The debate over the legalization of marijuana has been going on for years, and more and more states have recently elected to legalize it in some form, either recreational or medical. In fact, marijuana is now legal in 33 states for medical use, and 11 for recreational use. This prompted us at NC Family to feature an article titled “The ‘Charming’ and Alarming Face of New Marijuana” in our Spring/Summer 2019 edition of Family North Carolina magazine. As we shared then, many Americans, especially young people, may think this drug is harmless.
The American College of Pediatricians (ACPeds) thinks differently. The group recently published an updated position statement that outlines the startling and disastrous long-term effects of marijuana on young people. Dr. Jane Anderson is a board member of the ACPeds, and a clinical professor of pediatrics, and she joins Traci DeVette Griggs on this week’s episode of Family Policy Matters to discuss what effects her group has found of marijuana use in young Americans.
“The problems for marijuana use in the adolescent is that the adolescent brain is just developing,” says Dr. Anderson. “A younger adolescent who starts to use a drug like marijuana or alcohol is much more likely to have damage to their brain that we can document on brain scans and MRIs.”
What can this kind of brain damage lead to? “The mental health effects of marijuana include schizophrenia and psychosis, depression, and suicidal ideation,” warns Dr. Anderson. And the learning problems in teens with high marijuana use are even more startling, she adds.
“As states legalize for adults, it is giving the message to our adolescents that it is safe. And marijuana is not safe for adolescents. […] This is nothing to play around with; this is serious.”
Tune in to Family Policy Matters this week to hear Dr. Jane Anderson share about the dangers of marijuana use in young adults, and how parents can help protect their children from this drug.
TRACI GRIGGS: Thanks for joining us this week for Family Policy Matters. As more state and local governments legalize marijuana for medical and/or recreational use, people, and especially young people, may think it’s harmless. “Far from it” is the word from the American College of Pediatricians. The group published an updated position statement recently, which spells out some pretty startling long-term effects of marijuana use among young people, and it calls on government leaders to resist further legalization and instead focus on reducing marijuana use among America’s youth.
We are joined today by one of the primary authors of that statement, Dr. Jane Anderson. Dr. Anderson is a clinical professor of pediatrics at the University of California, San Francisco, a retired practicing pediatrician, and a board member of the American College of Pediatricians.
Dr. Jane Anderson, welcome to Family Policy Matters.
DR. JANE ANDERSON: Thank you for having me.
TRACI GRIGGS: Well, why don’t we start off with clarifying some terms. Can you briefly explain the difference between marijuana, cannabis, CBD and hemp?
DR. JANE ANDERSON: I think the main thing for parents and your listeners to know is that there is a distinct difference between the three things they’re going to hear about. Hemp, which is legal, does not produce a high; THC, which is marijuana basically—the chemical in marijuana—which does produce a high, and it’s that we’re going to talk about today that has the damaging effects on the adolescent brain. And then CBD, which is now available, being promoted all over as a use for a calming agent, and some people are using it for pain control, even topically, and that is legal and does not cause a high. So, we’re going to be talking about THC, the chemical in marijuana that causes most of the damage.
TRACI GRIGGS: Speaking of THC, another thing that parents may not understand if they’re talking to their teens, is that the concentrations of THC in today’s marijuana can be much higher than ever before, right?
DR. JANE ANDERSON: Oh my goodness, yes. So back in the 60s and 70s, during sort of the hippie era where maybe some of the parents or grandparents were using marijuana, the concentration of marijuana at that time was about three to five percent THC concentration. Nowadays, the average is averaging like 25 to 30 percent, and it is possible to find 100 percent THC available to be ingested or smoked. So, it is markedly more potent than it was back in the 1960s and 70s. And plants are being bred specifically to make more concentrated THC.
TRACI GRIGGS: Right. And this is one of the primary reasons that we’re seeing increased problems with marijuana use, right?
DR. JANE ANDERSON: Exactly. The problems for marijuana use in the adolescent is that the adolescent brain is just developing. And in fact, it isn’t really mature until really the early 20s, like 22, 23, 24. And so anything that impacts the brain is going to have more effect on the adolescent brain because this brain is still developing and maturing. Things like alcohol, for instance, or pornography, or even any kind of exciting experience will impact the brain much more in an adolescent. And then even the younger the adolescent, the more adverse effects will be seen. A younger adolescent who starts to use a drug like marijuana or alcohol is much more likely to have damage to their brain that we can document on brain scans and MRIs. They’re also more likely to have long-term damage and more likely to become addicted. So, it’s sort of a multiple adverse effect on the brain: the younger the teen starts, and then the more potent the drug, the more damage, and the more frequent the use, the more damage.
TRACI GRIGGS: There are also kinds of mental illness, right, that you’re finding connected with marijuana use?
