Is Marijuana a Safe Drug?

October 8, 2016

We all know individuals who have been able to use marijuana and be happy, successful and productive members of society. The precise proportion of users who fall into this category is not known, but what is clear is a substantial percentage of people cannot use marijuana with impunity. Unfortunately, you can’t tell ahead of time who that is going to be. There is no genetic test, no psychological profile, no family history screening that is reliable.

The question becomes not how many fatalities does use of marijuana cause, but can a young person use it occasionally, i.e. “responsibly,” like having a single beer once a month or once a week, and be sure that they’ll be O.K.? The answer is no, particularly in regards to psychotic outcomes. Some individuals experience acute psychosis after their first use.

1) Psychosis: hundreds of peer-reviewed, scientific articles show a correlation between marijuana use and psychotic outcomes such as schizophrenia, too numerous to list here. The question of whether marijuana is causal for psychosis has been answered in the affirmative by applying standard principles of causation used in pharmacological and epidemiological research:

 Dose response effect, so that heavier use of more potent product results in more users developing schizophrenia(Zammit et al., 2002; van Os et al., 2002; DiForti et al., 2009; DiForti et al., 2015)
 Administration of the active ingredient (∆9-THC) in the clinic under controlled conditions causes psychotic symptoms (D’Souza et al., 2004; Morrison et al., 2011; Bhattacharyya et al., 2011; Freeman et al., 2014).
 Self-medicating is not that likely, because many will try to quit to avoid the psychotic symptoms before they become too impaired (Fergusson et al., 2005), e.g. comedian Seth McFarlane; but for others it may be too late (as seen in The Other Side of Cannabis, Heartsgate Productions, 2015).
 Marijuana use generally comes before the psychosis, not vice-versa (Arseneault et al., 2002; Henquet et al., 2005; Kuepper et al., 2011).
 In users who have schizophrenia, the age of onset is earlier than for non-users, similar to the effect of carcinogens in causing an earlier onset of a suite of cancers (Veen et al., 2004; Barnes et al., 2006; Large et al., 2011)
 Of all recreational drugs, marijuana use is the most likely to result in chronic psychosis (Niemi-Pynttari et al., 2013).

What percentage experience a psychotic outcome? The low to moderate-strength marijuana available in the last century was shown to trigger single psychotic symptoms (paranoia, racing thoughts, delusions, hallucinations) in 12% to 15% of users (Thomas, 1996; Barkus et al., 2006; Smith et al., 2009). Of those with such “prodromal” symptoms, about 35% can be expected to develop full psychosis, i.e. a constellation of symptoms occurring at once (Cannon et al., 2008). For about half of these individuals, conversion to chronic schizophrenia spectrum disorder occurs irrespective of family history (Arendt et al., 2008; Niemi-Pynttari et al., 2013).

The result for low to moderate-strength marijuana was about a 2.5-fold increased risk of schizophrenia, but for the high strength product available today, the risk for schizophrenia is 5-fold compared to non-users (DiForti et al., 2015). That increase in risk translates into about one out of every twenty users if they don’t quit in time. Is this impact limited to adolescence? Given that the brain continues to develop in males through the late twenties (see figure on back), it seems unlikely that the risk for chronic psychosis is limited to adolescent users. Furthermore, administration of THC to adults in a clinical setting results in psychotic symptoms (D’Souza et al., 2004; Morrison et al., 2011. Bhattacharyya et al., 2011; Freeman et al., 2014).

Other Adverse Psychological Outcomes

2) Risks for anxiety, panic, and depression are increased by marijuana use: Zuardi et al., 1982; Thomas, 1996; Patton et al., 2002; Dannon et al., 2004; Hayatbakhsh et al., 2007; Medina et al., 2007; Hasin et al., 2008; Zvolensky et al., 2010; Fairman and Anthony, 2012; Silins et al., 2014; Cougle et al., 2015; with some studies showing that correction for confounding variables lessens the association with anxiety and depression, while others report the effect remains. For a review see: Miller CL, The Impact of Marijuana on Mental Health in: Contemporary Health Issues on Marijuana (Winters KC and Sabet K, eds), Oxford University Press, in press.

3) Risk for suicidal ideation is increased on average 7-fold: Arendt et al., 2006; Silins et al., 2014; Kvitland et al., 2016 , even after correcting for a prior history of depression: Clarke et al., 2014. In 2014 (the report specific for 2015 data is not yet available), the 2nd year after legalization of recreational use of marijuana, Colorado experienced the highest suicide rate in state history: “In 2014, there were 1,058 suicides among Colorado residents and the age-adjusted suicide rate was 19.4 per 100,000. This is the highest number of suicide deaths ever recorded in Colorado.” Office of Suicide Prevention Annual Report 2014-2015, Colorado Department of Public Health and Environment.

