The International Cannabis Survey 2018 – Kings College London

For the second year running, Kings College London (KCL) is running a survey on cannabis use (see here), the introduction explains

The aim of this study is to understand how individuals use cannabis, and what they experience when using cannabis. We are also interested in whether there are any differences between the effects of different types of cannabis and whether personality effects the experiences people have when they use cannabis

All well and good. Cannabis has been widely used in the UK for at least the past 40 or 50 years and with millions of consumers it should really be considered fairly mainstream, so the fact that we seem to know so little about it is a damning criticism of the prohibition regime which is designed to prevent the normalisation of something that is actually pretty normal.

But we are where we are and a survey designed to understand the cannabis using culture is welcome.

So I had great hopes for this survey when I first saw it last year, but when I sat down to complete it I ran into big problems. There is an address to e-mail with comments provided at the end of the survey and I listed my issues. Not one of my concerns was addressed and this year, the survey is just as bad and falls well short of achieving the aims it claims to want to achieve.

To understand why I have problems with the questionnaire it’s important to explain my experience of cannabis. I’m getting on a bit now at age 64 and no longer use cannabis, having stopped almost 15 years ago. Now when I say “I stopped”, what happened was I just lost interest in getting stoned, I didn’t stop in the way I had stopped using tobacco some time before. I have never slammed the door on future cannabis use as I had to with tobacco, I just chose not to consume any. It has to be said that overall my experience of cannabis was mostly positive over the 30 odd years of use. How typical I am I have no idea, but I know several others who have had a similar experience.

That said, I did use it for a long time having been introduced to hash back in 1973 at age 19.  Within a year or so I was a pretty much a regular joint smoker, albeit at a fairly low-level as these things go but it was enough to lead me to a tobacco habit. Before quitting tobacco in 1994 at age 40 I would consume around a quarter ounce (7 grms) a week, in later days with pure herbal that had dropped to around 3.5 grms a week or even less as a rule. In the thirty odd years I consumed cannabis of course, there were periods of heavier and lighter use, a lot happened and as a result and I have a wealth of experience I would like to share. So I was very eager to engage with the survey.

Sadly the survey is impossible for me to answer properly without giving misleading answers and it utterly failed to probe in important directions. Perhaps the best thing to do is to highlight the questions and issues that the caused the problems.

First a minor point that should have been picked up. The first page asks details about gender, age, race etc. which is fair enough, but under “race/ethnicity” it doesn’t list the usual “White British” as an option, instead I’m supposed to select “Caucasian (white)”, I doubt many people know the term “Caucasian”.

It starts oddly in that before asking anything about cannabis use it asks

Have you ever sought professional help for your mental health and well-being?

There are only two answers, yes and no and if yes, what was it?

Followed by

Have you ever been given a diagnosis of a mental health condition? 

and

Have you ever needed any treatment for your mental health? 

Which if you answer “no” to the first are pointless questions. But the point is that straight away suspicions are raised that this survey isn’t really looking for information about cannabis users’ experiences, but it’s fishing for a mental health/cannabis connection. That might be unfair but given this survey comes from KCL, well-known for its involvement in the “reefer madness” claims and the extreme sensitivity about this issue amongst cannabis users this has the subtly of a bull in a china shop and should have at least been left till later, and/or phrased a lot better.

After some questions about how and when cannabis use started page 5 offers a list of experiences and asked if they happen “rarely or never” through to “almost always”. Interestingly my answers to these are extreme, either “rarely or never” or “almost always”. I’d be interested to know how typical my responses are.

Then we are asked ‘how many times best captures the number of times you’ve used cannabis’? Well, if we assume an average of 5 times a week for 30 years we get 7,800, so I guess the “5001- 10,000” times is probably the best fit for me. That’s the almost highest option and I might actually be close to the 10,000 plus level.

I would have thought that answering this question with such a high answer would have framed the following questions a bit, but it doesn’t and this causes problems.

On page 8 we’re asked

Do you currently use cannabis? 

To which of course, I answered “No” and so I’m taken to a specific set of questions about why I stopped. Had I answered yes I would have had a page asking about experiences and I assume the questionnaire splits at this point. So they are now asking questions of someone with a 30 odd year career of cannabis use who no longer partakes. This is the point the questionnaire really fails.

Think about the six month period when you were using cannabis the heaviest. On this page the next few questions will ask you about your use based on the six months when you were using the heaviest

That is impossible to answer, I’ve had several – many(?) – periods of heavier and lighter use, usually dictated by events such as festivals, parties and so on, there wasn’t one clear six month period. There’s no way to explain this on the form, just a series of impossible questions, there wasn’t even a “why did it happen” type question which might have helped.

How old were you at this time
How often did you use cannabis in this six month period?
What was the primary method you used to take cannabis during this time?

At this point I hit a wall, although I tried hard to give some answers in truth they will be misleading at best. Is there an assumption being made that consumers start using cannabis, go through a heavy period and then never do it again, that there is only one process involved in determining what happens? Perhaps they assumed people don’t use cannabis without problems for really long periods of time?

Regarding your heaviest use: Think about the six months when you were using cannabis the heaviest. On average how much money per week have you spent on cannabis for personal use?

Back in 1973 we used to buy “quid deals” – a 1/16th ounce for £1. Last time I bought any it was £10 for the same amount and I understand it’s gone up since then. How can I possibly give meaningful figures to these questions?

