Le cannabis rend-il schizophrène ? (Pr Benyamina) – PSYCHE #12

Hi psychonauts As you know, if you follow us on social networks, we had the chance to be invited to the French congress of psychiatry held in Montpellier in November 2016

The congresses, it is the occasion to meet between professionals, but especially to continue to train and learn This year, we decided to make you take advantage of this opportunity and to interview personalities on topics that should please you We will start with Professor Benyamina to take stock of cannabis And you will see, he does not practice the language of wood Hello, I'm Amine Benyamina, I am a professor of psychiatry / addictology, and hospital practitioner at Paul Brousse Hospital

I am teaching at Paris 11 University, and I am also president of the French federation of addictology And to begin with, cannabis in France: where are we in 2016? We are on an inexorable rise of cannabis since about 2010 After experiencing a significant increase that scared us all in 2006-2007, we realized that France was a country that consumed a lot of cannabis through its youth, we then had measures taken, followed by a calm time, and then things started again in 2010 There are some lines of explanation but they are not conclusive The result is that teenagers in France consume a lot of cannabis, and these are the cannabis champions in Europe

By the way, how is cannabis used? Cannabis is rarely eaten alone, it is very often, if not exclusively, consumed with tobacco (the seal), which brings together the damage and risk associated with both products It is very often associated with taking alcohol, and now we know it, it's become a problematic social phenomenon, cannabis is also consumed with synthetic drugs Overall, not all young people, but we can have a typical profile of the one who consumes alcohol, cannabis / tobacco and synthetic drugs, especially during evenings once a week But cannabis is a quasi-permanent datum The age of consumers? The average age is 16-17-18 years, what is problematic is not the age of consumption but the age of initiation

We realize that the initiation is more and more early Which poses a problem in terms of psychological and psychiatric we now know that before the age of 15, we still commit elements of vulnerability who make you a candidate to develop diseases or problems psychological and psychiatric, more than others This permanent element is a consensus and no longer a debate The precocity of consumption is a problem, and it can make the bed with other vulnerability factors psychiatric or psychological diseases The relationship between schizophrenia and cannabis, we know what? Before talking about schizophrenia and cannabis, the first problems that we will see among consumers are problems of concentration and school dropout, relational difficulties

This, in my opinion, is the first emergency in terms of prevention (public health) Then, obviously, what matters to us, psychiatrists, it's the proven link between psychotic pathologies and cannabis use We know it, we see it, the proofs are numerous, whether it's scientifically, epidemiological or sociological On the other hand all those who consume cannabis do not necessarily become schizophrenic There is indeed a combination of factors that must be present, to increase the risk of deviation to schizophrenia

There are a few things everyone agrees on: the precocity, the quality of cannabis consumed; we know since 2007 that the dose of active principle plays an important role in the risk of developing schizophrenia We have recently another important factor, it's the quality of the components, the cannabinoids In cannabis, the higher the percentage of THC, the higher the risk And the less that percentage is, and the more that CBD, a cannabinoid, is high, the more likely you are to not develop the disease Cannabidiol is a protector against psychosis

These are extremely important elements, even if they look scientific, because they allow us to dictate a targeted prevention policy Basically, young people should not consume before a certain age, it's risk reduction, they must not smoke anything, and if they have a family history that has psychotic problems, these are then candidates for greater vulnerability In addition, we have more and more genetic factors on which we can rely to be able to say "we have risks" All these elements are there, are convincing, are present, they must guide us towards a targeted prevention policy, which is not the case What are the desired effects of cannabis? There are two positive effects sought: first, the feeling of relaxation, that's why we're talking about festive cannabis, it's like drinking a drink without being an alcoholic

It is therefore to take a product to have relaxation 90% of people who consume will not become addicted and will not present any problem The second effect, this time historic, is that cannabis, vis-à-vis the pharmacopoeia is very old Since all time, we have traces of cannabis as a product that helps people, that is to say therapeutic cannabis, whether for pain, appetite, potentially for psychosis It is not then about any cannabis: but cannabis in which we have in particular cannabidiol

In France, we have a drug that does not have a price yet, but has been approved for five years, the Sativex, in which we have a higher proportion of cannabinoids compared to THC This is an extremely interesting way but that is not supported I think it's a mistake not to support him, it's as if we banned powerful analgesics for very powerful pains because there are opioids inside, while we know full well that heroin, an opiate, is a drug We have this reasoning which is parallel but that does not apply to cannabis because there is an ideological debate behind this product And in France ? In France, there is no debate because there is no political portage

There are recommendations that have been written by the French Federation of Addictology who ask politicians the question, asking them to open the debate, which is not legalize, decriminalize but to pose elements on which there is consensus, discuss about those who are problematic, integrate the society and environment part, especially the price, the marketing, the delinquency linked to the consumption, all the profit, the fact that youth is captive France is the country in which we have the most prohibitive law concerning cannabis but beside that, it is in France that young people consume the most Take the example of the United States: States have legalized the festive character, others who have decriminalized it, or even legalized totally, and we have some interesting feedbacks: we see that there is an effect of increasing consumers but this increase did not result in an increase in consumption problems Be careful, do not draw conclusions right away, We'll see later The model of Uruguay is observed worldwide: the latter has fully legalized cannabis with a state-based cannabis spin-off, from culture, to marketing, as well as observation and monitoring of people

We'll see how things get organized One thing is certain: France's position is untenable I do not argue for a state that delivers its youth to consumption, I plead for a responsible state, who sees that youth is delivered to the traffic and who notices the inexorable rise of consumption The current model shows its limits For cannabis, we understood that things were at a standstill, but some signs show us an improvement, like for example the shoot rooms for heroin users, right? The advent of the shoot rooms goes in the direction of a possible opening towards a kind of complete inhibition of society on what seems to be the accompaniment of the addict

No, it's an interesting sign What is important is the notion of risk reduction, it's not because we allow people to consume that we will encourage them to consume They are allowed to consume in a secure environment to reduce their risks, and environmental and neighborhood risks It is this requirement that should guide the opening of this debate, and the relaxation, or improvement, of the 1970 Cannabis Act Suddenly, the shoot rooms, it allows access to care? What is interesting in the shoot rooms, is that we will try to allow with people who are breaking with society to enter an airlock that will allow them to be seen, watched, and helped

Here ! It's finish, we hope you had so much fun watching this chronicle that we do it, if so, feel free to share on Facebook, Twitter, to put us a little blue thumb, it's always fun, and to share on all the social networks that you think are sensible We remind you that we have a Tipee page, and by the way, we would like once again to thank our faithful Tipeurs who are there from the beginning and every month, then we will give special thanks to Nathalie Isabelle of the Organizing Committee of the French Congress of Psychiatry, as well as to Professors Courtet who both left us carte blanche And do not forget : Madness is sometimes the best way to adapt to reality


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