Cannabis or alcohol?

Sections

The history of ganja use in Jamaica
Prevalence of ganja use in Jamaica
Ganja use by a hospitalized male population
Ganja use in the community
Is ganja an alcohol substitute for poor Jamaicans?
Is ganja a safe euphoriant?
Other observations
The psychological and medicinal effects of ganja
Ganja and religious affiliation
Summary
Acknowledgements

Details

Author: Raymond PRINCE , Rochelle GREENFIELD , John MARRIOTT
Pages: 1 to 9
Creation Date: 1972/01/01

Cannabis or alcohol?

Observations on their use in Jamaica

M.D. Raymond PRINCE *
M.Ed Rochelle GREENFIELD **
M.D John MARRIOTT ***

One of the striking features of the patient population of Bellevue, the large mental hospital in Kingston, Jamaica, is the infrequency of disturbances associated with alcohol. Of 600 admissions to one typical ward over a two-year period, less than 2 % suffered such problems; not a single case of chronic brain syndrome associated with alcoholism was seen and we encountered neither delirium tremens nor alcoholic hallucinosis. The few alcohol-linked disturbances that did occur were, moreover, in patients who contrasted sharply with the predominantly low-income ward population in that they were from higher income levels or were highly acculturated, having spent several years in England or the United States or Canada.

This picture is unexpected first because in Jamaica, a major sugar producing country, rum is relatively cheap; and second, because it is in marked contrast with what we know of most other Caribbean islands. For example, annual returns indicate some 47% of admissions to mental hospital in Nassau and 53% in Martinique are alcohol-linked [ 1] . Murphy and Sam-path [ 6] found 50% of admissions in St. Thomas (to general hospital psychiatric unit in an area without a mental hospital) were related to alcohol use. These figures may be compared to Chafetz's [ 3] estimate of 30% alcohol-linked admissions to American mental hospitals and 40 % to mental hospitals in Santiago, Chile [ 4] . Although many of these statistics are approximate, such a gross contrast with Jamaica's 2 % of alcohol-linked admissions calls for some attempt at explanation. The hypothesis we wish to explore here is one that has already been hinted at by Beaubrun [ 2] . In his pioneer field survey of alcohol consumption in five Kingston suburbs, he found that heavy drinking was more prevalent in higher income groups. He suggested that for low-income groups "... ganja (marihuana) smoking is widespread ... and may play a role as an alcohol substitute." Our hypothesis is that the use of ganja as a euphoriant by low-income Jamaicans is a benevolent alternative to alcohol and may protect them against the consequences of' alcohol consumption - alcohol addiction, delirium tremens, chronic brain syndromes, Korsakoff psychosis and physical sequelae such as cirrhosis of the liver.

*Mental Hygiene Institute, Montreal; formerly PAHO/WHO consultant (Mental Health), Jamaica.

**Department of Psychology, Bellevue Hospital, Kingston, Jamaica.

*** Department of Psychiatry, McMaster University, Hamilton, Canada; formerly Department of Psychiatry, University of the West Indies.

In considering this hypothesis, we should explore three questions: (1) How widely is ganja used by the poor in Jamaica? (2) Is ganja regarded by them as a substitute for alcohol? (3) Is ganja a safer euphoriant than alcohol? None of these questions is easily answered, but in this paper we will present relevant findings from a survey of male mental hospital admissions and a key-informant type survey of ganja use in the community. But first let us review something of the history of ganja use in Jamaica and the Caribbean.

The history of ganja use in Jamaica

Jamaica is one of the larger Caribbean islands and lies some eighty miles south of Cuba. Its population of 1,800,000 is multi-racial including some 70% of African descent, 20% Afro-European, 2% European, 2 % East Indian and 1% Chinese. On a per capita basis, Jamaica is relatively well off (U.S.$407 per capita in 1967) but wealth is unequally distributed with a small affluent group and a much larger impoverished group living in rural areas or in extensive urban slums.

