Marijuana has been used by more than one in three Americans living today. Many have found that smoking a joint is as enticing and enjoyable as casually sipping a glass of wine. Some have attested to the plant’s medical properties: the MS patient who can move her limbs more freely or the parent of a child whose epilepsy seizures have been significantly curtailed.
For the majority of users, smoking marijuana is enjoyed in the mellow company of friends without causing any major problems. Most have neither crashed a car nor dropped out of school. None have suffered from the “reefer madness” caused by the “devil weed” as depicted in the alarmist film from 1936.
Yet marijuana is not a harmless drug for adolescents. It poses serious health risks in light of its increasingly high potency, impact on the teen brain, addiction potential and other physical and mental health risks. Regular marijuana use presents a significantly greater hazard for adolescents than for adults, especially before they reach the age of 18. Marijuana can affect teens’ personality and performance in school, sports and every area of their lives. The specific hazards of marijuana use by teens are discussed below.
Increased Potency of Today’s Marijuana
Tetrahydrocannabinol (THC) is the key active ingredient in marijuana that causes the high. It is found in the oil resin of the plant’s leaves and flowers. In the “old” days (fromthe ‘60’s through the ‘90’s), THC was at a 1-3% concentration (maybe 5% from some dealers). In the early 2000’s, the potency was as much as 8-10%. But in the last decade, there has been an explosion in cultivation techniques and technology resulting in genetic modifications and increased THC levels. Growers have increased the potency of marijuana in order to raise prices and gain profits.
Today it is not uncommon to see THC levels of up to 20-30%. The industry leader for 2016 (the Chiquita Banana strain) was 33% THC and this year it is likely to be even stronger. See http://cannabisreports.org/the-strongest-marijuana-strains-in-2017/ for examples of the strongest strains. In sum, the marijuana that parents may have smoked “back in the day” is nothing like today’s weed. If marijuana were like alcohol, this increase in intoxication potential would be akin to going from drinking a “lite” beer a day to consuming a dozen shots of vodka.
By contrast, modern breeding techniques have resulted in the reduction of another active ingredient, cannabidiol (CBD) - a non-psychoactive chemical which is what holds promise as medicinal treatment.
Vaping with Marijuana. Additionally, vape pens. e-cigarettes and vaporizers (desktop and portable) enable users to inhale heated liquid marijuana and hash oil concentrates. Many teens prefer these pens and e-cigarettes because they are harder to detect.
There is a multitude of personal vaping devices for marijuana: desk top vaporizers (which are not portable or discreet), portable vaporizers (which are usually small enough to fit in a pocket and are used for vaporizing dry herbs), vaporizer pens (mostly for wax and oil concentrates versus dry herbs) and e-cigarettes (mostly for vape juices). Vaping e-liquids (also known as tinctures) combine a flavor and a concentrate with pre-filled tincture cartridges. With less smell, vaping liquids is more discreet than burning herbs.
E-cigarettes also can easily be modified into an electronic pipe (e-blunt or e-joint). If dry herbs are used, a dry herb cartridge attachment is used. If vaping is in the form of THC concentrate (hash oil, wax, budder, BHO, full-melts), a concentrate cartridge or a glass globe attachment is used.
Those most likely to vaporize marijuana with e-cigarettes include males and younger students. According to a 2015 survey by Yale University published in Pediatrics, approximately 27% of high school e-cigarette users have used electronic devices for products containing THC (marijuana, honey oil, dabs, etc.). Dual use (of marijuana and tobacco) is common and initial use of any of these products increases the likelihood of future use of another.
To make these oils, butane is often used, which is highly flammable and can leave toxic solvents on the marijuana oil that is being inhaled. These concentrates contain high levels of THC. Hash oils are typically 60% THC and some concentrates have higher levels - as much as 80-90% or more.
Dabs (also known as Shatter, Wax, Earwax, Budder, Honeycomb, Honey Oil, Crumble Wax, Glob, Honey Buds) are an example of butane hash oils (BTOs).
As users develop a tolerance for THC, they can seek other drugs and bigger highs. Dabbing refers to the practice of inhaling the fumes of very strong concentrates of marijuana – usually waxes and hash oils – that have been heated.
