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TEEN RESCUE

A PROPOSAL FOR A PROGRAM TO RESCUE TEENS FROM SUBSTANCE ABUSE EARLY IN THEIR SUBSTANCE ABUSE CAREER

Don E. Miller, Ph.D.

619-422-2458

NOTE: The first five pages of this document constitute the basic plan to save teens from substance abuse, the next 72 (of 77) pages provide in-depth background research. The members of the Government Affairs Committee of the San Diego Psychological Association have expressed an interest in finding ways for the Teen Rescue proposal to become law.

Federal and state legislators have become more and more concerned about the high rate of drug overdoses nation-wide, apparently surpassing highway traffic deaths. Various bills have been proposed to deal with this issue. But the simple fact is that whatever interventions proposed generally still let many people drop through the cracks. At present it is estimated that one of ten people in San Diego County needing alcohol or drug treatment are receiving it. There are 157,634 teens between the ages of 13 and 17 in San Diego County. There are 43,741 12^th graders. About 21 percent report smoking marijuana in the last month and six percent smoke marijuana daily. Adding estimated totals of daily marijuana smokers from grades ten to 12 there are approximately six thousand daily marijuana smokers in San Diego County, approximately 2,000 are in treatment though the emergency rooms are being flooded with teen age overdoses of marijuana or synthetic cannabinoids. In County programs, about 1200 are in treatment a year but only 48% are listed as completing treatment. Included later in this document are several graphs presenting data on drug usage. There are 2,049,464 teens age 14 through 17 in California. Approximately 122,000 are daily users and approximately 409,892 are monthly users. Approximately ten percent are in treatment, leaving perhaps 100,000 teen age users in danger. More extensive data collection may alter these figures but no matter what the final numbers, many thousands of California teens will be found at risk of damage to their bodies and becoming long-term addicts. Again, nine out of ten drug users began using before the age of 18.

At present, if a mother calls any number of agencies including the police and rehab agencies and says, “I need help, my teenager is in the backroom smoking pot and flunking out of school,” what happens? Almost always, nothing. The parent is informed of various programs to which they can take their teen. If she says my teen refuses to go, then what? Again, almost always, nothing. What if, if that same mother called for help and a team made a home visit and did an assessment and determined the teen was under the influence of an illegal substance (in spite of all the medical marijuana cards, teens under 18 still can’t legally use marijuana). Could TEEN RESCUE legislation be put in place so that teen could be placed involuntarily in treatment with careful follow-through to save that teen from the multiple negative consequences of smoking marijuana? And what are these consequences? Increased rate of Schizophrenia, damage to the brain due to overwhelming cannabinoid saturation, preventing normal development of the brain, lack of motivation for school and most other things. If all pot-smoking teens were clean and sober by the time they were 18, think of the thousands of substance abusing teens in San Diego alone who would not go on to a career of substance abuse and jail. Nine out of ten adult substance abusers began before the age of 18. To have taught life-time sobriety tools to teens before the age of 18 would surely drastically reduce the adult substance abusing population perhaps by 50% or more. One of the major problems for certain segments of the population might be that many parents who are marijuana users who see no harm in the drug are lighting up and smoking marijuana with their teen age children. Incidentally, though Marijuana is the most frequently used drug, teens abusing other substances including meth, opium, heroin, alcohol, etc. will be eligible for participation in the Teen Rescue program. It is recognized that such a proposal would involve extensive effort. But the savings in multiple other areas would be worth it. Millions would be saved in Emergency room visits, prison costs, and loss of productivity, mental illness treatment including schizophrenia, anxiety and depression.
A parent’s phone call asking for help with a substance abusing teen currently often results in the parent being provided with a list of agencies that treat drug abuse. How many parental calls for help result in a teenager being rescued from substance abuse? Current policies rarely involve active intervention because of a parental phone call. Once youths have been arrested at least once, the system may begin to respond. How many youths new into substance abuse would be willing to admit they are involved in drugs and then go to drug treatment counseling and subject themselves to testing? Denial is the typical reaction of the teen on drugs when responding to their concerned parents accusations or fears.

The program being proposed would provide a response to parents asking for help. Drug counselors would visit the home of concerned/suspicious parents and obtain a sample of blood or urine to determine if the child or teen in question is under the influence of an illegal substance. New technologies may make it unnecessary to obtain blood or urine samples, as some pharmaceutical companies are claiming that even a fingerprint will reveal the presence of an illegal substance.

Isn’t this invasion of privacy? The law allows for collection of samples of blood or urine to determine if an individual is under the influence when there is probable cause. Parental suspicion based on finding drugs, paraphernalia, or noticing other symptoms of drug abuse, is probable cause. Other symptoms of substance abuse include mood changes, problem behavior, falling grades and truancy. Once found positive for an illegal substance, the individual is in violation of the law and a condition of probation is staying clean. Careful monitoring and treatment would guarantee continued sobriety in the “Teen Rescue” program.

If all that is required to rescue teens at the beginning of their drug abuse careers is enforcing already existing laws, why isn’t this being done now on a routine basis? Laws already on the books allow testing for an illegal substance based on probable cause. These laws are greatly under-utilized because the police and probation officers are busy “putting out fires” so to speak. They can’t even keep up with people re-arrested for new crimes committed under the influence. They claim that they don’t have the resources to go after kids already on probation for drug involvement who have run away from home and hang out taking drugs. And that’s even when they have been told where to go to find the kids. Basically, at both the child and adult level, people, who don’t show up for school, treatment or testing, are lost until re-arrested for a new crime. A stitch in time saves nine. Allowing teens to get very deep into their drug career, until they have committed various crimes is very expensive. The teen (or in a very short time, young adult) who could have been sobered up for a few dollars at the beginning of their substance abuse career is now costing $30,000 to $50,000 a year to maintain in prison.

Calls to rescue teens also could be fielded from the schools where basically everyone knows who the stoners are. That is, the ones who fall asleep in class, the ones found with paraphernalia or drugs. Often, even the finding of drugs on the person of a student on campus does not result in entering the legal system to get help in getting sober.

The “Teen Rescue” program should be allowed to exist for at least five years. It may be that a pilot program in perhaps once city in California will be tried first. The reason for a five year program is that by the fifth year there would be an opportunity to demonstrate a positive outcome. The hypothesis is that if drug addicts are stopped early in their careers, then teen and young adult crime rates should plummet, more so each year the program is in existence. A very large percentage of all people arrested for anything are under the influence at the time. Almost half of the approximately 2.3 million prisoners in U.S. jails are locked up for non-violent drug offenses. What about heroin and cocaine addicts? The kids don’t usually start with heroin; they start with pot and amphetamines. Many researchers now claim that marijuana is not a gateway drug and that people who like the effects of drugs will try a variety of substances. But teens who smoke marijuana are 85 times more likely to go on to hard drugs than non-pot-smoking teens.

The new and improved stronger marijuana strains result in psychosis for many teen users, sometimes just a few months after initiation into pot smoking. Marijuana is not harmless after all. There were approximately 38,000 crashes in 2003 involving drivers impaired by marijuana. Starting marijuana use during teen years often results in cognitive impairment later in life. There is evidence that individuals who start to smoke marijuana at an early age--while the brain is still developing--show greater cognitive deficits than do individuals who begin use of the drug when they are older. Individuals who started using marijuana at age 17 or younger performed significantly worse on the tests assessing verbal functions such as verbal IQ and memory of word lists than did those who started using marijuana later in life or who had used the drug sparingly. The risk of mental illness, including depression, anxiety, psychosis and schizophrenia are increased in teen age drug users, even when the numbers are controlled for predisposition and genetics.

Young people with a parent or sibling affected by psychosis have a roughly one in 10 chance of developing the condition themselves—even if they never smoke pot. Regular marijuana use, however, doubles their risk—to a one in five chance of becoming psychotic. If there are several thousand daily marijuana users in San Diego County, how many of them who would never have become psychotic, will become Schizophrenic due to marijuana? Some estimates suggest that one percent of the 700,000 children in San Diego County will become schizophrenic. But in the marijuana smoking population that number doubles so we end up with an estimated extra 100 schizophrenics. Taking care of a schizophrenic can cost a million dollars or more over their lifetime, so sobering up this youthful population should save San Diego County and the other agencies funding care for these individuals (including Social Security) 100 million or more over time. In comparison, youths in families unaffected by psychosis have a 7 in 1,000 chance of developing it. If they smoke pot regularly, the risk doubles, to 14 in 1,000.

Cooperation of the district attorney, the Juvenile Court System, must be obtained. It is anticipated that most of the teens enrolled in the “Teen rescue” program will become clean and sober without needing detox. Those who refuse follow-up testing and treatment will need more efforts, possibly time in a detox facility, possibly a brief stay in a drug free setting. The basic message will be, “You will be clean and sober, you can be clean and sober outside, while in treatment and follow-up testing, or, in some kind of facility. Take your pick.” The time in a facility could be as short as overnight with graduated increases if relapse periods continued. Enrollees in the program will be tasked with helping sober up each other. Reduced time (let’s say a third relapse has triggered a ten day stay in a rehab facility, perhaps mountain camp setting) by perhaps a day can be earned by an individual convincingly presenting evidence to their peers about the advantages of quitting drugs. And in cases where the drugs were used to numb unpleasant feelings resulting from trauma or disturbed family life, alternate methods of dealing with these feelings will be taught, including the multiple intervention methods available such as mindfulness, cognitive behavioral therapy, relaxation training, dialectical behavioral therapy, etc. In some continuation schools, daily marijuana use rises to 26% (instead of the typical 6% for 12th graders). Whatever traumas resulted in school problems (continuation school) and greater use among this population would also hopefully respond to counseling. Another incentive for shorter stays could be the avoidance of having to go physically take a youth who has missed appointments for a drug test or detox. If they come in by responding to a phone call they can do perhaps five days in detox instead of ten.

What about tracking the source of the teens’ illegal substances and catching and locking up dealers? This is not the purpose of the Teen Rescue program, we have learned by now that for every arrested dealer ten wait to take his place. There will be exclusive focus on reducing demand rather than supply. How do youths get alcohol? One way is to give a homeless guy a couple bucks for buying whatever you want to drink that day. In states like Colorado where marijuana is legal, teens have access to unlimited supplies. Thirteen percent of Colorado teens are daily marijuana smokers compared to a national average of around seven percent. California could go that route also if marijuana is legalized making the TEEN RESCUE program a very urgent matter. As it is, there are stories about adults signed up at ten different Medical Marijuana clinics to get pot for “headaches,” or other vague pains and then selling at double their price to their teen clients. Let’s hope we don’t waste time going after the middle-man because it is his teen client we want to help. This leads to the concept of a distinct revenue stream to fund the program. Even the medical marijuana clinics pay taxes. In Colorado, the pot stores provide a major source of governmental funding. Could the taxes from the Medical Marijuana Clinics, and the pot stores if California makes pot legal, be directly funneled to the Teen Rescue program? It makes sense that the taxes on the providers of the pot (not directly but through a middle-man) help pay to rehabilitate teens from the damage being done to their minds and bodies with pot and other substances. Cigarette taxes were used to fund various stop smoking campaigns. The difference is that smokers were not taken into rehab to stop smoking.

What is different about this program from the programs already in existence? Youths are already tested, housed in facilities. The difference is that once enrolled in the “Teen Rescue” program, no one will be allowed to fall through the cracks. As it is, even in the best programs in San Diego and the nation, too many fall through the cracks. In San Diego County, County funded programs treat 1200 of the teen drug users a year, only 48% finish their treatment. Eventually many teen-age substance abusers show up in the criminal justice system, some not until ten years later - after ten years of drugging and a series of violent crimes. In the “Teen Rescue” program workers will go out either the same night a teen doesn’t show up to an assigned rehab meeting or at the latest by the next day to rescue the teen from their injurious behavior. “Finishing treatment” will be redefined, possibly in various ways. Instead of going to 30 or 60 days of drug rehab, you might go for two days but whether you are sober or not determines outcome numbers, not how many days you went to treatment. Treatment could start with a ticket when the teen is found to be under the influence of a drug. If that ticket results in coming to test weekly, beginning the next day after the ticket (or the day after being found under the influence) and the test results show a decrease in toxicity over time (marijuana can take 30 days to get out of the system) perhaps as little as one meeting a week would be required.

