Hostname: page-component-76fb5796d-25wd4 Total loading time: 0 Render date: 2024-04-26T17:51:17.117Z Has data issue: false hasContentIssue false
  • English
  • Français

Cannabis and psychosis: revisiting a nineteenth century study of ‘Indian Hemp and Insanity’ in Colonial British India

Published online by Cambridge University Press:  27 May 2019

Oyedeji A. Ayonrinde Open the ORCID record for Oyedeji A. Ayonrinde [Opens in a new window]
Oyedeji A. Ayonrinde*
Affiliation:
Department of Psychiatry, Queen's University, Kingston, Ontario, Canada
*
Author for correspondence: Oyedeji A. Ayonrinde, E-mail: oaa@queensu.ca
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

In nineteenth-century British India, concern regarding large numbers of asylum patients with ‘Indian Hemp Insanity’ led to establishment of the Indian Hemp Drugs Commission. The exotic cannabis plant was widely used in pharmacopeia and a source of government revenue. The Commission was tasked with determining the public health risks of cannabis use, particularly mental illness. This analysis of the Commission report seeks to highlight the status of 1892 cannabis research and compare it with current evidence for medical and recreational cannabis use.

Methods

Detailed historiographic review of the Indian Hemp Drugs Commission Report (1892).

Results

In 1892, heavy cannabis use was considered to have been associated with severe mental illness (7.3% of asylum patients; 12.6% of patients with diagnoses). About two-thirds were children and young adults with higher relapse rates. Risk increased with early cannabis use and a family history of mental illness. Cannabis psychosis was found to have a shorter trajectory and better prognosis than other mental illnesses in the asylums. Different cannabis potency and modes of consumption had different effects. Occasional cannabis use was felt to have medicinal benefits for some. Appendices provided symptoms and demographic characteristics of cannabis-induced mental illness.

Conclusion

This important nineteenth-century study observed frequency and dose-related effects of cannabis on mental health, particularly psychotic symptoms in young people with a previous or hereditary risk of mental illness. Pathophysiological observations were consistent with current knowledge. As one of the most systematic and detailed studies of the effects of cannabis of the time it foreshadowed contemporary cannabis issues.

Keywords

AdolescentscannabishistoryIndian Hempmarijuanapsychosis
Type
Original Articles
Information
Psychological Medicine , Volume 50 , Issue 7 , May 2020 , pp. 1164 - 1172
Copyright
Copyright © Cambridge University Press 2019

