Marijuana and Today's Youth

Introduction

Since Caron's Adolescent Treatment Center opened in 1990, more than 3,000 teens have entered treatment at the residential facility for chemical dependency.

During the past six years, Caron has gathered data on all adolescents, ages 12 to 18, entering treatment. The following information highlights the results of this survey of drug preference and trends among teens.

The Analysis

During the admission process at the Caron Adolescent Treatment Center, teens are interviewed to gain information regarding their pattern of drug and alcohol use. This interview addresses in part the adolescents primary drug of choice, including alcohol. The primary drug of choice is defined as the patients number one drug and alcohol preference (excluding nicotine).

After reviewing six years of data gathered from initial interviews, several alarming trends on adolescent drug preference were noted. In particular, the last three years mark a significant change in drug/alcohol preference and use among teens treated at Caron.

Between 1991 and 1993, more than half of all adolescents entering treatment reported that their primary drug of choice was alcohol. During the same period, only one-third of the teens reported marijuana as their drug of choice. Yet, a notable trend began to emerge in 1994. For the first time since the opening of the center, marijuana overtook alcohol as the primary drug of choice for teens at Caron's inpatient treatment program.

From 1994 to December 1996, the preference for marijuana doubled. Two-thirds of all adolescents who entered treatment reported that marijuana was their drug of choice. Concurrently, the preference for alcohol among adolescents decreased sharply, from 65% to 21%. (Refer to Figure 1). These figures mirror current national surveys highlighting the rise and prevalence of marijuana use.

Although the decrease in alcohol preference coincides with the increase in marijuana preference, it is evident that this correlation does not account for the entire decrease in alcohol. Caron statistics show that heroin has also risen in popularity with adolescents. During the past six years, the preference for heroin increased from 1% to 7% among teens. This increase is a significant change.

Although male and female adolescents have shown similar changes in their drug preference, adolescent females take the lead in heroin preference. An average of 7% of adolescent girls entering treatment report that heroin is their drug of choice. In the last six years, the preference for heroin among females has risen from 0% in 1991 to 14% in 1996 (Refer to Figure 2). Similarly, a larger percentage of adolescent males continue to show a higher preference for marijuana than females (Refer to Figure 3).

Perceived Risks

Many addiction professionals and researchers believe that perception of risk plays an important role in drug trends and use. Today, many teens and their parents believe that marijuana is an innocuous drug. Consequently, the rate of marijuana use among youth has more than doubled nationally, based upon the 1995 National Household Survey (Refer to Figure 4). On September 25, 1996, National Parent's Resource Institute for Drug Education, Inc. (PRIDE) reported that student use of most drugs reached the highest level in nine years. Within this ninth annual survey of students in grades 6 through 12, PRIDE reported a 43% increase in junior high marijuana use (grades 6-8) and a 28% increase in high school students (grades 9-12). PRIDE speculates that the rise in marijuana use stems from the belief system that marijuana is not harmful.

Considering the findings from the University of Michigans "Monitoring the Future" study (1995), the perceived harmfulness of a drug is an important determinant of whether an individual uses or refuses the chemical. As clearly stated within this study, the number of students who view drugs, especially marijuana, as dangerous declined sharply in 1995.

In 1991, 79% of 12th graders within the Michigan study thought that marijuana users run a risk of harming themselves. By 1995, the percentage of those teens who viewed marijuana as a "great risk" dropped significantly, to 61% (Refer to Figure 5).

Examining the changes in drug patterns and perceived risks, there may be several factors leading to the profound reversal of drug use and the decrease in viewing marijuana as a dangerous drug.

Here are several reasons...

A parents attitude toward marijuana is shaped by his or her past use and experience with pot. If parents did not experience major consequences of their own marijuana use, they may minimize the risks of use and fail to convey appropriate and consistent warning messages to their children. With their own history of use, parents may feel uncomfortable confronting and discussing the risks of marijuana use with their children. According to several national surveys, parents who have tried drugs themselves often are unaware that their children are experimenting with drugs and less likely to perceive teen marijuana use as a crisis (Refer to Figure 6).

During the '60s, most teens who used marijuana began their use in their late teens or early twenties. Today, children are experimenting with and using marijuana at a younger age. In June 1996, The Department of Health and Human Services reported that the average age of first time marijuana users was 13.9 years. Unfortunately, teens are more likely to suffer negative consequences if they begin their use in early adolescence. Marijuana is more likely to lead to other drugs for first time pre-adolescent and young adolescent users than for older teens.