Once the program begins, it could be guaranteed that many thousands of youths who had started on drugs would remain clean and sober. The focus initially might be on teens at the very first stages of their substance abuse career. Treatment does not have to be voluntary. People coerced into treatment by the legal system can be just as successful as those who enter treatment voluntarily. Sometimes they do better, as they are more likely to remain in treatment longer and to complete the program. In 1999, over half of adolescents admitted into treatment were directed to do so by the criminal justice system. Treatment can help people. Studies show drug treatment reduces drug use by 40 to 60 percent and can significantly decrease criminal activity during and after treatment. There is also evidence that drug addiction treatment reduces the risk of HIV infection (intravenous -drug users who enter and stay in treatment are up to six times less likely to become infected with HIV than other users) and improves the prospects for employment, with gains of up to 40 percent after treatment. Hepatitis C infections will go down. Virtually no one wants drug treatment. Two of the primary reasons people seek drug treatment are because the court ordered them to do so, or because loved ones urged them to seek treatment. Many scientific studies have shown convincingly that those who enter drug treatment programs in which they face "high pressure" to confront and attempt to surmount their addiction do comparatively better in treatment, regardless of the reason they sought treatment in the first place.

New research documents the fact that teens who abuse substances are likely to continue into adulthood as substance abusers, limiting their chances of success in life. Nine out of ten adult substance abusers started abusing substances before the age of 18.

Difficult as it may be to face one’s problems, the consequences of drug use are always worse than the problem one is trying to solve with them. The real answer is to get the facts and not to take drugs in the first place.

So what accounts for the massive correlation between marijuana use and use of other drugs? One key factor is taste. People who are extremely interested in altering their consciousness are likely to want to try more than one way of doing it. If you are a true music fan, you probably won’t stick to listening to just one band or even a single genre. This doesn’t make lullabies a gateway to the Grateful Dead, it means that people who really like music probably like many different songs and groups.

In terms of the “TEEN RESCUE” program, there is still wide ranging and varied damage caused by marijuana and the other drugs used by teens. It appears that marijuana and other addictive substances may not be considered gateway drugs or substances, but very often are used in attempts to numb or control anxiety or other emotional problems (often results of a troubled childhood). There are reports of people using marijuana to help taper off other drugs or substances. But, if people are trading down to marijuana that may cause less damage than high usage of some other substance (meth, heroine) the damage caused by marijuana is still extensive Thus, teaching teens how to control or deal with their emotional problems with tools other than chemicals would necessarily be part of the TEEN RESCUE program. There are a wide variety of proven therapeutic interventions that have shown this is possible, among them Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, etc. Thus, identifying teens who are frequently using drugs and intervening in their drug use would at the same time, very frequently, result in interventions that will improve mental health. Due to the possibility of large numbers of teens involved, if this program is implemented, many changes may be necessary. For example, though 30 days might be considered as a typical inpatient treatment term, this might have to be shortened to five days but with intense follow-up to make sure the new-found sobriety/detox stays in place.

ADDITIONAL INFORMATION AND RESOURCE MATERIAL

I have written two e-books on drug topics, one fiction, “Angel on Probation” that can be accessed at Smashwords

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"The foundation for later substance use is set for most people by the time they finish high school," said Alicia Merline, a University of Michigan psychologist who studied men and women who graduated from high school between 1977 and 1983. She and her colleagues found that those who drank heavily in school were three times more likely to drink heavily at age 35 than those who were high school teetotalers. Those who had tried marijuana in school were eight times more likely to be using marijuana at 35 than those who hadn't tried it by graduation.

I described the proposed TEEN RESCUE PROGRAM to a client who screamed, “Where were you when my daughter died of an overdose?” I apologized for being too late for her daughter but that at some time in the future we might save someone else’s daughter.

THE GOOD, BAD AND THE UGLY REGARDING MARIJUANA

See the 5/25/2015 Time Magazine article, “The Great Pot Experiment,” by Bruce Barcott and Michael Scherer. The Good: May reduce pain and inflammation, may reduce disturbed sleep and spasticity in Multiple Sclerosis, and may work to reduce epileptic seizures and may kill certain cancer cells and reduce the size of others. The Bad: Same as throughout this paper, negatively altered brains, mental illness and addiction. The Ugly: Yasmin Hurd had rats get high on THC as adolescents. They showed changes in their brains. The offspring of these rats played a game, push a lever to get some heroin. When the game got harder, the offspring of the THC exposed parents (but not rats not exposed to THC) worked much harder to get the heroin. They wanted it more. Neural circuitry in offspring from THC exposed parents was different from offspring of non-exposed parents. Not all, but many findings with rats apply to humans. Multiple human THC users have demonstrated extensive neural changes. With more pot smokers are we turning into a stoner nation? This Time Magazine article quotes rates of one in ten adults and 35% of high school seniors in America smoke pot.

More on the stoner nation: As labor markets tighten, employers are having a harder time finding applicants free of drugs, especially marijuana. A New York Times article describes the new dilemma, “Hiring Hurdle: Finding Workers Who Can Pass a Drug Test. Hiring Hurdle: Finding Workers Who Can Pass a Drug Test.” A few years back, the heavy equipment manufacturer JCB held a job fair in the glass foyer of its sprawling headquarters near here, but when a throng of prospective employees learned the next step would be drug testing, an alarming thing happened: About half of them left. Though one in ten adults in America uses marijuana, various employers are legally obligated to make sure their employees are sober, especially those involved in transportation as many accidents are due to being under the influence of marijuana. For the complete article, click below:

http://nyti.ms/1rQZvdO

The California Department of Corrections has a ten billion dollar a year budget and over the past few years they eliminated and dismantled the Amity in-prison drug rehabilitation and the job training programs. In contrast, Susan Tucker, Ph.D., chief psychologist and assistant warden of Bossier Sheriff Medium Security Facility in Plain Dealing, Louisiana has received several awards for saving the state millions of dollars through her intensive prison drug education programs. Inmates that pass her programs are allowed to subtract a year off their prison sentence and the 2,000 graduates who did so (saving more money) had a three percent recidivism rate. California’s recidivism rate hovers around 70 percent.

In the “TEEN RESCUE” program, as noted, stays in detox could be reduced if the teens do a presentation on drugs to their fellow enrollees. Some of the material in this document, which shows the multiple ways marijuana has negative effects on both teens and adults, could be part of the curriculum. Or, proven programs such as that of Dr. Tucker could be used. Here are more details on that program: http://bossierpress.com/bossier-parish-correctional-facilitys-substance-abuse-program-wins-award/

Marijuana disrupts the regulation and balancing and protection system of the brain. Myelin sheathing is disrupted as well as multiple other negative outcomes including memory problems and higher levels of depression, anxiety and psychosis, even controlling for genetic make-up. The “Teen Rescue” program would allow a parent or a teacher to call for help in the sobering up of a substance abusing child (marijuana and other drugs including alcohol). This help would be in the form of meetings and testing and follow-up visits and days in detox for those who slip. What right does society have to determine if a teen is under the influence of an illegal drug? If there is probable cause to believe that an individual may be under the influence of an illegal drug, it is not necessary to obtain their permission for an examination, which can be conducted against their will to determine whether or not they are under the influence of an illegal drug. This is covered in the California Health and Safety Code Statute 11552. What is probable cause? Dilated pupils, slurred speech or erratic behavior suggest the possibility that an individual may be under the influence of an illegal substance. The Health and Welfare Code allows for graduated involvement periods (i.e., longer each time) upon relapse.

Sion Kim Harris, PhD, at the Center for Adolescent Substance Abuse Research at the Boston Children’s Hospital Harvard Medical School wrote of “The Teen Brain on Marijuana.” In 1991 over 70% of teens thought marijuana was harmful, in 2011 only 46% believed that. Not surprisingly, the recent increases in marijuana use have been accompanied by a steady decline in the percent of teens who perceive a great risk of harm from regular marijuana use.

The human brain is sensitive to marijuana because we are all born with “cannabinoid” receptors on our brain cells to which THC binds. These receptors were discovered when scientists were studying how marijuana worked in the brain. Other psychoactive drugs also bind to receptors in our brain, such as heroin (opioid receptors) and nicotine (nicotinoid receptors).

First discovered in 1992, it turns out that our own brain produces some chemicals (called endocannabinoids) that bind to the cannabinoid receptors. One of these chemicals is called anandamide. Essentially, THC and anandamide have some similarities in chemical structure which is why THC can “fool” the brain by binding to the same receptors that anandamide does. What does anandamide do?

It turns out that one of the major functions of the brain’s own endocannabinoid system is to regulate how active neurons are and how much neurotransmitter they release.

The endocannabinoid system acts like the brain cell’s volume control dial. If the volume or signal coming from one neuron gets too loud, the receiving neuron says “whoa there!” and sends anandamide backwards through the synapse to turn the volume down on that sending neuron.

So, the brain’s endocannabinoid system helps to regulate (monitor and control) how active neurons are, and how much neurotransmitter gets released, including neurotransmitters that affect pleasure, mood, pain, appetite, motivation, memory, muscle activity, etc. (e.g., dopamine, serotonin, endorphins). Therefore, the endocannabinoid system helps to keep brain cell activity in BALANCE, not underactive (like in depression or ADHD) or overactive (like in epilepsy or post-traumatic stress disorder).

To use an analogy that a teen might appreciate, a healthy brain is like a high performance race car. It’s a finely-tuned, sensitive instrument which you don’t want overheating or getting slow from too much gunk in the engine.

The endocannabinoid system is already present in the fetal brain and has been found to help guide neuron growth so that they get to the right places in the brain for correct function.

Also, because it helps to control neuron activity, it plays a major role in brain wiring – that is, how brain cells “learn” whether to grow new synapses and connections to other neurons. The more active neurons are, the stronger their connections get (neurons that fire together, wire together). The less active neurons are, the weaker their connections get, or the more they lose connections altogether.

Finally, the endocannabinoid system appears to play a role in the MYELINATION of brain cells. After neurons grow to a certain point, myelin, a fatty white substance, starts to wrap the long axons of neurons. This myelin sheathing on neurons acts like insulation on an electrical wire, helping the electrical signal pass down the axon more quickly and efficiently, therefore making communication across the brain more efficient.

So, proper endocannabinoid system function is important for neuron growth, activity, and connectivity, and therefore, for developing a brain that is efficient, balanced, and integrated.

So, how does THC compare to anandamide, the chemical which our own brain makes? Well, both THC and anandamide dial down neuron activity, thereby changing the amount of neurotransmitters released. However, when THC binds to our cannabinoid receptors, it has a MUCH STRONGER, LONGER effect on brain cell activity than anandamide. THC’s effect is like a sledgehammer compared to the precision scalpel of anandamide.

By occupying those cannabinoid receptors, THC interferes with anandamide’s ability to naturally protect and balance cell activity.

As mentioned before, a balance between inhibition and excitation of neuron activity is important for proper brain functioning. Because THC changes the levels of neurotransmitters in the brain, brain cells that get overstimulated by the effects of THC start to compensate by scaling back the number of receptors (this is why you get “tolerance” after repeated use of a substance, and this happens with all types of substance use).

On the other hand, repeated THC exposure continually dampens down the activity of many brain cells, causing there to be too much INHIBITION.

In response to this imbalance, the brain tries to compensate by making some cells MORE excitable. When a regular marijuana smoker does not smoke, the inhibitory effect of THC is not there, leaving some parts of the brain with too much excitation. This is why we see marijuana withdrawal symptoms like restlessness, anxiety, increased sensitivity or reactivity, difficulty falling and staying asleep, etc. These withdrawal symptoms may not be as dramatic as what is seen for opiate or alcohol withdrawal where people have physical pain, nausea, sweating, cramps, etc. However, people in marijuana withdrawal do report substantial distress over symptoms, particularly with difficulty sleeping, making it hard to quit.

One way that scientists examine whether a substance is potentially addictive is to see if research animals given free access to it will continually self-administer it. In rat experiments, rats were found to self-administer THC doses repeatedly, just as they do other addictive substances like cocaine, heroin, and nicotine.

