IRETA staff member Dr. Dawn Lindsay lends insight in the wake of legalization

For at least a quarter of a century—and probably much longer—American teens have been using marijuana more than any other illicit drug. Today, at the beginning of 2013, teen marijuana use is up.

As a researcher, clinician and parent, I see from several perspectives the relationship that exists between young people and marijuana. Now, amidst increasingly lenient societal attitudes toward marijuana, it is especially important for adolescents’ parents and doctors to face the relationship between teens and pot and to effectively communicate about marijuana use and the risks that it poses.

Stats on use

The numbers don’t lie. After a period of relative decrease in the beginning of the 2000s, every indicator of marijuana use among teens shows that it has been steadily growing over the past five years.

Results from the 2012 National Monitoring the Future (MTF) Survey were released last month: 11.4 percent of 8th graders and 36.4 percent of twelfth graders reported marijuana use in the last year. In 2007, these numbers were 10.3 percent and 31.7 percent, respectively.

Although data about annual use offers insight into marijuana exposure and availability among teenagers, the segment that reports regular marijuana use are those who are likely to have severe consequences as a result of use, if they don’t already. As with past 12 month use, daily or near daily use of marijuana has increased sharply over the past five years: 6.5 percent of high school seniors report daily use, as compared to 5.1 percent in 2007. The MTF survey shows that almost one quarter of 12th graders has smoked pot in the last month.

Perhaps even more troubling than the upward trend in marijuana use overall is that less than half of 12th graders agreed there is “great risk” in using marijuana regularly. And sure enough, the data also show a strong relationship between these two variables, in that teens who do not see great risk in using marijuana are much more likely to do so.

These numbers should get our attention.

These numbers should get our attention

A strong relationship between perceived low risk and use (MTF 2012)

Teens and pot

Before I came to IRETA, I was on the faculty at the University of Pittsburgh’s Department of Psychiatry, studying adolescent alcohol and other drug use.

When I talked to adolescents and their parents in addiction treatment about the issues that brought them there, I couldn’t help but observe the irony. Typical adolescent development dictates that teens be impulsive, sometimes even reckless, and that by definition they don’t consider the long-term consequences of their decisions. With marijuana use in particular, long term effects are major causes for concern. And further, because the teen brain is still developing, it is particularly vulnerable to marijuana’s harmful effects. But—again—teens are not the types to worry about these sorts of consequences. Thus, a complex and risky relationship between adolescents and pot is born.

“The message to teens now needs to be along the same lines as tobacco products. Although legal if you are of a certain age, most people in this day and age would agree that it’s not a great idea to start smoking.”

Consequences of use

Although the subject is understudied, research data consistently show us that marijuana use does have specific and lasting effects on cognitive abilities like attention, organization, and planning (read more). It is also widely acknowledged in research, clinical, and epidemiological communities that marijuana is addictive for some people. We see this in data showing that marijuana dependence regularly accounts for a large percentage of treatment admissions (18 percent in 2009), behind only alcohol and opioids. Research also shows that marijuana may significantly alter brain development. And as with other substances of abuse, the earlier that a person initiates the use of marijuana, the more likely he or she is to have problems with it in adulthood.

Legalization and how to talk about it

As we know, the recreational use of small amounts of marijuana was made legal in two states recently. I watched the coverage of this issue in November with some interest, again both as a parent and an addiction research professional. Watching the images of folks lighting up in celebration isn’t likely to help defuse the notion many kids have that marijuana is not that risky. Besides which, teens are constantly bombarded with pro-drug images in pop culture, more so now than a decade or two ago.

It occurs to me that the message to teens now needs to be along the same lines as tobacco products. Although tobacco is legal if you are of a certain age, most people in this day and age would agree that it’s not a great idea to start smoking. A recent Examiner article astutely pointed out that “legalization doesn’t make something ‘right’ or good for you.” Regardless of the ongoing political debates over decriminalization of marijuana which are sure to continue, researchers and clinicians agree that marijuana use among youth is clearly risky.

What should doctors do?

sbirt-400x275-gifSince our organization has become the National Screening, Brief Intervention, and Referral to Treatment ATTC,  I have done my fair share of reading about how SBIRT is being implemented into primary care practices, emergency departments, and employee assistance programs.

Many doctors, including this one, maintain that teens should be asked about drug and alcohol use at every visit, in the absence of the parent or parents. The case for universal screening is especially strong for adolescents.

When explaining the concept of universal screening, I like to compare SBIRT with blood pressure checks. Few would argue with the practice of taking one’s blood pressure at the doctor’s office. Given that one quarter of teenagers say that they’ve used marijuana, and given that many have regular contact with their pediatrician, the fit between SBIRT and primary care seems to be a good one.

What can parents do?

As an academic researcher at Pitt, and still to some degree in my work at IRETA, I am driven by the question of “why.” Why do some adolescents decide to try marijuana and others do not? After all, according to the MTF survey, 75 percent of 8th-12th graders reported they did NOT use marijuana during the previous year. Further, why do some adolescents who experiment with alcohol or other drugs seem to mature out of it while others succumb to the disease of addiction?

As a parent, the question of “why,” while still academic in nature, has taken on deeper importance. The question of “Why do some kids…” becomes “How do I get my kid not to…” Along with my own son who is now in first grade, I recently gained an 11-year old stepson. This means that in three short years, he will be in the eighth grade, and according to the MTF statistics, at least a quarter of his peers will have tried marijuana. A sobering thought, indeed. So although I have a Ph.D. and have studied adolescent addiction for years, the same questions and vague sense of helplessness remain when the issues hit home.

parentingJust this year, the Treatment Research Institute and The Partnership at Drugfree.org published a guide of six parenting practices to help reduce the chances of a drug or alcohol problem developing. This guide is research-based, clear and concise, and should be required reading for every parent. The most refreshing thing about this document is none of the practices reviewed are surprising or very difficult to implement. Here they are, in a nutshell.  (And here is the highly recommended full document.)

  1. Build a warm and supportive relationship with your child.
  2. Be a good role model when it comes to drinking, taking medicine and handling stress.
  3. Know your child’s risk level.
  4. Know your child’s friends.
  5. Monitor, supervise and set boundaries.
  6. Have ongoing conversations and provide information about drugs and alcohol.

This wonderful piece reminds us that no matter what the numbers are, there are actions that health professionals and parents alike can take to reduce marijuana use among our children and teens, and we can be assured that our efforts are well worth it.

Recommended Resources

Above the Influence

INTERVENE: A community of parents concerned about their teens’ alcohol and drug use

The Partnership at Drug Free for Teens

SAMHSA’s Tips for Teens 

NIDA’s Marijuana Facts 

 

dawnDr. Dawn Lindsay joined IRETA in April 2011. She completed her graduate work in clinical psychology at the University of Cincinnati in 2002 and was on the faculty in the Department of Psychiatry at the University of Pittsburgh before coming to IRETA. She has eight years of experience conducting NIDA- and NIAAA-funded research in the area of adolescent substance use disorders. She is a member of American Psychological Association and the American Evaluation Association.  Click here for a list of her publications