It is commonly believed that ganja was introduced into Jamaica by Indian indentured labour brought in to workthe sugar plantations after the abolition of slavery in 1834. Between 1838 and 1917, some 33,000 immigrants streamed into Jamaica from India. Even today they cluster in the rural sugar-growing parishes of Westmoreland, St. Thomas and St. Catherine. Cannabis has, of course, been widely used in India for centuries in its three major forms: charas,the potent resin collected from the fruiting and flowering tops of the female plant though charasis now prohibited in India; ganja,a less potent mixture of leaves and flower parts; and the weakest grade, bhang,prepared from the leaves and stocks. We have been unable to find any documentation of ganja use in Jamaica, but evidently it was widely used by Indian labourers in the cane fields to allay fatigue. Subsequently its use spread throughout the lower class Jamaican population. It is interesting to note that in the annual report for Bellevue hospital for 1872 in which Dr. Thomas Allan, the first superintendent of the hospital, gave a thumbnail sketch of each of the eighty patients admitted during the year, only one case was noted as "smoking tobacco and gunga ". He was a forty-year old, single, "coolie" (i.e. East Indian) shopkeeper from St. Andrew parish.

Ras Tafarian group, Kingston, Jamaica (Photo: Courtesy John Jörgensen)

Full size image: 170 kB, Ras Tafarian group, Kingston, Jamaica (Photo: Courtesy John Jörgensen)

In view of the large proportion of Bellevue patients using ganja today, it would appear that there has been a marked increase of ganja use over the past hundred years.

In Jamaica today, ganja use is certainly widespread among the lower class population. It is used in two general ways: as a folk medicine in the form of a tea or mixed with rum for a wide variety of ills (see below); or as a euphoriant, smoked from a water pipe or mixed with tobacco in the form of a cigarette. The Jamaicans have proved very ingenious in making water pipes from cows' horns, tin cans, bottles or coconut shells.

Of special interest is the use of ganja by the Ras Tafarian group. 1They use it not only for medicinal purposes and as a euphoriant, but also as part of their religious ritual. Many believe that the "herb" will protect them from all forms of illness and that there is no need for doctors. It is taken as a tea, but is also used as a medicinal bath and as an incense to purify the air. But its most important use is to permit the brethren to achieve supernatural insight into the meaning of the Bible. It is called the "wisdomweed." A group of brethren sit in a circle and pass the "steam-pipe" from one to the other while meditating and discussing the meaning of the Scriptures.

Ras Tafarian water-pipe used for ganja smoking (Photo: Courtesy Patricia Ling)

Full size image: 37 kB, Ras Tafarian water-pipe used for ganja smoking (Photo: Courtesy Patricia Ling)

1. The Ras Tafarians are a kind of black Zionist movement whose aim is to return to Ethiopia. Dating back to the 1930s, the beliefs of the group have their origins in the teachings of Marcus Garvey.

They number perhaps thirty thousand and cluster in loosely organized camps. They are by no means homogeneous in their beliefs or practices and are scattered widely over the island both in the urban and rural areas. Almost all derive from the most impoverished sections of the community. It is largely a masculine movement which attracts many school drop-outs. (Jamaica today suffers an unemployment rate of some nineteen per cent of the labour force.) Most Ras Tafarians are unemployed and live a communal existence, sharing whatever is available. They make their homes in slums, squatting on land they can never hope to own, often without electricity or water or sanitary facilities.

They believe that Adam and Eve were black, as were the Israelites and Jesus; at the time of the emancipation of the slaves, Queen Victoria became frightened of the power of the blacks; she therefore had the Bible translated so as to conceal the true identity of the Israelites. Those who call themselves Jews are impostors; Haile Selassie is God and will not die (9, 5).

As far as we have been able to ascertain, ganja or an other form of cannabis is not extensively used in other Caribbean islands. It is used in Trinidad but not nearly to the extent that it is in Jamaica. This is especially puzzling, since Trinidad has a much larger Indian population than has Jamaica (Trinidad's population includes some 36% East Indians as opposed to Jamaica's 2%). Ganja was certainly brought to Trinidad by the East Indians and it was sold in licensed East Indian shops up until the time its use was prohibited [ 8] . Perhaps the East Indians who migrated to Trinidad derived from Indian provinces where cannabis use was less prevalent or perhaps there are as yet unknown sociological reasons for this contrast between Jamaica and Trinidad. In many of the smaller Caribbean islands, such as St. Vincent and St. Lucia, cannabis use is virtually unknown apart from American tourists.

