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‘The most dangerous drug out there’

May 8, 2014
by Shannon Brys, Associate Editor
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When you opened this blog post, what were you expecting to see as ‘the most dangerous drug out there’? Methamphetamine, opiates, oxycodone or crack cocaine?

The answer is...none of the above, according to Douglas Marlowe, chief of science, law and policy at the National Association of Drug Court Professionals. “The most dangerous drug on the street today is marijuana,” said Marlowe, who spoke to an audience at the 2014 National Council for Behavioral Health conference in Washington D.C. about making treatment more effective by carefully matching an individual’s criminological risk-and-needs profile to a specific treatment plan.

He then answered the question the audience was dying to know: Why is marijuana the most dangerous drug out there?

“Because everyone thinks it’s safe,” Marlowe explained. “And because it’s a pediatric onset use.” Since there aren’t many cases of individuals who start to use methamphetamine or other illicit drugs at an early age when their brains are still developing, he believes this makes marijuana worse.

He also reminded the audience that the average reduction of IQ points for adolescent onset marijuana abuse syndrome is five to eight IQ points. “Eight for severe use, five for weekly but not severe use,” Marlowe said. “Let that sink in.”

Knowing this information, providers and clinicians should be aware that kids who start using marijuana in early adolescence are going to be harder to treat. Therefore they have a poorer prognosis, and will have to be treated differently than the ones with late onset, he explained.

“By the way, for those of you in support of legalization or de-criminalization, I’m not saying any of this to change your mind. I know that’s impossible,” he said. “I’m only saying this so that when it happens, I can say I told you so.”

Do you agree or disagree with Marlowe? I’d love to hear your thoughts! 

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Comments

What a curve ball for our Addiction industry. I am sure that we will survive. At the same time there will be a parting between opinions concerning THC's positives and negatives and social policy.

In this post a real problem with marijuana is the drop in IQs among teenage users depending on the severity of use. I've done a little research (university data bases) and I am suspect of those findings and the credibility of the statement. Perhaps we ought to let the genius use. They would probably do better than the average 100 IQ people. Last time I looked, the IQ test is without credibility and deceptive when used within different cultures. Since we live in an anti-intellectual society, the Republicans may start using pot. They survive on dumbing down the electorate for more votes. Dollars are more important than people, if I heard them correctly. The latest justification for War, G.W.Bush. The corporation is a person with one job, profit.

I am appalled that we would make statements like THC is BAD when our code of Ethics, IC&RC for example, states that our opinions should be based on research, hopefully a full account of the literature. I have not used for 30 years now, but in a society where tobacco and alcohol are legal and used to positive and negative outcomes, a re-examination of our understanding of the value of Marijuana needs some time and vigorious research before settling on one policy based on abstinence.

Ten years ago treatment centers would not admit chronic users to treatment if they took anti-depressants. Times (understanding) changes.

The THC revolution was predicted years ago and the current stimulant generation, Starbucks etc., probably appreciate the effect THC brings in the early, romantic, evenings of pleasure. Plus, I understand that THC could be considered a mild contraceptive since it reduces male sperm counts and viability. Some may consider this option.

If the addiction industries’ only response to legal use of marijuana is a black and white power thrust toward abstinence we will discredit our own disposition toward a wide range of positives and negatives related to treatment of mental illness, obesity, and other ailments that require medications that trick our endocrine system for a positive effect. Humans, in my opinion, range wider in emotional regulation, pleasure demands, and spiritual beliefs that require a better understanding of the goal for treatment centers; abstinence only. Perhaps the anorexive person could benefit from some munchies. Imagine, for one second, if we were talking about chain saws. "Use may include the loss of a limb, so don't use".

No, I don't believe teenagers should drive around under the influence, ever. Safety concerned activities like the Military, cops, correction officers, airplane pilots, and more are hopefully sober when on the job, and should be tested for the same. What I am saying is, Please understand that abstinence for all is not achievable and when promised only leads to the rule breaking effect. "My cold pill made me feel...."

The worst drug is our own small thinking on the big picture.

As an ex pot head, turned drug abuse counselor, now retired after 30 years, I absolutely agree with this assessment of the danger of THC. If I were still using I would say to jhermes, hey J, let me take a hit on that.
Some of my saddest cases were young men in their 30's who started using MJ in their early to mid teens. Being locked in their prepubescent adolescent mentality, they were never able to enter the adult conversation that is necessary to achieve true sobriety. They live in a delusional world that is all too unfortunately, with the legalization of marijuana in some states, becoming the societal norm.

What is the problem we are trying to solve ?
The issue before us is how do we reduce marijuana use particulary by vulnerable youth ? The word "Legalization" is a wolf in sheep's clothing for the "normalization" and "commercialization" of cannabis. The pro legalization position steps well beyond the
legal and into the public health sector. We need to look at the history of tobacco and remember that we ended up chasing the train after it left the station - we have the research that shows the risks and potential for harm and the public needs to get their hands on it. There needs to be a Surgeon General's Report before another state takes on a prolegalization position or we will suffer the same consequences and have no way back. In this century one billion people will die a tobacco related death, currently in American one in five deaths is a tobacco related death - we face a tobacco epidemic of drastic proportions and some people out there think we have won the tobacco fight - one in three young chinese men currently alive will die a tobacco related death due to that countries lack of public education on the risks of tobacco. Unless something radically changes their fate is sealed. We need to not let another addictive drug get away from us and into the hands of our children. It is a simple situation of limiting access and denormalizing cannabis not the other way around.

