Smoking cannabis has been part of counter-culture for over 50 years. In the 60s cannabis became a ‘lifestyle choice’ for some ‘hippies’ who rebelled against post-war traditions and opted for a post-modernist worldview that pushed boundaries, encouraged philosophical thinking and experimental behavior. Today, cannabis is glamourised in western popular music with artists like Snoop Dogg epitomising a culture and identity that resists conventional norms.

Smoking cannabis is not confined to a specific social group or class – now the smokers of the past are stereotypes of the present. In 2017 the United Nations Office on Drugs and Crime (UNODC) estimated there were about 183 million smokers worldwide. Cannabis is the most widely consumed global drug creating much debate with some academics discussing the apparent ‘normalisation’ of cannabis use. Professor Sveinung Sandberg described this drug as a ‘stable subculture in a changing world.’ He went on to say that cannabis has slowly evolved from the margins of society to become a widespread phenomenon. In a world where social attitudes are changeable, it is important to raise awareness about the effects of cannabis, as many smokers may be unaware of its harms.

Cannabis is a herbal plant best grown in hot climates that contains different chemicals – 70 are unique to the plant and they are called cannabinoids; the main psychoactive ingredient is delta-9-tetahydrocannabinol (THC) that produces the desired effect of feeling ‘stoned.’ These natural ingredients are produced and stored inside the leaves and trichome(appearing to the naked eye as sticky white crystals that cover the stem); they vary in size and potency.

There are a variety of cannabis containing products that are sold on the European drug market: herbal,hash, cannabis oil and edibles; the latter has been more recently been popularised within legal American markets. These products are cultivated and trafficked across the globe; hash is the resin from the plant, which is commonly produced in North African and Middle Eastern countries. A reduction in resin seizures from 77% in 1998 to 53% in 2010 ‘reflects a failing market share of cannabis resin in the European market’ as herbal production has increased (UNODC,2017).

Stigma is often attached to cannabis use as it is an illegal substance that is controlled in the UK under the Misuse of Drugs Act (1971), making it a criminal offence to possess,supply, distribute, sell, manufacture and import. Over the past two decades the UK has seen a decline in the prevalence of cannabis which has coincided with increased strength and greater prevalence of ‘skunk’ varieties of homegrown herbal cannabis.

Professor Val Curran, a renowned drug expert found skunk smokers in Britain had poor awareness around the increasing potency of their product. For regular users, this makes them more vulnerable to high potency THC containing products that are perceived ‘better value for money’. Often, people who smoke skunk are unaware of the association between high potency skunk and schizophrenia or other forms of psychosis (UNODC, 2017).

There is a strong link between high THC taken regularly and mental health issues. THC is most concentrated in hydroponically grown varieties of skunk and cross-bred strains that dominate the UK market, often they are grown by criminal gangs in cannabis ‘factories’. Skunk has a high THC content (15%) compared to hash (5%). People who occasionally smoke hash for a mellow high have a considerably lower probability of drug-induced psychosis as their product contains cannabidiol (CBD the main chemical ingredient that offsets paranoia), a chemical eliminated from skunk. They are also less vulnerable to developing dependence.

Smoking a joint is associated with feelings of relaxation,but for some people after use it can trigger anxiety that manifests itself as panic,worry or restlessness. Physical symptoms can also occur: sickness, shortness of breath or palpitations. Anxiety disorder can appear in naive drug-takers or dependent users who smoke high potency skunk. Some people who smoke cannabis might be anxious personalities who self-medicate to relieve tension, this can make withdrawal particularly stressful, heightening anxiety symptoms.

A recent study in New Zealand found 31% of people who smoked cannabis between the ages of 15 to 16 were more anxious than non-smokers at the age of 18 years (Crippa et al, 2009). There is a compelling body of evidence that discusses the implications of cannabis use on adolescent neurodevelopment- scientists conclude it has an immediate impact on cognitive function,impaired reaction time, memory and decreases verbal fluency. Escalating cannabis use is a lifestyle choice for some people at the cost of their memory.

Cannabis use in England & Wales might be on the decrease but there has been a surge in the number of people entering drug treatment with cannabis as their primary drug. A recent study by Freeman & Winstock found skunk was smoked by 72.5%; a causal link between the potency of skunk and the severity of dependency was discovered. The study reports people developing ‘specific aspects of cannabis use disorders such as tolerance, withdrawal craving, failing obligations, giving up persistent use in spite of problems’ (Freeman & Winstock, 2015: 3187).

In 2008 cannabis in the UK was reclassified from a Class C to B. There was public anxiety around the effects of cannabis use, especially those people in their teens and early twenties. In a report by the Advisory Council on the Misuse of Drugs (2008) experts discussed the motivation behind cannabis consumption: the desire to relax, alleviate boredom and enhance daily activities. On the other side of the coin, cannabis has come at a social cost as it has reduced academic attainment in some, created poor family relations and it has increased the likelihood of some young people getting a criminal record.

Cannabis has been described as a ‘gateway drug,’ for a relatively small percentage of people it lends itself to poly-drug use or dependency. Cannabis is the leading factor in the normalisation of drug-use where it can be fairly commonplace to smell it in urban environments. Like other drugs people tend to stop taking it as they get older,establish long-term relationships and responsibilities.

Effective drug education would also make people more sceptical of this ‘social drug’ now that it is more potent. Increased information on its effects and potency will help prevent misinformation and make people more aware of the harms.