Prevalence of ganja use in Jamaica

In considering the hypothesis that ganja functions as an important substitute for alcohol in Jamaica, it is first necessary to determine the extent of its use. Because ganja is prohibited by law and there are severe penalties for its possession, satisfactory prevalence data is hard to obtain. Field surveys are unsuitable for obtaining information about illegal practices. A survey of mental hospital admissions seemed a more promising source of information especially since one of the wards in Bellevue hospital had been organized as a therapeutic community and the various patient groups provided a good means for allaying anxiety about the confidentiality of the data. Of course the problem remained that when we had prevalence data on hospital admissions, we would not know how representative the patient group was of the population in the community. We therefore devised a key informant technique which we hoped would give us some idea of whether community use was as extensive as that of the hospitalized population. Such data would moreover have relevance to the question about the possible causal relation between ganja use and hospitalization.

Ganja use by a hospitalized male population

Because we felt that the use of ganja was largely a masculine practice, we collected information from the male population only. Data was collected on 112 consecutive male admissions to the demonstration ward using a questionnaire. Topics covered included demographic information, frequency of ganja use, method of use, effects, alcohol or ganja preference, family characteristics etc. For the most part patients seemed to be quite open about the information given. In six cases, however, the patient was either too psychotic to complete the interview or the interviewer had reason to doubt the validity of the information; these six questionnaires were excluded from the analysis. It is clear that the data on frequency of use must be regarded as a lower limit only since on the whole patients would tend to minimize their use rather than exaggerate it. Most of the patients were interviewed just before discharge.

In analysing our data it seemed useful to divide the sample into five categories according to the extent of ganja use as follows:

I . Heavy current use: uses ganja once a day or more.

II. Heavy past use: used ganja more than once a day in the past but not within 3 months of hospitalization.

III. Light current use: uses ganja less than once a day.

IV. Light past use: used ganja in the past but less than once a day.

V . Non-users.

As Table 1 indicates, 24% were heavy current users, 40% had never used ganja and the balance had used it in the past or were only light current users. The heavy current ganja users are significantly younger and also commenced using ganja at a younger age than the rest. The youngest age reported for starting ganja was five years though another remarked that he had used it "from the day he was born "; the oldest age for quitting was 40, but one current light user was aged 43. The mean age of beginning use was 18.2 years and of discontinuing was 24.8.

TABLE 1

Frequency of ganja use and age in 106 male admissions to mental hospital

Group

Number

Per-centage

Mean age

Mean age commenced

Mean age ceased

I. Heavy current
26 24.5 23.2 16.0
-
II. Heavy pas
5 4.7 30.4 20.0 26.5
III. Light present
7 6.6 29.8 20.2
-
IV. Light past
26 24.5 30.7 18.2 24.6
V. Non-users
42 39.6 30.5
-
-

Ganja use in the community

We have already commented on the difficulties in obtaining satisfactory information about ganja use in the community by field survey. As an alternative we experimented with a variation of the key informant technique. Twelve hospitalized, male, ganja users with whom we had developed good relationships were asked about the use of ganja among their neighbours (in the community). Subjects were first asked to list all the people (15 years old and older) living in their own homes and those living in the two households on either side of them: information was thus obtained about five houses from each informant. They were then asked to estimate age, sex and present use of ganja, using the heavy, light and non-user categories defined as we had done with our hospitalized population. Table 2 provides the results of this survey.

