Drugs and alcohol

More hyped nonsense this week about cannabis (whether it is ‘dangerous’ by causing psychosis, whether it should be reclassified to B, and so on). Although based on a Lancet study (a meta-analysis of previous work ), once the media and politicians got hold of the research it became a lot more robust than the study’s authors would hold.

The media:

Cannabis use linked to 40% rise in risk of schizophrenia The Guardian… ‘at least 800 people suffering serious psychosis in the UK after smoking the drug’

‘Cannabis doubles psychosis risk’ ITV

Dope ’causes schizophrenia’ The Sun

The scientists:

‘In conclusion, we have described a consistent association between cannabis use and psychotic
symptoms, including disabling psychotic disorders. The possibility that this association results from confounding
factors or bias cannot be ruled out, and these uncertainties are unlikely to be resolved in the near future.’

And that’s just the questions internal to cannabis use, never mind looking at the issue in the wider context.

Internally, what we don’t know are:

1. are any psychotic symptoms temporary and directly caused by cannabis, as opposed to long-term? If yes, then ceasing use may cause some people to be cured of their problem. (this is, to some extent, addressed by the analysis).

2. what causes what? or are they in symbiosis? Some studies reported try to deal with this by excluding those with psychotic symptoms, but we don’t know about underlying problems. One study assessed kids at 11 for psychotic symptoms but what we can’t know is whether, say at 14, a child starts having symptoms (perhaps caused by family stress) and then self-medicates with cannabis. Self-medication is often behind all kinds of drug use (for cannabis here’s one study). Alcohol is similarly used to alleviate depression. Perhaps there’s a downward spiral, or the drug could be useful: we don’t know. We need a controlled experiment!

3. Why hasn’t the huge rise in cannabis use resulted in a massive increase of people with psychotic illnesses? My theory would be that most people are light users, and the heavy users are probably poly-drug users who may well have been mixing alcohol and amphetamines if they were a generation earlier.

Which brings us to the issues of context. Saying that 800 cases of 18-34 year olds could be avoided if they didn’t smoke dope raises some interesting questions. Is this a lot or only a few? If they hadn’t taken cannabis, would they have taken something else instead? Would there be any other harms?

In particular, the problem of alcohol is highly relevant. It’s legal, yet can cause schizophrenia. 10% of people have anxiety disorders and often alcohol is used to overcome this (perhaps we all do… it’s the social lubricant effect) – that’s a lot of people. Alcohol is implicated in lots of crime – over half of the incidents of stranger violence. And apparently 3.8million people in England and Wales are alcohol dependent – that’s also a lot of people. But for most of us it actually makes are lives a bit better.
Of course any drug taken to excess, or in a dependent way, is going to be bad for us. And even in small doses they may do some harm. However, for most people the personal benefits (relaxing, the joie de vivre, the sociability and so on) outweigh the personal harms. Educating people to not overdo it would be a good approach. And when dealing with the wider harm to society, I think cannabis should be of low priority. The RSA’s report is a good start for some sensible discussion of what to do about the problem of drugs and alcohol in British society.

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Follow the money (times two)

This isn’t really on topic (re. the complexity of social life), but is definitely on the margins. Indeed, when it comes to things like the housing market explanations like ‘interest rates aren’t high so we’ll be OK’ are trying to create a simple story out of millions of individual experiences. In both this case, and the present one, it’s always interesting to ‘follow the money’.

Now I used to think that ‘cash buyers’ always had the upper hand. After all, I’d rather someone gave me a sum outright than me having to wait for it. How wrong could I be… when buying a car you get a lower initial price if you want credit.

I thought perhaps the dealerships get commission. Well, yes they do, but not in a simple way. The dealership I went to is contracted by VW finance to sell a certain percentage of cars using VW credit. If they achieve their targets, they then get credit from VW to have some new cars before paying for the, saving them interest on their investment.

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I’ve also had to think about insurance. I’m sure that the whole world and his/her partner already knows this, but finding out that the insurance market isn’t as competitive as one would think was a shock. The companies I thought I’d try were DirectLine and Churchill. But wait… their web forms are identical. And so it turns out that they are both (and many others) are part of RBS. Not only that, many of them are branded resellers – are these real insurance companies at all?

Churchill, Direct Line, and Privilege are RBS brands. UK Insurance Limited (part of RBS) underwrites the insurance for ’50 household brands’ where other companies have branched out into insurance (Tesco, Virgin etc.) and they also do Green Flag. Sainsburys insurance is esure AKA Halifax Bank of Scotland, so at least there’s competition on the high street. I don’t have figures, but there are reports that HBOS, RBS and Lloyds TSB are over-dominant in the non-life insurance sector, and the ILO (http://www.ilo.org/public/english/dialogue/sector/techmeet/tmbf01/tmbfr.htm) is concerned about lay offs after M&A activity in this area.

For the consumer (i.e. me) what I can’t stand is the inability to compare different companies without examining them all. What sort of competition is it when the two brands that come to mind first are part of the same company.