Particularly alarming, the Colorado media has reported sudden onset suicidal ideation or completed suicide in consumers of commercial edibles: Levi Thamba Pongi, Denver, 2014; Richard Kirk, Denver, 2014; Luke Goodman, Keystone, 2015, but also reported following the smoking of potent marijuana: Brant Clark, Boulder, 2007; Daniel Juarez, Brighton, 2012. (Editor’s note: In Seattle, 16-year-old Hamza Warsame jumped six floors to his death after smoking marijuana in December, 2015.) These responses can happen so quickly in individuals who were not previously suicidal that intervention may be impossible.

4) Lack of educational achievement and decreases in motivation – after covariate adjustment, the odds for marijuana users completing high school are reduced to about 0.37-fold that of controls (Silins et al., 2014); accounting for demographics and other factors, marijuana use adversely affected college academic outcomes, both directly and indirectly through poorer class attendance (Arria et al., 2015); decreases in motivation with marijuana use have been documented in clinical studies of humans (Bloomfield et al., 2014) and in animal models (Silveira et al., 2016).

5) Negative impacts on IQ: up to an approx. 7 point drop in IQ from childhood scores by age 38 in marijuana users who have been abstinent for 24 hours prior to testing; but only an approx. 5 point drop in those abstinent for a week prior to testing (Meier MH et al., 2012); a subsequent study of twins by Jackson et al., 2016, yielded mixed results, with an average decline of 4 points in marijuana users by late adolescence, however restricting the comparison to the matched twins (thereby controlling for genetics and a myriad of environmental factors), the effect of marijuana largely disappeared. The limitation of this later study is that brain development is not complete by late adolescence, particularly the wiring of the all-important cortex is still ongoing through the late twenties (see Figure below). There is no controversy, however, about the negative, real-time impact of marijuana use during tests of cognition and memory: Curran HV et al., 2002; Ranganathan and D’Souza, 2006; Morrison et al., 2009; Solowj et al., 2010; Pavisian et al., 2014.

By Christine Miller, Ph.D., for Moms Strong. Dr. Miller also wrote Ten Myths Marijuana Advocates Want You to Believe.

See 10 Myths Marijuana Advocates Want You to Believe for complete information, footnotes and the bibliography

Addiction, Gateway Drug

5 Reasons Marijuana is a Gateway Drug

September 26, 2016

Student Asked Attorney General if Marijuana is a Gateway to Heroin

When Attorney General Loretta Lynch went to Kentucky last week to address the heroin epidemic, a high school student asked if marijuana is a gateway to heroin addiction. The Attorney General never denied that marijuana may have an influence, but she drew a closer connection to the overuse of pills. The marijuana lobby claimed she said ‘marijuana is not a gateway drug.’ Her implication was that opiate pain pills may have the most direct link and immediate link to heroin addiction. (Heroin is cheap right now and it’s harder to get opiate pain pills.)

Certain biologists, addiction specialists, ONDCP director Michael Botticelli and parents are most capable of answering this question. Traditionally marijuana, alcohol and tobacco are considered gateways to other drugs. Under many circumstances, teen marijuana experimentation leads to the usage of other harmful drugs, including those that cause toxic overdose. Scientific studies on the drug have shown its ability to damage brain circuitry. It numbs the reward system, sending users on a search for a stronger high. Peer influence or personality traits can spiral into the use of drugs beyond marijuana. Here are some reasons why marijuana tempts someone to open the gate and try other drugs.

Marijuana advocates dismiss the gateway “theory,” but they also deny that marijuana affects different people very differently. It is not part of their agenda to accept or acknowledge these differences.

1. Biological Evidence and Plateau Effect:

Studies showing the damaging effects marijuana has on dopamine receptors and our brain’s reward system suggest marijuana may lead to the use of many other different drugs. In one study done by the University of Michigan Medical School, researchers found a negative correlation between the amount of marijuana consumed over time and the amount of dopamine that was released in the brain in response. This study suggests a change in the reward system over time with a high-inducing drug like marijuana. This decrease in the amount of dopamine released creates a plateau effect. Smokers will then seek other drugs in order to achieve the high they used to experience with pot.