TABLE 2

Ganja use in the community (As reported by key informants)

 

Non-users

Light use (less than once a day)

Heavy use (once a day or more)

Age

Male

Female

Male

Female

Male

Female

15-19
4 4 1   5  
20-24
2 1 3   10 1
25-29
4 7     6  
30-34
3 6 1 1 7 1
35-39
3 5     2  
40-44
4 5     4  
45-49
2 5     1  
50-54
3 5        
55-59
4 5        
60 plus 8 6     1 1
Total
37 49 5 1 36 3

Of the 131 individuals over fifteen years of age that were reported upon, 39 (30%) were said to be heavy users; 6 (4%) were reported light users and 86 (66%) were non-users. It will be seen (see Table 1) that there are both more non-users and more heavy users in the community compared with the hospitalized population. And if we restrict our attention to the community male population alone, the picture is even more striking. Of the 78 males reported upon, 36 (46%) were heavy users, 5 (6%) light users, and 37 (48%) were reported as non-users. As with the hospitalized population, it is the young male who is the heavy user; over the age of 40, use declines sharply. It is clear from the present data that the use of ganja in the areas from which our patients derive is at least as heavy as the use by the patient population.

Is ganja an alcohol substitute for poor Jamaicans?

We have now seen that ganja use is widespread among Jamaican males in the low-income bracket, especially within the age group 15-35 years of whom from 30 to 65 % use ganja every day. Do these men use ganja as an alcohol substitute and, if so, do they use it because they prefer it to alcoholic beverages or because it is cheaper than alcohol?

Let us first examine the question of cost. It Is clear that ganja is a cheaper euphoriant. According to our informants, the euphoriant effect of a "stick" or a "round" of ganja (costing 12 to 24 cents, American) is equal to the effect of three to four bottles of beer (at 18 cents a bottle), which is equivalent to three or four "drinks" of white rum (at 12 to 24 cents a drink). We may say then that ganja is very roughly three or four times cheaper than alcohol per "high".

TABLE 3

Expressed preference for alcohol or ganja if both were equally available

 

Group

Number

Prefer ganja

Prefer alcohol

Equivocal

Neither

I.
Heavy current.
26 20 4 2 0
II.
Heavy past
5 0 4 1 0
III.
Light current
7 3 3 1 0
IV.
Light past
26 1 17 7 0
V.
Non-users
42 0 31 0 11
 
Total
106 24 59 1l 11

Of course the subjective effects of ganja and alcohol are not the same. Do the Jamaican poor prefer the effects of ganja to the effects of alcohol? To explore this question we asked the hospitalized sample: "If alcohol and ganja were equally available to you, which would you prefer?" As Table 3 indicates, heavy current ganja users almost all said they would prefer ganja, but almost all the light users and heavy past users said they would prefer alcohol. It should also be noted that of the 26 heavy current users, ten were members of the Ras Tafarian cult who, as we have said, use ganja for religious reasons. When we remove this special group we find that only 25% of the remaining ganja users express a clear preference for ganja. Of course there may be other reasons why Jamaicans say they would prefer alcohol apart from the subjective effects. Is it a matter of status? That is, do these low income ganja users see alcohol as being used by higher status members of the community and would they prefer to use alcohol because of its higher status implications? Or is it that they prefer the taste of alcoholic beverages? Or do they say they would prefer alcohol because its use is free of the legal dangers of ganja use? Unfortunately, our questionnaire was not sufficiently explicit in this area so that we are unable to answer these questions. It does seem safe to conclude however that for many poor Jamaican males, ganja does serve as a substitute for alcohol and that it is used mainly because it is cheaper.

It is interesting to compare the age-frequency pattern of heavy ganja users in the hospital population with the pattern of heavy alcohol consumption found by Beaubrun in his field survey of Kingston suburbs (see Table 4).

The general picture supports the substitution hypothesis in that the greater frequency of ganja use is age 17 and younger and falls off rapidly after age 35; the reverse is true for alcohol consumption, where the peak frequency of use is during middle age. Of course the Bellevue sample is too small to provide the basis for firm conclusions. It is of interest that in Beaubrun's field survey, 10 per cent of the men were teetotalers, which is very close to our 9% who stated that they used neither alcohol nor ganja (Table 3).

TABLE 4

Ages of current heavy ganja users compared with heavy alcohol consumers

 

Heavy ganja users

 

Age

Number

Per-centage

Percentage of heavy drinkers (Beaubrun2) (N = 476)

17 or less
3 of 5
60
no data
18-19
4 of 10
40 6
0-24
9 of28 30 20
25-29
8 of 24
30 24
30-34
2 of 9
20 22
35-39
0 of 7
0 23
40-44
0 of 10
0 30
45-49
0 of 3
0 23
50-54
0 of 0
0 16
55-59
0 0 15
60 plus
0 of 2
0 27

Is ganja a safe euphoriant?

