Sunday, July 29, 2007


Reading the report below in conjunction with various previous reports (e.g. here and here) does lead to the view that cannabis can do serious harm. That is no reason for banning it, though. Alcohol and motorcars do serious harm too. It is more an argument for legalizing it so that any problems can be better dealt with

Cannabis users are 40 per cent more likely to develop a psychotic illness than non-users, a study has found. Heavy users are more than twice as likely to suffer mental illness, according to a group of British academics, who calculate that about one in seven cases of conditions such as schizophrenia is caused by cannabis.

The warnings come as the Prime Minister and the Home Secretary signalled that the "softly softly" era for cannabis may be coming to an end. Gordon Brown said last week that the Home Office would be consulting on whether it had been right to downgrade cannabis from a Class B to a Class C drug in 2004. Jacqui Smith, the Home Secretary, is to ask the Advisory Council on the Misuse of Drugs to review the evidence.

The paper, published in The Lancet, is written by a group of seven psychiatrists and psychologists from Bristol, Cardiff, London and Cambridge. They have pooled the findings from 35 studies in a number of countries, including the United States, Germany, the Netherlands, Sweden and Britain, and concluded that there is "a consistent association between cannabis use and psychotic symptoms, including disabling psychotic disorders".

They admit that they cannot be certain that the association means that there is a simple cause and effect, but say that policymakers "need to provide the public with advice about this widely used drug". They go on: "We believe there is now enough evidence to inform people that using cannabis could increase their risk of developing a psychotic illness later in life."

As well as looking at psychotic illness, they looked for evidence that cannabis could cause affective disorders such as depression, anxiety and suicidal thoughts. Almost all the studies point towards an increased incidence of such disorders. The evidence is less strong, the writers say, but is still of concern.

The study was welcomed by many experts, but others counselled caution. Leslie Iverson, of the University of Oxford, a member of the advisory council, said: "Despite a thorough review the authors admit that there is no conclusive evidence that cannabis use causes psychotic illness. Their prediction that 14 per cent of psychotic outcomes in young adults in the UK may be due to cannabis use is not supported by the fact that the incidence of schizophrenia has not shown any significant change in the past 30 years."

But Robin Murray, of the Institute of Psychiatry at King's College London, called it "a very competent and conservative assessment of what research studies tell us about the relationship between cannabis and psychiatric disorders". He said that the risk could be even higher then the authors had estimated, because the cannabis available today was stronger than in the past. "This report cannot tell us whether the risk is higher with the use of the skunk-like preparations which are now widely available, and which contain a higher percentage of tetrahydrocannabinol," he said. "My own experience suggests to me that the risk with skunk is higher. Therefore, their estimate that 14 per cent of cases of schizophrenia in the UK are due to cannabis is now probably an understatement."

Martin Barnes, chief executive of Drugscope and also a member of the council, said: "Cannabis is not harmless, and although it has been known for some time that the drug can worsen existing mental health problems, it may also trigger the onset of problems in some people." "The challenge is to ensure that information on cannabis use and the associated risks is understood by teachers and health professionals working with young people and conveyed in ways that young people will listen to. Since reclassification, cannabis use has continued to fall. We need to make sure this trend continues."

Marjorie Wallace, chief executive of the mental health charity SANE, said: "The Lancet report justifies SANE's campaign that downgrading a substance with such known dangers masked the mounting evidence of direct links between the use of cannabis and later psychotic illness. The debate about classification should not founder on statistics but take into account the potential damage to hundreds of people who without cannabis would not develop mental illness. "While the majority can take the drug with no mind-altering effects, it is estimated that 10 per cent are at risk. You only need to see one person whose mind has been altered and life irreparably damaged, or talk to their family, to realise that the headlines are not scaremongering but reflect a daily, and preventable, tragedy."

Martin Blakeborough, director of the Kaleidescope Project and a member of the council, said that it would be a waste of public money for the same panel, with the same evidence, to review the issue again. "There is significant danger in reviewing cannabis again, as it takes experts' minds off more important issues. Classification itself, although important, is not as urgent as the increasing epidemic of hepatitis B and C among drug users and the wider community, or the increase of stimulant drugs in our community."


British police tell mother: Don't scold daughter 'because of Maddy'

A mother who scolded her tantrum-throwing daughter in a shop was outraged to be visited at home by police who told her it was inappropriate to reprimand the girl in the light of Madeleine McCann's disappearance. Ruth Ball was at home when police officers knocked at her door and and ticked her off about the way she had chastised four-year-old Leigha. The 24-year-old was told that the method she had used to reprimand Leigha was "inappropriate" in the light of Madeleine's disappearance from her family's holiday apartment in Portugal.

Ms Ball was at a newsagent in Dunstable, Bedfordshire, when Leigha started screaming after being refused sweets. She swept her daughter out of the shop and put her in the car to calm down, standing a couple of feet away with her three-year-old son Jack. A few minutes later she got into the car and drove the family home, thinking no more of it.