Also, THC has been found to increase dopamine release in the “reward” or pleasure circuit of the brain, just like every other addictive drug. The brain’s reward circuit evolved to motivate us to engage in behaviors that helped our species survive, such as eating, sex, and social connection. Addictive drugs strongly stimulate this reward circuit, giving a “counterfeit” pleasure.

When looking nationally at statistics on why adolescents go into treatment for substance abuse problems, compared to alcohol, heroin, cocaine, etc., substances that everyone agrees are addictive, marijuana accounts for more teens in substance abuse treatment than any of the other substances combined.

We now know that adolescent brains are different from adult brains. That is, their brains are still developing, and are more “plastic” and adapt and learn faster than adults. Does this make teens more vulnerable to developing an addiction than adults?

The risk of marijuana dependence among those who started use before age 16 was over four times the risk (17% vs. 4%) as those starting after 21 (after the brain has mostly matured). That’s 1 in 6 teens who ever smoke marijuana develop addiction 3 out of 4 people in treatment for marijuana dependence (adult or teen) started using marijuana before age 17.

One well known effect of marijuana use is memory impairment. Scientists have found that THC dampens down the activity of hippocampal neurons, below the level needed to trigger the formation of a memory.

With chronic THC exposure, and therefore, continual suppression of hippocampal neuron activity, the neurons start to lose connections to other neurons, making it harder to form and retrieve memories. Brain imaging studies have found that regular marijuana users actually have, on average, smaller hippocampuses than non-users, and poorer memory performance. While we all tend to lose neurons in the hippocampus as we age (which explains why we have a harder time remembering and learning things as we get older), chronic THC exposure will speed up this process. Scientists found that young rats exposed daily to THC for 8 months showed the same level of hippocampal cell loss as unexposed rats twice their age. Long term marijuana users had lower IQs and the earlier marijuana use began the greater the drop in IQ.

There is a growing body of evidence suggesting that marijuana may increase risk for mental illness. Several studies followed individuals from childhood (ages 6 or younger), before marijuana use began, all the way into their late 20’s. So, they were able to determine whether symptoms of mental illness were present BEFORE marijuana use initiation, and perhaps contributed to individuals becoming marijuana users.

Even after controlling for the confounding effect of mental illness symptoms preceding marijuana use, these studies showed an increased risk of developing schizophrenia or mood disorders (depression, anxiety) in adulthood if individuals regularly smoked marijuana during adolescence. The risk was particularly heightened if there was any family history of mental illness (i.e., “genetics provided the loaded gun and marijuana pulled the trigger”). Also, mental illness, among those at risk, tended to show up earlier with marijuana use. The risk of mental illness is 2–5 times greater for those starting marijuana use before age 16.

Why would marijuana use increase the risk for mental disorders?

Scans of the different regions of the corpus callosum fibers reveals thinner corpus callosum fibers than the scan of the non- indicating that there are white matter integrity issues for the daily user.

Poorer communication across different parts of the brain that need to work together for proper cognitive function may be one cause of cognitive disorders such as schizophrenia.

I imaging studies are finding that there are similar white matter problems in the brains of people with schizophrenia and of regular marijuana users who started using in adolescence.

Recent national statistics show that, among fatally-injured drivers who were randomly selected for drug-testing (excluding tobacco, alcohol, and medications administered after the crash), more and more are testing positive. In 2009, the rate of positive tests had increased to 1 in 3.

Among positive tests, marijuana was the most common drug found.

Because there are cannabinoid receptors in brain areas and glands and organs (testes, uterus) throughout the body involved in growth, pubertal development, fertility, and reproductive hormones, marijuana use can affect all of these things.

Recent studies have found that regular marijuana before the age of 16 is associated with shorter height, and daily use may elevate risk for testicular cancer for males.

It is important to know that the marijuana of today is, on average, a lot more potent than it was 20 years ago.

The average THC content of thousands of samples of marijuana products confiscated each year in the US. From 1993 to 2008, the average THC potency of marijuana available in the USA more than doubled from less than 4% to about 9%. Some samples tested in 2007 were found to have as much as 37% THC!

As THC content of marijuana increases, so does its potential to cause adverse effects such as paranoia, anxiety and panic attacks, hallucinations, erratic mood swings and aggressive behavior.

The number of young people showing up in the emergency department for marijuana-related reasons has risen sharply in recent years. In 2009, over 376,000 emergency room visits nationwide were caused by marijuana use.

There is a huge increase in calls to Poison Control Centers across the country (from 13 calls in 2009 to 9,159 in 2011) by people having such adverse reactions after using “synthetic pot” – plant material sprayed with chemicals developed in labs to study the effects of THC. These chemicals mimic THC by binding to cannabinoid receptors. However, these synthetic chemicals are typically 10 times more potent than THC, which is why they cause more, and more severe, adverse reactions, including heart attacks and seizures. The marijuana clinics and laws allowing the recreational use of marijuana in some places has resulted in easy access to the drug for teens.

Studies have generally found that regular marijuana smokers report more of a range of common respiratory health issues, and more days sick than non-users, regardless of whether they smoked cigarettes.

Lisdahl points to a growing number of studies that show regular marijuana use — once a week or more — actually changes the structure of the teenage brain, specifically in areas dealing with memory and problem solving.

That can affect cognition and academic performance, she says.

"And, indeed, we see, if we look at actual grades, that chronic marijuana-using teens do have, on average, one grade point lower than their matched peers that don't smoke pot," Lisdahl says.

Evidence is mounting that regular marijuana use increases the chance that a teenager will develop psychosis, a pattern of unusual thoughts or perceptions, such as believing the television is transmitting secret messages. It also increases the risk of developing schizophrenia, a disabling brain disorder that not only causes psychosis, but also problems concentrating and loss of emotional expression.

Another new paper concluded that early marijuana use could actually hasten the onset of psychosis by three years. Those most at risk are youths who already have a mother, father, or sibling with schizophrenia or some other psychotic disorder.

In comparison, youths in families unaffected by psychosis have a 7 in 1,000 chance of developing it. If they smoke pot regularly, the risk doubles, to 14 in 1,000.

For years, now, experts have been sounding the alarm about a possible link between marijuana use and psychosis. One of the best-known studies followed nearly 50,000 young Swedish soldiers for 15 years. Those who had smoked marijuana at least once were more than twice as likely to develop schizophrenia as those who had never smoked pot. The heaviest users (who said they used marijuana more than 50 times) were six times as likely to develop schizophrenia as the nonsmokers.

Teens who smoke pot at risk for later schizophrenia, psychosis

Ann MacDonald

Posted March 07, 2011, 11:03 am , Updated November 30, 2011, 2:28 pm

Ann MacDonald, Contributor, Harvard Health

Teenagers and young adults who use marijuana may be messing with their heads in ways they don’t intend.

In one recent study that followed nearly 2,000 teenagers as they Smoke rises from a marijuana cigarette became young adults, young people who smoked marijuana at least five times were twice as likely to have developed psychosis over the next 10 years as those who didn’t smoke pot.

In comparison, youths in families unaffected by psychosis have a 7 in 1,000 chance of developing it. If they smoke pot regularly, the risk doubles, to 14 in 1,000.

So far, this research shows only an association between smoking pot and developing psychosis or schizophrenia later on. That’s not the same thing as saying that marijuana causes psychosis.

This is how research works. Years ago, scientists first noted an association between cigarette smoking and lung cancer. Only later were they able to figure out exactly how cigarette smoke damaged the lungs and other parts of the body, causing cancer and other diseases.

The research on marijuana and the brain is at a much earlier stage. We do know that THC, one of the active compounds in marijuana, stimulates the brain and triggers other chemical reactions that contribute to the drug’s psychological and physical effects.

But it’s not clear how marijuana use might lead to psychosis. One theory is that marijuana may interfere with normal brain development during the teenage years and young adulthood.

The teenage brain is still a work in progress. Between the teen years and the mid-20s, areas of the brain responsible for judgment and problem solving are still making connections with the emotional centers of the brain. Smoking marijuana may derail this process and so increase a young person’s vulnerability to psychotic thinking. (You can read more about how the adolescent brain develops in this article from the Harvard Mental Health Letter.)

While the research on marijuana and the mind has not yet connected all the dots, these new studies provide one more reason to caution young people against using marijuana—especially if they have a family member affected by schizophrenia or some other psychotic disorder. Although it may be a tough concept to explain to a teenager, the reward of a short-time high isn’t worth the long-term risk of psychosis or a disabling disorder like schizophrenia.

I have discussed finding legislative sponsors for legislation through the Community Mental Health Committee and/or the Government Affairs Committee regarding our next generation of drug addicts. Statistics seem to indicate that of 150,000 of San Diego County’s teen age population, 20% have used drugs, primarily marijuana, in the past month. Ten percent are heavy users, meaning, 15,000 teens. Initial figures I have indicate about 1,000 are in treatment, possibly leaving 14,000 (I will be double checking these figures) in danger as marijuana is a gateway drug. People argue this point but the vast majority of heavy drug users (Heroin, cocaine, etc.) used marijuana first. Marijuana disrupts the regulation and balancing and protection system of the brain. Myelin sheathing is disrupted as well as multiple other negative outcomes including memory problems and higher levels of depression, anxiety and psychosis, even controlling for genetic make-up. The “Teen Rescue” program would allow a parent or a teacher to call for help in the sobering up of a substance abusing child (marijuana and other drugs including alcohol). This help would be in the form of meetings and testing and follow-up visits and days in detox for those who slip. What right does society have to determine if a teen is under the influence of an illegal drug? If there is probable cause to believe that an individual may be under the influence of an illegal drug, it is not necessary to obtain their permission for an examination, which can be conducted against their will to determine whether or not they are under the influence of an illegal drug. This is covered in the California Health and Safety Code Statute 11552. What is probable cause? Dilated pupils, slurred speech or erratic behavior suggest the possibility that an individual may be under the influence of an illegal substance.

Hopefully in the next few months I will firm up the proposals and the implementation strategies. If the lost 14,000 are sobered up, in just ten years most San Diegans between the ages of 14 to 28 will be sober. The more easily available marijuana (getting it from card holders) puts more teens at risk. I have written e-books (“Angel on Probation” and “Escape from Hell”) and a movie script (“Street Kids”) on this subject. Details of the books and script can be found on my website drdonmiller.net.

I am attaching an excellent article on the teen brain on Marijuana. The article spells out the percentage of teens using the various drugs and marijuana users outnumber all the other drug users combined.

As brief a period as possible, first, given a ticket (if a mom calls in and the teen is found to have illegal substances in his or her body) that calls for next day attendance at drug rehab meetings. If they are a no show, the next day they are picked up and placed in detox/rehab for five days, released, and expected to show up for a meeting/testing the next day. If they don’t show up, they are picked up and put in detox/rehab for 10 days. If they don’t show up the next day for out-patient rehab/continued detox they are picked up and spend 30 days, then 60, then 90, then 180 days, with increasing periods in detox/rehab for each time they go out and don’t show up. In detox/rehab, in a secure facility, most of their day is spent in meetings. There will be education meetings, group therapy meetings, and possibly individual therapy meetings. As soon as possible, they can sign up to be helpers/teachers and within a short time as much as 75% of the meetings will be conducted by teens who are there themselves for detox/rehab. Conducting successful meetings will shorten their time in detox/rehab. Studies show that if a 10 grader is asked to spend time with a sixth grader teaching him reading, and measures are taken of increases in reading ability, the 10^th grade makes more gains in reading ability than the sixth grader, though both make gains. So, teaching a class on drugs and ways of avoiding re-addiction when they go out of rehab will likely make it more likely that they will remain clean and sober when they leave rehab.

Patterns of Current and Lifetime Substance Use in Schizophrenia by Ian L. Fowler, VaughanJ. Carr, Natalie T. Carter and Terry J. Lewin Schizophrenia Bulletin, 24(3):443-455, 1998

Cannabis abuse has been associated with the exacerbation of psychotic symptoms, increased hospital admissions,

6. ANGLIN, M.D., "THE EFFICACY OF CIVIL COMMITMENT IN TREATING NARCOTICS ADDICTION." IN LEUKENFELD, C.G., AND F. M. TIMS, (eds.), COMPULSORY TREATMENT OF DRUG ABUSE: RESEARCH AND CLINICAL PRACTICE. National Institute on Drug Abuse Research Monograph 86, Washington, D.C.: U.S. Government Printing Office, 1988.