Our study does not provide any hard facts about this important question. We did however elicit a good many opinions from our hospital informants. Such opinion was derived chiefly in response to three questions: "Do you think the government is right in discouraging the use of ganja? ", "Do you intend to use ganja after leaving the hospital?", "Why did you stop smoking ganja ?"

As Table 5 shows, 41% of the total sample expressed some criticism of ganja use. Criticism was greatest among the non-users and the light past users but there was also some among heavy users. Often the heavy users would indicate that ganja could have adverse effects but did not upon themselves.

TABLE 5

Adverse comment about ganja use (hospitalized population)

 

Group

N

Cause violence or anti-social behaviour

Cause mental trouble

Non-specific negative comment

Total

I.
Heavy current
26 3 1 2
6 (23 %)
II.
Heavy past
5 0 1 0
1 (20 %)
III.
Light current
7 0 0 0 0
IV.
Light past
26 2 3 7
12 (46 %)
V.
Non-users
42 10 7 8
25 (59 %)
 
Total
106 15 12 17
44 (41%)

Looking at the kinds of adverse comment, one of the commonest was that ganja caused violence or anti-social behaviour. This is of course one of the main reasons given for the legal sanctions against ganja. Some adversaries of ganja maintain that although both alcohol and ganja may be associated with anti-social behaviour, ganja is more dangerous because with ganja the individual maintains his competence to act whereas with alcohol the senses are dulled and the motor system unco-ordinated.

The following are some examples of anti-social behaviour mentioned by our informants:

People who use it can't control themselves. They do all kinds of things like getting into a fight and chopping people up and things like that.

It is dangerous because of the super-strength effect. A person can hurt someone with that kind of strength.

Others made vague remarks about the dangers of ganja, for example:

I would never have dealings with ganja because the government is against it. The government is right in prohibiting it because it makes a lot of trouble in the country by forcing people to do against their will. It gives people supernatural powers and hurts and damages people.

Because they say it's harmful and a devil's medicine.

The third general type of adverse criticism was of special interest to us. This was the idea that ganja produced mental disturbances of some kind.

It makes you to trouble people when you smoke it. I have heard that it can make you mad.

I have known friends who smoke it and it gets them mentally confused.

People would go around smoking it like regular cigarettes and Bellevue would jam up from too many crazy people. I believe it troubles your nerves.

In considering the possible adverse psychological effects, it is interesting to note the remarks of some of our informants about the relationship between ganja use and food. It is clear, as regards the damaging effects of alcohol, that most of these derive not so much from the alcohol itself but from the associated vitamin deficiencies. The alcoholic goes off his feed. With ganja use, on the other hand, there is often an increase in appetite. In our hospital sample, 38 of the 64 ganja users affirmed that ganja made them hungry; only one said that it reduced his appetite. Six respondents made unsolicited comments about the dangers of taking ganja when food was scarce or unavailable; the implication was that the user was in danger of "mental disturbances" in such circumstances.

After you take it, it calls for a whole heap of food. I can't afford food now as my mother and father are away and I had to cut down on the ganja.

Ganja doesn't do you harm unless you use it without food. Then it may make you crazy if you use too much.

I think the cause of my getting sick was perhaps I was taking too much ganja and too little food.

Most time it hurts you is when hungry. You should smoke only when eating. Best if smoking too much to eat something.

Although the hunger-inducing effect has been frequently noted in other reports, the danger of using ganja without food has not been mentioned to our knowledge. What the physiology of such an effect could be is not clear.

Although some 10 per cent of our hospitalized sample mentioned the danger of ganja causing some form of mental trouble, when the patients were asked directly about adverse mental effects upon themselves, the response was largely negative. We approached the problem of the relation of ganja use to psychosis in three questions, the results of which are given in Table 6.

Most often the references to ganja producing psychosis were vague or speculative:

A friend can put something in the ganja and give it to you to smoke and it may trouble your brain - may put grave dirt in it.