The following day a policeman visited her at her home in Luton to tell her off. The officer said it was inadvisable to shout at her daughter and shut her in the car after what happened to missing Madeleine. Ms Ball, who works as a care assistant, said: "I'm deeply sorry for what has happened to Madeleine, but why should I let my daughter get away with things because she was abducted? "I am trying to raise two decent human beings, even though I have been advised by the police to let them run riot, turn into thugs and help keep the prison population going when they're older. "Kids learn young. If they learn now that kicking, hitting and screaming gets what they want, what are they going to do when they're adults?"

Ms Ball added that she was shocked that somebody had taken down her numberplate and called police - but even more shocked that officers had visited her at home. Ms Ball said: "Even the police officer said he didn't see the point in him being here. He had to come and show his face and tell me not to tell her off."

The force has been involved in various scandals and gaffes, including three in the space of a fortnight in May last year. First, an elderly farmer was seized by armed police and thrown in a cell after - quite legally - firing a warning shot at a dog that was threatening his lambs. Then it emerged four police officers had resigned after giving remand prisoners special favours - including sexual liaisons with girlfriends - in exchange for false confessions. Days later, the force was criticised when a private school headmaster was found dead shortly after officers sent letters to parents asking if they had any 'concerns' about him. No arrest had been made at the time. In 2004, a dangerous driving case collapsed at crown court because the arresting officer was teaching golf in Spain on a five-year career break.

A spokesman for Bedfordshire Police said: "We received a call from a member of the public concerned for the safety of a young girl she had seen being put into a car. "We attended the address of the owner and it transpired that the child, who was happy with no injuries, had been put in the car after having a tantrum. "If Ms Ball is concerned with what happened or what was said, she is very welcome to contact us."


Pathological denial in Britain

Some in Britain have come up with an ingenuous way of countering the threat of jihad: They pretend it does not exist

One would think this would be rather difficult in the wake of the recent terrorist attempts in London and Glasgow, but the jihad-deniers use these very incidents to make their case. The failure of the bombs to go off, they argue, is proof that the would-be terrorists were an assortment of bungling fools. What's more, they extend this characterization to all those who swear by the cause. On this view, the whole concept of jihad is merely a silly concoction of some misguided dolts.

An article titled Evil plotters? More like sad and crackpot which ran recently in the UK Times offers a startling example of this line of thinking. This is what its author, the well-known British commentator Matthew Parris, writes:

Something is changing in the public mood, and I think it's this: terrorism is beginning to look a bit stupid. Those pictures of that idiotic and slightly overweight fellow with his clothes burnt off looked pathetic, undignified. It has occurred to even the meanest of intellects that concrete doesn't burn. And it isn't just the technical competence of alleged British terrorists that people are beginning to doubt: it's the whole jihadist idea. What world are they aiming for? Most British Muslims, just like most British everyone-else, think it's all pie in the sky: all rather silly. Yes, silly. Not "evil" as the red tops would have it. [...] We're not talking anything as clever as Evil here: we're talking Weird, we're talking Crackpot, we're talking Sad. The idea of using a Jeep to make a terminal explode was, in the latest lingo, a bit gay.

The trivialization and lightheartedness are hardly appropriate, especially since it was only due to sheer luck that the attacks did not translate into mass carnage. Explosives experts have repeatedly confirmed that had the London's terror plot gone as planned hundreds would have been engulfed by the blast and the accompanying fireball.

Neither are all would-be terrorists mere inept bunglers. Does Mr. Paris need to be reminded of that fatal morning of July 7, 2005? Does he recall the carnage that was unleashed then? Does he remember the destroyed double-decker and the twisted underground carriages splattered with blood? Did that look like the work of some blathering `crackpots' or like a horrific terrorist attack?

It is only a matter of good fortune that Britain has not been hit with more strikes like this. Last year Dame Eliza Manningham-Buller, then the head of Britain's counterintelligence service MI5, revealed that her agency was monitoring at least 30 high-priority plots. At one point they were tracking more than 200 hundred cells with over 1500 aspiring jihadists among them.

Such is their determination that London Police Commission Sir Ian Blair warned that it was all but inevitable that some would succeed. How irresponsible, then, for editorial writers to trivialize the danger when those most familiar with its extent are almost certain that Britain will be hit again. Worse still, there is a very real possibility that the next strike will make July 7 look like a minor incident.

Various investigations and sting operations in the last couple of years have uncovered a number of plots of breath-taking audacity. A Muslim convert by the name of Dhiren Barot was, among other things, laying plans to detonate a dirty bomb and flood the London underground by breaching the river Thames. An Islamist cell was scheming to bring down a British Airways airliner with bare hands. The idea was to purchase thirty tickets on a British Airways flight and then batter their way into the cockpit. There were also plots to poison London's water supplies and to attack a shopping center with a giant fertilizer bomb.