The relationship between addiction and crime is well established. Civil commitment can be an effective approach for reducing drug use. Evaluation of nearly 1,000 addicts who came into the California Civil Addict Program found that civil commitment (involuntary sobriety) suppressed daily drug use, justifying the use of a "long tail" or lengthy follow-up.

9. BALCH, JAMES E. AND PHYLLIS BALCH, PRESCRIPTION FOR NUTRITIONAL HEALTH. GARDEN CITY PARK, N.Y.: AVERY PUBLISHING GROUP, INC., 1990.

Refers to several studies showing that schizophrenics whose symptoms are in remission or partial remission can have a resurgence of psychotic symptoms, including, hallucinations, upon ingesting alcohol, marijuana and a variety of illegal drugs; lists dangerous side effects of marijuana including impairment of the immune system, reproductive system and lungs. Marijuana smokers run higher risks of bronchitis, emphysema and lung cancer. The impaired immune system leaves the marijuana smoker more susceptible to cancer, AIDS and other diseases. The user lacks ambition and direction, is passive, apathetic, and uncommunicative. Withdrawal from marijuana can result in insomnia, tremors, chills and other symptoms that can last for days.

26. COOK, L. F. AND B. A. WEINMAN, "TREATMENT ALTERNATIVES TO STREET CRIME," IN LEUKENFELD, C.G., AND F. M TIMS, (Eds.), COMPULSORY TREATMENT OF DRUG ABUSE: RESEARCH AND CLINICAL PRACTICE. NATIONAL INSTITUTE ON DRUG ABUSE RESEARCH MONOGRAPH 86, WASHINGTON, D.C. U.S. GOVERNMENT PRINTING OFFICE, 1988.

The TASC (Treatment Alternatives to Street Crimes) program was begun in 1972. This diversion program was backed by court authority to keep drug abusers in treatment. Some of the functions carried out by the program were identification, assessment, referral and monitoring of appropriate substance abusing, non-violent offenders. Several evaluations of the TASC programs found that the TASC linkage was cheaper than jail, and that TASC clients remained in treatment longer. One hundred sites in 18 states had TASC programs in 1987. Most important to the success of TASC was the case management aspect which meant that drug abusers were followed throughout their drug abuse careers.

27. CORN, DAVID, "JUSTICE'S WAR ON DRUG TREATMENT." THE NATION, 5/14/90, Pgs. 659-662.

"Stay'n Out" is a therapeutic community in-prison treatment program which takes convicts with a history of drug abuse who are within two years of parole and places them in units segregated from the general prison population. For a period of between nine months and two years they attend seminars and counseling sessions on subjects ranging from how to find an apartment to understanding what led to their addiction. Prison perpetuates low self-esteem. If you lock a guy up and give him nothing but hard time (meaning, he gets no treatment for his addiction) he'll be back. Stay'n Out claims a success rate of 78%. Over three-fourths of its alumni stayed off drugs and were not arrested during their parole period. Seventy-five percent of those not in any treatment programs who are released from state prisons are rearrested. Only 13% of the 10.6 million Americans who need treatment are receiving it. When inmates leave Stay'n Out they get a suit, $40, and a subway token. Even so, 70% stay sober. (Authors’' note: Add Stay'n Out to a good after prison support system which includes providing a place to eat and sleep and sober buddies, along with tight follow-up, and the success rate could easily go to 95% or more).

72. KRAKOW, BARRY CONQUERING BAD DREAMS AND NIGHTMARES. SAN FRANCISCO, CALIF: BERKELEY BOOKS, 1992.

Subjects who experienced nightmares were instructed to visualize or imagine themselves having the same nightmare or bad dream over again, while awake. But this time they visualized and repeatedly practiced new endings where they won out over the terrifying creatures of their nightmares. Not only did the nightmares stop, but depression and anxiety were lifted or alleviated. Feeding new signals into the unconscious mind can positively affect how well people feel.

78. LEUKEFELD, CARL AND FRANK M. TIMS, "COMPULSORY TREATMENT FOR DRUG ABUSE." THE INTERNATIONAL JOURNAL OF THE ADDICTIONS, 25(6), 1990, Pgs. 621-640.

Provides an extensive review of the drug abuse literature which leads to the inevitable conclusion that involuntary treatment is critical to even begin to impact on the drug addiction problem since as high as 98% of the participants drop out of treatment programs when their participation is voluntary. Involuntary treatment results in drastic reductions in crime and drug use. Half or more of those sobered up have legitimate jobs upon follow-up in two or three years.

114. PORTERFIELD, KAY MARIE, "MARIJUANA AND LEARNING: GRASS GETS AN F." CURRENT HEALTH 2 16: 11/89, Pgs. 24-27.

THC (the major mood altering ingredient in marijuana) lowers alertness and retards memory and learning. The higher the dose, the worse the memory. Students smoking marijuana feel alert but cannot comprehend, follow, or store much of what is going on in their long term memory. They may be drug free when they take a test later, but because they were stoned in the lectures, nothing is recalled. Even moderate doses over an eight month period destroys brain cells and causes premature aging of the brain. In a 1981 study of 2,000 high school students not only was the ability to learn impaired, the desire to learn was impaired. Marijuana has long been known as a drug which kills motivation and the desire to succeed. Formerly focused and successful youth, after smoking marijuana for a time, stopped setting goals for themselves. They forgot about their formerly important career plans. Five times as many just once-a-week marijuana smokers dropped out of high school compared to students who used the drug rarely or not at all. After smoking for a few weeks or months, and as the A's, B's and C's dropped to D's and F's, the students started to feel like failures. How did they cope with these unpleasant feelings? They smoked a little more dope to forget. Before daily marijuana use, only one in 25 students in a Virginia study had experienced serious school failure. After a few months of regular use, three out of five were failing in school, half were ditching at least one class a day and three-fourths had been suspended from school. The writer concluded "In the final analysis, marijuana doesn't make the grade - and neither do students who smoke it."

144. TAUBER, JEFFREY S. THE IMPORTANCE OF IMMEDIATE INTERVENTION IN A COMPREHENSIVE COURT-ORDERED DRUG REHABILITATION: A PRELIMINARY EVALUATION OF THE F.I.R.S.T. DIVERSION PROJECT. PREPARED FOR THE NATIONAL CONFERENCE ON SUBSTANCE ABUSE AND THE COURTS, WASHINGTON, D.C., 11/7/91.

Newly arrested drug offenders earn points for completing each stage of their court-ordered treatment. These points can be used to reduce the two year supervision period and their fine. Defendants have to participate in A.A. and N.A. meetings, community counseling programs, intensive drug education classes, and frequent meetings with probation officers. Defendants are given random urine tests but those who relapse get a second chance. People in crisis (which is the feeling people have just after arrest) are connected quickly to services and treatment. Treatment is provided immediately after arrest rather than several months later (or not at all, as is generally the case across the U.S.) The participants knew with certainty that they would be returned to jail for dropping out. Legal coercion can be a powerful incentive to change if it accompanied by meaningful treatment. The program costs $330,000 a year. Following participation in the program arrests of drug offenders dropped in half. The savings in arrest costs alone (not even counting what was saved by not having to send all those people to jail) paid for the program.

WIKIPEDIA

The gateway drug theory (also called gateway theory, gateway hypothesis and gateway effect) states that use of less deleterious drugs precedes, and can lead to, future use of more dangerous hard drugs^[1] or crime.^[2] It is often attributed to the earlier use of one of several licit substances, including tobacco or alcohol, as well as cannabis.^[1]

The reverse gateway theory posits that earlier regular cannabis use predicts later tobacco initiation and/or nicotine dependence in those who did not use tobacco before.^[3]

The hypothesis is that the use of soft drugs like cannabis leads to the use of harder drugs via a sequence of stages.^[1] This is based on the observation that many consumers who use cocaine or heroin have previously used cannabis, and most have used alcohol or tobacco; the hypothesis is that progression of drug use initiation continues from there to other drugs like cocaine or heroin.^[1] Some research supports that cannabis use predicts a significantly higher risk for subsequent use of "harder" illicit drugs, while other research does not.^[1] Some research finds that even alcohol represents a "gateway" drug, leading to the use of tobacco, marijuana, and other illicit substances.^[4]

While some research shows that many hard drug users used cannabis or alcohol before moving on to the harder substances, other research shows that some serious drug abusers have not used alcohol or cannabis first.^[1] The latter is evident in Japan, where the overwhelming majority of users of illicit drugs do not use cannabis first.^[1] One study finds no evidence that medical marijuana laws lead to an increase in cocaine or heroin usage.^[5]

The risk factor for using drugs in cannabis users may be higher because few people try hard drugs prior to trying cannabis, not because cannabis users increasingly try hard drugs such as certain substituted amphetamines (e.g., methamphetamine). For example, cannabis is typically available at a significantly earlier age than other illicit drugs.

Jacob Sullum analyzed the "gateway" theory in a 2003 Reason magazine article, noting that the theory's "...durability is largely due to its ambiguity: Because it's rarely clear what people mean when they say that pot smoking leads to the use of "harder" drugs, the claim is difficult to disprove.":

"Notice that none of these interpretations involves a specific pharmacological effect of the sort drug warriors seem to have in mind when they suggest that pot smoking primes the brain for cocaine or heroin. As a National Academy of Sciences panel observed in a 1999 report, 'There is no evidence that marijuana serves as a stepping stone on the basis of its particular drug effect.' Last year the Canadian Senate's Special Committee on Illegal Drugs likewise concluded that 'cannabis itself is not a cause of other drug use. In this sense, we reject the gateway theory.'"^[6]

The National Institute on Drug Abuse have noted that while most cannabis users do not go on to use "harder" substances, reported data is consistent with the theory that cannabis is a gateway drug. However, they also suggest an alternative explanation. It may be that some individuals are more prone to using drugs and that these people are more likely to start with readily available substances such as cannabis, tobacco, and alcohol.^[7]

Alcohol tends to precede cannabis use, and it is rare for those who use hard drugs to not have used alcohol or tobacco first; the 2005 National Survey of Drug Use and Health (NSDUH) in the United States found that, compared with lifetime nondrinkers, adults who have consumed alcohol were statistically much more likely to currently use illicit drugs and/or abuse prescription drugs in the past year.^[8] Effects were strongest for cocaine (26 times more likely), cannabis (14 times more likely), and psychedelics (13 times more likely). In addition, lifetime drinkers were also six times more likely to use or be dependent on illicit drugs than lifetime nondrinkers.^[8]

According to the NIDA, "People who abuse drugs are also likely to be cigarette smokers. More than two-thirds of drug abusers are regular tobacco smokers, a rate more than triple that of the rest of the population."^[9]

Alternative explanations for the correlation between the use of soft drugs (e.g., marijuana) and the use of hard drugs (e.g., cocaine, heroin) include, but are not limited to:

The Common Liability to Addiction theory (CLA) argues that a person's involvement with drugs and its various degrees, including potential development and severity of addiction, are based on biobehavioral mechanisms that are largely not drug-specific. Within the CLA framework, the sequence of drug use initiation - the essence of the "gateway theory" - is opportunistic and trivial: the "gateway" drugs, that is, the substances used first, are merely those that are (usually) available at an earlier age (thus usually licit) than those used later (usually, hard drugs). In an extensive review addressing the CLA and the "gateway" theory, it was pointed out (Vanyukov et al., 2012) that the "gateway" sequence applies only to the initiation of use of different drugs rather than different levels or extent of drug involvement (from use to dependence), questioning its relevance to addiction as a medical problem. Despite that, the "gateway theory" has significantly and, arguably, adversely influenced policy formation, intervention, and research.^[1]

Teenagers' trust of adults erodes when authority-figures exaggerate or make up the dangers of the "gateway" drugs, leading teenagers to regard all anti-drug messages as nonsense.^[12]

The peer environments in which "gateway" drugs are used can sometimes overlap with the ones in which harder drugs are used, especially in societies that prohibit the substances or impose very high age-limits.^[12]

References [

1. ^ Jump up to: ^a ^b ^c ^d ^e ^f ^g ^h Vanyukov MM, Tarter RE, Kirillova GP, et al. (June 2012). "Common liability to addiction and "gateway hypothesis": theoretical, empirical and evolutionary perspective". Drug Alcohol Depend (Review). 123 Suppl 1: S3–17. doi:10.1016/j.drugalcdep.2011.12.018. PMC 3600369. PMID 22261179.