Parents who grew up in the '60s frequently deny that their child would use pot at such an early age. This lack of awareness contributes to their failure in talking to their children about the dangers of marijuana use, until it's too late. In addition, parents are ignorant of the increase in marijuana potency despite the fact that potency has at least doubled since the 1970s (Figure 7). Clearly, the pot of the '60s and '70s is not the same pot of the 1990s. Yet, parents continue to base their beliefs upon their past experiences, thus negating the serious consequences of todays marijuana.

The Second Generation of Pot Users

"What can I say? How can I convince my own child that marijuana is dangerous when I used to smoked marijuana as a young adult? I smoked a lot of pot in college. How will my child ever hear warning messages from me? I was the generation of the '60s and '70s, the pot heads."

Parents often are caught in their own web of drug history, making it more difficult to give appropriate advice and consistent messages about drug use. Parents who smoked marijuana during their youth and early adult years may shy away from addressing the potential dangers of marijuana use with their children. They may feel hypocritical and deceptive in talking to their children about drugs, particularly marijuana.

Today's teens are the second generation of pot users. Yet, they have received little wisdom from their parents, "the baby-boomers," on the effects and consequences of marijuana. Why has this happened? Are their parents still using pot? Are they now hiding their pot behind the backs of their children? Are they still rebelling against the "establishment" and authority or is it difficult to assume the role of authority and of parent after years of rebellion?

Whatever the reasons, teens are missing a powerful resource to help them through their most vulnerable years of development, the adolescent years. With the onslaught of the second generation of pot users, another era of adults will enter society learning the motto, "Better living through chemistry." Rather than dealing directly with life problems and effectively learning coping skills to manage emotional issues and conflicts, the teens of the "baby-boomers" are quickly turning toward marijuana and other chemicals to cope.

The consequences of another generation of drug users are twofold. First, children are growing up in a family environment where drugs are more accepted than in previous generations. Second, parents who used marijuana during their adolescent and young adult years may model ineffective coping and conflict resolution skills. These parents are often scarred by their lack of emotional development due to substance abuse. Consequently, children who use marijuana may not only face serious emotional developmental lags in dealing with life problems and emotional issues but are further compromised by their parents developmental deficiencies caused by drug use. Thus, marijuana use among teens is adding subsequent insults to their injuries.

Without receiving a message of concern regarding marijuana use, children and teens will continue to believe that marijuana is a soft and harmless drug. Even as marijuana use continues to rise among children, parents remain reluctant to talk to their children about drug use. In July of 1995, The Center on Addiction and Substance Abuse (CASA) at Columbia University released a survey indicating that less than half the parents surveyed had a serious discussion with their children about the implications of drug use.

If we are to decrease the current growth in marijuana use, parents need to confront their own denial of the serious effects of marijuana and begin demonstrating alternatives to managing stress. They also need to acknowledge the possibility that their children use drugs. Parents need to see child and adolescent drug use as a crises, not just a phase of development.

To effectively communicate warning messages with their children, parents first need to address their feelings of hypocrisy if they have used drugs. In general, parents need to confront their own beliefs and myths about the dangers of marijuana use. Only then will they be able to provide a consistent and clear message about the dangers of marijuana and the consequences of use.

Potency: Is the pot of the 1960s the same pot of the '90s?

Marijuana has dramatically changed since the 1960s. Pot has become a far more powerful drug with the increase in potency. As a result, it takes less marijuana to get high today than it did 30 years ago. Cecilia K. Balzer, Intelligence Analyst at the Drug Enforcement Administration (DEA), reports that the potency of marijuana has doubled since the 1970s (Refer to Figure 7). She explained that more efficient methods of cultivation, harvesting and processing have led to higher potencies in marijuana samples across the United States. In recent samples, tetrahydrocannabinol (THC) concentrations are as high as 30% in specific areas of the country due to agricultural practices. THC is a physiologically active chemical from hemp plant resin that is the chief intoxicant in marijuana.

Consequently, teens are getting higher than they did in the past. According to the 1995-1996 PRIDE Survey, students are not just using drugs more frequently, more students are reporting that they are getting "very high" when they use marijuana. The survey noted that nearly 75% of high school seniors who smoked marijuana reported getting very high in comparison to 63% of seniors responding the same way in 1987-1988.

How does this impact our youth? If teens need less pot and report getting higher than before, they will suffer greater consequences from their use. Adolescents risk higher incidents of accidents, impaired judgment, and fatalities with the pot of the '90s. Goldberg (1994) suggests that teenagers who smoke marijuana and then drive cars are more than twice as likely to be involved in an automobile accident than when they do not smoke. In addition, it takes longer for teens to recover from their "highs." With higher concentrations of THC, they may experience more hallucinations, higher levels of anxiety and paranoia, greater disorientation and more frequent short term memory losses during their use.

