Book Review of Tell Your Children: The Truth About Marijuana, Mental Illness, and Violence
Scare hyperbole about a situation that deserves a more thorough discussion UPDATED 2/22/2023
The battles over marijuana legalization continue. The momentum has clearly shifted in favor of marijuana legalization over the past quarter-century, ever since 1998, with the passage of the first state “medical marijuana” legalization measure ballot initiative, California Proposition 215, by a popular majority of voters. But that track record of success has not been unbroken; most recently, in November 2022, voters in three states declined to approve legalization ballot measures. Marijuana continues to be classified as a DEA Schedule One prohibited substance under Federal law. And opponents of marijuana legalization are regrouping with attempts to demonstrate that marijuana is a substance so harmful and insidious that legalization efforts should not merely be contained, but reversed.
I think a discussion on the harm potential of cannabis is appropriate; overdue, even. We need to know what effective harm reduction can mean, in the era of legal cannabis, legal marijuana.
Tell Your Children, by Adam Berenson, is not the book to begin that discussion. It represents itself as a serious scientific inquiry, but it doesn’t have a single footnote or end note. It has no bibliography. It references a handful of studies and metastudies for its conclusions, and the study conclusions are in at least some respects far more equivocal than what’s implied in the book. The book occasionally makes claims that seem to imply that alcohol is less behaviorally toxic than marijuana-induced psychosis, and less of a violence problem. There’s also a potted history of the marijuana legalization movement with sinister conspiratorial undertones that only an agenda-confirming latecomer to the issue could possibly offer, and one whose narrative is easily contradicted by volume after volume on the shelves: Dan Baum’s book Smoke And Mirrors. Martin Torgoff’s Can’t Find My Way Home. Drug Crazy, by Mike Gray. Martin Lee’s book Smoke Signals. The book Reefer Madness, by Eric Schlosser. The author at one point draws a direct link between natural cannabinoids and quite recently invented snythetic cannabinoids that are more than an order of magnitude more potent, both physically and psychologically. There’s a medical consensus that there’s no valid comparison to be made between the harm profile of natural THC and the proven hazards of the synthetic cannabinoids, which were designed as special purpose research chemicals, not intended for human use (not until they became available through the gray market, that is. Boosted by market advantages like low cost and standard THC drug test undetectability.)The book spends a lot of time leaning on its supposedly rigorous adherence to science and scholarship, but it closes out with a handful of anecdotal accounts of gory homicides supposedly connected to cannabis use, including the account of a convicted murderer who blames his action on temporary insanity produced by his cannabis use.
I’ll have more to say. This is not a volume devoid of provocative data or the occasional valid observation. I’m open to discussing matters related to possible harm from early exposure to cannabis, and to the complications and increased risks associated with high-THC products. But overall, this book left me unimpressed.
I need to make my own views on cannabis and legalization clear before taking this review any further. I’ve been a foot soldier in the legalization movement since 1978. Which is why I find Berenson’s conspiracy insinuations so absurd; the legalization movement comprised only a small number of grassroots activists in the 1970s, and in the Reagan and Bush era, we were practically erased from media notice, even in California. The cannabis legalization movement in California achieved victory the old-fashioned way; we earned it. The support of some wealthy philanthropists was welcome. It’s questionable whether it was required, in order for us to win. It may have helped us to win a little faster.
I need to note here that I only foresaw some of the complications attendant to the way that cannabis legalization has since been implemented in the “legal states.” My personal emphasis as far as policy goals has always been focused on granting the legal right to cultivate household personal use quantities of cannabis as part of the decriminalization of personal possession and use. My attitude toward commercial legalization combines pragmatism with skepticism. Ideally there would be no commercial market for recreational cannabis, in my opinion. But as a practical matter, demand probably outstrips the ability of small cultivators to supply it, especially in the big cities. Because another main priority of my drug reform advocacy is to take the market out of the hands of organized criminal suppliers, some form of commercial legalization- licensed, taxed-regulated- is pretty much required in order to meet the consumer demand. Dismantling the organized crime enterprise is paramount.
That said, I never anticipated that legal cannabis outlets would be selling high-THC concentrates like shatter hash, or edible products that could be consumed as easily as a bag of Skittles. When I first began contemplating what a legal market might look like, my worries ran in the direction that the commercial legalization would lead to homogenized, generic, low-quality marijuana produced by a handful of large corporate interests benefiting from regulatory capture, over-regulation, and possibly even continued criminalized prohibition on household cultivation of even the smallest amounts of cannabis.
Wow. Was I ever wrong about that.
And this begins to get into the areas where I share agreement with the evidence presented by Alex Berenson (being already familiar with some of the clinical evidence he presents in Tell Your Children.) I’m persuaded by abundant evidence that high-THC cannabis products are more hazardous than the relatively low-test varieties. They’re capable of producing a level of disorientation that can lead to untoward outcomes, particularly in users with vulnerable temperaments and incipient or active mental disorders.
I need to clarify what I mean by “high-THC”, here: as a ballpark figure, anything over 11% THC. I can practically hear the jeers and the rhetorical brickbats already- but hey, this is Iconoclasms. ( In order to give myself the opportunity to show my critics that I don’t get shouted down that easy, I may even open up my posts to subscriber comment one day.)
