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My husband and I recently attended a community discussion about the drug use by young people in our community. While everyone was in agreement that heroin use is dangerous and must be addressed, the opinions about the use of marijuana were all over the map. Some parents expressed that it was just typical teenage behavior to do a little experimenting (as they admitted they did in their youth), some expressed that they knew "productive adults in the community that still smoke pot" and some were dead set against any drug or alcohol use.
-The direct negative health effects of smoking marijuana are not as significant as the risk for dependence.
-Marijuana use is considered a "gateway" to the use of other substances, as well as to other high-risk social behaviors such as unprotected sex.
-Although marijuana may induce cough and wheeze to a degree similar to tobacco, the estimated amount of marijuana required to promote chronic obstructive pulmonary disease is 4 to 5 joints per day for approximately 30 years.[3]
- Marijuana is a potential carcinogen for the respiratory tract and has known mutagenic effects. However, its relative effects in promoting tumor growth remain unclear.
-Cannabis dependence has been recognized and defined as a diagnosis by the Diagnostic and Statistical Manual, Fourth Edition, Text Revision (DSM-IV-TR), but estimations of the prevalence of cannabis dependence vary widely.[4] Two large studies found the prevalence to be 8% to 10% among young people in New Zealand and Germany.[5]
- In one study, weekly marijuana use was independently associated with a higher risk of leaving school early.[6] Another study found that increased marijuana use was correlated with a lower likelihood that a student would enter university or obtain a university degree.[7] In the latter study, there was no evidence of reverse causation, that is students who had lower educational achievements were not more likely to smoke marijuana.
-In a 25-year longitudinal study, the use of marijuana was associated with a higher risk for the use of other illicit substances, even when accounting for potential confounders that also increased the risk for drug abuse.[8] The gateway phenomenon was particularly strong during adolescence. Another study found that only 5.2% of participants who reported using illicit drugs deviated from the standard pattern of initial alcohol and tobacco use, followed by marijuana use, and eventual use of other illicit drugs.[9]
What Has Been Shown To Help Decrease Teen Marijuana Use:
-Brief interventions can have an impact on marijuana use among adolescents. In a small study, 2 sessions using motivational interviewing techniques resulted in a significant reduction in the number of days of marijuana use as well as a reduction of symptoms of marijuana dependence compared with a control intervention.[11]
-More intensive interventional approaches may yield better results for adolescents who smoke marijuana. The Cannabis Youth Treatment study found that 5 sessions of motivational enhancement therapy (to strengthen the motivation to change) along with cognitive behavioral therapy (to teach skills to reduce or eliminate the use of marijuana) were effective in improving the number of days of abstinence as well as the number of adolescents reporting no use of illicit drugs.[12] Adding 7 more therapy sessions (for a total of 12 sessions) failed to further improve study outcomes, nor did the addition of family therapy.
References:
- Compton WM, Grant BF, Colliver JD, et al. Prevalence of marijuana use disorders in the United States: 1991-1992 and 2001-2002. JAMA. 2004;291:2114-2121. Abstract
- Kuntsche E, Simons-Morton B, Fotiou A, et al. Decrease in adolescent cannabis use from 2002 to 2006 and links to evenings out with friends in 31 European and North American countries and regions. Health Behavior in School-Aged Children Study. Arch Pediatr Adolesc Med. 2009;163:119-125. Abstract
- Van Hoozen BE, Cross CE. Marijuana: respiratory tract effects. Clin Rev Allergy Immunol. 1997;15:243-269.Abstract
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC: American Psychiatric Association; 2000.
- Kalant H. Adverse effects of cannabis on health: an update of the literature since 1996. Prog Neuropsychopharmacol Biol Psychiatry. 2004;28:849-863. Abstract
- Lynskey MT, Coffey C, Degenhardt L, et al. A longitudinal study of the effects of adolescent cannabis use on high school completion. Addiction. 2003;98:685-692. Abstract
- Fergusson DM, Horwood LJ, Beautrais AL. Cannabis and educational achievement. Addiction. 2003;98:1681-1692. Abstract
- Fergusson DM, Boden JM, Horwood LJ. Cannabis use and other illicit drug use: testing the cannabis gateway hypothesis. Addiction. 2006;101:556-569. Abstract
- Degenhardt L, Chiu WT, Conway K, et al. Does the "gateway" matter? Associations between the order of drug use initiation and the development of drug dependence in the National Comorbidity Study Replication. Psychol Med. 2009;39:157-167. Abstract
- Morral AR, McCaffrey DF, Paddock SM. Reassessing the marijuana gateway effect. Addiction. 2002;97:1493-1504. Abstract
- Martin G, Copeland J. The adolescent cannabis check-up: randomized trial of a brief intervention for young cannabis users. J Subst Abuse Treat. 2008;34:407-417. Abstract
- Dennis M, Godley SH, Diamond G, et al. The Cannabis Youth Treatment Study: main findings from two randomized trials. J Subst Abuse Treat. 2004;27:197-213. Abstract
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