Chronic consumption of cannabis and cocaine can cause psychotic disorders

According to the latest data from the Ministry of Health, alcohol and tobacco are still the most common drugs taken legally in Spain, followed by the illegal drugs, cannabis and cocaine.

According to the 2021 report from the Spanish Observatory on Drugs and Addictions, 93.0% of those aged 15-64 say they have drunk an alcoholic beverage at some time in their life. This makes alcohol the most common psychoactive substance consumed, followed by tobacco, with 70% of the population saying they have smoked at some time in their life. Among illegal drugs, cannabis is by far the most widespread taken in Spain, and on the increase. One in 10 individuals has taken it at some time in their life, with cocaine ranking second. Meanwhile, amphetamine consumption has increased over the years The study also evaluated the prevalence according to sex, with men recording a higher rate of consumption for almost all psychoactive substances. In fact, a European study by the drug and addiction monitoring centre, which has collected data since 2011 and analyses wastewater from different cities in Europe, concluded that cocaine and cannabis were the drugs consumed most in Spanish cities.

Substance abuse mostly begins at the ages of 13-14 with tobacco, alcohol and cannabis before moving on to other drugs between the ages of 16 and 18. When a person takes an addictive substance, it leads to self-administration when consumption becomes a primary need. The drug acts on brain circuits causing reward and pleasure, leading to compulsive consumption by the person, despite the negative physical, psychological and social consequences. There are also behavioural addictions such as those involving gambling, sex, video games and even mobile phones. The clinical effects are similar, but cerebral circuits are not stimulated directly by a substance and therefore severity and prevalence are less.

There are three factors to consider when determining how harmful a substance is: brain toxicity, addictive capacity and epidemiological extent. Methamphetamine, for example, is one of the most toxic and addictive substances. Cocaine is similar, although it is not as toxic as methamphetamine; however, its use is more widespread. Cannabis is less toxic and addictive than both methamphetamine and cocaine, but is widely used by young people. It is estimated that a quarter of young people have taken this substance in the last year.

Continued use of cannabis can lead to psychotic disorders, lung diseases, decreased intellectual performance, academic failure, increased road accidents and amotivational syndrome, which is a loss of interest in any subject or activity. Meanwhile, frequent use of cocaine can lead to a significant risk of cardiovascular pathologies, including myocardial infarction and cerebral vascular accidents. It can also cause psychotic disorders, hallucinations, especially kinaesthetic ones (sensations within the body) and a persecution complex. It can also lead to perforation of the nasal septum and malnutrition. In both cases, the greatest risk is chronic use leading to addiction.

To reduce substance abuse, neither criminalisation nor legalisation can be used. The only prudent alternative is regulation, which must be done according to scientific and health criteria; however, not all substances can be regulated in the same way. Regulating a substance means finding a balance between price and availability. For example, alcohol and tobacco are legal substances and are the most consumed drugs with the worst social costs compared to all others. They are affordable and easy to get. Dr Antoni Gual, former head of the Addictive Behaviour Unit at the Hospital Clinic Psychiatry Unit, led ALICE RAP, a European research project for five years (2011-2016) and promoted the idea of regulation. Attempts were made to increase scientific evidence to inform public and political dialogue and stimulate a broad and productive debate on current and alternative approaches to addiction.

Information documented by: Dr Antoni Gual, former head of the Addictive Behaviour Unit at the Hospital Clinic Psychiatry Unit.