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Modern humans must learn how to relate to psychoactives
responsibly, treating them with respect and awareness,
working to minimize harms and maximize benefits, and
integrating use into a healthy, enjoyable, and productive life.
Marihuana-Thirty-five Years Later
Walter Bromberg, MD
Vol 125, Sept 3, 1968, 391-394
American Journal of Psychiatry
EDITOR'S NOTEBOOK

In December 1933 the New York Mirror, a tabloid, ran a story headlined "Loco Weed, Breeder of Madness and Crime." Unlike the Mirror, which suffered eventual demise, the "loco weed" (marihuana) and its use grew and flourished in the metropolitan area.

We observed a few cases of marihuana intoxication at the Bellevue psychiatric Hospital in 1932-33 and reported them in this journal in September 1934. They fell into three clinical categories: a) acute intoxication, b) reactive emotional states, and c) toxic psychoses, in which a basic cyclothymic or schizophrenic process rose to the surface and dominated the clinical picture. The sense-distortions found in the intoxications were recognized by Dr. Paul Schilder, then clinical director of Bellevue, as similar to those of mescaline; this included changes in visual, tactile, and proprioceptive perception with disintegration of body images, distortion in time sense, and emotional lability. The dozen cases observed were carefully scrutinized and their clinical manifestations duly noted in the paper mentioned above. The subject amounted to a medical oddity.

But marihuana usage continued to attract attention beyond its psychophysiological effects and the interesting changes wrought on perception. The fear that the drug (cannabis and the active principle, cannibinol) stimulated its devotees to criminal action continued to engender anxiety. The press took up the cudgels against this new breeder of crime. Malayan "running amok," the wild destructive behavior of hashish users in Asia Minor and northern Africa due to cannabis, and serious crime and dementia observed in India following ingestion of ganja (concentrated cannabis) were re-discovered. American law enforcement agents were alerted to this new "cause" of crime. The district attorney of New Orleans Parish, Eugene Stanley, wrote a paper in 1931 titled "Marihuana as a Developer of Criminals." Meanwhile the use of the drug spread among the demi-monde of our larger cities through Greenwich Village and among its aspirants to the youth in the streets, especially our crowded, underprivileged streets. The by then endemic smoking of marihuana was reported in 1938 by semi-official bodies such as the Foreign Policy Association as directly related to "heinous" crime, including murder.

To check these impressions, the records of some 16,800 criminal offenders in the psychiatric clinic of the Court of General Sessions. New York County (the largest criminal court in the world), were scrutinized over a period of five years for evidences of marihuana usage. Only 200 such users (addicts?) were found in the total number, and only a miniscule number (six) had been charged with violent crime, including sexual offenses. In the meantime 32 cases of marihuana intoxication and psychoses had been reported at Bellevue by 1939. The clinical breakdown fell into the same categories noted earlier. An important observation was that marihuana did not develop a true addiction in the sense that morphine derivatives did but a "sensual or hedonistic" addiction. Nowadays this phenomenon is called a "psychic dependence": in any event, the drug does induce apathy, indifference to current social values, and neglect of ordinary goals of industry and competitive striving.

With the advent of World War If experiences multiplied; as the bars were let down. marihuana became a common pacifier, an intoxicant, an introduction to the world of perception distortion-of chemical contentment and mind expansion. Marihuana became "pot." The threshold was lowered to include college and high school students, while the supra-world advanced to LSD and the nether-world regressed to heroin. To coin an expression, "Pot made the scene."

The questions aroused by its widespread use, however, assumed serious concern. The demand for further legislation to restrict its use through criminal sanctions came to the fore: stronger penalties have been advised for sale and use of the drug. Today a controversy rages as to whether marihuana should be prohibited or legitimized; officialdom insists it bears a relation to narcotic drugs, while hippies and the oncoming generation claim otherwise. Every psychiatrist, whether in hospital or private practice, has had experience with "pot" users. The lines are almost equally drawn between those who support the "establishment" and those who support the "left-activists" in this area.

Shorn of hysteria and official concern with the rising tide of crime in the streets, the psychiatric and psychologic facts of marihuana usage can be boiled down to a few principles: that the contentment and extended dimension given consciousness do lead to apathy and indifference to our accepted cultural standards; that a psychic "hedonistic" dependence does develop in its devotees after prolonged usage; that alcohol does share its toxic qualities and dangers. Corollary findings indicate that not every marihuana user progresses to heroin- that some become bored with it and the flat pleasures it induces but that those endowed with psychopathic tendencies are apt to stick with it.

The psychiatric profession, dedicated to preserving the mental health of the nation, can best serve the public by openly stating the psychic dangers of marihuana and putting the burden of its use or abuse squarely on the shoulders of the users. If rebellion against the "square" world is necessary, if the hypocrisy and double standards complained of require modification, it is incumbent on the oncoming generation to make these changes on the basis of clear and present need rather than the space-time-body image distortion of LSD, marihuana, or banana peel extract.

The mildewed thinking fostered by these drugs will result in more confusion than lamentably is present now. It would seem the better part of wisdom for psychiatrists neither to press for restrictive legislation nor for ligitimation. Instead, we should maintain an advisory capacity as informed observers of human behavior.