BY TERENCE O’ROURKE, JR. M.D., MEDICAL DIRECTOR, STUDENT HEALTH
Marijuana and Adolescents – there, I hope I got your attention. Like many of you, I was seated at the recent standing room only lecture about medical marijuana on campus. Like many of you, I also squirmed through the technical difficulties, but having just studied marijuana, especially how it relates to adolescents, I squirmed more while the speaker discussed the relative safety of marijuana. Compared to the side effects and toxicities of chemotherapy and other powerful legal medications, marijuana does indeed have a safer profile in adults as we understand it in 2015, but marijuana is perhaps most dangerous when it is used by adolescents, and that message was not delivered at all on that night.
The American College Health Association released a webinar in September of 2015 – here is the link: http://www.acha.org/ACHA/Programs_and_Services/CE_Activities/Marijuana_Update_2015.aspx. This document, which is quite good, will be the source for nearly all the information I will discuss in this column.
There is growing evidence marijuana can cause substantial – and often permanent – damage to the brain if it is used heavily during adolescence, particularly in the years just after puberty. Tetrahydrocannabinol, known as THC, and Cannabidiols, known as CBD, the main active ingredients in marijuana, interact with the human nervous system via the endocannabinoid system. The endocannibinoid system is found in multiple areas of the brain, and it appears to have a major role in the development and maturation of the brain cells during and after puberty. The human brain is not finished with development until the mid-twenties; there is rapid change during and after puberty that helps the brain to work more smoothly. It appears heavy doses of THC impede this development, in some cases permanently. Daily use of marijuana is particularly problematic, but things tend to
get worse at some level over monthly use. Effects on memory may be reversible with cessation of use, but problems with concentration, problem solving and coordination, for example, may be permanent. In addition, the heavy use of marijuana is linked with further substance abuse, onset of psychiatric problems like depression and anxiety and most worrisome, psychotic illnesses like schizophrenia.
Heavy use of marijuana is also linked with addiction. There are currently more adolescents in drug treatment programs for marijuana addiction than any other drug. Marijuana is not as addictive as heroin or nicotine, but it is certainly addictive for some. Once addicted, current treatments do not work very well and relapses are common.
Early reports from Colorado, one of the first states to legalize marijuana for recreational use, show an alarming trend to increased motor vehicles accidents while driving under the influence of marijuana, including fatal crashes.
There has been an encouraging trend emerging: as marijuana use has gotten more accepted among adults, adolescents seem to be spurning it, perhaps recoiling from doing something their parents think is cool. Still, parental use of marijuana at home is one of the biggest risks for adolescent use, as are mental health problems, friends using it, academic and social struggles and cigarette and alcohol use.