Evidence is growing of a link between cannabis and mental health problems. So what can be done to stop teenagers using the drug, asks Dipika Ghose.

Smoking cannabis may be seen by many as a largely harmless part of modern youth culture, but there is growing evidence linking the drug with mental health problems, such as depression, psychosis and schizophrenia.

And it is a link the charity DrugScope believes is more serious for young people. "Cannabis is a psychotic drug, so it would certainly have an effect on a developing brain," says a spokeswoman for the drugs information organisation.

Young worst affected

Research conducted by the University of Maastricht in the Netherlands on long-term cannabis use by 14- to 18-year-olds supports the organisation's argument. It showed that the younger the user, the more problems they developed.

But understanding and recognising the symptoms of depression could go a long way towards getting help for young people, says Dr Brian Fisher, a GP and mental health lead for Lewisham Primary Care Trust. "A lot of evidence shows a big link between cannabis smokers and depression," says Fisher. "One in four people suffer depression in the clinical sense, but a lot of young people don't really know what the symptoms are, so don't seek the right help."

He continues: "We would like to raise awareness among youth workers, Connexions workers and young people themselves of what depression is. The three messages to get across to people are don't increase your intake of cannabis or take alcohol if you feel depressed; find out how to describe depression to others; and know where to get help."

Kirstie Bogle, substance use and mental health nurse at Lewisham ARTService, which works with 11- to 18-year-olds, believes the link between cannabis and mental health is increasingly apparent. "A study of young cannabis users in Switzerland showed that those aged under 14 were four times more likely to have psychotic conditions than other young people," she says.

Bogle receives referrals mainly from youth offending teams, as well as GPs and child and adolescent mental health services. "Since I started my job in December I've already seen about 19 young cannabis users who have mental health problems," she says. "I try to engage with them confidentially and listen to what young people say. There are often a lot of underlying issues as to why they are taking drugs.Youth workers are good at engaging with young people, but it's important that the young people aren't overwhelmed and that they know where to tap into for appropriate services."

A social activity

But many young people will find it difficult to escape from a culture of cannabis smoking, according to Sally Glasson, drug worker at Plan B, a Bedfordshire project working with 13- to 25-year-olds.

"The majority roll or smoke a joint regularly and share the drug with friends, so it's often hard to break that link. For many young people, the friends they smoke with are the only support system they have," she says.

"Many of them tell us that they often have real anger issues and the drug helps calm them down. If they didn't have cannabis they worry they will not be able to handle their rage."

Last year's downgrading of cannabis from a class B to a class C drug has not produced the feared rise in young people's use of the drug. In fact, the recently published report Smoking, drinking and drug use among young people in England in 2004 by the National Centre for Social Research shows a two per cent fall between 2003 and 2004.

But the law change has caused confusion about the legality of cannabis, says Hannah Deal, youth services manager at Norfolk YMCA. "Many young people are unclear whether it is legal or not, so people are seeing it around more," she says. "There needs to be more training for drugs and mental health workers so they understand each other's side."

The challenge for youth workers, believes Glasson, is to work alongside other specialists. "Youth workers are not drugs workers, so they need to ensure they have access to other specialists to make sure young people are supported. People should not be afraid to know their limitations and use other agencies where possible."