DR. JANE ANDERSON: Yes. And I think this is, you know, one of the reasons we’re so glad you’re talking about this today. The mental health effects of marijuana include schizophrenia and psychosis, depression, and suicidal ideation. Now we’re specifically talking about teenagers here, but this was first noticed not in teens, but in adults, by British physicians who were working in India in the 1800s. They were actually taking care of patients in mental institutions, and they noticed that the patients who are using a specific drug seem to have more relapses. And that drug was marijuana. There really wasn’t much in the literature on the mental health effects of marijuana until 1972, and there were some case reports of adults at that time who had seemed to be psychosis that was induced by using marijuana. But since that time, we have a lot more data. There was a metanalysis that just came out this year, 2020, of 15 studies that found just one dose of THC could induce psychosis in adults who had no history of previous mental illness. And another study came out and showed that daily use was associated with an increased risk of psychosis. And it turns out that for teenagers, the risk of inducing psychosis is greatly increased if they have more frequent cannabis use. So, if they’re using more than several times a week, the earlier the age they start using, the higher the potency of cannabis or marijuana that they’re ingesting or smoking, and their risks are greatly increased. There was a seven-fold, increased risk of depression, a five-fold increased risk of suicidal ideation. And the risk for schizophrenia can be over six times the risk. This is nothing to sort of play around with; this is serious.
TRACI GRIGGS: Can you talk about the concept of risk? What do we mean when we’re talking about increasing risk, and why should that be something that we pay attention to even if the people around us aren’t showing some of those problems?
DR. JANE ANDERSON: We often talk about this five-fold increased risk, or seven-fold increased risk. So, if you took one in a hundred people that might normally develop schizophrenia, let’s just say as part of normal life with no causal factors, and if you increase the risk seven-fold, then you’re talking about seven people out of a hundred would get schizophrenia if they were using marijuana, let’s just say. So that means 93 people out of that 100 might not develop it, but you might be the person who did, and that is a lifelong illness that you’ll be dealing with.
TRACI GRIGGS: So let’s talk about vaping. Does that play a role in drug use, and particularly marijuana use among younger populations?
DR. JANE ANDERSON: Another great question. E-cigarettes, or vaping has obviously taken off in the last 5 to 10 years, and definitely adolescents can be vaping on marijuana. It’s one of the things they can vape. I want us to be very careful when we talk about vaping, however, to recognize that adolescents who are vaping can actually vape just flavors with no nicotine or no marijuana in their e-liquid. Whenever we talk about vaping or e-cigarettes, there’s so many different types and so many different ways and forms to vape and different liquids to vape, that we can’t make broad generalizations. But I believe it’s about 17 percent of teens who have vaped have used marijuana. So, they’re at just the same risk as if they were ingesting it or smoking it naturally.
TRACI GRIGGS: But there’ve been some health risks associated with vaping as well.
DR. JANE ANDERSON: Oh my goodness, yeah. And so one of the most serious and dangerous is the EVALI, which is vaping associated lung injury. That’s been identified in adolescents, particularly those who smoked or vaped marijuana, and it causes serious lung damage, and some teenagers have died from that. There are also many different toxins and ingredients that are either in the e-liquid or develop while the e-liquid is being heated in the cigarette. And they’re doing research now on those toxins and what they’re doing, but the evidence seems to be that not only does it cause respiratory damage and cardiac damage, but also immune system damage too. So, although teenagers often view vaping as a safer form of smoking, it is not.
TRACI GRIGGS: Okay. What about best practices for preventing young people from even starting to use drugs like marijuana?
DR. JANE ANDERSON: You are asking excellent questions, and I wish I had an answer to that. I am so concerned because as states legalize—let’s say medical marijuana, recreational marijuana for adults—it is giving a message to our adolescents that it is safe, and marijuana is not safe for adolescents. We could spend a lot more time talking about the learning problems that go on with teenagers who use marijuana. I think we are doing a huge disservice as adults to adolescents when we give them the message that marijuana in any of its forms is not harmful. It is very harmful to that adolescent and the adolescent brain. The first thing is, on one hand, we just need to change our policies, but I don’t see that happening. And so that means individual parents and families have to educate their teenagers. There was a lovely study that was years ago, and I don’t know if it could be replicated in today’s culture, but Columbia University did a study that showed that if parents one time told their teenagers they disapproved of marijuana use, it markedly reduced that teen’s likelihood of experimenting with marijuana. One thing we want to tell our parents is talk with your teens, ask them questions. Secondly, convey your values. Three, monitor everything. We have good evidence that parents who monitor and are aware of everything going on in their teenagers’ lives, their teens do much better. Invite their friends over, who are their friends? What are their friends doing? They’re much more likely to experiment with marijuana if their friends are. Bring their friends over, have them at your house, find out what’s going on, what they’re talking about and who their friends are. Give them meaning for life, whether it’s through faith or volunteering, but help them realize that their life is important; it’s valuable and they don’t need drugs to help them feel better.
TRACI GRIGGS: That’s excellent advice, thank you, Dr. Anderson. Before we go, where can our listeners go to read the statement from the American College of Pediatricians on marijuana and the other things we’ve been discussing today?
DR. JANE ANDERSON: The American College of Pediatricians, their website is acpeds.org and then you can go to where it says their position statements, and you will see the one on marijuana and mental illness. And then we will shortly have one up there on vaping, and it will address some of the other things that you mentioned. And there are other topics in our position statements. People might not know about the risk of breast cancer in young adolescents who have an abortion, so they might be interested in that. There’s one on the teenage brain that talks about the development of the brain. And we have an excellent statement on gender dysphoria, and one on pornography. So, lots of good topics on acpeds.org.
TRACI GRIGGS: Dr. Jane Anderson, thank you so much for being with us today on Family Policy Matters.
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