2. Jump up ^ Pudney, Stephen (December 2002). "The road to ruin? Sequences of initiation into drug use and offending by young people in Britain" (PDF). Home Office Research Study 253. (London: Home Office Research, Development and Statistics Directorate). ISBN 1-84082-928-1. ISSN 0072-6435. Retrieved 2009-04-04.

3. Jump up ^ Peters EN, Budney AJ, Carroll KM (August 2012). "Clinical correlates of co-occurring cannabis and tobacco use: a systematic review". Addiction (Review) 107 (8): 1404–17. doi:10.1111/j.1360-0443.2012.03843.x. PMC 3377777. PMID 22340422.

4. Jump up ^ Peters EN, Budney AJ, Carroll KM (August 2012). "Clinical correlates of co-occurring cannabis and tobacco use: a systematic review". Addiction 107 (8): 1404–17. doi:10.1111/j.1360-0443.2012.03843.x. PMC 3377777. PMID 22340422.

5. Jump up ^ Chu, Yu-Wei Luke (2015-05-01). "Do Medical Marijuana Laws Increase Hard-Drug Use?". Journal of Law and Economics 58 (2): 481–517. doi:10.1086/684043.

6. Jump up ^ Sullum, Jacob (24 Jan 2003), Marijuana as a "gateway" drug, Reason, retrieved 2014-04-01

7. Jump up ^ "Is marijuana a gateway drug?". drugabuse.gov. National Institute of Drug Abuse.

8. ^ Jump up to: ^a ^b Illicit Drug Use among Lifetime Nondrinkers and Lifetime Alcohol Users, NSDUH, 2005

9. Jump up ^ The National Institute on Drug Abuse (NIDA), part of the NIH, a component of the U.S. Department of Health and Human Services. – Nicotine Craving and Heavy Smoking May Contribute to Increased Use of Cocaine and Heroin^{[citation needed]} – Patrick Zickler, NIDA NOTES Staff Writer. Retrieved October, 2006.

10. Jump up ^ McNeill, A, SC (2015). "E - cigarettes: an evidence update A report commissioned by Public Health England" (PDF). www.gov.uk. UK: Public Health England. p. 38. Retrieved 24 August 2015.

11. Jump up ^ Bell, K. and H. Keane, "All gates lead to smoking: The ‘gateway theory’, e-cigarettes and the remaking of nicotine"., Social Science & Medicine, 2014. 119, quoted McNeill, pp. 37-38

12. ^ Jump up to: ^a ^b Brecher, Edward M. (1972). "Heroin on the youth drug scene - and in Vietnam". Licit and illicit drugs; the Consumers Union report on narcotics, stimulants, depressants, inhalants, hallucinogens, and marijuana - including caffeine, nicotine, and alcohol. Boston: Little, Brown. ISBN 0-316-10717-4.

Is marijuana a gateway drug?

Early exposure to cannabinoids in adolescent rodents decreases the reactivity of brain dopamine reward centers later in adulthood.²⁸ To the extent that these findings generalize to humans, this could help explain early marijuana initiates’ increased vulnerability for drug abuse and addiction to other substances of abuse later in life that has been reported by most epidemiological studies.²⁹ It is also consistent with animal experiments showing THC’s ability to "prime" the brain for enhanced responses to other drugs.³⁰ For example, rats previously administered THC show heightened behavioral response not only when further exposed to THC but also when exposed to other drugs such as morphine—a phenomenon called cross-sensitization.³¹

These findings are consistent with the idea of marijuana as a "gateway drug." However, most people who use marijuana do not go on to use other, "harder" substances. Also, cross-sensitization is not unique to marijuana. Alcohol and nicotine also prime the brain for a heightened response to other drugs³² and are, like marijuana, also typically used before a person progresses to other, more harmful substances.

It is important to note that other factors besides biological mechanisms, such as a person’s social environment, are also critical in a person’s risk for drug use. An alternative to the gateway-drug hypothesis is that people who are more vulnerable to drug-taking are simply more likely to start with readily available substances like marijuana, tobacco, or alcohol, and their subsequent social interactions with other drug users increases their chances of trying other drugs. Further research is needed to explore this question.

Once and for All, Marijuana Is Not a Gateway Drug

By Maia Szalavitz

As the 2016 election approaches, marijuana legalization is in the air once again, with ballot initiatives likely to succeed in at least five states, including California. As usual, politicians—including some presidential candidates, notably Carly Fiorina—are trying to turn back the tide by spreading fear that weed is a gateway to more dangerous drugs. But research increasingly shows not only that the "gateway" theory is incorrect, but that weed may actually help people with addictions stop taking other drugs, rather than start.

On the surface, the gateway idea seems reasonable enough. After all, there are almost no heroin users who didn't start their illegal drug use with marijuana, and marijuana smokers are 104 times more likely to use cocaine than those haven't tried weed.

Yet as scientists constantly remind us, correlation isn't the same thing as causation. For example, the number of people killed annually by dogs correlates almost perfectly with the growth in online revenue on Black Friday. And the rise in autism diagnoses is strongly correlated with the growth in sales of organic food. It's technically possible that some third factor causes both of these apparently haphazard connections. However, it's completely implausible that these connections are causal, and odds are that the links are due to random chance.

In terms of marijuana's specific correlation with other drug use, slightly less than half of Americans over 12 have tried marijuana, while less than 15 percent have taken cocaine and less than 2 percent used heroin, according to the latest National Household Survey on Drug Use and Health. Even smaller portions go on to become addicted to those drugs: Typically, only 10 to 20 percent of those who try alcohol and other drugs get hooked.

If marijuana were causing other drug use, most users should progress to more dangerous substances. But they don't. By the numbers, marijuana use seems more like a filter that keeps most people out than a gateway that lets the majority pass through.

While there are a few rat studies that suggest marijuana use "primes" exposed rodents to take more heroin or cocaine when it is offered, they are marred by a fundamental problem. Most rats do not like THC, the main active ingredient in marijuana. So they have to be forcibly injected with it, unlike coke or opioids, which they will happily press levers to receive.

However, stress itself—like, say, being shot up with a drug that makes you anxious and paranoid repeatedly—is a well-known risk factor for addiction. And of course, no one actually shoots marijuana. What these studies mainly suggest, then, is that stressed rats are at greater risk of addiction, rather than stoner rats. In fact, a recent study on rhesus monkeys suggests that being forced to take marijuana may actually make taking heroin less attractive and rewarding—and monkeys are a far closer model to humans than rats are.

Given these realities, regarding marijuana as a special pharmacological "gateway" to other drugs is about as sensible as seeing lullabies as a "gateway" to Insane Clown Posse. Yes, all types of music lovers tend to start with kids' tunes during childhood, but what makes someone into a passionate fan with unusual taste isn't merely raw musical exposure.

The most intense enthusiasts of any type of activity tend to try a variety of similar experiences. Wine lovers don't stick only to pinot noirs, and art aficionados check out more than just Picassos. The same is true of drug users: The first experience doesn't make the fan. Instead, taste develops in a social, psychological and biological context where people choose whether or not to repeat it.

Further, as with other forms of compulsive behavior, the reason an activity can go from being a source of joy or calm to a desperate need isn't necessarily inherent in the experience itself. No one would suggest that we try to treat obsessive hand-washing by banning first soap and then hand sanitizer, or stop cat collectors by making kittens illegal. But we do the equivalent in the war on drugs.

The gateway idea prevents us from making sense of addiction. Instead, we need to look at what makes the minority who do become addicted different from all those experimenters who don't. For one, a large proportion of people with addictions—at least half—are addicted to more than one substance.

This suggests a propensity to seek escape in general: if you have already discovered that your use of a substance is causing problems, why try another one that might make things even worse? Frequently, people with addictions try many different classes of drugs—stimulants, psychedelics, depressants—a variety that makes no sense if it is being driven by a particular drug changing the brain rather than by a person looking for the best way to manage her consciousness.

And in fact, one common reason that people seek numbness or oblivion is that they have a mental illness, which makes them feel apprehensive, disconnected or unhappy. More than half of all people with addictions have an additional psychiatric disorder.

Nearly all mental illnesses are linked with higher risk for addiction, from attention deficit/hyperactivity disorder (ADHD) to mood disorders, anxiety disorders and schizophrenia. In the vast majority of these cases, the psychiatric problem is not caused by the drug use, and studies that follow children into adulthood repeatedly show that those who wind up with addictions tend to have emotional and behavior issues that were often visible as early as preschool. This suggests genetic or perhaps early environmental risk.

Crucially, the nature of the problems that predispose people to addiction varies widely—there is no single "addictive personality" that creates vulnerability. Instead, those who are addiction-prone tend to be outliers on different, sometimes opposing dimensions. For example, shy, anxious and withdrawn kids are at risk—but so are those who are wild and impulsive.

Another critical factor is childhood trauma. Each exposure to extreme stress raises risk: from sexual, physical and emotional abuse to neglect, witnessing violence and death, losing one or both parents or facing severe illness or disaster, the more trauma a child experiences, the greater the odds of addiction. One study, for instance, found that children who had been exposed to four or more different types of what are known as "adverse childhood experiences" had a 700 percent increased risk of alcoholism, compared to those with no adverse experience. In terms of smoking, those with four or more trauma exposures had a risk that was doubled to quadrupled, compared to those with none.

Socioeconomic status can also affect addiction liability. While the American press mostly seems to focus much on addiction when it's framed as middle class problem—like the ongoing heroin scare—the fact is that those at the highest risk are the poor. If you make less than $20,000 a year, your risk of heroin addiction is roughly three times greater than if you make $50,000 or more—and similar figures are seen with other substance use disorders.

Marijuana isn't the gateway to addiction: that's far more likely to be trauma, mental illness, or socioeconomic distress. Most people who smoke pot neither become addicted to it, nor to any other drug. Addiction is a relationship between a person, their genetics, their childhood experiences, their social and economic world, and a substance or activity. Not all addicted people will have all risk factors, and not all of those who are vulnerable will get hooked.

And because marijuana use (and even addiction) is associated with far fewer negative consequences than other drugs, researchers have suspected for years that many heroin and cocaine addicts actually use cannabis to help them reduce addiction-related harm.

I reported on research in this area related to crack for Alternet back in 2001. Ethnographic data suggested that older crack smokers gradually replaced their cocaine smoking with cannabis, while young users smoked weed instead of the crack that they'd seen harm their older siblings or parents.

Two newer studies further suggest possible uses for marijuana in treating opioid addiction and alcoholism. The first was a controlled trial looking at whether adding synthetic THC to an anti-opioid medication could help people seeking abstinence from heroin or prescription medications. It showed that while the synthetic THC didn't improve treatment retention, it did reduce withdrawal symptoms. More intriguingly, however, the study also found that participants who chose to smoke pot on their own—regardless of whether they got the synthetic THC or placebo—had much less anxiety and insomnia and were less likely to drop out of treatment.

The second study surveyed medical marijuana users in Canada, finding that 87 percent used it to replace alcohol, prescription opioids or other illegal recreational drugs. 52 percent said that it helped them reduce alcohol use, while 80 percent reported using fewer prescription pain medications. While most of the people in this study were not using the drug to treat addiction per se, those who had past addiction treatment reported were twice as likely to report replacing other illegal drugs with medical marijuana and equally likely to use it instead of alcohol or prescription medications.

Because a tolerance builds up, marijuana can lead users to consume stronger drugs to achieve the same high. When the effects start to wear off, the person may turn to more potent drugs to rid himself of the unwanted conditions that caused him to take marijuana in the first place. Marijuana itself does not lead the person to the other drugs; people take drugs to get rid of unwanted situations or feelings. The drug (marijuana) masks the problem for a time (while the user is high). When the “high” fades, the problem, unwanted condition or situation returns more intensely than before. The user may then turn to stronger drugs since marijuana no longer “works.”

