A medical detox specialist for the Cliffside Malibu addiction treatment facility in California offers a telling anecdote about how the changing perceptions of marijuana's risks are affecting treatment settings.
“When I ask the young people I see to tell me which drugs they've been using, they may not even say marijuana. They'll list cocaine, Vicodin,” says Damon Raskin, MD. “When I mention marijuana, they'll say, 'Oh yeah.' They don't even consider that a drug. They might say, 'That's my medicine.'”
In an interview this week with Addiction Professional, Raskin described an emerging picture of the troubling effects of regular marijuana use on young people's cognitive processes. There remains much to be learned in this area, but it is becoming clear that marijuana is playing a prominent role in the lives of many youths whose brains are still developing (Raskin adds that only about 5 to 10% of the young patients he is seeing have been using only marijuana and no other substances).
Raskin says that at the very least, many young patients who have been regular users of marijuana exhibit patterns of poor decision-making, shortsightedness, low achievement at school or work, and lack of interest in productive activities for which they used to show passion. At extreme levels, patients have depressive episodes or feelings of paranoia and anxiety that persist long after the marijuana high. Raskin sees patients at both Cliffside Malibu and in private practice.
“We don't know what comes first”—the drug use or the mental health symptoms, says Raskin. “Are patients with depression self-medicating with marijuana?” It is therefore desirable to place these individuals in a setting where they can get clean and sober over a several-week period. “We don't want to immediately start antidepressant medication,” he says.
Research is legitimizing growing concerns in the field about access to high-potency marijuana. A study published online last month in Lancet Psychiatry compared first-episode psychosis patients in South London to a control group in the community, and found that users of high-potency “skunk” cannabis had a three times greater risk of a psychotic disorder than those who had never used the drug. The highest risk vis-à-vis non-users was seen in daily users of high-potency marijuana.
Raskin also remains concerned about some research that indicates that even when heavy marijuana users quit, they still don't catch up to their peers on certain measures of cognition. Youths and adults alike need to realize that when they perceive marijuana to be more like alcohol than harder drugs, they still are comparing marijuana to what amounts to a highly risky substance.