I began my counseling career in the field of marriage and family therapy. One stereotype about therapy involving multiple folks is that each person’s sole goal in therapy is to convince the therapist that (1) their perspective is right, (2) the other person’s perspective is wrong, and (3) all the problems would cease if the family member would just accept their perspective. Although it’s mostly a joke, when this setup does occur in therapy it can be quite amusing.
I see this phenomenon often when discussing drug use with young guys and their parents. Parents’ emotional reactions make them vulnerable to exaggerate their objections and concerns. Teen guys tend to dismiss parents’ concerns. They boast of marijuana’s benefits, especially compared to alcohol, and downplay any potential risks.
The conversation around marijuana and teenagers comes down to strong communication skills and sticking to the facts. Neither are automatically easy endeavors. But let’s try to look at some of the data regarding marijuana’s impact on teens.
How Safe Is Marijuana?
Kids are engaging in fewer risky or harmful activities than previous generations of teens. They are binge-drinking less. They are waiting later in life to have sex and teen pregnancy is at a record low rate. Youth violence is down and bullying is one-third what it was twenty years ago.
However, marijuana use among teens, which had declined from the late 1990s through the mid-to-late 2000s, is on the rise again. Government data show that almost 40 percent of U.S. high school students have tried marijuana, about 20 percent are current users and close to 10 percent first tried it before age 13.
Why are teens smoking more pot? Because more and more, teenagers think that marijuana is not harmful. Where are teens getting this message? Television, film, music and the media reflect our culture’s increasingly casual attitude toward pot. Media headlines champion the benefits of marijuana use or claim there are no risks to it. Why do 60 percent of high school seniors think marijuana is safe? Because our kids have gotten the idea or message that pot use is no big deal.
The campaigns to legalize marijuana has had the effect of persuading adolescents that marijuana is not dangerous. The politicizing of marijuana resulted in the American Academy of Pediatrics (AAP) publically declaring its opposition to legalizing marijuana, specifically citing the potential harms to children and adolescents. The AAP policy statement, “The Impact of Marijuana Policies on Youth: Clinical, Research, and Legal Update” and accompanying the technical report, states its opposition to “medical marijuana” outside the FDA regulatory process.
Safer Than “______” Does Not = Safe
Arguments around marijuana’s safety range from, “you cannot die from marijuana” to “it’s not as dangerous as other drugs like alcohol or heroin.” It is important to stick to the evidence and not exaggerate the risks. Yes, both alcohol and heroin result in more overdoses and fatalities. Yes, the risk for addiction is greater and more severe for both alcohol and other drugs such as heroin. The moment opponents of marijuana legalization exaggerate the risks they lose the higher ground and undercut their authority to speak on the matter.
But it is equally important to not ignore the evidence or shift the focus to harder (or more dangerous) drugs as a smokescreen for the marijuana conversation. You cannot definitively say “if you smoke cannabis you’re going to ruin your life.” I actually hear this statement quite often in my work as a licensed counselor. I do believe, however, a person can say with authority and with evidence to back it up, that (1) marijuana is not completely safe, and (2) the risks increase the earlier the age of use.
Marijuana is Not as Safe as It Once Was
Marijuana is not as dangerous as alcohol or heroin. But data shows today’s marijuana is more potent now than what was smoked 30 years ago. Some research suggests that the average THC (the psychoactive ingredient in marijuana) levels have increased from less than 3 to 4 percent in the 1990s, to nearly 13 percent today. Marijuana is a complex mixture of cannabinoids (more than 200 have been identified) and other molecules, and the risk–benefit ratio of this mixture has not been well defined.
Over the past several decades, selective breeding of marijuana species has resulted in higher concentrations of cannabinoids in the plant, resulting in a more potent psychotropic effect and possible increased risk of adverse effects. That makes it easier to overdose on marijuana, something that results not in death, but in panic, disorientation, loss of control and in some cases, hospitalization. Until marijuana is regulated by the FDA, its purity and THC content are not consistently verified, and because there are only small case studies available, the risk–benefit relationship cannot be determined.