But this is only the tip of the iceberg. There are many more plots in the works some of which are no doubt even more destructive and which may well come to our attention only after they have exacted their terrible toll.

Although we cannot predict when and how they will strike next, what we do know is that many of those who plan these atrocities are intelligent and well-educated individuals, not at all drifting dimwits as some would have us believe. We would do well to remember that the ringleader of London's 2005 terror strike - Mohammad Sidique Khan - was a respected teacher. Those responsible for the most recent attempts in London and Glasgow are all highly educated professionals. One of them, Dr. Mohammed Asha, is a neurologist who earned his appointment at a prestigious university hospital on the strength of his distinguished academic record. Another, Kafeel Ahmed, who apparently drove the explosives-laden jeep into the Glasgow airport terminal, is an engineer who was working toward a PhD in computational fluid dynamics. His passenger, Dr. Bilal Abdullah, is a diabetes specialist. Sabeel Ahmed, another man held in connection with this attack, is also a doctor.

The combination of smarts and advanced education is, in fact, a trademark of international jihad. Mohammed Atta held a couple of degrees from universities in Cairo and Hamburg. Several among his band of hijackers also had at least some college education. Ayman al-Zawahiri, Al Qaeda's second in command, is a cerebral surgeon. Bin Laden is a civil engineer himself. Sheik Khalid Sheik Mohamed holds a degree in mechanical engineering degree from an American university. Ramzi Yousef, one of the planners of the 1993 World Trade Center bombing, excelled in math and science and holds an engineering degree from West Glamorgan Institute in Wales. In addition to his technical prowess, he is also fluent in English, Baluchi, Urdu and Arabic. We could go on and on. If truth be told, few other criminal enterprises can boast so many clever and university educated conspirators.

To make light of the threat posed by these determined fanatics - as some in Britain are now trying to do - is self-delusional at best and suicidal at worst. The mortal danger we face at their hands will not go away if we pretend it does not exist. It is like sticking one's head in the sand hoping that the jackal will not eat you. This, however, is a fatally misguided hope, since this enemy is too determined, too driven and too smart to let such an opportunity pass by.


Hundreds of NHS hospital fatalities 'avoidable'

One third of deaths in hospital investigated by a patient safety watchdog could have been avoided, claims a report released today. The National Patient Safety Agency looked into 1,804 fatal hospital incidents reported to it in 2005. It found that 576 were "potentially avoidable" if there had been better communication between staff, faster recognition of the patient's deteriorating state, improved training and more accurate interpretation of test results.

Some 425 of the deaths investigated by the NPSA in 2005 were in acute or general hospitals. Of these, 71 were reported to be related to diagnostic errors, in 64 cases the patient's deteriorating condition was not recognised or not acted upon, and 43 involved a problem with resuscitation after cardiac arrest. The remainder were connected to medication errors, suicide or still-birth.

In 14 of the patients who deteriorated, no checks had been made on them for a prolonged time and changes in their vital signs such as blood pressure, heart rate or temperature were not detected. In a further 30 cases, the checks had been made but staff either did not recognise the patient's worsening condition or they did not act. In 17 other cases help was sought but there was a delay.

Professor Richard Thomson, the NPSA's director of epidemiology and research, said: "These are not new concerns but more effort is needed to recognise and act upon them. "This work helps us to further raise the profile of these issues and support a programme of activities involving a range of national organisations and individual experts. Every preventable death is a tragedy, not only for the family but for the staff involved."

The report says all staff should be trained in dealing with cardiac arrest. Among the 43 deaths involving resuscitation, the study found that many of the incidents suggested that "medical and nursing staff did not have the depth of knowledge and skills required".

It said: "In most cases the delay in starting the resuscitation was reported to be because staff did not recognise the acute situation, failed to call the resuscitation team or did not make an attempt themselves to resuscitate the patient."

Fourteen reported incidents related to the use of equipment. One such report said: "During a cardiac arrest, defibrillator found not to have the correct leads and paddle to fit the defibrillator. This caused a delay of approx five minutes during the arrest."

During 2006, the Medicines and Healthcare products Regulatory Agency (MHRA) received 141 reports of adverse incidents involving defibrillators. Many were related to problems with electrodes or batteries. In the first six months of 2007, the MHRA received 86 reports and receives an average of 14 incident reports a month on these devices, some of which are duplicate reports from manufacturers. The NPSA report said: "Several of these incidents occurred in resuscitation situations, when user error may have contributed to the incident, for example, incorrect connection of suctioning tubes."

The report stresses that there may be many similar cases which have not been reported to the NPSA. Researchers said that about 13 million people are admitted to hospitals in England and Wales each year.

The findings come as the National Institute for health and Clinical Excellence releases guidance to clinicians on how to manage patients in hospital who deteriorate rapidly. It emphasises making a complete medical assessment of the patient, regular monitoring and improving communication between staff.


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