September 19th, 2022
Marijuana Use: Past-year, past-month, and daily marijuana use (use on 20 or more occasions in the past 30 days) reached the highest levels ever recorded since these trends were first monitored in 1988. The proportion of young adults who reported past-year marijuana use reached 43% in 2021, a significant increase from 34% five years ago (2016) and 29% 10 years ago (2011). Marijuana use in the past month was reported by 29% of young adults in 2021, compared to 21% in 2016 and 17% in 2011.
Daily marijuana use also significantly increased during these time periods, reported by 11% of young adults in 2021, compared to 8% in 2016 and 6% in 2011.
Vaping: Nicotine vaping in the past month increased significantly among young adults in 2021 despite leveling off in 2020 during the earlier part of the pandemic. The continued increase in 2021 reflects a general long-term upward trend: in 2021, nicotine vaping prevalence nearly tripled to 16% compared to 6% in 2017, when the behavior was first recorded.
Prevalence of marijuana vaping in the past month among young adults had significantly dipped in 2020 but returned to near pre-pandemic levels in 2021. Since 2017, when marijuana vaping was included in this study, past-month prevalence has doubled – from 6% in 2017 to 12% in 2021. (NIH News Release)
Knowing this statistical reality, is marijuana safe for use in teens since clearly the use is occurring?
The American sentiment continues to shift to an "it is safe" feeling, especially out in the wild west. When it comes to drugs that affect the brain, we have to be very careful to conclude this on a population level. What happens in adults is vastly different than what happens in teens. The age of the user matters alot. Consider the vaping debacle of the last few years when pondering safety. Easy access can explode use and therefore increase the risk of a subset of teens having negative outcomes.
At any one time during adolescence, 10-20% of teenagers will suffer a mood disorder like anxiety or depression that is often self medicated with drugs. College students have to leave school every year secondary to psychological breaks that are induced by drug use including marijuana. I witnessed this first hand as I went to a very small school and things of this nature were hard to hide.
For me, the biggest concern with recreational drug use has always been the long term effects on the young mind. In the December 2017 edition of Scientific American, there is an article entitled Marijuana and the Teen Brain. It is a good read and I encourage you to read it. As author, Claudia Wallis, points out, parents have been warning teens away from drugs for centuries only for teens to hide in the woods and smoke before school with a smile. And yes, I do remember the high school students, "burnouts" we called them, who hid in the woods smoking daily behind my school.
Studies have shown that marijuana users have worsened attention, memory and learning. We know that some users can become delusional and even have psychotic breaks. What we do not know is who will and who won't. Some college students appear to be able to smoke often and remain fully functional as they are able to graduate and hold gainful employment. Whether they suffered weakened attention and memory would only be known with a pre and post assessment.
In states that have legalized marijuana use, there has been a 0.5% increase in HS dropout and a 2% decrease in college enrollment. That is a lot of children when you look at the number of states that have legalized marijuana and the volume of students overall.
Evidence seems to point to safety for use in adults where the brain is not growing and changing. In a meta analysis from 2012, the authors noted that after 25 days off of the drug, the users had no difference in cognitive function versus the non users. (Schreiner et. al. 2012)
Not so much for teen brains!
"For one thing, recent studies show that cannabinoids manufactured by our own nerve cells play a crucial role in wiring the brain, both prenatally and during adolescence. Throughout life they regulate appetite, sleep, emotion, memory and movement which makes sense when you consider the effects of marijuana. There are "huge changes" in the concentration of these endocannabinoids during the teenage years, according to neurologist Yasmin Hurd of the Icahn School of Medicine at Mount Sinai, which is why she and others who study this system worry about the impact of casually dosing it with weed." (Wallis 2017)
The body actually makes similar substances naturally all the time. There are receptors in the brain for this family of chemicals making it a concern for us if teenagers are saturating these receptors beyond what would normally happen in nature.
Some other disturbing findings are noted in the brain scans of users versus non users. Users have smaller amygdala and hippocampal volumes which means weakened emotional regulation and memory function. They also have reinforced this concern in animal studies that have shown that rats exposed to high dose marijuana during puberty suffered cognitive decline that was not present during adulthood.
In the American Journal of Psychiatry, the authors looked at the affects of alcohol and marijuana in teenagers. They followed 3,826 seventh grade students in Montreal, Canada until the completed the eleventh grade. Neuro-cognitive testing was performed and analyzed using a Big Data approach. The results were surprising in that alcohol ingestion was less toxic to the brain than marijuana! Only the marijuana users had adverse effects in all cognitive domains tested, especially working memory. Read the article for the full understanding of these profound results.
What is clear to me when thinking of the brain and development is that certain people are predisposed to poorer outcomes when exposed to an abnormal negative external stimulus. Think of concussions here: some people receive the same type of hit and one suffers a significant concussion where another does not. We know from epigenetic studies that mammals have different responses to external stressors and I assume that this is the same with drugs of recreation like marijuana. This seems to be the case by my observational experience.
Many young adolescents use drugs like marijuana to numb a psychological pain or current stressor. Is that persistent experiential negativity at the root of cognitive decline as well? I hypothesize that this is also correct. Couple stress, epigenetics and drug effects together and I think that we can safely say that using these drugs during puberty is not in one's best interest.
Mitigating the stressors of adolescence is where we should focus our efforts. Provide a true support system for teens before they feel the need to partake in a drug of this nature.
I highly recommend that all teenagers read a few books:
Extreme Ownership by Jocko Willink (my favorite)
Inch and Miles by John Wooden
Anything You Want by Derek Sivers
Jonathon Livingston Seagull by Richard Bach
The Daily Stoic by Ryan Holliday
If they are really bold, have them tackle Atlas Shrugged by Ayn Rand.
Meditation is a great place to start for stress reduction: look at the Mindfulness for Teens, Headspace or Calm websites.
Daily prayer and gratitude journals are also highly beneficial.
Consider taking your teen to a counselor for life coaching and stress reduction.
Consider mission trips and local charity work to keep everything in perspective.
As always, stay in their lives and keep parenting them as long as you can,
Dr. M
Wallis Scientific American Article
O'Grady Psychol Addict Behav Article
NIHM Statistics Article
Schreiner Exp Clin Psychopharm Article
Conrod Journal of Psychiatry Article
NIH News Release