Possibly it can affect the nerves. It is just a supposition, I am not sure.

TABLE 6

Patients' opinions about the relation of ganja use to their own psychosis

 

Heavy current

Heavy past

Light current

Light past

 

Yes

No

Yes

No

Yes

No

Yes

No

Were you using ganja more heavily before admission?
5 21 0 5 0 7 0 26
Anything to do with your being in hospital?
5 21 0 5 0 7 4 22
Some say ganja may drive a man mad. Have you ever had a period of mental disturbance after using ganja?
1 25 1 4 0 7 1 24

Regarding the question: "Do you think ganja has anything to do with your being in hospital?", two respondents felt that the reason they were in hospital was because they could not get ganja ! But three patients gave clear examples of how ganja had produced some kind of mental disturbance:

My brain cannot take ganja smoking. It makes my brain work too fast and that's why I went off my head.

On one occasion, I smoked it and began to feel strange in the head. I thought my friends were against me. Nobody liked me. This experience prompted me to stop using ganja.

I once had a period of mental disturbance after using ganja. I began feeling irregular. Felt not in my senses, not paying attention. I went to lie down. I heard bells growing louder and crashed on my head. My heart was beating fast. I was very frightened.

To conclude this section on adverse psychological effects of ganja, it is clear that short-lived episodes of anxiety and confusion may be produced in some individuals as described above. The question of the relationship between these episodes and food intake calls for further study. Do such episodes ever warrant admission to mental hospital in the Jamaican setting? Our two years' experience at Bellevue leads us to believe that such episodes seldom provide grounds for admission. We did not see a single case of such a short-lived toxic kind of reaction. Of course, since patients admitted to Bellevue have often spent two or three days in a police cell awaiting certification by a physician, such short-lived episodes caused by ganja would probably clear up before they could be admitted to Bellevue. Also such episodes might be handled at general hospitals more frequently. 2

It was frequently suspected by ward staff members that ganja was being smuggled into the hospital for use by the patients. There was a tendency on the part of the nursing staff to attribute any relapse, particularly if the patient was aggressive or wild, to the use of smuggled ganja. We did not see any adequate evidence for such an opinion. On only one occasion a clear example of the effect of ganja was observed by us. This was a nineteen-year-old, avowed heavy ganja user. He had been in hospital for several months and had taken a prominent and constructive part in the group activities of the therapeutic milieu. In one ward meeting, he was aggressive, garrulous and attempted to dominate the group. It was clear that he was intoxicated since this behaviour was foreign to his usual group behaviour. Ganja was subsequently found in his pocket. His behaviour returned to normal in an hour or two.

2. But in a study by one of the authors (J.M.) of 196 consecutive admissions to the psychiatric unit of a general hospital (the University Hospital of the West Indies), only one was diagnosed as an acute toxic confusional state due to ganja. In the same study, 26 patients (13%) were alcoholics of whom 22 were from the upper middle class. These findings would support the view that ganja seldom causes psychiatric disorders warranting hospital admission in Jamaica and that alcoholism is much more common in higher-income Jamaicans.

To return to the comparison of hospitalized men with their neighbours in the community, it will be recalled that the percentage of heavy ganja users at large was, if anything, higher than the percentage of ganja users on the ward. This finding would support our opinion that ganja use is not a significant cause of psychosis. The so called "ganja psychosis" is schizophrenia occurring in a ganja-using population.

Other observations

Our questionnaire study explored several areas not directly related to the central hypothesis: regarding the most popular mode of ganja use, the spliff (ganja mixed with tobacco in a cigarette) was the preferred mode for 43 ganja users; nine said they most often drank it in a tea or mixed with white rum, and seven used the steam-pipe most often. Regarding racial differences, the black group were the most frequent users; there were four East Indians in our sample, of whom two were users; there were nine patients of mixed racial origin and four were users; in the black group, 58 used ganja and only 34 did not. Soueif [ 10] found a correlation in Egypt between subjects from broken families and ganja use; our study failed to reveal such differences. Two other areas merit more extended comment: the psychological effects and medicinal uses of ganja; and the relationship between religion and ganja.

