Cannabis and the Tucson Shooter

1:16 pm in Uncategorized by Dr. Joe McSherry

The emotions arising from the Tucson tragedy run strong, empathy for the survivors and sadness for the loss of those who did not survive.  The shooter, who did survive, has not garnered much public understanding or empathy.  Putative explanations for his behavior have been forthcoming.

From descriptions of his persona and words reported by the Wall Street Journal and Mother Jones, using posts to the internet and interviews with long time friends, one sees a fairly typical middle school lad with a gift for “creative writing,” from time to time doing typical things young boys may do such as play video games, go to concerts and use illegal drugs like tobacco and cannabis (under age 16).  His social performance and academic performance was at least satisfactory.  At 18 or 19 years of age his life had taken a sharp turn and by the end of 2010 he was unable to function academically, withdrawn from most friends, living in a world of dreams, delusions and 24/7 anger.  The anger was fueled by his inability to get a job, even at a fast food joint.  And the government.  And grammar and the meanings of words.

The trajectory from imaginative middle school kid to frustrated, angry, dysfunctional young adult living in an alternate reality is consistent with the premorbid function, prodrome and onset of psychosis (Compton et al, in press).  What, if any, psychiatric diagnosis will ever be applied to the shooter is unknown to the public.  But putative explanations published have included “pot head.”  The usual “stoner” image of an amotivational syndrome does not fit as he was frustrated by repeated rejections from work, working out, and off drugs for two years, according to friends.  Indeed stopping nicotine and cannabis was associated with his “theories” going off the wall.

The prohibitionists identify cannabis as the cause of psychotic disorders, schizophrenia.  This has been hard, or impossible to prove.  This is in part because the onset of illegal drug use (underage nicotine, alcohol and cannabis) overlaps the onset of schizophrenia.  So the greater drug use by schizophrenic patients may be contributory, or self treatment – adult patients use drugs at a higher rate than their peers to mitigate the discomfort of their disease (Bottorff et al, 2009).  Or the association in youngsters may be coincidence, along with getting a driver’s license and going off the parent’s dole, explaining the impossibility of proving a connection.  In populations, at least, there is no increase in the incidence of schizophrenia when the use of cannabis among youth increases, and cultures that have low rates of cannabis use are not preserved from typical rates of schizophrenia (Frisher et al 2009). In medical school we are taught “to listen to the patient.”  Schizophrenic patients do not believe cannabis contributes to their disease (Buadze et al 2010).  The prohibitionists are wrong.  . . . Read the rest of this entry →