Jamaica: Ganja use complicates mental health care 11 years after decriminalization

Jamaica's decade-old decriminalization of ganja is now presenting significant challenges in mental health care, particularly for individuals presenting with psychosis and schizophrenia. While a definitive causal link between cannabis use and these conditions remains under investigation, the substance's prevalence among affected patients is complicating treatment protocols.

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What we do know is that the majority of psychiatric admissions in our public hospitals are coming from psychosis or schizophrenia. And the majority of those persons do use cannabis. So, we can look at that relationship and see that it is strong.

Data from the National Council on Drug Abuse (NCDA) indicates a rise in high-risk cannabis consumption and increased potency of the substance in Jamaica. Concurrently, the country has seen an increase in hospital admissions for psychosis and schizophrenia over the last ten years. Dr. Kristen Robinson Barrett, Director for Treatment Services at the NCDA, noted that a majority of psychiatric admissions stem from these conditions, and most of those patients use cannabis, suggesting a strong correlation.

However, Dr. Brian Kazaara, a psychiatrist at Bellevue Hospital, suggests that cannabis rarely causes psychotic disorders, despite its frequent presence among patients with mental health issues. He noted that while official studies are lacking at Bellevue, casual observation reveals that most admitted patients also use cannabis. A survey conducted at the University Hospital of the West Indies (UHWI) where Kazaara previously worked also found that the majority of patients in the psychiatric ward smoked cannabis.

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Cannabis-induced psychosis is not the norm. It is rare. At Bellevue we very, very rarely see that diagnosis. I also worked at UHWI for seven years [and] rarely saw it, almost never.

Kazaara explained that individuals with common psychiatric conditions like major depressive disorder or anxiety disorders use cannabis more frequently than those without mental illnesses. He emphasized that cannabis-induced psychosis is rare, with very few such diagnoses seen at Bellevue and almost none during his seven years at UHWI. Cannabis, as a psychoactive drug, can alter perception, leading to effects like relaxation or paranoia by interacting with cannabinoid receptors in the brain, affecting emotions, time perception, concentration, and reaction time. Kazaara cautioned that cannabis use can muddle the treatment of mental health issues, potentially leading to an earlier onset of psychosis in users.

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Cannabis definitely complicates psychosis, because for persons who use cannabis, they are more likely to develop an earlier onset of psychosis.