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Published: 13 June 2025

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Landmark JAMA Psychiatry study demolished scientific case for downgrading marijuana’s legal status

A devastating analysis published in JAMA Psychiatry tore apart the Biden administration’s case for cannabis rescheduling, revealing how political pressure trumped scientific rigour in one of America’s most consequential drug policy decisions.

The comprehensive report, authored by Harvard Medical School’s Dr Bertha Madras and Heritage Foundation legal scholar Paul Larkin, exposed how the US Department of Health and Human Services (HHS) abandoned decades of established medical standards to recommend moving marijuana from Schedule I to Schedule III under the Controlled Substances Act.

Ignoring the Evidence

The authors revealed that HHS systematically ignored mounting evidence of cannabis harms whilst creating entirely new, legally unprecedented criteria to justify rescheduling. Most strikingly, the agency downplayed the alarming reality that cannabis use disorder (CUD) affected up to 30% of users, with rates amongst young people reaching epidemic proportions.

“The prevalence of CUD amongst adolescents and young adults (16.5%) is converging with alcohol use disorder (16.4%),” the study noted, highlighting data showing that daily cannabis use had increased fifteen-fold since 1992. Even more concerning, by 2022, America recorded more daily cannabis users (17.7 million) than daily alcohol users (14.7 million) for the first time in history.

Medical Consensus? What Medical Consensus?

Perhaps most damning was the revelation that only approximately 2% of America’s patient-care physicians actually recommended cannabis to their patients. Of the 29,500 clinicians authorised to recommend medical marijuana, just over half held proper medical degrees—the rest included dentists, physician assistants, and other healthcare workers operating far outside their expertise.

The study exposed how cannabis recommendations often lacked basic medical protocols: “Cannabis recommendations often lack details on dose, frequency, composition, route of administration, THC content, tapering, or product quality, unlike FDA-approved prescriptions.”

Cherry-Picked Comparisons

HHS’s argument that cannabis had “low abuse potential” relied on comparing it to alcohol—a substance explicitly excluded from the Controlled Substances Act. This bizarre comparison ignored cannabis-specific harms including psychosis, schizophrenia, cognitive impairment, and the debilitating cannabis hyperemesis syndrome that sent thousands to hospital emergency departments.

The authors noted that assuming causality, “one-fifth of cases of schizophrenia amongst young males might be prevented or delayed by averting CUD.”

State Programmes: Politics, Not Medicine

The report dismantled claims about widespread medical acceptance by revealing the chaotic reality of state cannabis programmes. Geographic variation in authorising clinicians ranged wildly—from 0.8 per 1,000 patients in Oklahoma to 109 per 1,000 in Mississippi—suggesting the creation of “weed mills” analogous to the prescription opioid “pill mills” that fuelled America’s overdose crisis.

Many states allowed cannabis recommendations for virtually any condition without physical examinations or diagnostic tests. By 2021, states had approved cannabis for 105 different conditions, most lacking quality research support.

The Science Didn’t Stack Up

On the crucial question of medical efficacy, the study revealed that 24 meta-analyses examining cannabis for chronic pain—the most common reason for medical recommendations—had failed to endorse its use. The International Association for the Study of Pain explicitly stated there wasn’t “enough high-quality human clinical safety and efficacy evidence” to endorse cannabis for pain management.

For anxiety and PTSD—the second and third most common qualifying conditions—”no high-quality studies exist showing cannabis is effective,” the authors reported.

Youth at Risk

The analysis emphasised how rescheduling would have sent dangerous signals to young people at a critical developmental stage. With 53% of new cannabis users starting before age 21, and minors developing CUD at twice the rate of adults, the timing couldn’t have been worse for policy changes that might normalise cannabis use.

A Policy Crossroads

The study’s conclusions were clear: “The criteria and evidence HHS used to recommend reclassifying cannabis to Schedule III are flawed. If the DEA agrees, it will contradict past federal health concerns and ignore emerging data on rising use, disordered use, and negative health effects.”