The Effects of Marijuana Use

Physiological Effects - Cognition and Learning

Several studies have shown that smoking marijuana impairs short-term memory. Researchers are convinced that persistent cognitive impairment can result from chronic marijuana use. In an interview cited within the January 16, 1995 Drug and Alcohol Weekly, Christy Shannon, head of the National Adolescent Treatment Consortium reported that patients are taking two to four weeks post marijuana use for their cognitive functions to clear. Pope and Yurgelun-Todd (1996) report that heavy marijuana use is associated with reduced ability to sustain attention, a decreased capacity to shift attention, reduced learning and decreased mental flexibility.

The impact of marijuana upon learning, memory and cognition may be more devastating among youth than adults. Middle childhood and adolescence are critical stages of development and learning. Therefore, the effects of marijuana upon the developing body and brain may be quite substantial. With youth experimenting with and using marijuana earlier than the previous generation, they will be more vulnerable to the short and long-term physiological consequences of use. Childhood is the time of learning the emotional, social and cognitive skills necessary to interact in many life areas such as work and relationships. Marijuana can impede this process of development.

Physiological Effects - Respiratory, Immune and Cardiovascular Systems

Cannabis is a respiratory irritant. With chronic use, teens have a higher rate of chronic and acute bronchitis. According to Tashkin and others (1990), one marijuana cigarette equals twenty regular cigarettes in terms of bronchial damage. In addition, heavy marijuana use is associated with sinusitis, emphysema, chronic cough and cancer. Marijuana smoke contains more known carcinogens than tobacco, thus teens may increase their risk of cancer with heavy pot use.

Teens who smoke marijuana are also more likely to smoke nicotine. Consequently, they face more serious physiological effects with regular use of both substances. Individuals who smoke marijuana and nicotine on a regular basis suffer greater lung damage than individuals who smoke only marijuana or only tobacco (Gong et al., 1987). The use of nicotine and tobacco is a lethal duo.

Besides producing respiratory problems, marijuana affects the cardiovascular and immune systems. The effects may be temporary and dose-related but nevertheless marijuana use increases heart rate and suppresses the immunological functions. With this in mind, adolescents with existing cardiovascular problems may suffer even greater difficulties. Teens who use pot need to know that the temporary suppression of the immune system increases their susceptibility to sexually transmitted diseases, including AIDS.

Psychological and Social Effects

An adolescent's response to marijuana use will differ depending upon potency, frequency of use, expectations, and the psychological and physical make-up of the individual. Different individuals will produce different responses. For example, marijuana use has typically decreased aggressive responses in experiments with animals and humans. Yet, Cherek, professor of psychiatry at the University of Texas, Houston reported that when young men with antisocial personality disorders were given marijuana, it made them more aggressive*.

It is important to note that marijuana preys on the vulnerable. Intense emotional reactions and consequences may occur more frequently with adolescents dealing with emotional problems. In general, a higher prevalence of depression, motivational problems, and interpersonal problems are associated with marijuana use.

"Is Marijuana dangerous? Is it Addictive?," Congressional Quarterly Researcher. July,1995, 5, 28:657-680.

Sexual and Reproductive Effects

In June 1996, CASA released a study indicating that marijuana heightens the likelihood of unprotected sex among teens. Teenage girls and boys who used marijuana at least three times in the past month are more than twice as likely to be sexually active (Refer to Figure 8). In addition, the report states that boys and girls, 15% and 25%, respectively, are less likely to use condoms than those who never use marijuana.

Like alcohol, marijuana use can decrease sexual inhibitions as well as judgment. Although many marijuana users believe that marijuana use increases sexual pleasure, research has not been able to confirm this belief. In fact, marijuana use has many hidden costs within the reproductive systems of females and males. Marijuana use decreases levels of testosterone in males and hormones that affect ovulation in females. Pot use also reduces sperm count, structure and motility. Consequently, male and female regular pot smokers may experience higher rates of infertility.

Today, there is a growing body of evidence that prenatal marijuana exposure causes serious and harmful effects upon the developing embryo and/or fetus. Female adolescents who use marijuana during prenatal development also often use alcohol and other drugs. Unfortunately, the risks of anomalies increase with exposure to additional substances and younger birth mothers.

In October 1996, Alan Leshner, Ph.D., Director of the National Institute on Drug Abuse (NIDA), reported within the Drug and Alcohol Weekly that research suggests exposing embryos to cannabinoids often prevents the embryos from attaching to the uterine wall. In addition, prenatal studies point to higher probability of premature birth, low birth weight, Sudden Infant Death Syndrome, childhood cancer and the impairment of cognitive skills when children are exposed to regular marijuana use during prenatal development.

