When it comes to health, we never know as much as we think we do. Illustration: George Wylesol
By Alex Halperin
Just because today marijuana is widely regarded as safer than alcohol doesn’t mean that’s the final word. A bestselling anti-marijuana book is making waves for suggesting that the drug may be far more dangerous than the industry would have us believe. But how much credence should we give it?
Tell Your Children: The Truth About Marijuana, Mental Illness and Violence, by the former New York Times reporter Alex Berenson, reminds readers that when it comes to health, we never know as much as we think we do.
The most demonstrable health risk associated with marijuana is that for a small portion of users, largely men in their teens and early 20s, the drug may induce psychosis and schizophrenia, sometimes after only short-term use. By highlighting this real, and terrifying, risk of marijuana use, Berenson has done an important public service.
But as others have pointed out, the book overreaches in trying to establish a causal link between cannabis use and violence. And it suffers from Berenson’s refusal to consider marijuana as anything other than a serious threat to a relatively small segment of the population.
Science takes time and is not immune to the dogmas of its era. Today doctors universally recognize the dangers of cigarette smoking, but it took decades – and millions of early, agonizing deaths – before the consensus solidified. The best parts of Tell Your Children document the connection between pot smoking and psychosis, from 19th century Mexico and India to the present day.
The connection hadn’t been a secret. According to a 2013 statement from the American Psychiatric Association, “current evidence supports, at minimum, a strong association of cannabis use with the onset of psychiatric disorders. Adolescents are particularly vulnerable to harm, given the effects of cannabis on neurological development”. But Berenson has amplified it more effectively than anyone else.
It isn’t a fashionable argument right now. The for-profit cannabis industry promotes the drug as a nearly harmless “medicine” and it seems to be working. Last year, Canada became the first large country to legalize recreational cannabis. About 90% of Americans favor access to medical marijuana and roughly two-thirds favor full legalization.
The rapid shift in US public opinion towards legalization has been fueled by disgust with the war on drugs and mass incarceration, as well as the largely unproven hopes that medical marijuana can mitigate complex health crises such as the opioid epidemic.
According to Berenson, “the great majority” of teenagers who smoke weed will not be affected by psychosis. But young people who are at greatest risk deserve the best available information. By describing numerous psychotic breakdowns in excruciating detail, the book’s scare tactics could save a few lives. Berenson is also not the first person to soundly argue that the high-potency pot products available now are likely to make the problem worse.
The second part of Berenson’s argument, however, has attracted more criticism. He attempts to show that because marijuana can cause psychosis and psychosis can cause violence, marijuana causes users to commit senseless, nightmarish acts of violence. (For rebuttals see here, here, here and here. For a discussion of the issues involved see here.)
Tell Your Children opens with an Australian woman who knifed eight children to death, seven of them hers. Later it tells the story of Jared Loughner, a 22-year-old Arizona man who in 2011 shot six people to death and nearly killed then congresswoman Gabrielle Giffords; Loughner also smoked pot. There’s lots more.
Yet legal marijuana markets don’t seem to have witnessed an uptick in ultraviolence. Berenson suggests the crimes are out there but have not been well-publicized, and that the problem is gestating. Maybe, but the argument suffers from a definition of psychosis which seems to encompass everything from low-level paranoia to fits of homicidal rage.
And while Berenson focuses on questionable concerns over violence, he misses a number of less cinematic, but perhaps more dangerous threats. He could have looked, for example, into the little studied question of whether cannabis use by pregnant women can impair fetal brain development.
Every adult in America, meanwhile, knows someone they think smokes too much weed, not because the user mutilated someone, but because it seemed to diminish their emotional or intellectual capacities. By some estimates, 10% of marijuana users develop a dependency on the drug. Under any legalization scenario, it’s this population, the anonymous problem user, who will weigh most heavily on society.
A better anti-weed book would tell their stories. But this would force questions Berenson has no interest in answering. If 20% of marijuana users have a problem, 80% don’t. Berenson doesn’t want to come off as a prig. He gets that people like to get high and tries not to hold it against them. But he’s uninterested in why people get high, much less able to acknowledge the possibility that there’s any good reason for it.
Like a lot of weed opponents, he says only a small fraction of marijuana users use it to treat a clinical medical need. That’s true. Much about weed invites this kind of easy contempt. But the great bulk of users feel it’s beneficial, because it helps them relax, it improves their sex life or makes it more fun to play with their kids. Maybe it helps them drink less alcohol, which they find more destructive.
And at the other end of the spectrum from the problem users is a population who consider weed something like a performance-enhancing drug. They can be found, among other places, throughout the ranks of Hollywood and Silicon Valley. The last century of music, one might argue, was brought to us by weed.
The book would have been better if Berenson had some understanding of, or curiosity about, the drug’s allure and complexity, or even could put its dangers in context.
“By some criteria, I am dependent,” the journalist Andrew Sullivan wrote in 2017. “Weed most definitely isn’t for everyone. But compared with all the other substances available, and most other avenues to chill and friendship, it remains, it seems to me, a no-brainer to legalize it, and for many sane adults, one of God’s great gifts to humankind.”