The psychological and medicinal effects of ganja

We have already discussed in some detail the adverse effects of ganja. Turning now to other effects, Table 7 presents the frequencies of response on a number of categories of psychological effects.

It was surprising to find that 19 maintained that ganja increased their sexual urges. Other studies have noted that although cannabis may induce sexual fantasies, it reduces sexual appetite. In the "current heavy user" group, 12 of the 26 (46%) claimed that ganja increased their sexual urge. One respondent remarked spontaneously that "some men buy it only to get a heat for sex. " Among light ganja users and heavy past users only 7 of the 38 (18%) claimed it increased their sex urge. In the main this increase in sex urge was regarded as a good thing though one man commented "they should lock up the sex people, them" indicating that ganja made some men behave in a sexually anti-social way. Another commented on the other hand that "itgives me the strength to leave women".

TABLE 7

What effect does ganja have on you?

Increased appetite
38
Improved sleep
36
Makes happy
36
Improved thinking
35
Work better
35
Improves understanding
33
Focus attention
33
Feel close to God
30
Make smarter
29
Increased sex urge
19

Other comments about ganja included several to the effect that ganja improved inter-personal relationships:

It makes you more mannerable to other people.

If you are with another person and thinking something, there is better communication between you. It makes you clairvoyant. That is, it increases your five senses and your capacity to be more observant.

Other effects mentioned included:

It increases your stamina and it slows the reflexes. It is not habit-forming but a euphoric, a means of escaping reality. It is used by non-conformists as a way to help them live in their own world. It makes me feel charged.

It gives me the inspiration to read the Bible.

It makes me still and quiet and relaxed to go to bed.

It helps you to meditate.

I like to go to a dance and use it, it makes you feel lighter and calm.

It makes you feel " cool " and dreamy, but it may make you feel ambitious if you were ambitious before.

TABLE 8

Opinions about medicinal uses of ganja

Fever
32
Asthma
30
Cough, colds, flu
21
Merasmi (malnutrition in children)
17
Tuberculosis
13
Stomach ache
10
Sprains (local application)
10
Venereal disease
9
Any pain
8
All diseases
7
For blood, tonic
4
Nerves
3

It helps you to think further and more clearly.

Helps you to talk better and find more words.

It makes you lazy. You feel proud even if you have nothing in your pocket.

As we have said ganja is used widely for a variety of medicinal effects. It is generally brewed as a tea for this purpose, but it may be taken with white rum or mixed with coconut milk. Table 8 gives the frequency of response to the question about medicinal effects.

Ganja and religious affiliation

During the study it became clear that religion was one of the most important social categories linked with ganja use. Affiliation with one of the traditional religions often precluded ganja use. This point was made frequently during the key informant survey; when an informant was asked whether a given individual used ganja, he would remark " No, he doesn't use it, he is a Christian ". Table 9 adds weight to this idea; 80% of those who have never used ganja are affiliated with a traditional religious group and 71% of those who deny any religious affiliation have used ganja or are using it. One subject, a heavy past user, when asked why he stopped using ganja, said that at the age of 21 he got "saved" within the Church of the Lord and because the church was against it, he stopped using it.

The Ras Tafarians are of course a special group in this regard. Twelve of the thirteen Ras Tafarians are current users and the other one used it in the past. The question as to whether the subject used ganja alone or with friends brought out further differences between the groups with different religious affiliations. As Table 10 indicates, ganja use for the Ras Tafarian is a socially integrative activity, whereas for the other groups it may be socially isolating; the following remarks by non-Ras Tafarians clarify this point:

I use it alone because using it with friends is the way to get yourself tricked i.e. you might get arrested because friends will tell the police.

I never use it with friends because the friends might get you in trouble.

It is a special treat for myself. I never offered it to a friend as he might call the police.

TABLE 9 Religious affiliation and ganja use

Group

Number

No religion

Ras Tafarian

Catholic

Fundamental Protestant

Church of England

I
26 9 10 1 5 1
II
5 1 0 2 2 0
III
7 2 2 0 2 1
IV
26 8 1 5 12 0
V
42 8 0 7 25 2

TABLE 10

Social and solitary use of ganja among current heavy users (N = 26)

 

Always alone

Always with friends

Both alone and with friends

Ras Tafari
0 9 1
Not Ras Tafari but accept doctrine
0 1 1
Traditional religion
4 2 1
No religion
2 3 2

Typical Ras Tafarian remarks included:

I always use it with friends because we always have something to talk about.

