New View on Pot

Marijuana is a generally harmless intoxicant that produces serious psychological effects only in users who are emotionally disturbed to begin with. So. at least, runs the prevailing view, held by potheads and professional researchers alike. Last week, a challenge to that idea came from two Philadelphia psychiatrists who believe that regular pot smoking can cause grave psychiatric ills, including psychosis, even in young people who previously were stable.

Writing in the Journal of the American Medical Association, Dr. Harold Kolansky and Dr. William T. Moore reported that all 38 patients in their study were adversely affected by smoking pot. Of eight who became psychotic, four tried to kill themselves, and of 13 unmarried girls who became promiscuous (some with other girls and some with both sexes) seven became pregnant. Eighteen developed anxiety, depression, apathy or poor judgment, and many had trouble concentrating, remembering, speaking clearly, and distinguishing fact from fantasy. None of the patients, who were from 13 to 24 years old, used any drug but pot and none had a history of serious mental illness.

Klan Potentate. Typical of the psychoses that sometimes developed after pot use was the paranoia of a 16-year-old girl who thought her older sister's husband was sexually interested in her. She began to attack teachers and friends verbally, dropped out of school and attempted to hang herself. In other cases, a 24-year-old came to believe he was the first member of a new superrace, a 20-year-old thought he was a Ku Klux Klan potentate in charge of the Mafia, and a 17-year-old decided he was the Messiah returned to earth. In each case, Kolansky and Moore theorize, pot disrupted the patient's view of reality so that the ego had to "develop a delusional system to restore a new form of reality." When they gave up pot, the psychotic youngsters were able to give up their delusions as well, but lapses in memory and concentration remained.

Among other cases described by Ko-lansky and Moore was a college freshman of 19, a good athlete and student in high school--where he smoked one or two marijuana cigarettes every weekend --who increased his pot smoking to several every day in college. As a freshman, he stopped going to classes, avoided sports and social activities, and often lost his train of thought. Another A student in high school became "apathetic, disoriented and depressed" in college two months after starting on cannabis. Confiding to a college counselor that he thought marijuana was making it hard for him to think straight, he was "reassured that the drug was harmless." He gave up pot nevertheless, and not long afterward regained his motivation and ability--which suggests that the drug had been responsible for his problems.

Russian Roulette. Explaining the apparent effects of marijuana, the two doctors suggest that the drug accents youthful worry over things that trouble every adolescent: his changing body, his awakened sexual interests, his longing to be as dependent as a child and his wish to be as self-sufficient as an adult. Pot interrupts "normal psychological adolescent growth processes," thus, says Moore, producing "a lot of young adults who are psychologically still children." Kolansky agrees, adding that the adolescent who smokes pot "is playing chemical Russian roulette because his personality is naturally unstable and changing." If he has psychological problems in addition, "marijuana can be dynamite--it can hit like a bomb."

Several behaviorists were quick to take issue with the Kolansky-Moore study. They pointed out, for example, that eleven patients in the group indeed did have at least minor problems --anxiety, depression, difficulty in concentrating--before they took up pot, so that marijuana smoking did not actually initiate their problems. Other critics cite the small number of cases investigated by Kolansky and Moore and point out that school troubles, promiscuity, and psychosis often occur in adolescents who have never experimented with drugs. Among the doubters is Harvard Psychiatrist Lester Grinspoon, author of the heavily documented new book Marihuana Reconsidered. "This is an uncontrolled study. You can't tell which is cause and which is effect--the drug, the life style, or the psychological problem." He adds a warning against "alarming reports" about the presumed hazards of pot based on "slim data" because, he says, such reports widen the credibility gap between doctors and adolescents.

Significantly, however, Grinspoon himself opposes the use of marijuana by youngsters. His reason: Many ordinarily harmless drugs can set off a psychosis in people with shaky egos--and in adolescence, a shaky ego is a normal condition of life.

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