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Book Review

Marijuana and Madness, 2nd ed

Thomas J. Riordan, MD

Published: August 15, 2013

Marijuana and Madness, 2nd ed

edited by David Castle, Robin M. Murray, and Deepak Cyril D’ Souza. Cambridge University Press, New York, NY, 2012, 240 pages, $90.00 (hardcover).

You may have noticed during the last national election that some of the country was caught in the grips of a cannabis frenzy neatly summarized in the title of this book, Marijuana and Madness. Legislative activity in 24 states and the District of Columbia now allows for either medical marijuana use, decriminalization of some possession, or both.1 The public health and clinical implications of such activity should, therefore, be of equal or greater concern. While the legal status of marijuana products is not the focus of this publication, the resulting rising public interest in Cannabis sativa has associated grave mental health consequences. This book endeavors to explore the possibility of such consequences from a scholarly and scientific perspective.

In this second edition, editors Castle, Murray, and D’ Souza compile 21 chapters from 49 global contributors. Represented are researchers and clinicians from locations spanning the United Kingdom to the United States and Australia as well as France, Germany, Israel, the Netherlands, and Spain. Having contributors from diverse locations and backgrounds allows for the exploration of marijuana availability through a nuanced and objective global lens. Attempting to survey the range and depth of this topic in a concise manner, the book weaves together this vast collection of information with a functional purpose.

Early chapters delve into the known elaborate neuroanatomic setting and receptors of the cannabinoid system. Later chapters cover short- and long-term effects of chemicals such as tetrahydrocannabinol (THC) on the endocannabinoid system. Evidence of how these chemicals impact the brain is culled from animal and postmortem human studies as well as epidemiologic data. Several chapters focus on the role cannabis plays in clinical syndromes, such as its impact on neurodevelopment, cognition, depression, and bipolar disorder, yet greater attention and emphasis are given to the growing understanding of a link between cannabis exposure and psychosis. Another chapter dedicates 20 pages to the public health concern of increasing marijuana potency, which worldwide has shown "at least a 2-fold increase in THC content compared with pre-2000 products" (p 51). Missing, however, from any of these discussions is the potential liability implications for a government entity that liberalizes access to a drug with such known psychomimetic and clinically deleterious properties.

For colleagues in the mental health field, and in particular those specializing in addictions, this text can serve as an up-to-date and comprehensive reference. Moreover, before moving ahead on marijuana-related legislation, any governor, lawmaker, or physician with "medicinal" inclinations—as well as the general public—would be well-advised to become familiar with the contents of this book.


1. US Department of Transportation/FAA. Advanced HIMS Seminar; April 15, 2013; Herndon, Virginia.

Thomas J. Riordan, MD

Author affiliation: Widener University, Chester, Pennsylvania.

Potential conflicts of interest: None reported.

J Clin Psychiatry 2013;74(8):e781 (doi:10.4088/JCP.13bk08679).

© Copyright 2013 Physicians Postgraduate Press, Inc.

Volume: 74

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