The National Institute on Drug Abuse says cannabinoids are able to decrease the reactivity of brain dopamine reward circuits over time, leaving frequent marijuana users vulnerable to other drug addiction. Additionally, THC promotes an enhanced response to other drugs in the same way that alcohol and nicotine do, which may lead to the progression of more drug addictions that may cause toxic overdose.

2. Social Environment:

It is important to consider the pot smoker’s social environment. Most high schoolers now say it’s easier to get marijuana than alcohol. Those who begin using pot and alcohol, usually the first two illicit substances of abuse, are likely surrounded by other frequent users. In no time some of these peers will have moved on to chasing other highs. If your teen is already high on pot or inebriated — even slightly — it’s hard to resist the invite from a friend to try another substance. A teen who has resolved to do “only pot” can quickly break down and try other drugs when he or she has lost inhibitions.

3. Craving the High:

Marijuana, alongside alcohol, is one of the most accessible high-inducing drugs on the market, making it a gateway drug to intoxication. Jon Daily, an adolescent and young adult addiction specialist in California explains that he and his colleagues treat drug addicts who were always first addicted to marijuana and/or alcohol. In his practice, over-prescribing by doctors did not cause the problem. Jon contends that it is not necessarily the substance that people get hooked on that is really important. (Please take note that the price of heroin is so low right now. ) “Addicts are hooked on intoxication,” so it makes sense that those who become opiate or heroin addicts began with marijuana because it was the most readily available drug which later lead to their pathological relationship to getting high. Daily does mention a very small portion who get addicted because they were given pain pills after surgery, but these people are the exception.

4. Childhood Trauma or Sexual abuse can lead to marijuana use to numb the pain, typically followed by stimulants:

Our children who grow up in poverty or who are victims of abuse can be most at the most risk. It is one reason that Parents Opposed to Pot always recommends counseling over drug usage for victims of trauma and asks that parents, schools and communities be supportive. Victims of trauma will initially use marijuana and alcohol to create a numbing effect, and to allow disassociation. When the numbing is too much and the victims need to feel energized and alive again, stimulants such as as speed, cocaine and opiates would be used. It’s a vicious cycle. (Of course this cycling is not limited to trauma victims; it is the type of cycling that Lady Gaga describes also.) Marijuana and heroin have the greatest numbing effect, according to one paper on the subject. Read Janina Fisher’s paper on Traumatic Abuse and Addiction.

Substance abusing parents can be violent and neglectful. It is in this way that many young people and people whose parents were substance abusers become addicted themselves. (There is much more to drug abuse than addictive genes.) Today multi-substance abuse or addiction is the norm.

5. Impoverished communities are preyed upon by gangs who will use multiple drugs:

Children of poverty are also at risk. One of the most prevalent subcultures in this country is that of drug dealing gangs. Gangs prey on poor and minority communities. (Marijuana stores seem to be following that example.) These gangs use intimidation and violence to enforce their rule and make their money. They often appear to be the leaders in their communities who have the most money and power. Check out the story of one man, Eddie Martinez, who grew up in the Chicago projects. He managed to overcome a life of drug dealing and crime. Today he advises young people to steer clear of the dangers of marijuana, drugs and its victims.

Other Gateway Drugs or Reasons for Addiction?

What about ADHD drug usage and Addictive personalities?

For some people, marijuana use a one-time event, or something only used occasionally. There are others who can’t seem to stop, for whom marijuana is an addiction. Yet some writers and theorists discard the larger society’s expectations that teens will use drugs plays a roll in addiction.

Addiction counselors notice that a large number of young people who show up for treatment were diagnosed with ADHD. Those who were given Ritalin, Adderall or other stimulant drugs also have a high potential to abuse marijuana. However, we do not know if these young people become addicted because of the ADHD or because these youth have brains that had already been altered by the ADHD drugs at a young age. Government and educators would be wise to come up with an alternative to using powerful mind-altering drugs for those who have difficulty concentrating.

Another theory is what is known as an addictive personality. Especially males, who are often considered “risk-takers,” have a greater chance of becoming addicts when they are willing to engage in extreme behaviors. So while marijuana presents itself as a gateway drug to many, the risks to an individual depends their personal choices.

THE RELATIONSHIP to ADHD drugs and marijuana, opiate and heroin abuse, as well as the roll of addictive personalities in this epidemic needs to be studied further.

(Your child or teen is at risk for developing three other negative outcomes from marijuana experimentation: addiction to marijuana, loss of mental abilities and/or mental illness.)

NOTE: Teen tobacco use has gone way down, as fewer adults smoke. There is nothing fashionable about it at this time. However, adult marijuana use is growing and a corresponding growth in youth usage can be expected. It is just as the marijuana lobby hopes.

