Is Cannabis Dangerous in Adolescence ?

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Feb 11, 2007
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#1
Journal of American Medical Association… Published on February 13, 2019.

“Cannabis is the world’s most widely used illicit drug, with 3.8% of the global population having used cannabis in the past year.1 Prevalence of use as a fraction of the world’s population has remained stable since the 1990s,1 although patterns in individual countries are changing, with the percentage of individuals aged 18 to 29 years in the United States who reported using cannabis in the past year roughly doubling between 2001 to 2002 and 2012 to 2013, from 10.5% to 21.2%.2 Among US adolescents from 1991 to 2011, the prevalence of cannabis was high, with 20.9% of adolescents reporting use in the past month3; additionally, about 7% of US high school seniors are daily or near-daily users of cannabis.4 …

The regular use of cannabis during adolescence is of profound concern9 as use in this age group is associated with an increased likelihood of deleterious consequences, such as diminished scholastic achievement, lower degree attainment and school abandonment, liability to addiction,10 earlier onset of psychosis,11 and neuropsychological decline.12 Furthermore, in the general population, there is substantive evidence for statistical associations between cannabis use and increased risk of motor vehicle crashes; the development of psychoses with the highest risk among the most frequent and high potency cannabis users; increased cannabis use frequency and the progression to developing problem cannabis use; adverse birth outcome in the offspring of mothers with cannabis smoking habits; and worse respiratory symptoms and more frequent chronic bronchitis episodes with long-term cannabis smoking….


These findings highlight the importance of initiatives aiming to educate teenagers on the risks associated with using cannabis and teach them skills to resist peer pressure. Given the likelihood of a window of risk during adolescence when the deleterious effects of cannabis are most pronounced,10 the findings in this meta-analysis suggest that cannabis is a serious public health concern and there is an urgent need to implement better drug use prevention programs targeting the use of cannabis among adolescents and interventions aimed at educating adolescents to develop the skills to resist peer pressure on drug consumption.”
 

steross

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This article was not in JAMA. It was in JAMA Psychiatry.

Interestingly, this article was in the same Journal. Cannabis is associated with doing worse in school etc. Prescription antipsychotics are associated with death. Why did you decide one was worth sharing but not the other?


Importance: Children and youths who are prescribed antipsychotic medications have multiple, potentially fatal, dose-related cardiovascular, metabolic, and other adverse events, but whether or not these medications are associated with an increased risk of death is unknown.

Objective: To compare the risk of unexpected death among children and youths who are beginning treatment with antipsychotic or control medications.

Design, Setting, and Participants: This retrospective cohort study was conducted from 1999 through 2014 and included Medicaid enrollees aged 5 to 24 years in Tennessee who had no diagnosis of severe somatic illness, schizophrenia or related psychoses, or Tourette syndrome or chronic tic disorder. Data analysis was performed from January 1, 2017, to August 15, 2018.

Main Outcomes and Measures: Deaths during study follow-up while out of hospital or within 7 days after hospital admission, classified as either deaths due to injury or suicide or unexpected deaths. Secondary outcomes were unexpected deaths not due to overdose and death due to cardiovascular or metabolic causes.

Conclusions and Relevance: The findings suggest that antipsychotic use is associated with increased risk of unexpected death and appear to reinforce recommendations for careful prescribing and monitoring of antipsychotic treatment for children and youths and to underscore the need for larger antipsychotic treatment safety studies in this population.
 
Jul 20, 2018
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#4
This article was not in JAMA. It was in JAMA Psychiatry.

Interestingly, this article was in the same Journal. Cannabis is associated with doing worse in school etc. Prescription antipsychotics are associated with death. Why did you decide one was worth sharing but not the other?
It's pretty simple. He started a thread about Cannabis, not antipsychotic drugs.
 

okstate987

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So @docjoctoo , no one has proposed that teens smoking pot is a good or beneficial thing. It is pretty important to try to avoid disrupting the brain's pruning process whenever possible. Those that have a history of schizophrenia in their family should avoid it too. Both of these things have been scientifically established for quite some time.