Dr Kevin Sabet, a former White House drug policy advisor, emphasised the stakes: “We cannot allow policy to be driven by commercial interests and political momentum while ignoring public health. The evidence in this paper makes it clear that rescheduling marijuana would undermine decades of prevention efforts.”

As the Drug Enforcement Administration considered HHS’s recommendation for cannabis rescheduling, this landmark analysis offered a critical framework for evidence-based decision-making. The question was whether scientific integrity would guide the future of America’s drug policy or if political pressures would take precedence.

The authors issued a stark warning: rescheduling “could undermine FDA authority and compromise the integrity of our drug approval process and pharmaceutical supply.”

In an era of growing policy polarisation, this analysis stood out as a rare source of clear, evidence-based guidance on one of the most significant public health decisions of our time. (Source: WRD News – JAMAWRD News – JAMA)

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Published: 10 June 2025

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A System Built on Sentiment, Not Science: What began as a compassionate response to desperate families seeking relief for children with epilepsy has morphed into what critics aptly describe as “a commercial monster” – a barely regulated medicinal cannabis industry where doctors write cannabis prescriptions every four minutes and patients receive “Chernobyl-strength” products after brief phone consultations with non-medical staff.

The numbers are staggering and speak to a system utterly divorced from proper medical oversight. One doctor issued 17,000 scripts in six months – mathematically impossible to provide adequate patient care. Eight practitioners each churned out over 10,000 prescriptions for the highest-strength THC products in just half a year. A single pharmacist dispensed nearly one million cannabis products annually – that’s 2,600 products every single day for an entire year without a break.

These aren’t the statistics of a carefully managed medical programme. They’re the hallmarks of a prescription mill operating under the thin veneer of healthcare legitimacy.

The “Vote for Medicine” Deception: The rot began with what the Dalgarno Institute correctly identifies as the “vote for medicine” protocol – a deliberate strategy to bypass rigorous clinical trials and scientific evidence in favour of emotional manipulation and political pressure. The Victorian Law Reform Commission’s 2014 consultation was a masterclass in manufactured consent, drawing from a mere 99 submissions and poorly attended public hearings dominated by cannabis advocates.

Policymakers staged political theatre, disguising the legitimisation of a recreational drug as compassion and medical necessity, abandoning evidence-based policymaking. The consultation process heavily favoured bias, systematically marginalising and silencing the Dalgarno Institute’s representative when they presented evidence-based research on cannabis harms. Meanwhile, cannabis advocates freely made unsubstantiated claims such as “Many, many people have been cured – from just about anything and everything” – statements now debunked by a decade of disappointing clinical outcomes.

Doctors as Drug Dealers: The transformation of medical practitioners into what one doctor described as “glorified cannabis dealers” represents a fundamental corruption of the medical profession. Dr Claire Noonan’s experience exposes the insidious pressure applied to healthcare providers: “There was a bit of pressure to be, perhaps more of a dealer… it’s more being used for my signature on a script.”

When doctors earn money based on the number of prescriptions they write, when companies pressure practitioners to override their clinical judgment, and when nurses without medical training conduct “consultations,” it stops being medicine. It’s a sophisticated drug distribution network masquerading as healthcare.

The conflict of interest is breathtaking: companies pay doctors to write prescriptions, then directly sell and ship the products to patients. This vertically integrated drug business model operates so efficiently and with such legal protection that it would make any street dealer envious. Some companies even pay commissions to shop owners who host their iPad kiosks, creating a multi-tiered financial incentive structure that has nothing to do with patient care and everything to do with maximising drug sales.

The Australian Medical Association has recognised this perversion of medical practice, with doctors coining the phrase “I’m a healer not a dealer” – yet the system continues to pressure practitioners into exactly that role. Young doctors and those without specialist training are particularly vulnerable to these pressures, potentially compromising an entire generation of medical professionals.

