standard dose they will not experience a powerful 'stone' in the way that a Casual user might. Quantifying this tolerance is likely to be a difficult task because of the variables noted above: a tolerance built up for one type of cannabis will not necessarily remain affective on the consumption of a different type of cannabis. Tolerance itself, however, seems not to be effected by mood and is not irreversible since a short break of at least two weeks, probably several months for a Heavy user, will return them to a mimetic of the Casual user.4.2 As tolerance increases, the user will not appear to be, or feel, 'stoned'. Thus Regular or Heavy users will be able to consume (usually smoke) cannabis throughout their working day without notice.
5. Conclusion
5.1 If clinical trials are to be conducted, the variables noted must be taken into account either to standardise for accuracy in comparative studies or to extend the scope of individual research projects beyond one type of cannabis.5.2 I believe, based on anthropological evidence, that there is a need for more research into the potential for effective therapeutics within the multifarious properties of cannabis, and that that research should be extended to illuminate consequences for the recreational user.
5.3 Further consideration needs to be given to methods of preparation and administration to satisfy the very different needs of the variously ill; and, to avoid the further complications associated with smoking while attending to its benefit of immediacy.
5.4 There seems no doubt that if the market in cannabis is to remain an illicit one then, if for no reason other than education, a clearer understanding of what impurities appear in cannabis resin used in the UK is essential.
5.5 I have found through my work as an Expert Witness 11 in the field of cannabis use that the extent to which a Heavy user can consume cannabis is largely unappreciated. In line with appreciating how little an amount is necessary for some therapeutic applications, further research into dosage for both recreational and therapeutic users should be conducted.
6. Experience
6.1 I have researched cannabis use since 1989. In 1994 I was commissioned by Channel Four Television to research the use of cannabis in the UK. My report resulted in their transmission of 'Pot Night' (a series of cannabis related programmes); two articles of mine were published in their accompanying booklet and for 'Pot Night' I produced a film entitled 'Amsterdam by Night' which looks at cannabis culture and 'coffee shop' society in Amsterdam. I am currently completing an MSc in Social Anthropology at Edinburgh University and will begin a PhD this autumn; my subject being cannabis. I am a Fellow of the Royal Society of Arts, a Fellow of the Royal Anthropological Institute and a member of the International Cannabinoid Research Society.
Neil M. Montgomery FRSA FRAI
12th May, 1998
------------------------------------------------------------------------
Notes:
1. See the section on DOSAGE for more information about the psychoactive effects of cannabis. Return to text
2. I will, in the main, refer to the use of cannabis resin (Hash) rather than herbal cannabis (Grass) since Hash is by far the most common form of cannabis in use, in the UK, today. It is, however, worth noting here that herbal cannabis is consumed at twice the rate (by weight) of cannabis resin. Return to text
3. This quantity will vary depending on the purity and type of cannabis being consumed; as with all the quantities referred to in this paper, unless otherwise specified, they are particular to the consumption of the most common varieties of cannabis resin that find their way to the UK and occupy the bulk of the illicit market - Dark Moroccan Hash; known as 'Dark Rocky' or 'Soap Bar'. Return to text
4. See the section on TOLERANCE for more information about dosage throughout the day. Return to text
5. Heavy users form approximately 5% of all recreational users in the UK - it could be considered that their use has gone beyond recreation to dependency but for now they will remain categorised as 'recreational users'. Return to text
6. I say 'psychologically addicted' because there appear to be no physical problems associated with stopping, even for the Heavy user. There will, however, be a noticeable change in sleep patterns; the sleeping experience appears to be lighter and briefer during the first week after discontinuing use. Return to text
7. The last five years have shown a gradual increase in the home cultivation of cannabis in general but those with therapeutic stimulus seem more prepared to run the legal gauntlet than the Casual or Regular user. Return to text
8. I have outlined a research project to the Scottish Office, Chief Scientist's Office which combines Anthropology and Forensic Science to tackle this very issue. Return to text
9. I have applied this figure using data from the ISDD research publication, 'Drug Misuse in Britain 1996', 1997, p38, which covers only England and Wales; I have estimated an increase to include Scotland. Return to text
10. For the moment I put aside any reluctance to smoke; however, I make note of it in my conclusions. Return to text
11. I have provided Expert Evidence on eighty seven occasions to the High Courts and Sheriff Courts of Scotland and to the Crown Courts of England in cannabis cases; predominantly but not exclusively those that involve cultivation. Return to text