The vast majority of cocaine users (99.9%) began by first using a “gateway drug” like marijuana, cigarettes or alcohol. Of course, not everyone who smokes marijuana and hashish goes on to use harder drugs. Some never do. Others quit using marijuana altogether. But some do turn to harder drugs. One study found that youth (12 to 17 years old) who use marijuana are 85 times more likely to use cocaine than kids who do not use pot, and that 60% of the kids who smoke pot before the age of 15 move on to cocaine.

The use of marijuana is not only harmful to the pot smoker himself. He can also become a risk to society.

Research clearly shows that marijuana has the potential to cause problems in daily life. A study of 129 college students found that, among those who smoked the drug at least twenty-seven of the thirty days before being surveyed, critical skills related to attention, memory and learning were seriously diminished. A study of postal workers found that employees who tested positive for marijuana had 55% more accidents, 85% more injuries and a 75% increase in being absent from work.

In Australia, a study found that cannabis intoxication was responsible for 4.3% of driver fatalities.

It is almost impossible to grow up in America, or any country, and not be exposed to drugs. Peer pressure to do drugs is high and honest information about the dangers of drugs is not always available.

Many people will tell you marijuana is not dangerous. Consider who is telling you that. Are these the same people who are trying to sell you some pot?

Marijuana can harm a person’s memory—and this impact can last for days or weeks after the immediate effects of the drug wear off. In one study, a group of heavy marijuana users were asked to recall words from a list. Their ability to correctly remember the words did not return to normal until as long as four weeks after they stopped smoking.

Students who use marijuana have lower grades and are less likely to get into college than nonsmokers. They simply do not have the same abilities to remember and organize information compared to those who do not use these substances.

Drugs block off all sensations, the desirable ones with the unwanted. So, while providing short-term help in the relief of pain, they also wipe out ability and alertness and muddy one’s thinking.

Medicines are drugs that are intended to speed up or slow down or change something about the way your body is working, to try to make it work better. Sometimes they are necessary. But they are still drugs: they act as stimulants or sedatives, and too much can kill you. So if you do not use medicines as they are supposed to be used, they can be as dangerous as illegal drugs.

The real answer is to get the facts and not to take drugs in the first place.

Why do people take drugs?

People take drugs because they want to change something in their lives.

Here are some of the reasons young people have given for taking drugs:

To fit in

To escape or relax

To relieve boredom

To seem grown up

To rebel

To experiment

They think drugs are a solution. But eventually, the drugs become the problem.

http://www.drugwarfacts.org/cms/Adolescents#sthash.g2ZB8rU0.0SZzH4Nm.dpbs

(Risk of Future Addiction Disorder) "Teen users are at significantly higher risk of developing an addictive disorder compared to adults, and the earlier they began using, the higher their risk. Nine out of 10 people who meet the clinical criteria for substance use disorders involving nicotine, alcohol or other drugs began smoking, drinking or using other drugs before they turned 18. People who begin using any addictive substance before age 15 are six and a half times as likely to develop a substance use disorder as those who delay use until age 21 or older (28.1 percent vs. 4.3 percent)."

Source:

"Adolescent Substance Abuse: America's #1 Public Health Problem," National Center on Addiction and Substance Abuse at Columbia University, June 2011, p. 2.
http://www.casacolumbia.org/addiction-research/reports/adolescent-substa...

(Lifetime Marijuana Use Among Students in the US, by Race and Gender) "Nationwide, 39.9% of students had used marijuana one or more times during their life (i.e., ever used marijuana) (Table 47). Overall, the prevalence of having ever used marijuana was higher among male (42.5%) than female (37.2%) students; higher among white male (40.3%), black male (48.5%), and Hispanic male (45.0%) than white female (35.4%), black female (37.7%), and Hispanic female (39.1%) students, respectively; and higher among 9th-grade male (34.9%) and 11th-grade male (48.7%) than 9th-grade female (26.4%) and 11th-grade female (42.1%) students, respectively."

Source:

"Youth Risk Behavior Surveillance — United States, 2011," Morbidity and Mortality Weekly Report (Atlanta, GA: Centers for Disease Control, June 8, 2012) Vol. 61, No. 4, p. 19.
http://www.cdc.gov/mmwr/pdf/ss/ss6104.pdf

(Early Drug Exposure and Later Drug Use) "The teen brain is a work in progress, making it more vulnerable than the mature brain to the physical effects of drugs. The potential for developing substance abuse and dependence is substantially greater when an individual’s first exposure to alcohol, nicotine and illicit drugs occurs during adolescence than in adulthood."

Source:

Steinberg, L., Distinguished University Professor and Laura H. Carnell Professor of Psychology, Department of Psychology, Temple University and author of "You and Your Adolescent: The Essential guide for ages 10 to 25" (personal communication, June 9, 2011), as quoted in "Adolescent Substance Use: America’s #1 Public Health Problem," The National Center on Addiction and Substance Abuse at Columbia University (New York, NY: National Center on Addiction and Substance Abuse at Columbia University, June 2011), p. 13.
http://www.casacolumbia.org/addiction-research/reports/adolescent-substa...

(Perceived Availability of Drugs Among Youth in the US)
"In 2014, about half (47.8 percent) of youths aged 12 to 17 reported that it would be fairly easy or very easy for them to obtain marijuana if they wanted some (Figure 11). Slightly less than 1 in 10 (9.4 percent) indicated that heroin would be easily obtainable, about 1 in 9 (11.6 percent) reported that it would be easy to obtain LSD, and about 1 in 7 (14.4 percent) reported that it would be easy to obtain cocaine. The percentages of adolescents in 2014 who indicated that it would be easy to get cocaine and crack were lower than the corresponding percentages in each year from 2002 through 2012 (Table A.2B in Appendix A). For LSD and heroin, the percentages of youths in 2014 who reported that it would be easy to obtain these substances were lower than the corresponding percentages in most years from 2002 through 2011. However, the percentages of adolescents who reported that it would be easy to obtain all five of these substances were similar between 2013 and 2014. The percentage of youths who perceived that marijuana would be fairly easy or very easy to obtain was lower in 2014 than in 2002 through 2009, but it was similar to the percentages in 2010 to 2013."

Source:

"Risk and Protective Factors and Initiation of Substance Use: Results from the 2014 National Survey on Drug Use and Health," NSDUH Data Review, Substance Abuse and Mental Health Services Administration (Washington, DC: Department of Health and Human Services), October 2015, NSDUH-DR-FRR4-2014, p. 12.
http://www.samhsa.gov/data/sites/default/files/NSDUH-DR-FRR4-2014%20(1)/NSDUH-DR-FRR4-2014.htm
http://www.samhsa.gov/data/sites/default/files/NSDUH-DR-FRR4-2014%20(1)/NSDUH-DR-FRR4-2014.pdf

(Disapproval of Drug Use Among 12th Graders in the US)
"• The vast majority of 12th graders do not condone regular use of any of the illicit drugs (see Table 8-6). Among 2014 12th graders, 73% disapprove (including strongly disapprove) of regular marijuana use and between 92% and 97% disapprove of regular use of each of the other illicit drugs. (Regular steroid use meets with a 88% disapproval rate.)
"• For each of the drugs included in this set of questions, fewer respondents indicate disapproval of experimental or occasional use than of regular use. However, the differences are not great for the use of illicit drugs other than marijuana, because nearly all 12th graders disapprove of even experimenting with them. For example, the proportions disapproving of experimental use are 95% for heroin; 90% for cocaine; 89% for crack; 89% for sedatives (barbiturates); 86% for cocaine powder; 85% for LSD; and 83% for ecstasy (MDMA). The extent of disapproval of illicit drug use by peers is no doubt underestimated by adolescents and, as we have written for some time, the extent of disapproval that actually does exist could be widely publicized and provide the basis for some potentially powerful prevention messages in the form of normative education.10
"• For marijuana, the rate of disapproval varies substantially for different usage levels, although not as much as it has in the past. Disapproval for this drug is really quite high. About half of all seniors (48%) disapprove of even trying marijuana once or twice, about three of five (57%) disapprove of its occasional use, and three of four (73%) disapprove of regular use. Looked at another way, only about one quarter of 12th graders (27%) say they don’t disapprove of regular marijuana use."

Source:

Miech, R. A., Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2015). Monitoring the Future national survey results on drug use, 1975–2014: Volume I, Secondary school students. Ann Arbor: Institute for Social Research, The University of Michigan, p. 367.
http://monitoringthefuture.org//pubs/monographs/mtf-vol1_2014.pdf
http://monitoringthefuture.org/pubs.html

(Impact of Medical Marijuana Laws on Adolescent Marijuana Use) "Concerns about laws and policy measures that may inadvertently affect youth drug use merit careful consideration. Our study does not show evidence of a clear relationship between legalization of marijuana for medical purposes and youth drug use for any age group, which may provide some reassurance to policymakers who wish to balance compassion for individuals who have been unable to find relief from conventional medical therapies with the safety and well-being of youth. Further research is required to track the trends in marijuana use among adolescents, particularly with respect to different types of marijuana laws and implementation of laws in each state."

Source:

Choo, Esther K. et al. (2014), "The Impact of State Medical Marijuana Legislation on Adolescent Marijuana Use," Journal of Adolescent Health, Volume 55, Issue 2, p. 160 - 166.
http://www.jahonline.org/article/S1054-139X%2814%2900107-4/abstract
http://www.jahonline.org/article/S1054-139X%2814%2900107-4/pdf

Estimated 30-Day Prevalence of Use of Various Drugs for Grades 8, 10, and 12 Combined in the US, 1998-2014 (Entries are Percentages)
Year:	1998	1999	2000	2001	2002	2003	2004	2005	2006	2007	2008	2009	2010	2011	2012	2013	2014

Any Illicit Drug	19.5	19.5	19.2	19.4	18.2	17.3	16.2	15.8	14.9	14.8	14.6	15.8	16.7	17.0	16.8	17.3	16.5

Marijuana/Hashish	16.9	16.9	16.3	16.6	15.3	14.8	13.6	13.4	12.5	12.4	12.5	13.8	14.8	15.2	15.1	15.6	14.4
Cocaine	1.9	1.9	1.7	1.5	1.6	1.4	1.6	1.6	1.6	1.4	1.3	1.0	0.9	0.8	0.8	0.8	0.7
Crack	1.0	0.9	0.9	0.9	1.0	0.8	0.8	0.8	0.7	0.7	0.6	0.5	0.5	0.5	0.4	0.4	0.4
Heroin	0.6	0.6	0.6	0.4	0.5	0.4	0.5	0.5	0.4	0.4	0.4	0.4	0.4	0.4	0.3	0.3	0.3
Hallucinogens	2.8	2.5	2.0	2.3	1.7	1.5	1.5	1.5	1.3	1.4	1.4	1.3	1.4	1.3	1.1	1.1	1.0
Ecstasy	1.2	1.6	2.4	2.4	1.8	1.0	0.9	0.9	1.0	1.1	1.1	1.2	1.5	1.4	0.8	1.0	0.8
Tranquilizers	1.9	1.9	2.1	2.3	2.4	2.2	2.1	2.1	2.1	2.0	1.9	1.9	1.9	1.7	1.5	1.5	1.5
Amphetamines	4.3	4.2	4.5	4.7	4.4	3.9	3.6	3.3	3.0	3.2	2.6	2.7	2.7	2.8	2.5	3.2	3.2
Methamphetamine	-	1.5	1.5	1.4	1.5	1.4	1.1	0.9	0.7	0.5	0.7	0.5	0.6	0.5	0.5	0.4	0.3

Any Illicit Drug Other Than Marijuana	8.2	7.9	8.0	8.2	7.7	7.1	7.0	6.7	6.4	6.4	5.9	5.7	5.7	5.7	5.2	5.4	5.4
Alcohol	37.4	37.2	36.6	35.5	33.3	33.2	32.9	31.4	31.0	30.1	28.1	28.4	26.8	25.5	25.9	24.3	22.6
Been Drunk	20.4	20.6	20.3	19.7	17.4	17.7	18.1	17.0	17.4	16.5	14.9	15.2	14.6	13.5	14.7	13.5	11.9
Cigarettes	27.0	25.2	22.6	20.2	17.7	16.6	16.1	15.3	14.4	13.6	12.6	12.7	12.8	11.7	10.6	9.6	8.0
E-Cigarettes																	13.9
Inhalants	3.4	3.3	3.2	2.8	2.7	2.7	2.9	2.9	2.7	2.6	2.6	2.5	2.4	2.1	1.7	1.5	1.4