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Published: 10 June 2025

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The conversation around marijuana and mental illness has taken a new, alarming turn. A systematic review published in the journal Biomolecules this March presents fresh evidence of a strong link between marijuana use and severe mental health issues, particularly schizophrenia and psychosis. Notably, the study highlights that adolescents are at a significantly higher risk, amplifying urgent questions about its impact on younger users. This article explores the findings and sheds light on how marijuana use could contribute to the development of mental illness.

The Risk of Psychosis and Schizophrenia

The Biomolecules review analysed data from 10 separate studies, all of which documented an association between marijuana use and an increased risk of developing schizophrenia or psychosis-like events. Crucially, nine of those studies identified the risk as statistically significant. One staggering takeaway from the review is the calculated odds ratio. Individuals using marijuana had a 2.88 higher likelihood of developing psychosis-related conditions than those who abstained.

Adolescents who use marijuana, however, face an even greater threat. The study authors pointed to a “large age effect,” suggesting that the impact of marijuana on younger users is far more severe. This age factor underscores the vulnerability of developing brains to marijuana-related risks.

Why Adolescents Are at Greater Risk

One key hypothesis from the researchers is that marijuana affects adolescents in two major ways. First, it can cause acute psychotic sensations that resemble those triggered by hallucinogenic drugs, indicative of acute toxicity. Second, it disrupts synaptic plasticity during adolescence, leading to developmental changes in the brain that could contribute to long-term mental health issues.

The findings are consistent with a growing body of evidence implicating marijuana use as a driver of severe mental illness. This runs counter to the commonly held notion that mental illnesses like schizophrenia lead people to self-medicate with cannabis. Instead, these results suggest that cannabis use may precede such conditions.

The End of the Self-Medication Argument

For years, the “self-medication hypothesis” has been used to explain the relationship between marijuana and schizophrenia. It claimed that individuals with schizophrenia used cannabis as a coping mechanism to manage symptoms. However, the review pushes back strongly against this narrative, stating that in these cases, it’s the cannabis that comes first. Alison Knopf of Alcoholism and Drug Abuse Weekly emphasised that these findings mark a key step in resolving the “chicken-and-egg conundrum” around marijuana and mental illness.

Implications for Young People and Beyond

The Biomolecules review underscores the need for consistent research and public awareness regarding marijuana’s effects on mental health. For teenagers experimenting with cannabis, the data provides a stark warning about the potential consequences on their mental and cognitive futures.

Additionally, it raises important questions for governments, medical professionals, and communities. How can we educate younger generations about these risks to decrease early exposure? And as marijuana is increasingly decriminalised and commercialised worldwide, how do we ensure this knowledge informs broader drug policies?

The new data linking marijuana use with mental illness highlights the importance of informed decision-making, especially for young people and their families. Weed may be legal in many places, but that doesn’t mean it’s harmless. We must look beyond political debates and consider what science tells us about its risks.

(Source: WRD News)

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Published: 05 June 2025

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Cannabis use has long been a topic of interest in both scientific and public health discussions. One emerging area of concern is the link between cannabis and psychosis risk, particularly how cannabis might influence the brain’s dopamine system. By examining new research, we can better understand the potential risks associated with cannabis use, especially for individuals who may be vulnerable to psychotic disorders.

The connection between cannabis use and psychosis is explored, with a focus on recent findings about its impact on the brain’s dopamine system. The importance of this research lies in understanding the mental health risks associated with cannabis use.

The Connection Between Cannabis and Dopamine

Is cannabis linked to the dopamine pathway involved in psychosis?

Research shows that cannabis use, particularly in individuals with cannabis use disorder (CUD), affects the brain’s dopamine system. Dopamine, a neurotransmitter, plays a crucial role in motivation, reward, and emotional responses. It is also heavily implicated in psychotic disorders such as schizophrenia.

A recent study involving neuromelanin-sensitive magnetic resonance imaging (neuromelanin-MRI) has revealed an increased neuromelanin signal in the midbrain regions of individuals with CUD. Elevated neuromelanin levels often indicate changes in dopamine functioning, which is linked to psychosis. These findings suggest that cannabis use may affect the same pathways associated with psychosis symptoms.