I picked the 11% figure because as recently as the early 1990s, that percentage was widely considered the practical limit of THC content in natural, outdoor-grown cannabis female flowering tops in the most optimal habitat in the world, in Turkestan. Then the 1990s-era technological innovations of indoor growing transformed an annual flowering herb into a THC factory. First by hybridization of high-resin, high-THC strains; then by the use of indoor hydroponic high-intensity light and manipulation of photoperiods to grow cloned cuttings that as a rule yielded all-female seedless flowering buds; then by cooling the hydroponic nutrient solutions with dry ice, to maximize nutrient uptake at both the roots and through respiration in a CO2-rich environment; and also by manipulating light distance and intensity for the optimal production of only the most dense, high-THC cannabis flower tops. An indoor product that achieved THC levels of over 20% soon after those intensive growing techniques were implemented in the 1990s, and which is currently capable of producing a uniform product potency that’s closing in on 30% THC.
I view the “stronger is better” goal as a mistaken effort. It’s based on axioms associated with the requirements of the illegal market, as well as some assumptions about THC and cannabinoids that deserve a lot more examination than they’ve been given so far by the press or the general public, although thankfully that examination is far enough along in the community of scientific and empirical researchers- including some cultivators- that it’s yielding some honest and intelligent insight about the most beneficial ways to use cannabis either for medical or recreational purposes. The direction of the research- a mix of brand-new psychophamacology study and old-head experience- indicates that most users benefit from a product with a balanced cannabinoid profile, especially in regard to the leavening effect of CBD on THC. There’s also some intriguing evidence about a so-called “entourage effect” of other cannabinoids and terpenes that appear to favor “heirloom” cannabis strains that benefit from cultivation in soil and sunlight, and even possibly beneficial effects from judicious pollination. At this early date, it’s difficult to know for sure how much of the “entourage effect” might be more about esthetics than pharmacology, but my own experience in inclined to grant it some conditional credence.
What’s less controversial are the developing conclusions about the way to obtain the most harmonious effect from THC, which basically add up to “less is more.” Martin Lee- about as good a science journalist as we have on this subject, and just a diligent science reporter in general- pointed out in a 2019 article on his Project CBD website that
“…For most medications, a higher dose will pack a stronger therapeutic punch. With cannabis, however, it’s not so simple. THC and other cannabis components have biphasic properties, meaning that low and high doses generate opposite effects. Small doses of cannabis tend to stimulate; large doses sedate…”
Lee also goes on to state in the same article that high doses of THC are very often experienced as undesirable or debilitating, and capable of inducing or exacerbating mental dysfunction, up to and including acute psychosis. So, yes, Martin Lee agrees with Alex Berenson- and myself- about that liability. All of which leads me to wonder why retail cannabis outlets currently place so much emphasis on stocking strains of cannabis with a THC percentage of 15%-27%! Someone has to be very acclimated to regular use of a product that strong in order to find it enjoyable. To be candid about it, my exposure to the 20% THC cannabis that became a standard of the West Coast illicit market c.2000 eventually led me to give up using it a few years later. I know what I like about smoking pot, and it isn’t that. Even one hit is too much for me, because of the bolus effect. I don’t want to have to deal with 15 minutes of THC disorientation before I can settle into enjoying it. The ubiquity of the high-test product also has to have turned off a lot of newbies from cannabis entirely, for better or worse.
All I can say to the retail merchants is: live and learn. If you aren’t seeking out heirloom strains and moderate percentages, you’ve already hampered your own market. (The strength can be as low as 3%- just make sure that the product hasn’t gone stale and turned to drowsy CBN, useful only at bedtime) I know, the market is inertial, and a can of worms, what with all of the sunk cost investment in high-tech indoor cultivation. But the plain fact is that cannabis is inherently a solar energy proposition. Grown outdoors, in the right microclimates, in its proper season.
Another market dilemma has to do with the Edibles. And I do mean dilemma, personally speaking; I’m ambivalent about the pros and cons. On the con side, many of the edibles appear to be practically designed like confections, sweets, fast food. In my early naive projections of the prospect of legality, an edibles market never even occurred to me; I simply took it for granted that if people wanted to orally ingest cannabis, they’d have to cook it themselves. I never dreamed that legal retail stores would be selling chocolate bars containing >100mg of THC! Like, whoa Nelly! I mean, I’m familiar with the effect of that, but it isn’t for beginners. (Frankly, I don’t need to be either that dazed or that confused.) As for product warnings to limit consumption to just, say, 1/10 or 1/5 of a candy bar, or only one gummy out of a package of 10- isn’t that really counterintuitive? At least for Americans, like myself- who does that, with a regular candy bar or package of gummy bears, or Skittles, or what have you? Just nibble at the edge of a candy bar? Just have one gummy bear? Is there a food more addicting than sugar?
On the other hand: in contrast to the uncertainties of edibles purchased in the illegal market, I find it quite reassuring to be able to read a THC/CBD/cannabinoid percentage on the package of an edible product. It’s what a “pure food and drug” regulation is supposed to do: provide consumers with accurate information to make their own decisions. And realistically speaking, while the necessity to prepare one’s own edibles would act to some extent as a check on consumption, nothing rules out the ability cook down a 1/4 oz. of pot into one seriously powerful preparation of clarified cannabis butter. At this point, we can all be glad that strictly in terms of physical toxicity, cannabis is much less poisonous than any herb commonly found in a kitchen spice rack (and also less mind-altering than some of them, truth to tell.)
[to be continued]