Then come questions about what happened during the “six months of heaviest use”.

How many hours were you “stoned” on a typical day when you had been using cannabis?

This is just meaningless to me. It seems to assume the period of heavy use is just sitting around stoned in some sort of wasted state, probably watching daytime TV as per the stoner stereotype, whereas on the whole they were periods of great fun and social interaction for me. Cannabis use was always an adjunct to the events, not a dominant aspect of life. I was never an habitual user in the sense I think they’re assuming and I never had a six month period of unmotivated, uncontrollable heavy use. There was no opportunity to explain this.

It continues with a series of options probing supposed negative aspects of cannabis use with options from “never” to “almost daily”:

You were not able to stop using cannabis once you had started?

You devoted a great deal of your time to getting, using, or recovering from cannabis?

You did not do what was normally expected from you because of using cannabis?

You had a problem with your memory or concentration after using cannabis?

You used cannabis in situations that could be dangerous e.g. driving or operating machinery?

What they’re fishing for here is signs of addictive behaviour and it’s another example not only of being crassly unsubtle but actually having the effect of creating false results. In the world of KCL heavy use is only ever problematic, well it can be for sure, but it isn’t always like that.

Worse, they’re also missing an important effect caused by prohibition with the question about devoting time to obtaining cannabis; the need to maintain a dealer supply does involve putting some effort into keeping supplied. More about that later.

Think about the time uptil(sic) these six months when you were using the heaviest. Did you ever think about cutting down, or stopping, your use of cannabis?

“Uptil” isn’t a word incidentally, I assume they mean “before”.

Again, this implies the periods of heavier use weren’t deliberate, that it was just a spiral into addictive behaviour.  The only answers allowed are:

Never uptil these six months
Yes I had before but not during these six months
Yes I had these thoughts during these six months

This section simply didn’t relate to my experience at all and there was no opportunity to flag this up.

Then we’re asked about the type of cannabis used in the last six months of use followed by

On this page and the next we are going to ask you about your experiences of one type of cannabis that you use / have used the most. If you do not know what type of cannabis you used then write “don’t know’ in the text box below

Seriously? For years it was almost all hash of various types, then the last decade or so herbal of various types. How can I answer a question like that? Anyway, other than some home growing enthusiasts even if you think you know what you’re consuming, because of prohibition most people don’t actually have much of a clue other than it being hash or weed.

Before or after quitting tobacco? Actually this is significant. Kicking tobacco was such a huge landmark event that it had a significant effect on just about every aspect of my cannabis use, but it’s not investigated and there’s no real opportunity to highlight it. For example, my use of cannabis dropped by at least 50% as I no longer had the cravings associated with the tobacco addiction (I never smoked cigarettes). Tobacco use is understood to be a major confounding factor in cannabis use and surely questions about it should have been included in a meaningful way?

We are eventually given some small text boxes to provide what should have been essential information for a cannabis use survey

Any other types of cannabis your prefer? Please describe what kind of experiences do you have with them?

Thinking about whether your experiences have changed over the time you used cannabis please note how they changed or did not change below

If your pattern of using cannabis has changed over time – state why?

This is the sort of information I had expected the questionnaire to be investigating with proper, structured questions, I could have written a huge amount in these text fields, but what would have been the point?

Then the final killer of a question, one which is so annoying, based on false assumptions and utterly impossible to answer. I detest this question.

Each rung of this ladder (from 1 to 10) shows where a person might be in thinking about changing their marijuana use. Select the number that best matches where you are now (choose one). 

(1) I enjoy using cannabis and have decided never to reduce it. I have no interest in changing the way that I use cannabis;
(2) I never think about changing the way that I use cannabis, and I have no plans to cut down;
(3) I rarely think about changing my cannabis use, and I have no plans to cut down.
(4) I sometimes think about the way that I use cannabis, but I have no plans to cut down;
(5) I often think about the way that I use cannabis, but I have no plans to cut down;
(6) I definitely plan to change my cannabis use to cut down, but I’m not ready to make any plans about how to change.
(7) I definitely plan to cut down my cannabis use, and I’m almost ready to make some plans about how to change;
(8) I plan on using cannabis. But I’ll make some changes, like cutting back on the amount of cannabis that I use.
(9) I have changed my cannabis use to cut down or quit, but I still worry about slipping back, so I need to keep working on the changes I’ve made
(10) I have changed my cannabis use to cut down or quit and will never go back to the way I used cannabis before

All that is totally inapplicable to me, sorry.

Nowhere in this survey does it look for any impact of the prohibition policy, for me this is especially important in terms of ensuring I had a constant supply. Playing the illegal market involves always keeping in touch with dealers and always planning ahead to some extent and is a significant driving factor toward habitual use.

The real pity is it doesn’t seem to consider reasons why people choose to use cannabis, it doesn’t look for the way cannabis integrates so well in social activities or anything like that, instead it just seems to think of cannabis use as some sort of drug use with no cultural motivation, so much for the aim of understanding what “people experience when using cannabis”.

Also of course, although it’s correct to say that most of my experience of cannabis was positive of course over the 30 year period there were bumps in the road. A better designed questionnaire could have discovered something from this I’m sure.

So from  my point of view this is a huge wasted opportunity to investigate cannabis use the attitudes and experience of users. Your experiences will not be the same as mine and so I would ask everyone to take this survey, but do let the researcher know if you have problems with any of it. There is an e-mail at the end of the questionnaire.