Marijuana and the Teen Brain is a Bad Romance
Why is marijuana use among teens so concerning? Because there are harmful effects on the developing brain. Adolescent brain development proceeds into the mid-twenties, particularly in the prefrontal cortex. Functional MRI studies examining neural activity in abstinent marijuana users have found deficits in spatial working memory, verbal encoding, and inhibition.
Synaptic Pruning May Be Disrupted
Synaptic pruning, or refining, is not a concept that many folks I encounter are familiar with. It consists of a reduction in gray matter, primarily in the prefrontal and temporal cortex areas and in subcortical structures through the elimination of neural connections. In synaptic pruning, extra neurons and synaptic connections are eliminated in order to increase the efficiency of neuronal transmissions. This allows increased neural connectivity and efficiency and better integrity of white matter fiber tracts.
Recent studies evaluating brain structure have found effects of marijuana use on hippocampal, prefrontal cortex, and white matter volume. Specifically, heavy marijuana users have been found to have greater gray matter volume, particularly in the left hippocampal area, suggesting an interference with synaptic pruning.
Why is synaptic pruning so important? Because it is the remodeling of the brain, allowing it to be more efficient. The adult brain can focus on a single problem for longer and carry out more complex thought processes.
Synaptic pruning also is linked to what Dr. Daniel J. Siegel refers to as “integration.” Dr. Siegel is the executive director of Mindsight Institute and a clinical professor of Psychiatry at David Geffen School of Medicine at UCLA and works in a field called interpersonal neurobiology. Integration creates the possibility of regulation—of attention, mood, emotion, thought, social interactions, and behavior. Recent research supports this notion that impaired integration in the brain is at the root of many psychiatric disturbances. Bottom line, you don’t want to disrupt the developmental step of synaptic pruning.
Marijuana and Mental Health Implications Are Murky at Best, Dangerous at Worst
There is solid evidence that taking cannabis leads to acute adverse mental effects in a high proportion of regular users. Many of these effects are dose-related, but adverse symptoms may be aggravated by constitutional factors including youthfulness, personality attribute, and vulnerability to serious mental illness. The link between marijuana use and psychosis has already been well established in research and literature.
Yes, the common response to cannabis generally includes euphoria and feelings of detachment and relaxation. Adverse effects are not uncommon: these are generally short-lived but may persist or recur with continued use of the drug. One study suggested that cannabis misuse makes a direct contribution to the risk of serious self-harm, either directly or by aggravation of other mental disorders.
The teenage years already represents a vulnerable period for the teen brain. The onset of many mental disorders happens during this stage of life. Adding marijuana use may only exacerbate mental health struggles.
Earlier the Use = Greater Risk for Cognitive Decline
Although several factors are involved (genetic predisposition, environment, and mental disorders), it has been postulated that the developing adolescent brain is particularly at risk for the development of substance use disorders. The earlier the brain is exposed to mood altering substances, the greater the risk for abuse and addiction.
Recent data from newer techniques in studying brain structure and function suggests that the use of marijuana may alter the level of adolescent neurocognitive functioning. In one recent study that examined data from 1,037 New Zealanders, clinical psychologist Madeline Meier of Duke University and her colleagues found that people who began using pot earlier in life and used it most frequently over the years experienced an average decline of eight IQ points by the time they turned 38. By comparison, those who never smoked pot had an average increase of one IQ point by the same age. Another study that was published in Development and Psychopathology, a Cambridge University Press journal found that adolescents who smoke marijuana as early as 14 do worse by 20 points on some cognitive tests and drop out of school at a higher rate than non-smokers.
Marijuana is Here to Stay. So Let’s Get the Facts Straight
So far the results of limited research indicate the need for caution. More research is needed before anyone can definitively claim that marijuana use during teen years is either beneficial or devoid of risk, or that the value outweighs the threat. However, the documented effects on cognition and the emerging data that correlate these effects with detrimental effects on brain structure and function should serve as cautionary evidence to discourage recreational marijuana use in adolescents.
The conversation around marijuana and teenagers comes down to strong communication skills and sticking to the facts. Neither are automatically easy endeavors.
Next up: How to Talk About Marijuana with Your Teen.