Dopamine and psychosis

The dopamine hypothesis of psychosis proposes that excessive dopamine activity in certain brain regions contributes to psychotic symptoms. This hyperactivity, particularly in the midbrain areas like the substantia nigra/ventral tegmental area (SN/VTA), is often observed in individuals experiencing psychosis.

Cannabis use, especially when frequent or heavy, appears to disrupt dopamine regulation. Δ9-tetrahydrocannabinol (THC), the active compound in cannabis, can temporarily increase dopamine levels, potentially leading to psychotic episodes in vulnerable individuals. However, long-term effects of cannabis on dopamine function remain complex and not fully understood.

The Role of Neuromelanin-MRI in Research

Neuromelanin-MRI offers a non-invasive way to study dopamine activity in the brain over time. Neuromelanin accumulates in dopaminergic neurons, making it a useful marker for understanding changes in dopamine systems.

The study revealed that individuals with CUD exhibited higher neuromelanin signals in psychosis-related brain regions. Interestingly, these signals were even more pronounced in those with both CUD and first-episode schizophrenia (FES). Persistent cannabis use over time also maintained elevated neuromelanin signals, suggesting a lasting impact on dopamine pathways and psychosis risk.

How Cannabis Use Affects Psychosis Risk

Cannabis use and psychotic symptoms

Cannabis use disorder is linked to a higher risk of both positive and negative psychotic symptoms:

• Positive symptoms include hallucinations, delusions, and altered perceptions.
• Negative symptoms include diminished motivation, reduced social interaction, and emotional blunting.

Research indicates a dose-dependent relationship, meaning higher levels of cannabis use increase the risk of psychosis. Additionally, individuals with CUD frequently experience earlier onset of psychotic illnesses compared to non-users.

Dose-dependent risk

The study found that greater cannabis use severity correlated with higher neuromelanin signals in psychosis-related brain areas. This dose-dependent effect underscores the progressive risk associated with more frequent or prolonged cannabis use.

Long-term impact

Cannabis’ long-term effects on the brain remain under investigation. While THC temporarily elevates dopamine levels, continued use may alter dopamine regulation, potentially increasing susceptibility to psychosis. Persistent changes in neuromelanin signals support the idea of lasting effects.

The Role of Other Factors in Psychosis Risk

Interaction with other substances

The study noted that individuals with CUD had higher nicotine use. While cannabis appears to have a unique association with psychosis, other substances like tobacco may also contribute to changes in the dopamine system.

Individual vulnerability

Not everyone who uses cannabis develops psychosis. Genetics, environmental factors, and early-life stress may all play roles in determining a person’s vulnerability to cannabis-induced psychosis.

Implications of the Research

Why these findings matter

The findings of this study highlight the significant impact of cannabis on dopamine functioning and psychosis risk. They provide important insights into how cannabis interacts with the brain, adding to our understanding of its long-term effects on mental health.

Potential applications

Neuromelanin-MRI could become a valuable tool for identifying individuals at higher risk of psychosis due to cannabis use. It could also help in developing targeted interventions for CUD and psychotic disorders, potentially improving treatment outcomes.

Public health relevance

Cannabis is widely used, and its legalisation in many countries has led to increased accessibility. Understanding its potential mental health risks is essential for informed decision-making, both at an individual and societal level.

Key Takeaways From the Link Between Cannabis and Psychosis

1. Cannabis use disorder is linked to increased neuromelanin signals in dopamine-rich brain areas.
2. These signals are particularly elevated in individuals with psychosis, such as first-episode schizophrenia.
3. There is a dose-response relationship, where higher cannabis use severity correlates with greater changes in dopamine pathways.
4. Neuromelanin-MRI offers a promising method for studying the long-term effects of cannabis on the brain and its connection to psychosis.(Source: WRD News – JAMA Network)