Lots of my patients smoke cannabis every day. In fact, I am no longer surprised when people tell me that they do. I have seen everyone from new-mums to grandfathers, labourers and lawyers who admit to using it. Some use it to relieve the symptoms of migraine and anxiety and others for chronic pain; some seemingly just smoke it for the enjoyment.
Observation of my patients’ cannabis use tells me three things:
1. Cannabis seems to have some positive effects.
2. Cannabis is generally safe, at least compared to lots of other drugs.
3. Drug enforcement laws are highly ineffective.
I have seen lots of people with chronic pain who have not got on well with conventional pain killers but have been able to manage their symptoms effectively using cannabis.
However, I have a handful of patients whose symptoms are caused or made worse by their habit. This is especially true of people with mental health problems.
Initially, they will often report that the cannabis relaxes them but over time their symptoms get worse. Despite this they continue to deny that cannabis has any role in their illness, and they begin to smoke more of it to try to replicate the relief that they got at the start. I once saw a patient who was spending £40 a day on cannabis despite the fact that he was unemployed. Needless to say he was highly anxious.
The ones who seem to be using it sensibly don’t worry me too much. They are basically doing my job but with an illegal drug rather than one that I have prescribed them. There are clearly some risks with smoking cannabis, including the damage that they are doing to their lungs, but compared to something dangerous like alcohol it is not that bad.
However, as a Muslim and a doctor my advice to everyone is to stop smoking cannabis completely. In practice things are not that simple.
Often patients are so convinced that it is helping them that they simply refuse to give up. Rather than stop there, I try to convince them that cannabis might be making their anxiety worse, or that smoking it might cause cancer, or psychosis. When they say that they don’t really care about those things, I don’t have many options left.
I could call the police and have them arrested for using illegal drugs but I doubt that either they or the police would care very much. All that would happen is that our therapeutic relationship would be ruined.
The only option that I am left with is to try to help them to reduce the harm that cannabis might do to them, so in the final 30-seconds of our busy 10-minute consultation I throw them a list of harm-reduction measures:
- Consider using a method other than smoking cannabis with tobacco, like a water bong, a vaporiser or eating it;
- Use it as infrequently as possible and no more than once a day;
- Never in the morning;
- Finish your household chores and to-do-list for the day before getting high;
- Try to have at least three “rest days” in a week;
- Try to use it only with other people;
- Don’t use any other drugs with it, including alcohol;
- Never drive or operate machinery after smoking it;
- Never use it around children;
- Never get into debt because of it.
As a convert from atheism, I am able to admit more openly than most Muslims that I have smoked cannabis, so I know how it feels to get high. I know that it is a very pleasurable experience, and I can see why so many people use it regularly, but long-term use is not without its risks. The very best thing to do would be not to smoke it at all, but if you do decide to, make sure that you do everything that you can to limit the possible negative effects to your health.
One of the reasons that Islam teaches us that we should never use cannabis or other drugs is that it is easy to lose control. Drugs give us pleasure so it is very difficult to resist going back to them and this can quickly spiral into an addiction. Another reason is that Islam asserts humans are a perfect being created by Allah using a fine balance of chemicals. Adding something that was not intended to be there can damage that delicate balance. Islam is also concerned about the harm that drugs do in society; drug addiction causes crime, illness, homelessness and death.
My solution to the problems caused by cannabis in Britain would be to make it legal, but regulated in a similar way to alcohol and tobacco. At least that way the government would make some money to put back into helping addicts and they would save even more on the cost of drug enforcement, which doesn’t seem to be that effective anyway. It would also open up cannabis to medical research, which might result in the development of a new medicines or maybe even a tablet which could help cannabis users to quit, in much the same way that there are now prescription drugs that I can prescribe to help people to stop smoking cigarettes. Once it was legal, I would invest some of the money made from cannabis taxes into education with the aim of reducing the number of people who start using it in the first place. Finally, I would use the new-found wealth to tackle some of the underlying causes of drug addiction such as poverty and childhood abuse.