We get it, you dont like pot. Let me know when you bring something of value to the table with this discussion, or better yet, demonstrate that you can see past your own bias by posting a scholarly source with a benefit from marijuana. You won't have to look very far.
 
Aug 3, 2018
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#8
So @docjoctoo , no one has proposed that teens smoking pot is a good or beneficial thing. It is pretty important to try to avoid disrupting the brain's pruning process whenever possible. Those that have a history of schizophrenia in their family should avoid it too. Both of these things have been scientifically established for quite some time.

We get it, you dont like pot. Let me know when you bring something of value to the table with this discussion, or better yet, demonstrate that you can see past your own bias by posting a scholarly source with a benefit from marijuana. You won't have to look very far.
I missed something here. If you support pot smoking by teenagers, then why don't you post some supporting articles/links?
 

bleedinorange

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#9
https://childmind.org/article/teenage-marijuana-use-affect-iq/


Does Teenage Marijuana Use Affect IQ?
What the latest study suggests about the adolescent brain, and kids who self-medicate
Harold S. Koplewicz, MD
A much-publicized report on a long-term study of the effects of marijuana use drew a frightening conclusion: that adolescent users could actually be shaving points off their IQs. The study was of 1,000 kids in New Zealand who had IQ tests in early adolescence and again when they were 38 years old. In between they were interviewed every couple of years about their pot use. Researchers found that those who were frequent pot smokers by their 18th birthday and continued to use heavily had on average lost eight IQ points by the time they were retested.
It’s important to note that these results weren’t for the occasional pot user, or even the habitual pot user (defined in the study by use at least four days a week) but rather the subset of users who were diagnosed as clinically dependent on pot in at least two of those midpoint interviews. Those who lost the average of 8 IQ points were in the most extreme group, and there were only 19 of them.
That said, what may be significant here is that marijuana users who started later, after adolescence, didn’t show a comparable decline in IQ. And that highlights something very important about adolescence: that adolescent brains are still developing—they are plastic, changeable—and are hence particularly sensitive to insults and influences.
The developing brain
Things that affect the developing brain include the child’s genes, his experiences, and what he’s exposed to in the environment. Kids are learning all the time, formally and informally, and their brains are busy forming pathways, and pruning old pathways, based on patterns of use.
In the case of the marijuana study, there’s no way to know if the loss in IQ is related to the cannabis itself, or what the persistent pot user is doing — or not doing — with his time (like zoning out instead of studying) or who he’s hanging out with (like-minded pals). What we do know is that the brain is affected by all these things, which we call biopsychosocial factors.
What we also know is that we can use biopsychosocial interventions in positive ways: to help children who are affected by psychiatric illness. I’m talking about children with severe anxiety, crippling depression, developmental delays, eating disorders, and disruptive behaviorthat’s wreaking havoc on their lives and the lives of their families. Since the headquarters of psychiatric disorders is the brain, the ability of the young brain to rebound is the key to the success of early intervention.
Changing the trajectory
The onset of 50 percent of all psychiatric illness occurs by the age of 14, and 75 percent by the age of 24. By treating children in a timely way, we have an opportunity to change the trajectory of their lives.
Childhood is the ideal time to identify and treat disorders before they become fixed as not only an identity and a lifestyle, but in the very structure of the brain. We need to treat kids before they have lost a great deal of childhood learning because they were too anxious, distracted or despondent. We need to treat them before their maladaptive coping mechanisms become established patterns — before they develop a habit of self-medicating with pot, alcohol, or painkillers.
I think everyone can see that chronic drug abuse is a waste of potential. What’s not as intuitive to many people is the terrible loss of potential in people with untreated psychiatric illness. When these kids don’t get treatment they not only drink and do drugs more than other kids, they drop out of school, they hurt themselves, they have trouble holding a job and being good parents, they have more physical symptoms and complaints as adults. The cost to the individual, and the rest of us, is very high.
And the reality is that untreated psychiatric disorders are much, much more common than those pot addicts who lost IQ points in the New Zealand study. Which is why it’s tragic that the stigma against mental illness, and against giving kids medication to treat it, causes many, many children to be left to struggle unaided.
Timely treatment

