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When Marijuana Is the Drug of Choice

November 1, 2006
by Candis Siatkowski
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Youths' perceptions about the drug can cloud prospects for effective treatment

Marijuana is the most widely abused illegal drug in this country, according to the National Institute on Drug Abuse (NIDA). The 2004 National Survey on Drug Use and Health found that more than 2 million Americans begin to experiment with marijuana each year, and 1.3 million of that group are adolescents. These national findings are consistent with patterns seen in the patient population at Caron Treatment Centers, a residential drug and alcohol treatment facility in southeastern Pennsylvania.

The majority of the patients at Caron who have been admitted for marijuana treatment are younger than 30. Although many older patients also abuse marijuana, it tends for them to be a secondary drug of choice, after alcohol, cocaine, heroin, prescription medication, etc. Treatment for marijuana abuse in the younger patient population poses some significant and unique challenges for professionals.

Marijuana abuse often starts with a subtle nod from peers, pop culture, and even parents that “getting stoned” constitutes a natural rite of passage. Consider that many movies and television programs showcase marijuana use as a normal teen activity, and that many parents of teens might have abused the drug themselves. These factors may lead young people to believe there is no real harm in using marijuana. They may not realize the dangerousness of the drug or that it can have serious long-term health effects.

Marijuana's mood-altering properties are derived from the potent chemical THC (delta-9-tetrahydrocannabinol). About 400 other chemicals are found in marijuana as well. Over the years, with cultivation and plant breeding, the concentration of THC in marijuana has increased. The THC from smoked marijuana connects to cannabinoid receptor sites in the brain, found in areas that regulate movement, coordination, and cognitive processes such as learning, memory, judgment, perception, and concentration. THC overstimulates the receptors and disrupts normal functioning. Typical results can be euphoria, lack of motivation, slowed thinking and reaction time, confusion, and impaired memory and learning. After the effects of smoking marijuana wear off, a person can become tired and depressed; anxiety attacks are not uncommon as well.

Treatment elements

At Caron, marijuana abuse is treated within a 30-day residential primary adolescent care program. The program's holistic approach includes psychological, spiritual, and physical components to help patients better understand their problem and find new ways of coping. Caron recommends total abstinence and encourages patients to identify strengths and create goals that would be sabotaged by continued abuse.

“However, treating marijuana abuse often presents different challenges compared to alcohol and other drugs because counselors must change both the patient and parental perception that marijuana use is ‘normal' and not addictive,” according to David Rotenberg, executive director of Caron's Adolescent Treatment Center. While Rotenberg reports that half of the adolescents at Caron consider marijuana their drug of choice, he adds that many have been able to avert “the more severe, stereotypical consequences of drug use, such as legal problems.”

As a result, “The adolescents in treatment don't feel they have a problem with marijuana,” Rotenberg says. “They consider it a ‘softer' drug, doing much less damage than hard drugs. We try to communicate that it may be slower and more insidious compared to heroin and crack but it will ultimately be just as painful.”

In addition, many parents also minimize the issue of marijuana use. “Parents are saying, ‘I'm glad my kids only smoke marijuana because it's better than them using alcohol, or at least they're not banging dope,'” Rotenberg says.

Janice Styer, clinical coordinator of Caron's adolescent girls' programs, echoes Rotenberg's observations by saying that “adolescents who come here for marijuana dependency report they feel it is ‘no big deal' because some of their parents use it— the baby boomers. They also know a lot of professionals who use it and still have a good life.”

Caron experts work on tackling these misperceptions in individual, group, and family therapy sessions by showing patients and their families the negative impact marijuana has had on their lives in the short term, and revealing common long-term consequences. Counselors point to a significant drop in grades, decrease in quality of life, and changed values as immediate consequences of marijuana use. Styer recalls a former patient of the Caron adolescent program who had maintained a straight A average in high school and received a medical scholarship to a prestigious university. After his shift toward marijuana-abusing behaviors, the youth's grades plummeted and he lost the scholarship.

Education serves as a major component of the treatment process for young patients and their families. Counselors offer a variety of handouts that provide detailed information on the consequences of marijuana abuse (including long-term health effects) and offer tips for working a recovery program. The handouts juxtapose myths such as “Marijuana gives a pleasant, easy-to-control high” with realities such as “Marijuana's effects are hard to predict.” Counselors also provide parents with readings around how their attitude and behavior toward marijuana can affect their teen's recovery from marijuana abuse. Parents who may use the drug occasionally are strongly encouraged to quit for the sake of their child's recovery.

Substitute behaviors

Once patients and parents come to terms with the severity of marijuana abuse, the next step is to help them find other more appropriate ways to enjoy life. More and more, counselors are finding that exercise can replace marijuana as a natural high and be a critical component of successful long-term treatment for adolescents and young adults.