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abrams, DI (2018) The therapeutic effects of Cannabis and cannabinoids: an update from the National Academies of Sciences, Engineering and Medicine report. European Journal of Internal Medicine 49, 7–11.CrossRefGoogle ScholarPubMed
Andréasson, S, Allebeck, P, Engström, A and Rydberg, U (1987) Cannabis and schizophrenia. A longitudinal study of Swedish conscripts. The Lancet (London, England) 2, 1483–1486.CrossRefGoogle ScholarPubMed
Arseneault, L, Cannon, M, Poulton, R, Murray, R, Caspi, A and Moffitt, TE (2002) Cannabis use in adolescence and risk for adult psychosis: longitudinal prospective study. BMJ (Clinical Research Edition) 325, 1212–1213.CrossRefGoogle ScholarPubMed
Arvid Carlsson – Nobel Lecture. NobelPrize.org. Nobel Media AB (2019 a) Friday, 19 April 2019. Available at https://www.nobelprize.org/prizes/medicine/2000/carlsson/lecture/.Google Scholar
Arvid Carlsson Biographical (2019 b) https://www.nobelprize.org/prizes/medicine/2000/carlsson/biographical /.Google Scholar
Baxter-Tyrie, CC (1897) A case of poisoning by Cannabis indica. The Lancet 150, 1452.CrossRefGoogle Scholar
British Pharmacopeia (1867) General Council of Medical Education and Registration of the United Kingdom. Spottiswoode and Co.; p. 68.Google Scholar
Carlsson, A and Carlsson, ML (2006) A dopaminergic deficit hypothesis of schizophrenia: the path to discovery. Dialogues in Clinical Neuroscience 8, 137–142.Google ScholarPubMed
Carney, R, Cotter, J, Firth, J, Bradshaw, T and Yung, AR (2017) Cannabis use and symptom severity in individuals at ultra high risk for psychosis: a meta-analysis. Acta Psychiatrica Scandinavica 136, 5–15.CrossRefGoogle ScholarPubMed
Casadio, P, Fernandes, C, Murray, RM and Di Forti, M (2011) Cannabis use in young people: the risk for schizophrenia. Neuroscience and Biobehavioral Reviews 35, 1779–1787.CrossRefGoogle ScholarPubMed
Cascini, F, Aiello, C and Di Tanna, G (2012) Increasing delta-9-tetrahydrocannabinol (Δ-9-THC) content in herbal cannabis over time: systematic review and meta-analysis. Current Drug Abuse Reviews 5, 32–40.CrossRefGoogle ScholarPubMed
Clausen, L, Hjorthøj, CR, Thorup, A, Jeppesen, P, Petersen, L, Bertelsen, M and Nordentoft, M (2014) Change in cannabis use, clinical symptoms and social functioning among patients with first-episode psychosis: a 5-year follow-up study of patients in the OPUS trial. Psychological Medicine 44, 117–126.CrossRefGoogle ScholarPubMed
Davison, JL (1896) Editorial. The cigarette habit. The Canada Lancet 28, 166.Google Scholar
Di Forti, M, Morgan, C, Dazzan, P, Pariante, C, Mondelli, V, Marques, TR, Handley, R, Luzi, S, Russo, M, Paparelli, A, Butt, A, Stilo, SA, Wiffen, B, Powell, J and Murray, RM (2009) High-potency cannabis and the risk of psychosis. The British Journal of Psychiatry: The Journal of Mental Science 195, 488–491.CrossRefGoogle ScholarPubMed
Di Forti, M, Marconi, A, Carra, E, Fraietta, S, Trotta, A, Bonomo, M, Bianconi, F, Gardner-Sood, P, O'Connor, J, Russo, M, Stilo, SA, Marques, TR, Mondelli, V, Dazzan, P, Pariante, C, David, AS, Gaughran, F, Atakan, Z, Iyegbe, C, Powell, J, Morgan, C, Lynskey, M and Murray, RM (2015) Proportion of patients in south London with first-episode psychosis attributable to use of high potency cannabis: a case-control study. The Lancet Psychiatry 2, 233–238.CrossRefGoogle ScholarPubMed
Di Forti, M, Quattrone, D, Freeman, TP, Tripoli, G, Gayer-Anderson, C, Quigley, H, Rodriguez, V, Jongsma, HE, Ferraro, L, La Cascia, C, La Barbera, D, Tarricone, I, Berardi, D, Szöke, A, Arango, C, Tortelli, A, Velthorst, E, Bernardo, M, Del-Ben, CM, Menezes, PR, Selten, J-P, Jones, PB, Kirkbride, JB, Rutten, BP, de Haan, L, Sham, PC, van Os, J, Lewis, CM, Lynskey, M, Morgan, C, Murray, RM and EU-GEI WP2 Group (2019) The contribution of cannabis use to variation in the incidence of psychotic disorder across Europe (EU-GEI): a multicentre case-control study. The Lancet Psychiatry 6, 427–436.CrossRefGoogle ScholarPubMed
