Editor’s note: This commentary is by Dr. Jill Rinehart, of South Burlington, who is a full-time pediatrician with Hagan, Rinehart & Connolly Pediatricians. Dr. Rinehart is the president of the Vermont Chapter of the American Academy of Pediatrics, clinical associate professor of pediatrics at the Robert J. Larner School of Medicine at the University of Vermont Medical Center and a member of the Vermont Medical Society.
[S]ome are saying that commercial sales of recreational marijuana in Vermont is a “done deal.” I hope this is not the case. Why is marijuana such a troublesome drug for me, your community pediatrician? You may read about marijuana-associated traffic tragedies or small children accidentally eating “edibles” that are in the home.
In fact, the effects of marijuana that I see daily in my practice are more subtle, but as heart-wrenching, horrifying and sad.
The adolescent who “smokes a bowl” every night “to help her sleep,” but whose anxiety is now increased overall so she is withdrawn from family, can’t get her homework completed, her grades suffer and her dreams of being a neuroscientist are gone, in a literal puff of smoke. This is what marijuana addiction does. Weekly marijuana use as a teen doubles the risk of developing anxiety and depression later in life. And it happens, all of the time. In Vermont, more people seek out substance abuse treatment for marijuana dependence than all other substances combined (including opiate addiction).
Or the frantic call from a mother whose son is picked up from college early because of marijuana-induced psychosis. “He’s not himself anymore.” This can occur in adolescents with minimal or even first time marijuana use, often (but not always) in a family with a history of mental illness and can be unrelenting, leading to a lifelong diagnosis of schizophrenia even in the absence of continued marijuana exposure. With today’s higher levels of the psychoactive drug THC (a 300 percent increase in potency since the late ’90s), the rate of schizophrenia, acute psychosis and marijuana associated injury and overdose has increased dramatically.
Recent Vermont laws have loosened the regulations around the use of marijuana. We have marijuana available for those with chronic pain, epilepsy, chemotherapy associated nausea and other medical uses. We have decriminalized marijuana so that one may possess small amounts and even grow at home for personal consumption. We are justifiably trying to treat marijuana addiction as an illness and not a criminal offense.
But the social justice and medical benefits stop here and if we are concerned about the health consequences of marijuana use, so must our efforts to make marijuana more available.
Commercialization of marijuana gives our youth the wrong message — that marijuana as legal, must be safe. When youth believe the risk of harm from a substance is less, their use of that substance increases.
Although political lines have been drawn around the loosening of regulations for marijuana, across the political spectrum one thing is agreed upon: let’s keep children and adolescents away from marijuana. But how is that possible, when the success of the marijuana industry depends on creating lifelong users — and doing so relies on an adolescent marijuana market? In states where commercialized marijuana exists, 80 percent of the consumption is by 20 percent of the users. Today’s youth are the chronic daily marijuana users of tomorrow.
Then there is the science of brain development which tells us how susceptible the adolescent brain is to the long-term consequences of substance use — it causes cognitive problems like difficulty with short- and long-term memory, it worsens one’s problem-solving ability, and prevents youth from “changing course,” that is, breaking a habit, even when the need to change that habit is imperative. Perhaps it is this effect on the brain that allows marijuana to “prime” the adolescent brain for long-term addiction. Youth who use marijuana are three times more likely to become addicted to marijuana than adults. Youth use is associated with decreased school and job performance. Marijuana has introduced many of my patients to nicotine (often combined with weed), alcohol and opiates.
Vermont has done well to become one of the healthiest states in the union by valuing access to medical care and investing in the well-being of our children and families. Commercialization of marijuana is at cross purpose to these values and the well-being of our state’s population will suffer as a consequence of further legalization.