Jean Costentin's little arrangements with the truth

While the need for therapeutic cannabis has been validated by ANSM last December and the CSST is currently considering how to regulate it, a few prohibitionist outbursts are scattered throughout the French press, with the same man at the helm, Jean Costentin.

The school of prohibition

If it's not him writing directly, it's his colleagues at the Centre national de prévention, d'études et de recherches sur les toxicomanies (C.N.P.E.R.T), the empty shell responsible for housing all French prohibitionists, of which Costentin is president. After being stuck on Boulevard Voltaire for a long time, Costentin and co. recently gained access to the stands of the Figaro and La Croix. They use the same arguments, emphasizing their status as “emeritus” professors and scientists, which should lend them a certain credibility. Unfortunately, between propaganda and misinformation, their discourse is, to say the least... unscientific.

We also took a close look at some of his arguments in 2017, The result is a tendency to dramatize, bias and lie. The discourse has not changed. Certain fears are legitimate, however, and were shared in more or less the same way before the various legalizations in the American states, Uruguay and Canada. But these latest examples have also served to demonstrate the reality or otherwise of these anti-cannabis arguments. It doesn't take much checking to see that some of the arguments put forward by these “emeritus” professors are hollow. Let's list them here:

• Cannabis is more dangerous than alcohol and tobacco
• Cannabis is highly addictive
• Legalizing cannabis will increase road accidents
• Cannabis makes you lazy
• THC lowers the immune system
• THC disrupts pregnancy
• Consumed during pregnancy, THC can disrupt the unborn child
• Consumed before and during pregnancy, THC will induce the unborn child to use cannabis
• THC encourages alcohol consumption
• Cannabis addiction leads to cocaine and heroin
• THC promotes anxiety and depression
• Cannabis lowers IQ points
• Cannabis causes schizophrenia
• The benefit/risk ratio of medical cannabis is against cannabis

Cannabis is «more dangerous than alcohol and tobacco».»

The three substances have different risks and effects. If we want to compare their dangerousness, we can compare the mortality they cause or their toxicity. In terms of mortality, it's hard to argue that cannabis is more dangerous than alcohol and tobacco. The latter are respectively responsible for 41 000 and 73 000 deaths per year in France. As for cannabis, it has never caused any direct deaths, but is present in approximately 230 road deaths a year, a figure inflated by Costentin and which should be qualified by the fact that THC can be detected in the blood a long time afterwards these effects have worn off.

As far as toxicity is concerned, cannabis does not cause direct death. That said, if it is consumed in the form of joints, its smoke could cause lung cancer in the same way as tobacco, although this has not yet been verified by research. As with nicotine, this toxicity is not inherent to cannabis, but rather to its combustion, which releases toxins. The 1998 Roques report describes cannabis as having very low overall toxicity. Compared to alcohol, it is 114 times less toxic.

There is, however, a risk with cannabis that should not be overlooked. This stems from the fact that it is a prohibited substance that is traded clandestinely. Indeed, unscrupulous dealers can add toxic substances during cultivation (pesticides, heavy metals, etc.) or resale (cut pot) to increase yields. The illegality of the product prevents it from being verified and subjected to production standards.

Cannabis is highly addictive

Jean Costentin points out that there are 1.3 million regular cannabis users. Regular users are those who consume cannabis around 10 times a month, not to be confused with daily users, who number around 700,000 according to the figures. OFDT report of 2017. At what level of consumption is cannabis addiction? Should it be measured in terms of quantity consumed, repetition of the act or the impossibility of doing without? The same debates exist for alcohol.

Concerning cannabis addiction, It's a very real thing, but it should be treated with a grain of salt. A distinction must be made between psycho-behavioural and physical dependence. It seems that the former is more widespread than the latter, although studies show that the latter affects about 10% from consumers. Symptoms of withdrawal include anxiety, irritability and difficulty sleeping, but are milder in intensity than the risks of quitting alcohol abruptly.

Legalizing cannabis will increase road accidents

Driving under the influence of cannabis increases the risk of accident (by a factor of 1.3), due in particular to slower reflexes. However, post-legalization data in the United States and Canada showed no overall increase in road accidents following legalization. In conducting tests, a Michigan commission charged with studying the issue also found that cannabis users, as opposed to alcohol users, had tendency to compensate for subjective effects cannabis by driving slower.

Cannabis makes you lazy

A amotivational syndrome does exist among heavy consumers. However, this is not a generality of consumption. Going in the other direction, some artists use cannabis as a driving force in their creative process.

THC lowers the immune system

The active ingredients in cannabis do interact with the immune system. In particular, they have anti-inflammatory properties. Inflammation is the body's response to limiting the risk of an infection spreading. It's a crude shortcut to say that cannabis reduces the body's immune defences.

Originally, inflammation was a mechanism designed to protect man in a hostile environment. Today, however, we have other means of limiting infections (antiseptics, antibiotics, etc.), which we prefer, because inflammation is uncomfortable and painful. It can be beneficial in certain cases, but is dangerous when it becomes chronic.

As explained in an article in Le Monde, Today, in our society of comfort, this defense mechanism has turned against man. It is now at the root of many chronic diseases: diabetes, cancer, obesity, psoriasis, neurodegenerative diseases... diseases for which cannabis is proving a promising treatment option.