ElSohly, MA, Mehmedic, Z, Foster, S, Gon, C, Chandra, S and Church, JC (2016) Changes in Cannabis potency over the last 2 decades (1995–2014): analysis of current data in the United States. Biological Psychiatry 79, 613–619.CrossRefGoogle ScholarPubMed
Fischer, B, Russell, C, Sabioni, P, van den Brink, W, Le Foll, B, Hall, W, Rehm, J and Room, R (2017) Lower-risk Cannabis use guidelines: a comprehensive update of evidence and recommendations. American Journal of Public Health 107, e1–e12.CrossRefGoogle ScholarPubMed
Freeman, TP and Swift, W (2016) Cannabis potency: the need for global monitoring: letters to the editor. Addiction 111, 376–377.CrossRefGoogle Scholar
Freeman, TP, van der Pol, P, Kuijpers, W, Wisselink, J, Das, RK, Rigter, S, van Laar, M, Griffiths, P, Swift, W, Niesink, R and Lynskey, MT (2018) Changes in cannabis potency and first-time admissions to drug treatment: a 16-year study in the Netherlands. Psychological Medicine 48, 2346–2352.CrossRefGoogle ScholarPubMed
Gaoni, Y and Mechoulam, R (1964) Isolation, structure, and partial synthesis of an active constituent of hashish. Journal of the American Chemical Society 86, 1646–1647.CrossRefGoogle Scholar
Headland, FW (1859) Remarks on the proposed British Pharmacopeia. The Lancet 73, 434–436.CrossRefGoogle Scholar
Health Canada (2018) Information for Health Care Professionals: Cannabis (marihuana, marijuana) and the cannabinoids (October 2018) Available at https://www.canada.ca/en/health-canada/services/drugs-medication/cannabis/information-medical-practitioners/information-health-care-professionals-cannabis-cannabinoids.html.Google Scholar
House of Commons (1884) Hansard. House of Commons Debate. Warton. 26 March 1884, vol. 286 cc801-11801.Google Scholar
House of Commons (1891) Hansard London., Papers relating to the consumption of ganja and other drugs in India’ in British Parliamentary Papers, vol. 66, p. 3.Google Scholar
Indian Hemp Drug Commission Reports (1894 a) Available at http://digital.nls.uk/74908458.Google Scholar
Indian Hemp Drugs Commission (1894 b) Evidence of Witnesses. Vol. IV, p. iii, SIMLA.Google Scholar
Indian Hemp Drugs Commission (1894 c) Enquiry as to the connection between hemp drugs and insanity. Vol. II. Appendices. SIMLA.Google Scholar
Jackson, TH (1857) Uncertain action of Cannabis indica. British Medical Journal 1, 15.CrossRefGoogle Scholar
Kalant, OJ (1972) Report of the Indian Hemp Drugs Commission, 1893–94: a critical review. International Journal of the Addictions 7, 77–96.CrossRefGoogle ScholarPubMed
Ley, W (1843) Observations on the Cannabis indica or Indian hemp. Provincial Medical Journal and Retrospect of the Medical Sciences 5, 487–489.Google Scholar
Ley, W (1844) The medicinal properties of Indian hemp. The Lancet 43, 153.CrossRefGoogle Scholar
Marconi, A, Di Forti, M, Lewis, CM, Murray, RM and Vassos, E (2016) Meta-analysis of the association between the level of Cannabis use and risk of psychosis. Schizophrenia Bulletin 42, 1262–1269.CrossRefGoogle ScholarPubMed
McGuire, P, Robson, P, Cubala, WJ, Vasile, D, Morrison, PD, Barron, R, Taylor, A and Wright, S (2018) Cannabidiol (CBD) as an adjunctive therapy in schizophrenia: a multicenter randomized controlled trial. American Journal of Psychiatry 175, 225–231.CrossRefGoogle ScholarPubMed
McHugh, MJ, McGorry, PD, Yung, AR, Lin, A, Wood, SJ, Hartmann, JA and Nelson, B (2017) Cannabis-induced attenuated psychotic symptoms: implications for prognosis in young people at ultra-high risk for psychosis. Psychological Medicine 47, 616–626.CrossRefGoogle ScholarPubMed
Mikuriya, TH (1968) Physical, mental, and moral effects of marijuana: the Indian Hemp Drugs Commission Report. International Journal of the Addictions 3, 253–270.CrossRefGoogle Scholar
Mills, JH (2000) Madness, Cannabis and Colonialism: The ‘Native Only’ Lunatic Asylums of British India, 1857–1900. Basingstoke: St. Martin's Press.CrossRefGoogle Scholar
Minozzi, S, Davoli, M, Bargagli, AM, Amato, L, Vecchi, S and Perucci, CA (2010) An overview of systematic reviews on cannabis and psychosis: discussing apparently conflicting results. Drug and Alcohol Review 29, 304–317.CrossRefGoogle ScholarPubMed