A “how to do dabs” You Tube video, courtesy of High Times is at https://www.youtube.com/.
Edibles come in the form of infused baked goods (brownies, cookies and cake), candy (gummi bears and lollipops), and a bewildering array of other foodstuffs such as gelato, “Nugtella,” “Pot Tarts,” popcorn products and “canna-olive oil.” Marijuana can also be infused into beverages such as multi-flavored sodas.
These foods and beverages can be especially potent and are attractive to kids and to those who don’t like to smoke. Dosing is erratic and therefore the effects are unpredictable and can be dangerous. For example, with gummi bears, few kids are going to eat just the heads - which can equal one dose! Moreover, the effects are delayed with edibles so users tend to ingest more.
At a Quinceanera in San Francisco last year, 19 guests, mostly aged 18 or younger, including a 6-year old, became ill and were hospitalized after eating candy.
Combining Nicotine and Marijuana. Gaining in popularity is a “Spliff” which is a cigarette rolled with a mixture of tobacco and marijuana. This mixture produces its own high: tobacco increases the vaporization efficiency creating more available THC (the active ingredient of marijuana) so that the user feels the effects of marijuana more quickly. This results in a special kind of head rush with the tobacco stimulating adrenaline production.
Susceptibility of the Teen Brain
The teen years are the biggest period of development since the womb. Teen brains are not fully developed until the mid 20s for women and late 20s for men. Until these ages,their neurological wiring is being laid down.
Marijuana is a complex plant containing at least 85 chemicals called cannabinoids. These impact natural cannabinoid receptor sites throughout the brain and the endocannabinoid system. This affects memory and learning (the hippocampus), novelty, emotion and appetite (the amygdala), motor skills (the basal ganglia), real time coordination, selective attention and time sense (the cerebellum), reward mechanisms (the nucleus accumbens) and finally, executive functions (the cortex).
The frontal lobe of the cortex which governs executive functions (such as judgment, reasoning, impulse control, decision-making, problem solving, planning, execution, empathy, compassion and flexibility) is the last to develop. These are all mature brain functions that help teens grow into responsible adults. In other words, teens’ “GO” mechanism in the brain is more fully developed than their “STOP” mechanism. This is why a teen thinks it’s okay to smoke weed daily and does not think doing so will have an impact on their health.
Females More Susceptible
Girls appear to be most affected in terms of their brain development and stunted emotional development. A September 2014 study found that because of their estrogen hormones, females are more susceptible to the effects of THC. In the first ever study to assess gender differences in sensitivities to THC, a National Institute on Drug Abuse (NIDA) funded study found that females develop tolerance to THC more quickly and thus have increased vulnerability to negative side effects such as anxiety, panic attacks, paranoia, depression and addiction.
Previous studies also found that women were more prone to marijuana abuse and dependence and that withdrawal symptoms of irritability, sleep disruption and decreased food intake was shown to be more severe.
A 2002 study in the British Medical Journal of a longitudinal Australian study concluded that weekly use in female teenagers predicted an approximately twofold increase in risk for later depression and anxiety, and that daily use was associated with an over fivefold increase.
Marijuana is Addictive. Period.
Although marijuana is not as addictive as drugs like tobacco or heroin it affects the reward centers of the brain in the same way that other addictive drugs do. These drugs of abuse result in the brain adapting to unnatural levels of reward and stimulation from the release of more dopamine than with natural rewards like food, sex and social interaction.
THC bypasses the brain’s GABA receptors (which slowly release dopamine) and instead the brain is flooded with dopamine. This results in the brain not naturally producing the dopamine. The void in dopamine can cause depression which leads to further use.
Overall, 9% of users become addicted, but this increases to 17% (or one in six) with those who start in their adolescent years. This is because of not only their developing brains but also the speed of addiction, which is greater with adolescents. Between 20-50% of daily or near daily adolescent users get addicted. Bear in mind that many studies are outdated because marijuana product development is occurring so fast. With increasing potency, these numbers are likely to worsen.
In 2010, 4.5 million people in the United States met the criteria for abuse and dependency, as established by the American Psychiatric Association. According to the National Institutes of Health (NIH), there are more marijuana addicts in the U.S. than Americans addicted to prescription pain relievers, cocaine, tranquilizers, hallucinogens and heroin combined.