I think that someone who is involved with drug courts and the law may have a different view on health aspects of cannabis than a physician or someone who can critically appraise the scientific literature.

There is precious little difference between methamphetamine and Ritalin, as Carl Hart has written about. Given the massive overprescription of amphetamines to children (see Esquire's Drugging of the American Male), I am far more concerned about the way this is affecting their brain than any cannabis exposure. I join most experts in believing that regulation rather than prohibition is a more effective solution in reducing the use of cannabis by children.

Looking at the 8 point decrease in IQ that you quote, you fail to mention the controversies surrounding that study. Anyone familiar with the literature should be aware of the followup article: "Correlations between cannabis use and IQ change in
the Dunedin cohort are consistent with confounding from socioeconomic status"

I realize that your title is for shock value, but if anyone would like to see a more evidence based assessment of the most dangerous drugs, check out the Lancet: Drug Harms in the UK.

The researchers in the Dunedin Study controlled for the socioeconomic factors in their findings and have also considered other confounders to their findings. The drop in IQ appears to be real. See their rebuttal here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3600438/

While I don't necessarily agree that marijuana is the most dangerous drug out there, I do think its risks are being seriously underestimated in a full PR campaign for legalization. There will be a social cost. I don't even want to say "I told you so." I'm just sad to see it coming.

I was asked by this publisher, "When you opened this blog post, what were you expecting to see as ‘the most dangerous drug out there’? Methamphetamine, opiates, oxycodone or crack cocaine?"

In the early '90s I had a 2 year position as an admission counselor at the local Salvation Army, Addiction Treatment Center here in Honolulu. I listened to many "auto-biographies" of acquaintance, use, abuse, and dependence. Sometimes this process was interrupted by incarceration or long and short term sobriety. I had an ER nurse that gathered the 1/2 full vials of Fentinel left behind for clean-up and a teen that was sent to drug court for tobacco in school. Perhaps the questions about the worst drug is one of those "depends" question, like how many strings does it take to reach the moon; "it depends on the length of the string?"

After reading Eric Clapton's Autobiography I got the sense that he was dependent on heroin in his youth; however, the worst was alcohol. I read somewhere that people in recovery switch addictions some slower and some faster. There are a lot of diets in the world and it is the one that is activated that works. I supervise a staff member that goes to great lengths to gain the approval from every staff member and all the clients (Big Issues). He cannot help it. At 48 y/o he has to call "mom" for approval about the slightest pivot point he encounters. Pivot points are the moment of making a decision with consequences, good or ill, large or small. The only cure for any of the above Bad Drugs is for the human being to focus on and discover how to loosen musterbation and take responsibility for one's behavior.

I understand that kids now drink caffeine infused alcohol and experience a high first and depression later. I think the idea of the worst drug requires a context to make sense. 5-10 years ago my TC was populated the 90% meth addicts. Today it is perhaps 60% meth and 35% heroin, if you believe the person that is talking to you. It depends.

Dr. Peele likes to point out that a huge percentage of "in country infantry during the Viet Nam War" had a heroin problem until they came home and most gave it up. He makes the argument that Addiction is Context related.

I have recently been inundated with literature about "trauma informed care". Of course, when a human organism is reduced to an existence defended against perceptions, good or ill, will believe in and tether themselves to something, devils included.

Perhaps love or money or ego is the worst of drugs. Babies cry for it and Adults will die for it.

It depends.
J

If we developed a substance out of cotton that would produce a high; could be smoked, eaten, vaped, or used in other ways; seemed, by comparison to other substances, relatively safe; and evaded complete safety and dose-related analysis by the Food and Drug Administration since it was so common and since the use of it spread overnight to every age group and socioeconomic group--we would have the situation we are in with marijuana. In all of of the legalization talk, I have not heard one argument that includes the fact that marijuana can stop a heart in a regular user or a new one. Now, this is not a relatively frequent occurrence, but as the number of users rise, it will become better known and more common. I would not know of it if I had not been doing an 'overdose survey' of death certificates--including any deaths where a person did not have a chronic fatal condition, and where a drug toxicology report was done. The coroner had written "known drug user" on the certificate and had done the toxicology sampling. I am grateful he did not change his finding when the report came back showing that marijuana was the sole drug in the deceased person's blood. Cause of death: myocardial infarction. (Google: Myocardial infarction and Marijuana.) As I was flipping through records, I ran upon a boatload of myocardial infarction deaths--sudden deaths requiring an autopsy--in a population that was relatively young. Since they were not "known drug usere," they did not have toxicology done. In truth, we don't know the frequency of the occurrence in our population. No studies were done when the drug was "illegal," and only now is the FDA insisting on dose accuracy labeling on the product.

Shannon Brys