Change Your Mind

A new study shows that alcohol may not be the only problem for repeat drunk drivers. More than half of DUI offenders also suffer from at least one mental illness in addition to a drug or alcohol-use disorder. The study found almost 60 percent of those with two or more DUI convictions reported experiencing major depression, bipolar disorder, obsessive-compulsive disorder or posttraumatic stress disorder over their lifetime.

The study consisted of people convicted of at least two DUI offenses in the past 10 years, and 40 percent had three or more DUI arrests. The majority of both men and women reported having at least one psychiatric disorder, as well as alcohol- or drug-abuse or dependence. Women had higher rates of depression than men and were more likely to suffer PTSD.

“People who deal with drug and alcohol abusers need to understand there are often other disorders that need to be dealt with as well,” said Sandra Lapham, M.D., M.P.H., principal investigator of the study. “That’s why we need to screen repeat offenders for multiple disorders. The offender should be viewed as a unique person with a unique set of issues. If they include psychiatric problems, these should be treated along with drug and alcohol issues.”

Lapham is director of the PIRE Behavioral Health Research Center of the Southwest in Albuquerque, New Mexico. She says the data suggests DUI evaluations by the courts and treatment programs should include psychiatric screening and assessments.

The study participants were part of a three-year program called Driving Under the Influence of Intoxicants Intensive Supervision Program (DISP) developed by Multnomah County Circuit Court in Portland, Oregon. The volunteer program requires intensive probation, close monitoring and built-in punishments and rewards, in exchange for reduced jail time.

“The results of this study should encourage the courts to develop a more comprehensive approach to dealing with the hard-to-treat drinking driver,” says Multnomah County Circuit Court Judge Eric J. Bloch.

“Assessing the mental health of a DUI offender will help us choose the program that will reduce the chance of a re-offense.”

The study published in the September edition of Journal of Studies on Alcohol was funded by the National Institute on Alcohol Abuse and Alcoholism.

By Ben Hirschler for Reuters

LONDON - Brain scans showing how cannabis affects brain function may help explain why heavy consumption of the drug triggers psychosis and schizophrenia in a small number of people, scientists said on Monday.

Psychiatrists are increasingly concerned about the mental health impact of smoking large amounts of modern super-strength marijuana, or skunk, particularly among young people.

Until now, the mechanism by which cannabis works on the brain has been a mystery but modern scanning techniques mean experts can now detect its impact on brain activity.

Professor Philip McGuire and Zerrin Atakan of London’s Institute of Psychiatry said their work using magnetic resonance imaging, or MRI, showed patients given the active cannabis compound tetrahydrocannabinol (THC) had reduced function in the inferior frontal cortex brain region. This area is associated with controlling inappropriate emotional and behavioral responses to situations.

“What THC seems to be doing is switching off that part of the brain, and that was associated with how paranoid people became,” McGuire told reporters.

Their research will be presented at a two-day International Cannabis and Mental Health Conference at the Institute of Psychiatry this week. Similar findings from other teams also highlight the link between THC dose and the risk of schizophrenia-like symptoms, conference organizer Professor Robin Murray said.

“It’s no longer a contentious issue. The expert community, by and large, accepts that cannabis contributes to the onset of psychotic symptoms in general and the severe form of psychosis, schizophrenia,” he said.

DOUBLE-STRENGTH JOINTS

One reason for the growing problem is thought to be the increasing strength of modern strains of cannabis, which are cultivated to produce the maximum amount of THC. In recent years, the average THC content of marijuana sold in Britain has doubled to 12 percent from around 6 percent, while in the Netherlands it is about 18 percent, Murray said.

Most users of cannabis still do not have a problem with the drug but a minority, possibly because of genetic factors, are vulnerable to long-term damage from modern skunk — which Murray says is to old-fashioned dope what whisky is to lager.

The rise in THC content is linked with a decline in another active ingredient called cannabidiol (CBD), since the two products compete biochemically inside the cannabis plant. CBD, which reduces anxiety but does not produce the euphoric high of THC, may help offset some of the paranoid feelings.

Markus Leweke of Cologne University said a clinical trial involving 42 patients showed CBD was as effective as the established medicine amisulpride, sold as Solian by Sanofi-Aventis, in treating patients with psychosis. “It seems there are good guys and bad guys within cannabis,” Leweke said.