Intended for healthcare professionals

Soundings

Unlikely scenarios of 1997

BMJ 1997; 315 doi: https://doi.org/10.1136/bmj.315.7099.65 (Published 05 July 1997) Cite this as: BMJ 1997;315:65
  1. Liam Farrell, general practitioner
  1. Crossmaglen, County Armagh

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    We are approaching that utterly depressing time of year again when the Ulster calendar deviates from the Julian; over here, it's January, February, March, March, March. March: the only verb in the English language which always begins with a capital. Is strife inevitable? Perhaps not if we imagine this unlikely scene.

    Orangeman (inhaling deeply): “My child, my flower, my flower child, we were kind of wondering if you'd mind us boogieing along your road.”

    Resident: “OK, Rasta-man, come on down and we'll groove on it for a while. And hey, bring some records.”

    Orangeman: “Yo, bro, I got some Otis Redding, James Brown, a few white guys.”

    Resident (inhaling): “Big daddy, I think this march … is … happening! Can I try on your hat?”

    Orangeman: “Hey man, I love you.”

    This obvious antidote to the primitive savagery of the marching season unfortunately remains unavailable to us. Remember 1967? The summer of love; Woodstock, Janis Joplin, Big Mama, Country Joe, and the Fish; peace and love and rock'n' roll. Yeah man, and cannabis too, to get everyone tripping and in a good mood. Nobody wanted to go home and beat their wives or crash their cars or wreck their lives, or increase their chances of lung cancer and heart disease, like with our favourite legal drugs.

    Every society chooses its favourite method of achieving an altered state of consciousness: mescaline, opium, alcohol, turf, country and western music, some palpably more harmful than others. Cannabis has been known for 4000 years, and currently has over 260 million users world wide, two and a half million in the United Kingdom alone. Even Bill Clinton has had an occasional toke, although apparently (and uniquely) he didn't inhale. The Pandora's box is open, the genie is out of the bottle, and forcing it back in is not an option. Spinoza said, “All laws which can be violated without doing anyone any injury are laughed at,” but as the editor of the BMJ, Richard Smith, has observed, the real difficulty is that legalisation of cannabis is viewed as a moral problem and not as a public health issue.

    One of the reasons for the widespread use of cannabis, quite apart from the pleasure involved (probably the main reason for certain groups wanting to ban it on moral grounds) is its relative safety; the risk of overdose is small, and physical dependence and withdrawal symptoms do not occur, though heavy users may report apathy, depression, and, rarely, psychological dependence. The most significant side effect may be the respiratory problems caused by the tobacco used to prepare cannabis for smoking.

    Annual alcohol related deaths run at 40 000, giving a death rate for drinkers of 0.5%; I cannot find any figures on death rates for cannabis. Would alcohol or cannabis be your choice as the Spirit of Drumcree 1997?

    Tune in, turn on, drop out … and March home.