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Pontifications on Poison

Being some ramblings on events associated with poisonous plants.

Monday 6th February 2012

Sometimes, I find myself amazed at the things that get written up as scientific papers. I’m not just talking about nonsense surveys of the sort that are supposed to show that one particular day is the saddest of the year or ‘prove’ that someone’s choice of shirt colour can be used to demonstrate their likelihood of committing a crime.

I’m meaning those papers that have conclusions that seem to me to be so obvious or so intuitive that I can’t believe that no-one has written a paper about it before.

A Tweet from Dr Harry Sumnall drew my attention to this paper that, going from the abstract, claims to have discovered that the quantity of the psychoactive components of Cannabis sativa, marijuana, consumed determines its effects. The abstract states that ‘quantity, above and beyond frequency, is an important predictor of cannabis problems’.

I am really surprised that this is a new discovery. Back in 2008, ‘Addiction’ published a paper that found that claims about increased potency due to ‘skunk’ could not be substantiated because so much of the literature failed to actually measure dose relying instead on ‘number of joints’ as equating to consumption.

When I wanted to find out more about what was meant by a ‘bucket bong’, I looked at a number of YouTube videos of various people smoking cannabis with this type of device. What struck me was that there was a very obvious variation in the dose of active ingredients different users were getting based on their different ways of using the bong.

I found this description of how to make and use a bucket bong when I was writing ‘Is That Cat Dead? – and other questions about poison plants’;

 ‘The bucket bong is another full-hit wonder. It's simple to prepare. Get your big bottle and cut away the bottom. Put the bottle in the bucket so it touches the bottom. Then fill the bucket with water. The water level should not rise above the bottle neck. Place the 'mix cone' onto the mouth piece of the bottle and apply flame to the 'mix' continuously as you raise the bottle away from the water. This creates suction and you'll see the smoke being drawn into the bottle-chamber.

‘Once the bottom of the bottle has just reached the water’s surface, quickly remove the 'mix cone' and place your mouth over the bottle's mouth piece, then push the bottle down again, while you inhale the smoke getting pushed up.’

But, watching YouTube, I saw users removing the bottle from the water completely and simply drawing in the smoke as you would from a cigarette, as well as those, as described above, who pushed the bottle back into the water to drive the smoke deep into their lungs.  Even then there were variations as some users exhaled immediately while others held the smoke in their lungs for varying times.

It was obvious to me that you couldn’t measure dose based on the number of hits taken from a bucket bong and, by extension, nor could you by simply asking people how many joints they smoke. And yet, most of the research I read continued to use frequency of use as a measure for dose.

I know that, for tobacco, cigarettes per day is often used as a shorthand for dose but at least researchers now ask whether the smoker uses a low, medium or high tar brand and whether they have a filter tip or are unfiltered and the best quality studies examine concentrations of nicotine or other substances so that a completely subjective measure of dose can be obtained.

I’m not criticising Zeisser et al for their work. If nobody had previously said that there needs to be a better measure of dose that ‘a joint’, it was high time somebody did say it. But I don’t see how we’ve got this far without everyone already being aware of the need for a more scientific measure.

As Professor David Nutt said, in the Q & A after his lecture in Canterbury, there are some signs that the presence, or absence, of cannabidiol may be as important as the content of tetrahydrocannabinol (THC) when determining the effects of cannabis. That’s another reason for saying ‘a joint’ is not ‘a joint’.