Among even the most well-meaning parents there’s a tendency to ignore emotional problems, think kids will grow out of them. And all too often parents who seek treatment for kids who are struggling are attacked as being overprotective or obsessed with perfection. In fact they are doing their kids a huge favor, by getting them treatment before the kids start “treating” themselves. Some of the most successful tools we have to help kids are behavioral therapy for children as young as preschool, and in some cases medications are very helpful.
But even when medications are shown to be clearly effective in well-designed clinical studies, as stimulant medications are for most kids who have ADHD, they are often dismissed as unnecessary or even dangerous. The truth of the matter is that 70 years of clinical experience and all of the rigorous studies that have assessed the effects of stimulant medication have concluded that it is effective, and that any deleterious effects in adulthood—drug abuse, reduced brain volume — result from untreated ADHD, not the medication.
People who worry out loud about the side effects of taking psychiatric drugs don’t express nearly enough worry about the effects of denying children or a teens the medications to treat their psychiatric disorders — or the effect of the drugs they take to make themselves feel better.
Which brings us back to those 18-year-old New Zealand kids who became dependent on marijuana. You don’t have to be a scientist or a doctor to see that those kids were not treating their brains well, and were jeopardizing their mental acuity. I’m sure those kids had parents who weren’t happy with their behavior, and were worried about their futures. But until we address children’s emotional health as forthrightly as we do their physical health — taking a whole-child approach — there will be a lot of kids finding “medication” on their own.
 

steross

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There are LOTS of things that are bad for adolescences. Sugar, screentime, opiates (kill), antipsychotics (possible kill), access to firearms/shootings (kill), lakes (there is a peak in drownings in that age group), motor vehicles since are beginner drivers and underdeveloped frontal lobe. etc, etc etc.

Nobody is saying marijuana is good. All that is being said is of all the things that are severely bad and cause early death, it is pretty interesting that this one thing that takes quite a bit of epidemiologic research to even figure out how it is bad gets so much attention around here as bad.
 
Feb 11, 2007
4,126
1,894
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Oklahoma City
#12
https://childmind.org/article/teenage-marijuana-use-affect-iq/


Does Teenage Marijuana Use Affect IQ?
What the latest study suggests about the adolescent brain, and kids who self-medicate
Harold S. Koplewicz, MD
A much-publicized report on a long-term study of the effects of marijuana use drew a frightening conclusion: that adolescent users could actually be shaving points off their IQs. The study was of 1,000 kids in New Zealand who had IQ tests in early adolescence and again when they were 38 years old. In between they were interviewed every couple of years about their pot use. Researchers found that those who were frequent pot smokers by their 18th birthday and continued to use heavily had on average lost eight IQ points by the time they were retested.
It’s important to note that these results weren’t for the occasional pot user, or even the habitual pot user (defined in the study by use at least four days a week) but rather the subset of users who were diagnosed as clinically dependent on pot in at least two of those midpoint interviews. Those who lost the average of 8 IQ points were in the most extreme group, and there were only 19 of them.
That said, what may be significant here is that marijuana users who started later, after adolescence, didn’t show a comparable decline in IQ. And that highlights something very important about adolescence: that adolescent brains are still developing—they are plastic, changeable—and are hence particularly sensitive to insults and influences.
The developing brain
Things that affect the developing brain include the child’s genes, his experiences, and what he’s exposed to in the environment. Kids are learning all the time, formally and informally, and their brains are busy forming pathways, and pruning old pathways, based on patterns of use.
In the case of the marijuana study, there’s no way to know if the loss in IQ is related to the cannabis itself, or what the persistent pot user is doing — or not doing — with his time (like zoning out instead of studying) or who he’s hanging out with (like-minded pals). What we do know is that the brain is affected by all these things, which we call biopsychosocial factors.
What we also know is that we can use biopsychosocial interventions in positive ways: to help children who are affected by psychiatric illness. I’m talking about children with severe anxiety, crippling depression, developmental delays, eating disorders, and disruptive behaviorthat’s wreaking havoc on their lives and the lives of their families. Since the headquarters of psychiatric disorders is the brain, the ability of the young brain to rebound is the key to the success of early intervention.
Changing the trajectory
The onset of 50 percent of all psychiatric illness occurs by the age of 14, and 75 percent by the age of 24. By treating children in a timely way, we have an opportunity to change the trajectory of their lives.
Childhood is the ideal time to identify and treat disorders before they become fixed as not only an identity and a lifestyle, but in the very structure of the brain. We need to treat kids before they have lost a great deal of childhood learning because they were too anxious, distracted or despondent. We need to treat them before their maladaptive coping mechanisms become established patterns — before they develop a habit of self-medicating with pot, alcohol, or painkillers.
I think everyone can see that chronic drug abuse is a waste of potential. What’s not as intuitive to many people is the terrible loss of potential in people with untreated psychiatric illness. When these kids don’t get treatment they not only drink and do drugs more than other kids, they drop out of school, they hurt themselves, they have trouble holding a job and being good parents, they have more physical symptoms and complaints as adults. The cost to the individual, and the rest of us, is very high.
And the reality is that untreated psychiatric disorders are much, much more common than those pot addicts who lost IQ points in the New Zealand study. Which is why it’s tragic that the stigma against mental illness, and against giving kids medication to treat it, causes many, many children to be left to struggle unaided.
Timely treatment