Marijuana Dependence

According to the U.S. Department of Health and Human Services, teens are addicted when they begin to feel that they need to take the drug to feel well. Although dependence does not occur with every teen who uses or abuses marijuana, many adolescent heavy marijuana users show compulsive use - a primary sign of dependence.

Marijuana dependence usually develops over an extended period of time. The pattern of dependency is typically characterized by a gradual increase in both frequency and amount of marijuana use. The American Psychiatric Association (APA) recognizes marijuana as a drug that is potentially addictive and identifies several key signs of dependency. These include:

Some heavy marijuana users also show additional signs of dependence noted by withdrawal symptoms when they do not use the drug. Withdrawal symptoms may include restlessness, loss of appetite, trouble with sleeping, cognitive difficulties, and weight loss. Yet, teens as well as adults do not need to exhibit these symptoms to be considered dependent. There are many adolescents who need help to fight their dependency even though they deny withdrawal effects.

In 1995, SAMHSA reported that over 100,000 people entered drug treatment programs disclosing that their primary drug of abuse was marijuana. With more individuals entering treatment programs to address marijuana as their primary problem, it is quite evident that marijuana is a powerful drug of dependence requiring intervention and treatment.

Prevention: Suggestions for parents, schools and professionals

Be good role models.

Studies continue to show that parents significantly influence their childs choices in life. With this in mind, parents need to continue to communicate effectively with their children. Learning to talk and listen to your children can help protect them from seeking other deadly avenues.

Parents need to be good role models. Even if they have used drugs in the past, current behavior has a considerable influence upon their children's choices in drug use. Parents need to model the behavior they expect from their children and set consistent no-use rules about drinking and other drug use. By giving a clear and concise message about drug and alcohol use, children will witness good decision-making skills. Parents need to provide opportunities for their children to learn critical thinking and decision making skills to combat the peer pressure to use drugs. Teens are likely to experience more pressure to use illegal drugs today than they did several years ago.

Stay involved with your children.

To help prevent early drug use, parents need to remain involved in their children's lives. Hoffman (1994) reported that less family involvement and greater drug-using peer associations lead to greater marijuana use among younger adolescents. If parents resign themselves to the belief that they cannot influence their childrens behaviors, they will increase the likelihood that their children will use. Some parents need to confront their belief that their children's drug use is inevitable, while other parents need to address their denial that their child would use drugs.

Focus on the problem before it starts.

Generally, the major weakness in drug prevention is that the programs do not begin before teens start using drugs. Parents, schools and counselors need to provide earlier prevention. Children need to learn skills to resist peer pressure before confronting peer pressure to use alcohol and other drugs.

Early prevention and education can decrease the possibility of drug use among children and younger teens. A follow-up study (Botvin, et al. 1995) on a life skills training program for seventh graders found that by the time students reached 12th grade, the chances of them using drugs were 40% lower than students who had not received the skills course.

Studies have suggested that the earlier teens use marijuana, the greater the chance that they will use other drugs. Consequently, prevention may make the difference in whether marijuana becomes a gateway drug for an adolescent or child.

Help correct the misperception that "everyone does drugs."

Often, teens may believe that "everyone does drugs" based on their peer relationships and the messages they receive from media. Parents and schools need to convey a message that not everyone uses drugs.

Talk about the danger of using more than one drug.

Teens need to know the risks of each drug and the possible deadly combinations of various drugs. Talking to teens about drugs will not lead to use, but could prevent a death. Children and teens need to know the effects of combining drugs. For instance, pot can inhibit the natural feeling of nausea, thus decreasing the bodys tendency to reject toxic amounts of alcohol. The adolescent could possibly face the lethal danger of alcohol overdose when using alcohol and marijuana together.

Warn children about drug use.

Children and teens need good information about drugs and alcohol. They need to receive a message that drug use is wrong and dangerous. Parents can help prevent drug use by providing appropriate warnings to their children. The 1995-1996 PRIDE survey reported that children whose parents warn them about drugs use less than their peers.

Don't make it easy for your children to use.

Adolescents who are limited in their exposure to drugs are less likely to use drugs. Studies point to the pattern that limiting accessibility to drugs decreases adolescent's initial use. In addition, parents need to know that their children will more likely use at a friend's house rather than any other place. Based on the PRIDE survey (1996), school is the least likely place of use, whereas a friend's house is the most common place. Parents must not assume that their children are being appropriately supervised when visiting other homes.

