5 takeaways:
➀ Marijuana remains the most popular of all illicit drugs. For people 12 and older, about 19% – about 53 million Americans – used an illicit drug in 2018. Of those, 44 million used marijuana. Next was misuse of prescription pain relievers, by 10 million. “It even dwarfs opioids, even though of course the medical consequences are very different for the two substances,” said Dr. Tauheed Zaman, an assistant professor of psychiatry at the University of California, San Francisco.
➁ People who think they know what they’re getting with their daily joint don’t. Marijuana refers to the parts of a cannabis plant that contain a substantial amount of tetrahydrocannabinol, or THC. But the plant contains more than 100 other chemical compounds as well. And even the level of THC is hard to know. In edible medical cannabis products sold legally, only 17% accurately labeled their THC content, according to a 2015 study in JAMA. When one of Zaman’s patients said, “I actually know exactly what I’m getting,” Zaman said he wanted to tell him, “Actually, there’s about a 17% chance that we know what you’re getting.”
➂ Risks of are greater for young users, whose brains are still developing. Human brains aren’t fully developed until people are in their late 20s, and the last to develop are the frontal lobes, which control thinking, executive function, cognition and impulse control. Heavier users of cannabis show poorer life outcomes, such as lower rates of high school completion and higher rates of depression and welfare dependence. How much is due to the marijuana and how much is due to other factors? Those associations are still being studied, but Zaman said, “We want to protect the brain as long as we possibly can from the influence of substances including cannabis, alcohol, opioids, because we want these frontal lobes to have a chance to myelinate and develop properly.”
➃ Cannabis use increases the risk of psychosis. The connection between cannabis use and psychosis has been well studied, and higher usage leads to a greater risk of psychotic disorders, Zaman said. A “psychotic outcome” means a brief episode of psychosis, emergency room visit or a hospitalization for a psychotic break. “There is a dose-dependent risk,” he said. “So the more cannabis someone uses, the more at-risk they are of a psychotic outcome.” In patients with a family history of schizophrenia or another psychotic illness, cannabis use speeds up the onset of psychosis by an average of about seven years, he said.
➄ Young users and regular users are more likely to get hooked. Only 9% of cannabis users develop an addition, but 17% of adolescents do. Among daily users, the addiction rate is 25-50%. While cannabis withdrawal is not as intense as opioid withdrawal, it can be “incredibly uncomfortable,” Zaman said. Withdrawal symptoms include irritability, anger or aggression; anxiety; sleep difficulty; decreased appetite; restlessness; depressed mood; and shakiness, sweating, fever, chills or headache.
This program is sponsored by the American Society of Addiction Medicine, with support from Arnold Ventures. NPF retains sole responsibility for programming and content.