Colorado, Testimonies

I Wish We Had Never Moved Here…..

September 19, 2016 Leave a comment

Born in Massachusetts, our son started out life with a very bright future. As a toddler he was interested in things with wheels, and anything his big sister was doing. As he got older, Legos was his obsession. In his early school days he tended to get really into a subject, even those of his own choosing. For a while it was Russian language and then it was the Periodic Table. He begged me to buy him a 2½-inch thick used Chemistry textbook before he was a pre-teen. I did.

I was able to be a stay-at-home parent until our son was 8. I tried to do all the right things. We played outside, limited screen time, and got together with other little ones and their moms for play groups. I read to him and his sister every night until they both reached middle school and wouldn’t let me anymore. Our son routinely tested in the 99^th percentile on standardized tests and at least 3 grade levels above. Now, at age 17, he has dropped out of high school.

My husband and I both have Master’s degrees, and my husband is a public school administrator. His father is a retired architect. My mother is a retired elementary school teacher. Our family believes in education, we believe in learning and growing. When asked why he continues to use drugs, mostly marijuana, my son said, “I think it’s because of the people we’re around.”

In reflecting back on “What happened?” I blame marijuana. We now live in Colorado, where marijuana is legal and widely available to everyone. What if we had never moved here?

How it All Began

My son’s first time using was in 7^th grade when marijuana was legal only if used medicinally with a “Red Card,” if recommended by a physician. Coloradans voted on legalization in November 2012 and marijuana stores opened in January, 2014. But back in 2012, he and some buddies got it from a friend’s older brother who had a Red Card. From what I can tell, the use just kept escalating until his junior year in high school when he was using at least once a day…and when he attempted suicide.

Between that first incident in 2012 and the suicide attempt in 2015, his father and I waged an all-out battle on the drug that was invading our home. We grounded him; I took to sleeping on the couch outside his bedroom because he was sneaking out in the middle of the night; we yelled and screamed; I cried, we cajoled and tried to reason with him: ”You have a beautiful brain! Why are you doing things that will hurt your brain?”

We did weekly drug tests, we enlisted the school’s support, we enlisted our family’s support and we even tried talking to his friends.

But nothing worked. Our son was in love with marijuana. Our sweet, smart, funny, sarcastic, irreverent, adorable boy was so enamored with this drug that nothing we did — NOTHING — made any difference. And we slowly lost him.

At the same time I was battling marijuana at home, I was also leading a group in our community to vote against legalizing it in our small town. I had teamed with a local business-owner and a physician and the three of us got the support of many prominent community members, including the school superintendent, the police chief, and the fire chief. We ran a full campaign, complete with a website where you could donate money, a Facebook page, and yard signs.

Tokingparents — Why does he continue to use marijuana? “I think it’s because of the people we’re around.”

My son’s use isn’t the reason I got involved. I had started advocating against marijuana legalization long before I even realized he had a problem. My background is in health communication and I work in the hospital industry. I sit on our local Board of Health, so allowing retail stores to sell an addictive drug just doesn’t make any sense. I did think about my children; what I was modeling for them; what kind of community we were raising them in, and the kind of world I envisioned for their future. Those are the reasons I got involved. My son’s use is actually the reason that I’ve pulled away from any sort of campaigning.

Unfortunately, we lost our fight. So in 2014, it became legal in our small town to purchase pot without a Red Card. And the following year, his junior year, he almost slipped away from us forever.

It Got Scarier and Scarier

His use by then had escalated to daily (and I suspect often more than once a day). Pot seemed to be everywhere! We found it hidden all over the house — in the bathroom, on top of the china cabinet, in his closet, outside, even in his sister’s bedroom. It’s a hard substance to hide because of the strong smell. Even in the “pharmacy” bottles and wrapped in plastic bags, the skunk stench still manages to seep out. But it sure seemed easy for a young boy to get!

He started leaving school in the middle of the day, or skipping school altogether, and his grades plummeted. Where he was once an A/B student and on the varsity cross-country team, he was now failing classes and not involved in anything. This boy who had tested in the 99^th percentile was failing high school. And this boy who had once been the levity in our home, who used to make me laugh like no one else could or has since, this boy became a stranger.

Our son withdrew from everything except his beloved drug. His circle of friends (never big in the first place), was reduced to only those who could supply him with marijuana. His relationship with his older sister all but disappeared. And his relationship with his father has been strained beyond almost all hope of repair.