As a proactive step, parents need to join together to combat the risk of drug use. Through building support systems and encouraging communication among parents, adolescents and children will receive consistent messages and supervision in a nurturing environment.

Help build a healthy and resilient child.

Parents, schools and counselors can help create an environment that decreases teen drug use and other high-risk behaviors. Here is list of protective factors which can help a child become more drug-resistant:

Summary

With the rise in marijuana use among adolescents and children, we need to stay vigilant. Todays marijuana is not the "soft drug" of the 1960s. It has serious implications for the psychological, emotional and physiological development of adolescents. With teens using more potent marijuana and starting use at an earlier age, more prevention programs and research are needed to address this serious situation.

Parents, schools, professionals and communities need to use the many resources available to them in providing assistance for our most valuable resource, our children.

About the Author

The author of this study, Claudia Blackburn, M.S., is Director of Program Development and Research at Caron. Ms. Blackburn has more than 17 years of professional experience in the chemical dependency and family therapy fields, and currently writes a regular column on womens issues for Professional Counselor magazine.

She previously served as Vice President of Adult and Family Services at Caron, following many years working as a therapist with chemically dependent and co-dependent individuals and their families.

Since 1985, Ms. Blackburn has lectured and conducted training seminars and workshops throughout the United States and Europe. She has also shared her expertise with the media, serving as a source of information on chemical dependency for programs on MTV, National Public Radio and Frontline PBS, among others.

She is an international consultant in the development of inpatient and outpatient addiction treatment programs and, since 1990, has traveled regularly to Poland and other Eastern European countries to train professionals working with chemically dependent individuals and their families.

References

Botvin, G. J., et al. (1995, April 12). Long-term follow-up results of a randomized drug abuse prevention trial in a white middle-class population. Journal of the American Medical Association, pp. 1106-1112.

Brook, J. S., Brook D. W., Gordon, A. C., Whiteman, M. & Cohen, P. (1990). The psychosocial etiology of adolescent drug use: A family interactional approach. General Psychology Monogram, 116, 111-267.

Chemicals in marijuana can cause problems in pregnancy. (1996, October 21). Alcoholism and Drug Abuse Weekly, p. 7.

Curley, B. (1995, January 16). Marijuana surge, coupled with treatment cuts, spells disaster. Alcoholism and Drug Abuse Weekly, p. 5.

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.

Friend, T. (1996, September 10). Many parents resigned to kids drug use. USA Today, p. A1.

Goldberg, R. (1994). Drugs Across the Spectrum, West Publishing Company.

Gong, H., Fligel, S., Tashkin, D.P. & Barbers, R.A. (1987). Tracheobronchial changes in habitual, heavy smokers of marijuana with and without tobacco. American Review of Respiratory Diseases, 136, 142-149.

Hoffmann, J. P. (1994). Investigating the age effects of family structure on adolescent marijuana use. Journal of Youth and Adolescents, 24(2), 215-235.

Johnston, L. D., OMalley, P. M., & Bachman, J. G., (1995, December). National survey results on drug use from the monitoring the future study. Ann Arbor, Michigan: University of Michigan.

Marijuana Potency Monitoring Project: Quarterly Report. (1996, April 1996 to June 31). Mississippi: University of Mississippi, Research Institute of Pharmaceutical Sciences.

National Survey of American Attitudes on Substance Abuse. (1995, July). New York: Columbia University, Center on Addiction and Substance Abuse. Also see, Adolescents say drugs are biggest worry. (1995, July 18). New York Times. p. A8.

Pope H. & Yurgelun-Todd, D., (1996). The residual cognitive effects of heavy marijuana use in college students. Journal of the American Medical Association, 275, 521-527.

Pope, H., Gruber, A. J., and Yuregelun-Todd, D. (1995). The residual neuropsychological effects of cannabis: The current status of research. Drug and Alcohol Dependence, 38, 25-34.

Shalala calls for "reality check on marijuana." (1996, July 1). Alcoholism and Drug Abuse Weekly, p. 7.

Stephens, R.S., Roffman, R.A., & Simpson, E. F. (1993). Adult marijuana users seeking treatment. Journal of Consulting and Clinical Psychology, 61, 1100-1104.

Substance Abuse and Mental Health Services Administration, Office of Applied Studies. (1996, August). Preliminary Estimates from the 1995 National Household Survey on Drug Abuse. Washington DC: U.S. Department of Health and Human Services, Public Health Service.

Resources & Facts

Do you or a loved one need help?

Get Help Now

Tour Caron Pennsylvania

Click Here