I always use it with people because I'm not selfish and it makes you circulate with people.

I prefer it with friends because we get to reason after smoking -we mostly reason about human rights.

I always use it with friends and we sit and talk about God.

Summary

  1. Of 106 male admissions to the mental hospital in Jamaica, 24% use ganja once a day or more, 40% have never used it and the remainder are occasional users. The favoured mode of use is mixed with tobacco and smoked as a cigarette, but it is also used in a waterpipe or as a medicinal tea.

  2. A key-informant technique revealed that at least as many males in the communities from which the patients derive also use ganja once a day or more.

  3. Ganja is used mostly by low-income males in the age group 15-35 years; whereas alcohol is used mostly by higher income groups with the greatest use during middle age.

  4. Ganja is a significantly cheaper euphoriant than alcohol and 75% of non-Ras Tafarian, ganja-using patients state they would prefer to use alcohol if both ganja and alcohol were equally available.

  5. A good deal of negative opinion about ganja use was expressed particularly to the effect that ganja may produce violent or anti-social behaviour or mental trouble. Few patients however saw themselves as suffering such effects from ganja.

  6. There was a prevalent opinion that ganja use without adequate food might lead to mental trouble.

  7. Religious affiliation correlated strongly with ganja use. Traditional religion seemed to protect against ganja use. All Ras Tafarians used ganja in a socially integrative way, but those who denied any religious affiliation or belonged to traditional religions and used ganja were more likely to use it while alone.

  8. In general this study supports the view that ganja is used as an alternative to alcohol by low income Jamaicans. Whether it is a "benevolent" alternative is less clear: we found no evidence however that ganja was an important cause of mental hospitalization. This study suggests further areas for research: what is the longitudinal history of the use of alcohol and ganja by individuals; is it common to use ganja as a young man because it is cheap and then switch to alcohol as income increases? Are there long term cognitive effects of chronic ganja use? A study such as that of Negrete and Murphy on the cognitive defects of coca leaf chewers would be of interest in this regard [ 7] .

Acknowledgements

We would like to thank Dr. Sam Street, Chief Medical Officer, Ministry of Health, Jamaica, for permission to publish this paper. We would also like to thank Dr. V. O. Williams, Dr. F. Shoucair and Dr. K. Royes for their advice and assistance in this project.

References

001

M. Beaubrun, "Treatment of Alcoholism in Trinidad and Tobago, 1956-65", Brit. J. Psychiat. 113: 643-658, 1967.

002

M. Beaubrun, "Alcoholism and Drinking Practices in a Jamaican Suburb ", Paper presented to Metropolitan Hospital, New York, June 9, 1967.

003

M. E. Chafetz, "Alcoholism", in (ed. A. Freedman and H. Kaplan) Comprehensive Textbook of Psychiatry, Baltimore, Williams and Wilkins, 1967.

004

J. Horwitz, Personal communication.

005

S. Kitzinger, "Protest and Mysticism: The Ras Tafari Cult of Jamaica ", J. Scientific Study Religion, 8: 240-262, 1969.

006

H. B. M. Murphy and H. M. Sampath, "Mental Illness in a Caribbean Community: A Mental Health Survey of St. Thomas, Virgin Islands ", Mimeographed report, 145 pages.

007

J. C. Negrete and H. B. M. Murphy, "Psychological Deficit in Chewers of Coca Leaf", Bull. on Narcotics, 19: 11-18, 1967.

008

H. M. Sampath, Personal communication.

009

M.G. Smith, Angier and R. Nettleford, The Ras Tafari Movement in Kingston, Jamaica, Kingston, Institute of Social and Economic Research, 1960.

010

M. I. Soueif, "Hashish consumption in Egypt, with special reference to psychosocial aspects", Bull. on Narcotics, 19: 1-2, 1967.