Moreover, the fact that cannabis is already widely recognized as an adjuvant in the treatment of cancer and AIDS, two diseases that cause a decline in the immune system, is in total contradiction with Professor Costentin's claims. Cannabis is also prescribed for autoimmune diseases such as multiple sclerosis and Crohn's disease.

THC disrupts pregnancy

Little is known about the effects of cannabis on pregnancy. Some studies suggest that pregnant women who regularly use cannabis are indeed more likely to give birth prematurely, and their newborns are lighter. These risks are the same as those identified for tobacco. They are due to the carbon monoxide released into the body by smoke, which causes a lack of oxygenation in the fetus, but not necessarily to THC.

When in doubt, doctors in California, for example, recommend against using cannabis during pregnancy, even though it can help with pain and nausea.

Consumed during pregnancy, THC can disrupt the unborn child

It appears that fetuses exposed to cannabis during pregnancy have a higher incidence of cognitive neurological disorders and attention deficit disorders in adolescence. In an article, Dr. Evelyne Mazurier, of the pediatrics department at Montpellier's Arnaud de Villeneuve hospital, takes stock of the potential effects of cannabis on the fetus.

Consumed before and during pregnancy, THC will induce the unborn child to use cannabis

According to two studies in this thesis (p23), prenatal cannabis use is correlated with increased exposure to drug use (tobacco, alcohol, cannabis) in children during adolescence, more so in boys than in girls. However, no causal link is suggested, not least because it's difficult to distinguish between genetic predisposition and the social environment.

THC encourages alcohol consumption

First and foremost, this statement is false. THC itself does not encourage alcohol consumption. That said, cannabis and alcohol are both risky behaviours and are culturally associated (poly-drinking). It is the search for intoxication and a reduced perception of risk that bring them together, but there is no causal link. Moreover, post-legalization data from the United States show that alcohol consumption is down in states where cannabis is legal.

Cannabis addiction leads to cocaine and heroin

This is the famous gateway drug theory. This was refuted many times. On the contrary, studies are beginning to emerge showing that cannabis could help detoxification. On the other hand, if some cannabis users are inclined to take «harder» drugs, this derives from a behavioral logic that consists in seeking an outlet, not perceiving the risks or engaging in a logic of self-destruction, but this is in no way directly caused by cannabis.

THC promotes anxiety and depression

This statement is undoubtedly the most divisive. While some studies suggest that long-term use of cannabis promotes the development of anxiety disorders and depressive behaviours, most cannabis users are not aware of any long-term effects. turn to cannabis to relieve anxiety and depression. A recent survey shows that 55% of Canadian consumers use it to relieve anxiety. Yet an overdose also promotes paranoia.

It's hard to know more at this stage. Is it possible that cannabis relieves immediate anxiety but promotes long-term anxiety disorders? Does a low dose of THC relieve anxiety, while a high dose promotes it? For the moment, the data are paradoxical, and further long-term studies are needed.

Cannabis lowers IQ points

In his article, Jean Costentin refers to cannabis as the «drug of cretinization», accusing it of causing the loss of life. irreversible of 9 IQ points. It is based on a New Zealand study dating from 2012, which has since was criticized. In fact, other studies have been carried out to verify these results and have not reached the same conclusions. In fact, Sciences et Vie, which had relayed the first study in 2013 a then updated his article with another study showing that poorer cognitive performance were not irreversible, which implies that there is no loss of IQ.

Cannabis causes schizophrenia

The link between cannabis and schizophrenia is murky, to say the least. There appears to be a correlation between daily cannabis consumption and the onset of mental disorders, including schizophrenia. However, no causal link has yet been demonstrated. It could be that people predisposed to schizophrenia are also predisposed to cannabis use, and that cannabis use «triggers» latent disorders. It could also be that excessive cannabis consumption causes schizophrenia even in people who are not predisposed to it. Some studies have also shown that CBD had anti-psychotic effects. Cannabis could be both the poison and the antidote for some people.

The benefit/risk ratio of medical cannabis is against cannabis

The benefit/risk ratio of a drug is always assessed for a given pathology. For the time being, research into medical cannabis is only at a preliminary stage. It is, however, already widely authorized to treat severe forms of epilepsy and drug-resistant multiple sclerosis. Patients and doctors agree that its side effects are relatively mild (drowsiness, disorientation) and that the benefits are substantial. In clinical trials, however, the benefits of cannabis are often low, but this does not prevent us from seeing the benefits.

The particular case of chronic pain is interesting. Such pain is very often treated with opioids, prescription drugs that create a strong physical dependency. Opioid addiction was responsible for 70,000 deaths in the United States in 2017. Yet their «benefit/risk ratio» was considered positive by the pharmaceutical industry. Medical cannabis has gradually emerged as an alternative that makes it possible to replace opioids precisely because its side effects are fewer.

Be that as it may, it is hollow to assert without any precision that the benefit/risk ratio of medical cannabis is unfavorable to cannabis. Research will prove this pathology by pathology. Research is underway on a number of neurological pathologies, including Alzheimer's disease, autism and Parkinson.