Despite slight decreases in use in recent years, marijuana remains the most commonly used illicit drug in our country. More than 1.2 million Americans ages 12 and over participated in substance use treatment for marijuana in 2006, making it the second most prevalent substance of concern behind alcohol. The percentage of Americans seeking treatment for marijuana use more than doubled from 1993-2005.1,2
Clients in treatment for alcohol and marijuana use are somewhat more prone to denial, justification and rationalization than clients in treatment for “harder” drugs such as cocaine, heroin and methamphetamine. I suspect this is the case because many people have smoked marijuana without experiencing significant consequences, because many of marijuana's effects develop gradually and are therefore difficult to recognize, and because societal attitudes about marijuana are ambivalent.
Some clients adhere to beliefs about marijuana use that make it more difficult for them to recognize the harmful impact of use on their lives. Here I will explore four “marijuana myths” I have encountered in my practice, and I'll offer strategies for generating critical thinking about these myths.
Myth #1: Marijuana is all-natural. Therefore, it is safe and healthy to smoke it. (Variations: “God put it on this earth for a reason.” “It grows in nature, so it's fine.”)
Today's marijuana is not the same substance as the plant that grew indigenously in nature. The main psychoactive ingredient in marijuana is delta-9-tetrahydrocannabinol (THC). The average THC content in seized street marijuana more than doubled in 14 years, increasing from under 4% in 1983 to 9.6% in 2007.3 This increase is attributed to decades of crossbreeding and cultivation techniques used by people intending to synthesize a more potent substance.
The belief that marijuana is healthy because it grows in nature presupposes two ideas:
If something grows in nature, then it must be healthy. Using this logic, one could argue that rubbing poison ivy on one's skin or eating poisonous mushrooms is healthy. In truth, some things in nature are healthy for consumption while others are not.
Plants that grow in nature were intended to be smoked by humans. If marijuana exists for some cosmic purpose, that doesn't necessarily mean it was intended to be smoked. Perhaps human beings weren't designed to smoke anything, since inhalation of smoke is a tissue irritant that is initially rejected by the body. Tobacco, opium and coca all occur in nature, but I have encountered few marijuana users who believe that smoking those substances is healthy. Historically, marijuana has been used for other purposes (e.g. rope, clothing, mats, fishnets and oils).
Myth #2: Marijuana is harmless. (Variations: “No one dies from it.” “It never hurt anyone.”)
There is an element of truth in this belief, given the lack of strong evidence that marijuana use causes fatal overdose. However, overdose is just one way in which substance use can be fatal. In the 2002 Drug Abuse Warning Network (DAWN) report, marijuana was the only substance involved in 2 overdoses, 35 deaths by suicide, 53 accidental deaths and 69 other drug-related deaths. A national estimate of deaths associated with marijuana only is 581, but that figure might be low as some metropolitan areas do not include marijuana in toxicology tests and others do not report any toxicology results. This number also excludes any deaths in which any substance besides marijuana was also detected.
Recent advances in technology have allowed scientists to unlock some of the mysteries of the brain. THC molecules bind to receptor sites in areas of the brain responsible for the regulation of the functions found to be adversely affected by marijuana use, giving us an explanation for how marijuana does what it does.
For example, marijuana use can cause significant impairment when a person drives a vehicle or operates machinery, which undoubtedly poses a risk for accidents, legal problems and fatality.5 Chronic use has been linked to cancers, respiratory ailments and immune system malfunction.6,7,8,9 Marijuana causes sleep stage irregularities, affecting memory, immunologic functioning and subjective well-being.10 Marijuana-related memory impairment can have vocational and educational implications.11 Chronic use has been linked to reproductive impairment.12 Clients with Axis I conditions (e.g., ADHD, bipolar disorder, psychotic disorders) are prone to self-medicating with marijuana, but use can exacerbate their symptoms.13,14