Then in late 2015 our son attempted suicide. He was hospitalized, first overnight at the very hospital where I work, and then for a 3-day locked psychiatric unit stay. I remember very little from this difficult (and surreal) time except learning that it wasn’t his first attempt, and that he blamed us for how awful he felt. He started taking an antidepressant and after he was released we took him to a drug counselor for a total of three visits but after that he refused to go — he threatened to jump out of the car if we tried to take him. We tried a different counselor and that only lasted for one visit.

Changing Strategies and a Truce

At this point I convinced my husband that we had to approach things differently, because obviously what we were doing wasn’t working. We stopped the weekly drug tests (we knew he was using so there seemed to be no point anyway). We stopped yelling and punishing. And basically my husband stopped talking to our son altogether — they are both so angry and hurt that any communication turns toxic very quickly. He refused to go back to school so we agreed that he could do online classes.

wreckedmyself — More and more, our son is feeling isolated from the rest of his family.

There is an uneasy truce in our home right now. Now it just feels like waiting. Waiting for what will happen next. Waiting for the other shoe to drop.

Our son, 17, still lives with us. His sister left for college this past summer. I acknowledge that he uses pot and doesn’t want to quit, but I continue sending the message that it’s not good for his brain. The one thing my husband and I won’t bend on is no drugs on our property. He has started five different online classes, but has so far finished only one. He doesn’t feel any pressure to finish school — he says he’ll get a GED, but hasn’t made any effort towards that end. He doesn’t drive and doesn’t express any desire to learn, which is probably good because I doubt he could be trusted to drive sober. He started working at a local restaurant recently and has been getting good feedback from his managers, which I take to be a positive sign. (I’ll take any positive signs at this point!)

Trying Something Else and Blacking Out

I don’t know if the suicide attempt and hospitalization were rock bottom for our family, but I suspect not. Just this past weekend our son came home and I could tell he was on something — and it wasn’t marijuana or alcohol. I checked him periodically throughout the night and in the early morning he was awake and asked me how much trouble he was in. I replied that it depended on what he had taken. He said Xanax. He also said that he had blacked out and couldn’t remember anything that had happened from about an hour after he took it.

Later in the morning, when we were both more awake, I asked him about the Xanax (he got it from someone at the restaurant) and the pot use and what he saw for his future. He has no plans to stop using, but said that he probably wouldn’t take Xanax again (he didn’t like blacking out). He said that he’s very happy with his life right now, that he knows a lot of people who didn’t go to college who work two or three jobs and live in little apartments, and that he’s happy with that kind of future for himself.

I tried not to cry. Imagine that as the goal for a boy who started life with so much curiosity and such a desire to learn.

It’s not that I don’t think he can have a good and decent life without a college education. But I know that he’ll have a much harder life. Statistically, Americans with fewer years of education have poorer health and shorter lives (partly due to lack of adequate health insurance), and Americans without a high school diploma are at greatest risk. It’s not just life without a college education, but it is life with a brain that has been changed by marijuana. Will he be able to give up pot? If he does give up pot, will he recover the brain he had at one time? Will he lose motivation?

I asked him why he used pot when he knew how his father and I felt about it and when we had tried so hard to steer him in a different direction.

He said: “I think it’s because of the people we’re around. And all the drugs that are around.”

I’ve finally accepted that his use is not in the range of normal teenage experimentation, and I’m barely surviving on the hope that he’ll eventually grow out of it…and that he doesn’t do any permanent damage. In the meantime, I’m sorry that we ever moved here.

Testimonies

My Daughter Was Murdered for Weed

September 14, 2016

By Anonymous from Maryland I support your organization and everything that you are doing. Thank you for your work to protect children from the drugs and drug dealers.

My 17-year-old daughter was murdered, in a murder-for-hire scheme because someone thought she set up a drug robbery. The killer was paid in marijuana because the killer had a fix. He needed his weed. The person robbed testified that the killer was paid in $400 cash and $200 of marijuana.

Testimony indicated that my daughter did not rob anyone.

(The murder took place in 2005; the murderer is up for parole next year.)

We wonder why marijuana legalization advocates say: “Legalize to free police for more serious crimes.” Note the following: *Since marijuana was legalized in Colorado, prosecutors have noticed an increase in murders motivated by marijuana. *Humboldt County, California, principle pot-growing region of the USA, has a murder rate that far exceeds national averages. *On the first day of legalization in Washington state in 2012, two people were murdered when they tried to steal a marijuana grow. *More recently, the murder of 8 family members in southern Ohio revealing a marijuana growing business.