Among even the most well-meaning parents there’s a tendency to ignore emotional problems, think kids will grow out of them. And all too often parents who seek treatment for kids who are struggling are attacked as being overprotective or obsessed with perfection. In fact they are doing their kids a huge favor, by getting them treatment before the kids start “treating” themselves. Some of the most successful tools we have to help kids are behavioral therapy for children as young as preschool, and in some cases medications are very helpful.
But even when medications are shown to be clearly effective in well-designed clinical studies, as stimulant medications are for most kids who have ADHD, they are often dismissed as unnecessary or even dangerous. The truth of the matter is that 70 years of clinical experience and all of the rigorous studies that have assessed the effects of stimulant medication have concluded that it is effective, and that any deleterious effects in adulthood—drug abuse, reduced brain volume — result from untreated ADHD, not the medication.
People who worry out loud about the side effects of taking psychiatric drugs don’t express nearly enough worry about the effects of denying children or a teens the medications to treat their psychiatric disorders — or the effect of the drugs they take to make themselves feel better.
Which brings us back to those 18-year-old New Zealand kids who became dependent on marijuana. You don’t have to be a scientist or a doctor to see that those kids were not treating their brains well, and were jeopardizing their mental acuity. I’m sure those kids had parents who weren’t happy with their behavior, and were worried about their futures. But until we address children’s emotional health as forthrightly as we do their physical health — taking a whole-child approach — there will be a lot of kids finding “medication” on their own.
While our brain continually changes as we age, young brains as your article says is particularly susceptible to injury by drugs and even by harmful destructive experiences.
 
Feb 11, 2007
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1,894
1,743
Oklahoma City
#14
There are LOTS of things that are bad for adolescences. Sugar, screentime, opiates (kill), antipsychotics (possible kill), access to firearms/shootings (kill), lakes (there is a peak in drownings in that age group), motor vehicles since are beginner drivers and underdeveloped frontal lobe. etc, etc etc.

Nobody is saying marijuana is good. All that is being said is of all the things that are severely bad and cause early death, it is pretty interesting that this one thing that takes quite a bit of epidemiologic research to even figure out how it is bad gets so much attention around here as bad.
Steross, what prompted my report was my experience working with a Stillwater internist and pain clinic physician who deals with addiction problems. He asked me to speak to some OSU student employees whom he said didn't seem to understand the dangers of marijuana. Secondly I have a grandson who is a member of an OSU fraternity. He told me that he estimates that 40% of his fraternity use marijuana on a regular basis. I offered to speak to them. But he told me they are unlikely to listen to me or anyone else. Their motto he said is: "I'm not here for a long time, I'm here for a good time".
 
