Introduction

Recently I watched an Australian documentary called Messing With Heads which explores the links between heavy cannabis use and the onset of mental psychosis in teenagers and young adults[1]. I tuned in because this is an issue that has affected my own life and that of others around me, yet it continues to occupy a grey area in discussion and debate in the public arena.

My early dependence on cannabis grew over time into an addiction so complete that it rivaled that of any of the ‘hard’ drug users I have met in my attempts at recovery. Over time the drug altered my behaviour, my personality, my emotional landscape, my psychological functioning and ultimately opened a crack inside my mind that has never completely closed.

My obsession with smoking dope as a teenager and young adult really muddied the waters when I began to experience symptoms of a full-blown psychiatric illness in my mid- twenties. I will never know with certainty whether the cannabis caused the illness, or whether it exacerbated fissures in my mind that may have already existed. One thing is clear though: together the onset of bipolar disorder and my addiction to cannabis interacted to ransack my mind, spirit and life in a way that has taken fifteen years to piece back together.

Over many years my heavy cannabis use consumed my ambition, my motivation, and broke down my good sense of what was right and what was wrong. None of this happened overnight, and in fact the problematic effects of cannabis are often sneaky, insidious; they creep up on a user slowly and with stealth, not appearing with the rapid intensity of drugs such as ‘P’ or LSD. My father once said to me rather sagely,

  ‘It is as though some people can get away with smoking marijuana and some can’t. But by the time you find out you’re a can’t, it’s already too late’. That was certainly my experience.

The perception in our society of cannabis as a ‘soft’ drug does not factor into the equation any of the myriad human complexities that influence the effect the drug may have upon an individual. Especially when smoking starts at a young age and becomes a regular habit or an addiction. The mind is a fragile ecosystem, and as I will explain through my story, I went down the road of discovering what happens when that ecosystem becomes too polluted to maintain a stable chemical and psychological environment. I discovered, too late, that my emotional, physical, social and spiritual selves were intricately entwined in the breakdown precipitated by my ‘harmless’ cannabis use. All dimensions of myself fell prey to the cannabis cause and effect, no part of me was spared.

Debate continues in contemporary New Zealand as to the rights and wrongs of liberalising legislation relating to cannabis use, possession, and supply. I am of the view that we are looking at this issue from a skewed perspective. The question being asked through debate in select committees and the media boils down to ‘Should cannabis be legalised, decriminalised, made available for medical purposes or retain it’s current legal status as a Class C drug?’[2]  To my mind, the legal discussion is secondary to the more pressing issue of the difficulties faced by the ‘can’t’ sector of the population. How do we help or make provision for the people in our society who are experiencing significant harm from the drug, and will do so irrespective of whether it is legal or not? Our psychiatric hospitals and prisons contain many such people. Like tobacco and alcohol, changing the legal status of cannabis will not change the fact that many of our people are seriously affected by the drug and need a lot of support to move out of the cannabis way of life.

There are uncomfortable truths and deeper questions which emerge when the veil is lifted on the cannabis issue. Maybe when we can answer these questions, we will be in a better position to revisit the legal status of the drug.

The recognition of ‘dual diagnosis’, sometimes termed ‘dual disorder’, is a recent acknowledgement by the psychiatric profession that an individual suffering both drug and/or alcohol problems and a diagnosable mental illness presents with a unique and complex set of difficulties at the treatment coalface. This book sets out to examine some of these complexities. In doing so it explores the nature of addiction and mental illness through my own experiences both personal and professional, and through the lives of others I have met along the way.

I have attempted to provide a discussion that will be of relevance to sufferers, family members and professionals working in the many fields which intersect with the dual diagnosis individual. The book explores why it is in the best interests of us all to search for a way forward.

I hope you will find the book both a useful and optimistic insight into the illness and recovery process, and a resource for informing learning around the sometimes perplexing topic of dual diagnosis.