National Academies of Sciences, Engineering, and Medicine (ed.) (2017) The Health Effects of cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research: Report. Washington, DC: The National Academies Press.Google Scholar
Oliver, J (1883) On the action of Cannabis indica. British Medical Journal 1, 905–906.CrossRefGoogle ScholarPubMed
O'Shaughnessy, WB (1843) On the preparations of the Indian Hemp, or Gunjah. Provincial Medical Journal and Retrospect of the Medical Sciences 5, 363–369.Google Scholar
Reynolds, JR (1890) On the therapeutical uses and toxic effects of Cannabis indica. The Lancet 135, 637–638.CrossRefGoogle Scholar
Schoeler, T, Monk, A, Sami, MB, Klamerus, E, Foglia, E, Brown, R, Camuri, G, Altamura, AC, Murray, R and Bhattacharyya, S (2016 a) Continued versus discontinued cannabis use in patients with psychosis: a systematic review and meta-analysis. The Lancet Psychiatry 3, 215–225.CrossRefGoogle ScholarPubMed
Schoeler, T, Petros, N, Di Forti, M, Klamerus, E, Foglia, E, Ajnakina, O, Gayer-Anderson, C, Colizzi, M, Quattrone, D, Behlke, I, Shetty, S, McGuire, P, David, AS, Murray, R and Bhattacharyya, S (2016 b) Effects of continuation, frequency, and type of cannabis use on relapse in the first 2 years after onset of psychosis: an observational study. The Lancet Psychiatry 3, 947–953.CrossRefGoogle ScholarPubMed
Shamir, R and Hacker, D (2001) Colonialism's civilizing mission: the case of the Indian Hemp Drug Commission. Law & Social Inquiry 26, 435–461.CrossRefGoogle Scholar
Sherva, R, Wang, Q, Kranzler, H, Zhao, H, Koesterer, R, Herman, A, Farrer, LA and Gelernter, J (2016) Genome-wide association study of Cannabis dependence severity, novel risk variants, and shared genetic risks. JAMA Psychiatry 73, 472.CrossRefGoogle ScholarPubMed
Stockings, E, Campbell, G, Hall, WD, Nielsen, S, Zagic, D, Rahman, R, Murnion, B, Farrell, M, Weier, M and Degenhardt, L (2018 a) Cannabis and cannabinoids for the treatment of people with chronic noncancer pain conditions: a systematic review and meta-analysis of controlled and observational studies. Pain 159, 1932–1954.CrossRefGoogle ScholarPubMed
Stockings, E, Zagic, D, Campbell, G, Weier, M, Hall, WD, Nielsen, S, Herkes, GK, Farrell, M and Degenhardt, L (2018 b) Evidence for cannabis and cannabinoids for epilepsy: a systematic review of controlled and observational evidence. Journal of Neurology, Neurosurgery, and Psychiatry 89, 741–753.CrossRefGoogle ScholarPubMed
Storm, J (2019) Marijuana and Lunacy: The Magnificent Failure of the Indian Hemp Drugs Commission – Cannabis Digest [online]. Available at https://cannabisdigest.ca/marijuana-lunacy-magnificent-failure-indian-hemp-drugs-commission/ (Accessed 17 April 2019).Google Scholar
Tibbo, P, Crocker, CE, Lam, RW, Meyer, J, Sareen, J and Aitchison, KJ (2018) Implications of Cannabis legalization on youth and young adults. Canadian Journal of Psychiatry 63, 65–71.CrossRefGoogle ScholarPubMed
van Os, J, Bak, M, Hanssen, M, Bijl, RV, de Graaf, R and Verdoux, H (2002) Cannabis use and psychosis: a longitudinal population-based study. American Journal of Epidemiology 156, 319–327.CrossRefGoogle ScholarPubMed
Verweij, KJH, Abdellaoui, A, Nivard, MG, Sainz Cort, A, Ligthart, L, Draisma, HHM, Minică, CC, Gillespie, NA, Willemsen, G, Hottenga, J-J, Boomsma, DI and Vink, JM (2017) Short communication: genetic association between schizophrenia and cannabis use. Drug and Alcohol Dependence 171, 117–121.CrossRefGoogle ScholarPubMed
Wilkinson, ST, Radhakrishnan, R and D'Souza, DC (2016) A systematic review of the evidence for medical marijuana in psychiatric indications. The Journal of Clinical Psychiatry 77, 1050–1064.CrossRefGoogle ScholarPubMed
World Health Organization (WHO) (2016) The Health and Social Effects of Nonmedical Cannabis Use. Geneva, Switzerland: World Health Organization.Google Scholar
Zammit, S, Moore, THM, Lingford-Hughes, A, Barnes, TRE, Jones, PB, Burke, M and Lewis, G (2008) Effects of cannabis use on outcomes of psychotic disorders: systematic review. British Journal of Psychiatry 193, 357–363.CrossRefGoogle ScholarPubMed