27 Aug The Daily Telegraph Misrepresents ‘Skunk’ Cannabis Mental Health Cases With Figure of 82,000. True Figure is 1,600.
Two almost identical articles were published in The Daily Telegraph on 11th and 12th August 2017
In both articles, journalist Martina Lees wrote that:
“…hospital admissions with a primary or secondary diagnosis of drug-related mental and behavioural disorders have more than doubled over the past decade, to almost 82,000 a year. Most are believed to be cannabis-related.”
This is a combination of wildly misleading manipulation of data and brazen falsehood.
Hospital Episode Statistics are maintained in great detail by the NHS using a system of coding called ICD10 – a medical classification list by the World Health Organization (WHO). containing codes for diseases, signs and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases.
The specific code for ‘mental and behavioural disorders due to use of cannabinoids’ is F12. For the past 11 years, ‘finished admission episodes’ (FAE) for F12 have averaged 973, so the claim that most of the 82,000 are cannabis-related is simply false. (Unless of course, Ms Lees is going to claim she made a mistake.)
So where does the extraordinary figure of 82,000 come from (the exact figure is 81,904)?
Firstly, it is for all illicit drugs or ‘drug misuse’ including the following ICD10 codes:
F11 Mental and behavioural disorders due to use of opioids
F12 Mental and behavioural disorders due to use of cannabinoids
F13 Mental and behavioural disorders due to use of sedatives or hypnotics
F14 Mental and behavioural disorders due to use of cocaine
F15 Mental and behavioural disorders due to use of other stimulants, including caffeine
F16 Mental and behavioural disorders due to use of hallucinogens
F18 Mental and behavioural disorders due to use of volatile solvents
F19 Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances
Secondly, the figure is not just for primary diagnosis but for secondary diagnosis. So the primary reason for one of these cases might be a broken leg or any other medical condition. The secondary diagnosis might be that the person was high on speed or any of the drugs mentioned. The primary diagnoses for all these codes adds up to about 8,000 FAEs but the figure is inflated ten-fold by the inclusion of secondary diagnoses. Why do this? Why have the figures been presented in this way? With what purpose? After an accident, I have permanent neck and back pain. At night I can not sleep from the pain. From the family doctor, I got 10 mg. Valium. What a trait. I became very soothed and calmed, and yes, it is said to be muscle-relaxing and soothing. That is also not in the leaflet. Have more people had the same experiences?
If the whole premise of her article is about the mental health effects of cannabis, why does Martina Lees use this massively larger figure for all illicit drugs when the specific figure for cannabinoids is easily available? And if the purpose of the article is to investigate the effect of cannabis on mental health, why look at secondary diagnoses – except that it handily inflates the figure ten-fold?
Three other important points about this data:
1. ‘Finished admission episodes’ is not the same as people, its caseload, so those 1606 cases in 2015-16 almost certainly includes cases where the same person has been admitted more than once.
2. ‘Cannabinoids’ includes synthetic cannabinoids such as Spice and anyone with any knowledge of current affairs will know how problems with Spice have exploded in recent years. It is a fact that Spice is much more harmful to mental health than cannabis so the increase in F12 FAEs in recent years is almost certainly explained by this.
3. I’m not a believer in always comparing any data about cannabis with equivalent data for alcohol but it is worth noting, to put these figures into perspective, in 2015-16 the number of FAEs for mental and behavioural disorders due to use of alcohol was 44,491. As there about 10 times more people use alcohol regularly than cannabis, that means anyone is nearly three times as likely to be admitted for ‘alcohol psychosis’ as ‘cannabis psychosis’.
I have written to Martina Lees asking her to comment on this data and explain why she has used it in such misleading fashion.