Many chronic marijuana users who attempt to go “cold turkey” experience physical withdrawal symptoms. Within three days, these symptoms begin to peak, making abstinence challenging to maintain. A Harvard neuropsychologist has noted that she has seen more physical withdrawal symptoms in adolescents in the last decade, including trouble sleeping, severe mood swings, inability to handle stress, headaches, blurred vision, nausea and flu like symptoms lasting for one week. Local treatment centers note the same increases. Note that these symptoms occur in the absence of other substances.
Moreover, it takes teens longer to recover from addiction. This is because teens don’t have the skills built up or the underlying brain foundations that help them know how to make reasonable, rational decisions.
Treatment and rehab centers across the country report that most of the adolescents they see (85%) have a marijuana use disorder where they are dependent or abusive of marijuana. In California, with medical marijuana, we have already seen a huge escalation in the number of users seeking treatment for abuse or dependence. Between 1992 and 2008, there was a near quintupling of the number of treatment admissions due to marijuana.
Decreased Functioning in School
The harm done to the educational progress are real and strong, and are even greater than the risks of addiction or the harm done to the brain. Marijuana affects learning and can destroy motivation (amotivational syndrome), interfere with memory, because loss of concentration and gradually affects self-esteem. Kids often say it makes them feel “lazy” or “dumb.” Grades drop and ambitions disappear.
Memory impairment poses is a serious consequence of chronic or long-term use of marijuana, and these effects can be experienced long after marijuana use is suspended.
One study found difficulties in verbal story memory, along with impairments in learning and working memory for up to six weeks after cessation of use. Another study found that long term heavy cannabis users show impairments in memory and attention that endure beyond the period of intoxication and worsen with increasing years of regular cannabis use.
Research shows that adolescents who smoke marijuana on weekends only, over a two-year period, are nearly six times more likely to drop out of school than non smokers, more than three times less likely to enter college than non smokers, and more than four times less likely to earn a college degree. Whether marijuana causes this is unknown but we do know there are strong effects on learning and motivation.
Loss of IQ points
Marijuana use results in cognitive deficits. A stunning landmark 2012 longitudinal 25-year study in New Zealand of 1,037 subjects showed on average an eight-point decline in IQ. Those who used marijuana persistently and heavily by age 18 and into adulthood experienced the drop at age 38. This drop is irreversible.
The IQ loss did not happen with adults: those who used marijuana frequently after age 18 did not experience a drop in IQ. The results were later re-examined (after being criticized for failing to control for socioeconomic status) and it was definitively concluded that the decline in IQ could not be attributed to socioeconomic factors alone.
Even Casual Use in Young Adults is Linked to Brain Abnormalities
A 2014 study by Northwestern University Medicine and Massachusetts General Hospital/Harvard Medical School showed that even those young adults (ages 18 to 25) who were not heavy or chronic users (some using once or twice a week) showed significant abnormalities in two key brain regions (the amygdala and nucleus accumbens). These regions are important in emotion and motivation and are also associated with addiction.
The more joints a person smoked, the more abnormal the shape, volume and density of grey matter (i.e., where most cells are located in brain tissue) in the brain regions according to MRI images. This is the first study that has been funded to research the effects of causal versus heavy use of marijuana by teens.
Adverse Socioeconomic Consequences
A recent study conducted by an international team of researchers led by UC Davis and Duke epidemiologists concluded that people who use marijuana end up with lower paying, less skilled and less prestigious jobs and experience more financial, work-related and relationship problems. Regular marijuana users ended up in a lower social class than their parents. The study looked at 947 of the participants in the 2012 New Zealand study, discussed above, who were observed over a 25-year period.
Note that these users experienced more financial difficulties than those who were alcohol dependent. The study also found that the financial, work and relationship difficulties worsened as the number of years of regular cannabis use progressed.
These issues did not arise because of prosecution or criminal records. The study observed more antisocial behavior in both work and relationships. It also found lower motivation to achieve as well as abuse of alcohol and harder drugs. The study found these problems began in adolescence, with antisocial behavior and depression and higher levels of impulsivity.