Source:

Johnston, L. D., O’Malley, P. M., Miech, R. A., Bachman, J. G., & Schulenberg, J. E. (February 2015). Monitoring the Future national survey results on drug use: 1975-2014: Overview, key findings on adolescent drug use. Ann Arbor: Institute for Social Research, The University of Michigan, Table 3, p. 57.
http://monitoringthefuture.org//pubs/monographs/mtf-overview2014.pdf

(Use Of Any Illegal Drug and Illegal Drugs Other Than Marijuana Among 8th, 10th, and 12th Graders in the US)

Trends in Lifetime Prevalence of Use of Various Drugs for 8th, 10th, and 12th Graders in the US (Entries are in Percentages)
	2000	2001	2002	2003	2004	2005	2006	2007	2008	2009	2010	2011	2012	2013	2014
Any Illicit Drugs
8th Grade	26.8	26.8	24.5	22.8	21.5	21.4	20.9	19.0	19.6	19.9	21.4	20.1	18.5	21.1	20.3
10th Grade	45.6	45.6	44.6	41.4	39.8	38.2	36.1	35.6	34.1	36.0	37.0	37.7	36.8	39.1	37.4
12th Grade	54.0	53.9	53.0	51.1	51.1	50.4	48.2	46.8	47.4	46.7	48.2	49.9	49.1	49.8	49.1
Any Illicit Drug Other Than Marijuana
8th Grade	15.8	17.0	13.7	13.6	12.2	12.1	12.2	11.1	11.2	10.4	10.6	9.8	8.7	10.4	10.0
10th Grade	23.1	23.6	22.1	19.7	18.8	18.0	17.5	18.2	15.9	16.7	16.8	15.6	14.9	16.4	15.9
12th Grade	29.0	30.7	29.5	27.7	28.7	27.4	26.9	25.5	24.9	24.0	24.7	24.9	24.1	24.8	22.6
Marijuana
8th Grade	20.3	20.4	19.2	17.5	16.3	16.5	15.7	14.2	14.6	15.7	17.3	16.4	15.2	16.5	15.6
10th Grade	40.3	40.1	38.7	36.4	35.1	34.1	31.8	31.0	29.9	32.3	33.4	34.5	33.8	35.8	33.7
12th Grade	48.8	49.0	47.8	46.1	45.7	44.8	42.3	41.8	42.6	42.0	43.8	45.5	45.2	45.5	44.4

Source:

Miech, R. A., Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2015). Monitoring the Future national survey results on drug use, 1975–2014: Volume I, Secondary school students. Ann Arbor: Institute for Social Research, The University of Michigan, Table 2-1, p. 45.
http://monitoringthefuture.org//pubs/monographs/mtf-vol1_2014.pdf
http://monitoringthefuture.org/pubs.html

(Noncontinuation Rates Among Youth for Alcohol, Tobacco, and Other Drugs Among Youth in the US, 2013)
"• One indication of the proportion of people who try a drug but do not continue to use it can be derived from calculating the percentage of those who ever used a drug (once or more) but did not use it in the 12 months preceding the survey.38 We use the word 'noncontinuation' rather than 'discontinuation' because the latter might imply discontinuing an established pattern of use, whereas our current operational definition includes noncontinuation by experimental users as well as established users. Figure 4-3 provides these noncontinuation rates for most drug classes and all three grades in 2013; drugs are ordered from lowest to highest rates among 12th graders. This figure shows that noncontinuation rates vary widely Among 12th graders, the highest noncontinuation rate is observed for inhalants (64%), followed by heroin without a needle (51%). Many inhalants are used primarily at a younger age, and use is often not continued into 12th grade. The rank ordering for noncontinuation of other drugs is as follows: LSD, ecstasy (MDMA), crystal methamphetamine (ice), cocaine powder, and heroin in general (all between 43–45%); cocaine in general, crack, hallucinogens other than LSD, hallucinogens (adjusted), tranquilizers, and methamphetamine (all between 39% and 42%); and narcotics other than heroin, sedatives (barbiturates), steroids, and amphetamines (all between 29% and 36%).
"• The drugs least likely to have been discontinued include cigarettes (21%), marijuana (20%), being drunk (17%), smokeless tobacco (15%), and alcohol (9%). Note that several psychotherapeutic drugs are among those least likely to have their use discontinued. It is important to recognize, however, that substantial proportions of students who try the various illicit drugs do not continue use, even into later adolescence. (Note: Use of heroin with a needle and PCP are not included due to the very low case counts.)
"• Because a relatively high proportion of marijuana users continue to use marijuana at some level over an extended period (as is documented further in Chapter 10), it has consistently had one of the lowest noncontinuation rates in the senior year of any of the illicit drugs (20% in 2013). It is noteworthy that, of all the 12th graders who have ever used crack (1.8%), only about one third (0.6%) report current use and 0.1% of the total sample report current daily use. While there is no question that crack is highly addictive, evidence from MTF has consistently suggested that it is not addictive on the first use, as was often alleged.
"• In contrast to illicit drugs, noncontinuation rates for the two licit drugs are extremely low. Alcohol, tried by the great majority of 12th graders (68%), is still used in the senior year by nearly all who have ever tried it (62% of all 12th graders), yielding a noncontinuation rate for alcohol of only 9%.
"• Noncontinuation had to be defined differently for cigarettes because respondents are not asked to report on their cigarette use in the past year. The noncontinuation rate is thus defined as the percentage of those who say they ever smoked 'regularly' and who also reported no smoking at all during the past 30 days. Of the 12th graders who said they were ever regular smokers, only 21% have ceased active use."

Source:

Johnston, L. D., O’Malley, P. M., Bachman, J. G., Schulenberg, J. E. & Miech, R. A. (2014). Monitoring the Future national survey results on drug use, 1975–2013: Volume I, Secondary school students. Ann Arbor: Institute for Social Research, The University of Michigan, pp. 96-97.
http://www.monitoringthefuture.org/pubs/monographs/mtf-vol1_2013.pdf

(Opioids Do Not Have Potential To Cause Malformations To An Embryo Or Fetus) "It is important to note that, contrary to alcohol, benzodiazepines and nicotine, opioids do not have teratogenic potential (3). Thus, special attention needs to be paid to dependence and abuse of legal substances and prescription drugs that can have severe consequences for the foetus and newborn, such as foetal developmental disorders or sudden infant death syndrome (Fetal Alcohol Spectrum Disorders Center for Excellence, 2013; McDonnell-Naughton et al., 2012)."

Source:

European Monitoring Centre for Drugs and Drug Addiction, "Pregnancy and opioid use: strategies for treatment," EMCDDA Papers (Publications Office of the European Union: Luxembourg, 2014), p. 3.
http://www.emcdda.europa.eu/publications/emcdda-papers/pregnacy-opioid-u...
http://www.emcdda.europa.eu/attachements.cfm/att_232995_EN_TDAU14006ENN....

(Perceived Availability of Illicit Drugs and Likelihood of Use Among Youth in the US, 2012)
"• Youths aged 12 to 17 in 2012 who perceived that it was easy to obtain specific illicit drugs were more likely to be past month users of those illicit drugs than were youths who perceived that obtaining specific illicit drugs would be fairly difficult, very difficult, or probably impossible. For example, 17.4 percent of youths who reported that marijuana would be easy to obtain were past month illicit drug users, but only 2.9 percent of those who thought marijuana would be more difficult to obtain were past month users. Similarly, 14.4 percent of youths who reported that marijuana would be easy to obtain were past month marijuana users, but only 1.1 percent of those who thought marijuana would be more difficult to obtain were past month users.
"• The percentage of youths who reported that marijuana, cocaine, crack, heroin, and LSD would be easy to obtain increased with age in 2012. For instance, 19.5 percent of those aged 12 or 13 said it would be fairly or very easy to obtain marijuana compared with 50.1 percent of those aged 14 or 15 and 71.0 percent of those aged 16 or 17.
"• In 2012, 13.2 percent of youths aged 12 to 17 indicated that they had been approached by someone selling drugs in the past month. This rate declined between 2002 (16.7 percent) and 2012, although the 2012 rate was similar to the 2011 rate (13.8 percent)."

Source:

Substance Abuse and Mental Health Services Administration, Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-46, HHS Publication No. (SMA) 13-4795. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2013, p. 70.
http://www.samhsa.gov/data/NSDUH/2012SummNatFindDetTables/Index.aspx
http://www.samhsa.gov/data/NSDUH/2012SummNatFindDetTables/NationalFindin...

Prevalence of Substance Use Among Youth in the US

(Estimated Prevalence of and Attitudes Toward Marijuana Use Among Youth in the US, 2015) "Marijuana, the most widely used of the illicit drugs, did not show any significant change in annual prevalence this year in any of the three grades, nor in the three grades combined. After rising for several years, the annual prevalence of marijuana has more or less leveled out since about 2010.
"This year, 12 percent of 8th graders, 25 percent of 10th graders and 35 percent of 12th graders reported using marijuana at least once in the prior 12 months. Of more importance, perhaps, is their daily or near-daily marijuana use (defined as smoking marijuana on 20 or more occasions in the past 30 days). These rates stand at 1.1 percent, 3.0 percent and 6.0 percent in 8th, 10th and 12th grades, respectively.
"In other words, one in every 16 or 17 high school seniors is smoking marijuana daily or near daily. These rates have changed rather little since 2010, but are from three-to-six times higher than they were at their low point in 1991.
"'The proportion of our young people smoking marijuana this frequently remains a matter of concern,' Johnston said.[2],[3]
"He notes that the percent of students who see regular marijuana use as carrying a great risk of harm has declined substantially since about 2005, and is still declining. Over the past 10 years, the percent seeing a great risk in regular marijuana use has fallen among 8th graders from 74 percent to 58 percent, among 10th graders from 66 percent to 43 percent and among 12thgraders from 58 percent to 32 percent."

Source:

Johnston, L. D., O'Malley, P. M., Miech, R.A., Bachman, J. G., & Schulenberg, J. E. (December 16, 2015). "Use of ecstasy, heroin, synthetic marijuana, alcohol, cigarettes declined among US teens in 2015," University of Michigan News Service: Ann Arbor, MI, p. 5.
http://www.monitoringthefuture.org//pressreleases/15drugpr_complete.pdf

(Availability of Marijuana Among Youth Measured by Monitoring The Future (MTF) Study) "Ever since the MTF study began in 1975, between 81% and 90% of 12th graders each year have said that they could get marijuana fairly easily or very easily if they wanted some. It has been considerably less accessible to younger adolescents. Still, in 2012, 37% of 8th graders, 69% of 10th graders, and 82% of 12th graders reported it as being fairly or very easy to get. It thus seems clear that marijuana has remained highly accessible to the older teens."

Source:

Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2013). Monitoring the Future national results on adolescent drug use: Overview of key findings, 2012. Ann Arbor: Institute for Social Research, The University of Michigan, p. 12.
http://www.monitoringthefuture.org/pubs/monographs/mtf-overview2012.pdf

(Availability of Alcohol Among Youth As Measured by Monitoring The Future Study) "Perceived availability of alcohol, which until 1999 was asked only of 8th and 10th graders, was very high and mostly steady in the 1990s. Since 1996, however, there have been significant declines in 8th and 10th grades. For 12th grade, availability has declined only modestly with 91% still saying that it would be fairly easy or very easy to get alcohol. In 2012 the drop in availability halted in the upper grades. Overall, it appears that states, communities, and parents have been successful in reducing access to alcohol among the younger teens."

Source:

Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2013). Monitoring the Future national results on adolescent drug use: Overview of key findings, 2012. Ann Arbor: Institute for Social Research, The University of Michigan, p. 38.
http://www.monitoringthefuture.org/pubs/monographs/mtf-overview2012.pdf

(Availability of Cigarettes Among 8th and 10th Graders According To The Monitoring The Future Study) "After holding fairly steady at very high levels for some years, the availability of cigarettes to 8th and 10th graders began to decline modestly after 1996, very likely as a result of increased enforcement of laws prohibiting sale to minors under the Synar Amendment and FDA regulations. Those declines continued among 8th graders, including a significant decrease in 2009; the proportion saying that they could get cigarettes fairly or very easily fell from 77% in 1996 to 56% in 2010, before declining significantly to 50% by 2013. Over the same interval, the decline among 10th graders was from 91% in 1996 to 71% in 2013. These are encouraging changes and suggest that state and community efforts to reduce accessibility to adolescents—particularly younger adolescents—seem to be working."

