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A sample of 524 young drug addicts consecutively treated at a special hospital ward has been followed by registers for an average of 10 years. A total of 62 were found to have died drug-related deaths at an average age of 28 years; 19 of them had committed suicide. Representativeness of the sample is investigated. Sex and choice of drugs were predictive factors behind fatal outcome: male opiate addicts died 5.4 times and male amphetamine abusers 2.5 times as often as expected. The males were exposed to greater risk than the females. Those who committed suicide had an hereditary disposition for mental disturbances, especially affective disorders. Lethal substances proved to be opiates, barbiturates and alcohol and/or other psychotropic preparations. Signs of heart disease were often found in the overdose cases. Most of the addicts who died were in a compulsive stage of the drug career, but some were abstaining or trying to abstain from drugs. A critical period seems to be at 26-28 years of age, a period when the abuse seems to be most intense and compulsive, the suicide risk is high and the efforts to abstain from drugs most serious and hazardous.

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That cannabis use may provoke mental disturbances is well known to Scandinavian psychiatrists today. A review of the psychiatric aspects of cannabis use is given, and the clinical signs of 70 cases of cannabis psychoses collected in Sweden are described. The bluntness and "amotivation" following chronic cannabis use are discussed. Anxiety reactions, flashbacks, dysphoric reactions and an abstinence syndrome are all sequels of cannabis use. Three risk groups begin to emerge: a) Young teenage cannabis users who lose some of their capacity to learn complex functions and who flee from reality to a world of dreams. With its sedative effect, cannabis could modify such emotions as anger and anxiety and slow down the liberation process of adolescence. b) Heavy daily users, often persons who cannot cope with depression or their life circumstances. c) Psychiatric patients whose resistance to relapses into psychotic reactions might be diminished according to the psychotropic effects of cannabis.

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