Jul 20, 2018
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#15
Steross, what prompted my report was my experience working with a Stillwater internist and pain clinic physician who deals with addiction problems. He asked me to speak to some OSU student employees whom he said didn't seem to understand the dangers of marijuana. Secondly I have a grandson who is a member of an OSU fraternity. He told me that he estimates that 40% of his fraternity use marijuana on a regular basis. I offered to speak to them. But he told me they are unlikely to listen to me or anyone else. Their motto he said is: "I'm not here for a long time, I'm here for a good time".
Their motto should be "I'm not here for a long time so, what little time I have, will be all fuzzy".
 

steross

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#16
Steross, what prompted my report was my experience working with a Stillwater internist and pain clinic physician who deals with addiction problems. He asked me to speak to some OSU student employees whom he said didn't seem to understand the dangers of marijuana. Secondly I have a grandson who is a member of an OSU fraternity. He told me that he estimates that 40% of his fraternity use marijuana on a regular basis. I offered to speak to them. But he told me they are unlikely to listen to me or anyone else. Their motto he said is: "I'm not here for a long time, I'm here for a good time".
You should discuss with your pain mgmt friend the more than 250,000 Americans who have died from prescription pain medications, including many adolescence, and compare that to the safety profile of cannabis as a chronic pain reliever.

Tell me, you are a doc, what happens if you take 20 times the recommended dose of oxycodone? Same for cannabis? That lack of cannabinoid receptors in the brainstem should be looked at as a gift from God. Instead, many doctors are still practicing reefer madness.
 

okstate987

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#17
Steross, what prompted my report was my experience working with a Stillwater internist and pain clinic physician who deals with addiction problems. He asked me to speak to some OSU student employees whom he said didn't seem to understand the dangers of marijuana. Secondly I have a grandson who is a member of an OSU fraternity. He told me that he estimates that 40% of his fraternity use marijuana on a regular basis. I offered to speak to them. But he told me they are unlikely to listen to me or anyone else. Their motto he said is: "I'm not here for a long time, I'm here for a good time".
You are a pain doc and it is very ironic that you have major concerns about marijuana and dont seem to have any about opioids. Why dont you do a presentation on the dangers of opioids, or is that bad for business?

I cannot recall you ever posting about the dangers of opioids, how they can cause respiratory depression, constipation, low testosterone, addiction and death. As @steross said, one of these have killed hundreds of thousands of people, the other hasn't.
 

bleedinorange

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#18
When opiates became the drug de-jour all the claims about their safety and benefits were touted as MJ is today. I suspect as MJ use becomes as systemic in our culture as opiates the negative aspects will become known. Unike opiates, MJ should not have the deadly connotations but there will likely be cultural ramifications. The MJ today is 5X the strength of what it was only a few years ago. It will be interesting to watch with an entire generation of regular users as a social experiment. The conclusions are yet to be written and we're left with unsupported opinions from both sides. Personally, I'll err on the side of avoidance.
 

NotOnTV

BRB -- Taking an okie leak
Sep 14, 2010
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Gondor
#19
When opiates became the drug de-jour all the claims about their safety and benefits were touted as MJ is today. I suspect as MJ use becomes as systemic in our culture as opiates the negative aspects will become known. Unike opiates, MJ should not have the deadly connotations but there will likely be cultural ramifications. The MJ today is 5X the strength of what it was only a few years ago. It will be interesting to watch with an entire generation of regular users as a social experiment. The conclusions are yet to be written and we're left with unsupported opinions from both sides. Personally, I'll err on the side of avoidance.
Cultural ramifications? Like skyrocketing sales of Oreos, McDonald's fries, and Bob Marley on iTunes?
 

NotOnTV

BRB -- Taking an okie leak
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#20
I would never advise anyone to start as young as I did (14), but it has helped me maintain this Southpark conservative stoner persona over the years.