Mental Illness Risks Include Psychotic Symptoms and Schizophrenia
Numerous studies have found that marijuana can trigger mental illnesses or worsen underlying conditions such as anxiety, depression, bipolar disorders, paranoia, psychotic breaks and schizophrenia. Suicidal thoughts can also be a by-product. Studies show that marijuana increases the risks of occurrence of these mental illnesses, which are even more pronounced in those with a family history.
A wide array of studies show that the more chronic the marijuana use and the earlier in life that use begins, the greater one’s chances are of developing psychosis typified by delusional thinking or experiencing the onset of schizophrenia, characterized by a breakdown in thought processes. Even if adolescents and teens don’t become dependent (and the majority do not), it’s the alteration of brain structure and function that is at the root of mental health problems later in life.
Treatment centers such as the local Muir Wood Adolescent and Family Services report they are seeing more and more teens experiencing psychotic breaks.
Physical Health Effects of Marijuana.
Studies show that marijuana use is associated with accidents and injuries, bronchitis, acute cardiovascular events, gastrointestinal issues, and possibly infectious diseases and cancer. With the much higher THC levels in today’s marijuana, these physical health effects are likely to worsen.
Respiratory System. Marijuana smoke contains many more chemicals than tobacco smoke. The American Lung Association states on its website that marijuana smoke “contains a greater amount of carcinogens than tobacco smoke. In addition, marijuana users usually inhale more deeply and hold their breath longer than tobacco smokers do, further increasing the lungs’ exposure to carcinogenic smoke.” A wealth of medical study backs up these contentions.
New Zealand scientists determined that smoking one joint of marijuana was comparable to the effects on airflow obstruction of between two and one half and five tobacco cigarettes. Marijuana smokers hold their breath about four times longer than cigarette smokers, allowing more time for extra fine particles to deposit in the lungs.
Moreover, marijuana is packed more loosely than tobacco so there is less filtration and more particles are inhaled. Respiratory symptoms found by Yale researchers include shortness of breath, frequent wheezing, frequent phlegm and chronic bronchitis. UCLA scientists found additional effects including a potential predisposition to the development of respiratory malignancy as a result of carcinogens.
Cardiovascular System. Within minutes of inhaling marijuana fumes, a person’s heart rate increases and can double, blood vessels expand, the eyes redden and a variety of impacts on the heart and cardiovascular systems can occur.
Overdoses from Dabbing. There have been reported overdoses from passing out after dabbing. Users can inhale so much concentrated smoke at once that they pass out.
Link to Cancer. Whether smoking marijuana is a trigger for causing cancer, especially lung cancer, remains an open question. More research is needed, which is mixed on this issue. However, the evidence is increasingly tilting toward the conclusion that marijuana use can be a risk factor.
People with preexisting immune system deficiencies (for example resulting from AIDS or chemotherapy) can be more susceptible to developing cancer or a recurrence of cancer because of an enzyme that marijuana smoke contains. Another toxic chemical in marijuana smoke was found to damage a person’s DNA and increase their risk for developing cancer, according to a 2009 study by British scientists.
Combining Marijuana with Alcohol and Other Drugs
Teens often combine marijuana with hard alcohol and sometimes with pills from Molly (Ecstasy) to Xanax. The dangers are obvious. Deaths are not uncommon. In Marin, young adults have been dying from a combination of alcohol, marijuana and other drugs at an alarming rate. See September 2016 Marin Magazine article entitled “A Dangerous Game” at http://www.marinmagazine.com/.
Effect of Marijuana on Driving
Driving under the influence of marijuana is unsafe. Marijuana affects reaction time, short-term memory, hand-eye coordination, concentration and perception of time and distance. Studies show that drivers who used marijuana followed cars too closely (a sign of spatial distortion) and swerve in and out of lanes of traffic.
Yet a common misperception is that it is safe to drive high because stoned drivers are slower. Alarming rates of teen “designated drivers” abstain from alcohol but not from marijuana because of this erroneous perception. See Redwood Bark (student run newspaper) article at http://redwoodbark.org/2011/09/29/marijuana-impairs-drivers-but-does-it-endanger-them/.
In Oregon, nearly half of current marijuana using 11th graders who drive say they drove within three hours of using the drug.