Cannabis- the therapist’s opinion… DrugFAM supports Sarah Graham’s views:
Sarah Graham is a Priory trained addictions counsellor and director of Sarah Graham Solutions. She is a leading authority on drugs use by teenagers and regularly appears in the media as an expert commentator for Frank. This is her personal and professional view of the drug and how to treat cannabis abuse and dependency:
Of all the mind-altering drugs that people use, cannabis is the one that causes the most controversy and about which there is enormous cultural denial. My appearances on TV talking about cannabis often bring me considerable hate mail from people who think that cannabis is “just a bit of spliff”.
It is believed in popular culture that you “can’t become addicted to cannabis” and is often described as a “soft drug”, because it’s use wasn’t thought to lead to physical dependency; in the way that heroin and alcohol use does.
Professionals working with young people are having to rewrite the rule book about cannabis use- as skunk takes over the lion’s share of the cannabis market here in the UK.
Those of us working with young people are seeing physical symptoms of withdrawalfrom the stronger “skunk” strains of cannabis. Along with extremely entrenched psychological dependencies that are very difficult to break.
In some cases we are seeing quite severe reactions- from both the taking the drug and when the client starts to reduce cannabis use and become abstinent. These symptoms may include hallucinations, loss of coordination, shaking, sweating, nausea, mood swings, panic attacks, memory loss, cognitive function problems, sleep disturbance, angry outbursts, uncontrollable giggling, ravings for the drug, binge-eating, or loss of appetite, diarrhoea, self-harming, reduced fertility and psychotic illnesses including schizophrenia.
You probably know this from your own experience- but it may help to have it confirmed in black-and-white by an addictions expert. People can become addicted to cannabis (F12.2 Cannabinoid Dependence Syndrome, to use the term referred to in the World Health Organisation classification volume ICD-10).
I work with people addicted to all drugs- including the “hard ones”. And the treatment process of cannabis addiction is often one of the most challenging- for the individual and the therapist. Ironically, it can take longer to successfully treat a young cannabis dependent person than a young person addicted to “harder drugs”. Why? Because of what it does to their brains and the length of time it remains in the system after totally stopping smoking and “getting abstinent” (4-6 weeks). With a heroin or alcohol addiction, once the physical dependency has been medically managed (2-4 days detox) the person stands a good chance of being relatively clearheaded and able to process information; and engage in treatment.
Counselling skunk smoking teenagers, it is often painful to witness just how difficult it is for the young person to retain information and how damaged they can be by the thing they crave. And how strenuously they will defend it against all the mounting evidence they and their loved ones are experiencing. Sadly, even if they are very motivated and really want to make changes the effects of the drug are very counter-therapeutic. Getting to an appointment on time- especially in the morning- can be very difficult. Cannabis use saps motivation and energy and the low mood, panic attacks and paranoia it can induce, makes it very difficult to get up and “do the work” necessary to get well.
In my company- Sarah Graham Solutions- we prioritise working with cannabis dependent teens because we’ve seen enough serious cases to understand just how damaging cannabis use can be; and what a time-bomb skunk use by teens may be for individuals and society. The drug has “evolved” through man-made interventions and it may be years before the medical science can “prove” what many experts like me believe to be the case.
I think that skunk use is a key factor in gangs and the upsurge in the violent crime that accompanies them. Some of the teens I have worked with have become extremely violent and behaved in ways they are very remorseful about; and can attribute this to their use of skunk cannabis- or its lack of availability; and definitely not the way they were raised. Others have turned inwards and spent months and years living in a solitary, internal head place, that feels lonely and quietly desperate.
Teenagers who smoke cannabis regularly- or who binge smoke heavily- seem particularly at risk of developing a dependency and the very latest neuroscience suggest they are seriously risking permanent brain damage; because their brains are still growing and can’t repair once the damage has been done. This addiction can be very powerful- the psychological grip it can have over an individual can seem almost impossible to break.
I hear often that an individual has tried to stop many times and “failed” this has led to ever-decreasing self-worth. Loss of educational aspirations and a sense that life is going nowhere. The good news is- it is possible to stop smoking and for a person to turn things around.
We’ve worked with many people who have managed to stop smoking and gone on to have healthy, happy, successful lives. Even the best addictions counsellors are not miracle workers though and anyone who offers a quick-fix should be avoided.
Cannabis treatment that gets the best results often needs to be long-term and using an holistic model (it can take 3 months to a year of regular support for a young person to feel secure in their recovery). Teens are often part of a cannabis using peer-group and the pressure to conform can be tough to resist. The USA has many residential rehabs for teens and sadly we don’t (although I’m trying to find funding to set one up).
As a trained counsellor and auricular acupuncturist and person in recovery, I know what works; and what doesn’t. I have fostered close ties with Talking About Cannabis because I understand how vital good family support is- to achieve successful results (and preserve everyone’s sanity).
There are some other very good projects available to do this therapeutic work (contact Frank to ask what’s in your area) but don’t be put off if your Dr or local service doesn’t know much about cannabis or minimizes the seriousness of its use).
We have a long way to go to bring all professionals up-to-speed and when we start to see the scale of the problem (and the potential cost of treatment) you can understand why this subject is such a political hot potato. It’s sad but true that a lot of the treatment agenda is driven by crime stats. Heroin and crack addicts can create one-person crime waves- so getting them into treatment is a political priority.
Cannabis and its impact on mental health may cost society a great deal too- but up until recently it hasn’t been something that could harness voters. This may change as more is discovered about the links between skunk and violence especially knife crime.
Cannabis’ place in society has long been contentious. It’s been a symbol of counter-cultural rebellion and many politicians formed their opinions at college and haven’t reassessed the facts. Cannabis has even been seen by some parents as a safer alternative to alcohol. I smoked cannabis for many years- from 14 until I came “into recovery” 7 years ago; and at one time wanted a cannabis leaf tattooed on my wrist (thankfully I was too young). Having smoked traditional cannabis- grass and hash- and skunk in Amsterdam and Mexico, I can tell you first-hand, that cannabis has changed.
The THC/CBD ratio change in skunk has fundamentally altered the way the drug feels and its impact on the brain. We need to bring everyone up to speed. And quickly!
I would say, in summary- that skunk is a very powerful, neuro-toxic substance- that should be respected by all people and is best avoided completely by teenagers. Until we know more about the long-term effects I would definitely say “Err on the side of caution”.
If you or your family member is using it and you are worried ask for help now. Don’t leave it until a serious, potentially irreversible, mental illness has taken hold.
Sarah Graham Solutions has clinics in Surrey and on Harley Street.
She will try and answer all questions sent to her via her website: sarahgrahamsolutions.com
Thanks to The Hale Clinic