Source:

Johnston, L. D., O’Malley, P. M., Bachman, J. G., Schulenberg, J. E. & Miech, R. A. (2014). Monitoring the Future national survey results on drug use, 1975–2013: Volume I, Secondary school students. Ann Arbor: Institute for Social Research, The University of Michigan, p. 460.
http://www.monitoringthefuture.org/pubs/monographs/mtf-vol1_2013.pdf

("Drug-Infected" Private Schools) "For the first time, this year more than half of private high school students say that drugs are kept, used or sold at the school they attend; we call these drug-infected schools. This is an increase of 50 percent in just one year, from 36 percent in 2011 to 54 percent in 2012."

Source:

QEV Analytics, LTD., "National Survey of American Attitudes on Substance Abuse XVII: Teens," The National Center on Addiction and Substance Abuse at Columbia University (New York, NY: National Center on Addiction and Substance Abuse at Columbia University, August 2012), p. 3.
http://www.casacolumbia.org/addiction-research/reports/national-survey-a...

("Drug-Infected" Public Schools) "Sixty percent of high school students and 32 percent of middle school students say that students keep, use or sell drugs on their school grounds. For seven of the past eight years, at least 60 percent of high school students have said they attend a drug-infected school."

Source:

QEV Analytics, LTD., "National Survey of American Attitudes on Substance Abuse XVII: Teens," The National Center on Addiction and Substance Abuse at Columbia University (New York, NY: National Center on Addiction and Substance Abuse at Columbia University, August 2012), p. 5.
http://www.casacolumbia.org/addiction-research/reports/national-survey-a...

(Prevalence of Marijuana Use Among Youth in the US, 2014) "Annual marijuana prevalence peaked among 12th graders in 1979 at 51%, following a rise that began during the 1960s. Then use declined fairly steadily for 13 years, bottoming at 22% in 1992—a decline of more than half. The 1990s, however, saw a resurgence of use. After a considerable increase (one that actually began among 8th graders a year earlier than among 10th and 12th graders), annual prevalence rates peaked in 1996 at 8th grade and in 1997 at 10th and 12th grades. After these peak years, use declined among all three grades through 2006, 2007, or 2008; after the declines, an upturn occurred in use in all three grades, lasting for three years in the lower grades and longer in grade 12. Annual marijuana prevalence among 8th graders increased in use from 2007 to 2010, decreased slightly from 2010 to 2012, and then leveled. Among 10th graders, it increased somewhat from 2008 to 2012 and then leveled. Among 12th graders, use increased from 2006 to 2011, leveled from 2011 to 2013, and declined somewhat in 2014. (Only one of the 1-year changes in 2013 or 2014 was significant.) As shown in Table 8, daily use increased in all three grades after 2007, reaching peaks in 2011 (at 1.3% in 8th), 2013 (at 4.0% in 10th), and 2011 (at 6.6% in 12th), before declining modestly since. Daily prevalence rates in 2014 were 1.0%, 3.4%, and 5.8%, respectively."

Source:

Johnston, L. D., O’Malley, P. M., Miech, R. A., Bachman, J. G., & Schulenberg, J. E. (February 2015). Monitoring the Future national survey results on drug use: 1975-2014: Overview, key findings on adolescent drug use. Ann Arbor: Institute for Social Research, The University of Michigan, p. 12.
http://monitoringthefuture.org//pubs/monographs/mtf-overview2014.pdf

(Illicit Use of Prescription Drugs) "Nationwide, 20.7% of students had taken prescription drugs (e.g., Oxycontin, Percocet, Vicodin, codeine, Adderall, Ritalin, or Xanax) without a doctor’s prescription one or more times during their life (i.e., ever took prescription drugs without a doctor’s prescription)"

Source:

"Youth Risk Behavior Surveillance — United States, 2011," Morbidity and Mortality Weekly Report (Atlanta, GA: Centers for Disease Control, June 8, 2012) Vol. 61, No. 4, p. 23.
http://www.cdc.gov/mmwr/pdf/ss/ss6104.pdf

(Drugs Sold at School) "Almost half of high school students (44 percent) know a student who sells drugs at their school. When asked what drugs are sold at their school:

• 91 percent said marijuana;
• 24 percent said prescription drugs;
• 9 percent said cocaine; and
• 7 percent said ecstasy."

Source:

QEV Analytics, LTD., "National Survey of American Attitudes on Substance Abuse XVII: Teens," The National Center on Addiction and Substance Abuse at Columbia University (New York, NY: National Center on Addiction and Substance Abuse at Columbia University, August 2012), p. 2.
http://www.casacolumbia.org/addiction-research/reports/national-survey-a...

(Marijuana Use and Educational Attainment) “Teen marijuana users are approximately twice as likely as non-users to drop out of high school.234 One study found that, compared to students who did not use marijuana at all in the past year, those who used marijuana less than weekly were 2.6 times as likely to be school dropouts (5.8 percent vs. 2.2 percent) and those who used marijuana at least weekly were 5.8 times as likely to be school dropouts (12.8 percent vs. 2.2 percent).235 Students who use marijuana before age 15 are twice as likely as other students to report frequent truancy and three times as likely to leave school before age 16.236 One study found that, by their 40s, individuals who used marijuana in adolescence and young adulthood had more than a third of a year’s less educational attainment than non-users. The more frequent the marijuana use in this age group, the fewer the number of years of educational attainment achieved.”

Source:

"Adolescent Substance Use: America's #1 Public Health Problem," The National Center on Addiction and Substance Abuse at Columbia University (New York, NY: National Center on Addiction and Substance Abuse at Columbia University, June 2011), p. 57.
http://www.casacolumbia.org/addiction-research/reports/adolescent-substa...

(Ease of Obtaining Drugs) "This year we asked teens, 'Which is easiest to get: cigarettes, marijuana, beer or prescription drugs?' (prior to 2010, we asked, 'Which is easiest to buy?') Cigarettes remain at the top of the list, with 27 percent of teens saying cigarettes are easier to get than other drugs. Beer closely followed cigarettes as the easiest drug for teens to get. Marijuana is third, with 19 percent of teens reporting that it is easiest to get this year, compared to 22 percent last year. Compared to 2011, slightly more teens this year say prescription drugs are easier to get than other drugs (13 percent in 2012 vs. 10 percent in 2011)."

Source:

QEV Analytics, LTD., "National Survey of American Attitudes on Substance Abuse XVII: Teens," The National Center on Addiction and Substance Abuse at Columbia University (New York, NY: National Center on Addiction and Substance Abuse at Columbia University, August 2012), p. 21.
http://www.casacolumbia.org/addiction-research/reports/national-survey-a...

(Deaths and Risk Behaviors) "In the United States, 72% of all deaths among youth and young adults aged 10–24 years result from four causes: motor vehicle crashes (26%), other unintentional injuries (17%), homicide (16%), and suicide (13%) (1). Substantial morbidity and social problems also result from the estimated 410,000 births (2); 517,174 cases of chlamydia, gonorrhea, and syphilis (3); and 2,036 cases of human immunodeficiency virus (HIV) (4) reported in 2009 among youth aged 15–19 years. Among adults aged ≥25 years, 57% of all deaths in the United States result from cardiovascular disease (34%) and cancer (23%) (1). These leading causes of morbidity and mortality among youth and adults in the United States are related to six categories of priority health-risk behaviors: 1) behaviors that contribute to unintentional injuries and violence; 2) tobacco use; 3) alcohol and other drug use; 4) sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases (STDs), including HIV infection; 5) unhealthy dietary behaviors; and 6) physical inactivity. These behaviors frequently are interrelated and are established during childhood and adolescence and extend into adulthood."

Source:

"Youth Risk Behavior Surveillance — United States, 2011," Morbidity and Mortality Weekly Report (Atlanta, GA: Centers for Disease Control, June 8, 2012) Vol. 61, No. 4, p. 2.
http://www.cdc.gov/mmwr/pdf/ss/ss6104.pdf

(Impact of Parental Incarceration on Young Adults) "RESULTS: Positive, significant associations were found between parental incarceration and 8 of 16 health problems (depression, posttraumatic stress disorder, anxiety, cholesterol, asthma, migraines, HIV/AIDS, and fair/poor health) in adjusted logistic regression models. Those who reported paternal incarceration had increased odds of 8 mental and physical health problems, whereas those who reported maternal incarceration had increased odds of depression. For paternal incarceration, with the exception of HIV/AIDS, larger associations were found for mental health (odds ratios range 1.43–1.72) as compared with physical health (odds ratios range 1.26–1.31) problems. The association between paternal incarceration and HIV/AIDs should be interpreted with caution because of the low sample prevalence of HIV/AIDs."

Source:

Rosalyn D. Lee, Xiangming Fang and Feijun Luo, "The Impact of Parental Incarceration on the Physical and Mental Health of Young Adults." Pediatrics 2013;131;e1188; originally published online March 18, 2013; DOI: 10.1542/peds.2012-0627.
http://pediatrics.aappublications.org/content/131/4/e1188.abstract
http://pediatrics.aappublications.org/content/131/4/e1188.full

(Proportion of Students Using Any Drug Changes Slowly) "Overall, these data reveal that, while use of individual drugs (other than marijuana) may fluctuate widely, the proportion using any of them is much more stable. In other words, the proportion of students prone to using such drugs and willing to cross the normative barriers to such use changes more gradually. The usage rate for each individual drug, on the other hand, reflects many more rapidly changing determinants specific to that drug: how widely its psychoactive potential is recognized, how favorable the reports of its supposed benefits are, how risky its use is seen to be, how acceptable it is in the peer group, how accessible it is, and so on."

Source:

Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2013). Monitoring the Future national results on adolescent drug use: Overview of key findings, 2012. Ann Arbor: Institute for Social Research, The University of Michigan, p. 10.
http://www.monitoringthefuture.org/pubs/monographs/mtf-overview2012.pdf

(Prevalence of Substance Use Among Youth in the US, by Race/Ethnicity, 2014)
"• For a number of years, 12th-grade African-American students reported lifetime, annual, 30-day, and daily prevalence rates for nearly all drugs that were lower — sometimes dramatically so — than those for White or Hispanic 12th graders. That is less true today, with rates of drug use among African Americans more similar to the other groups. Also, use rates for most drugs were generally lower for African-American students than for White and Hispanic students in 8th and 10th grades, as well; therefore, their relatively low usage rates in 12th grade were almost certainly not due primarily to differential dropout rates. These differences were also less observable in 2014.
"• The association between annual marijuana use varies by grade level. In all three grades prevalence is highest among Hispanic students, followed by African Americans, and then Whites. Differences in prevalence across the groups are proportionately largest in 8th grade (16% for Hispanics and 9% for Whites), somewhat smaller in 10th grade (33% for Hispanics compared to 27% for Whites), and negligible in 12th grade (37% for Hispanics and 35% for Whites).
"• A number of drugs have consistently been much less popular among African-American teens than among White teens. These include hallucinogens, amphetamines, sedatives (barbiturates), tranquilizers, and narcotics other than heroin. Several additional drugs have historically been less popular among African-American teens but did not show much difference in 2014 among 8th graders, though they still are less popular in the upper grades. These include LSD, ecstasy, cocaine (in recent years), powder cocaine, and Vicodin.
"• By 12th grade, White students have the highest lifetime and annual prevalence rates among the three major racial/ethnic groups for many substances, including LSD, hallucinogens other than LSD, narcotics other than heroin, amphetamines, sedatives (barbiturates), tranquilizers, been drunk, cigarettes, and smokeless tobacco. The differentials for LSD have narrowed considerably in recent years as overall prevalence has declined substantially for this drug. Not all of these findings are replicated at lower grade levels, however. See Tables 4-5 and 4-6 for specifics."

Source:

Miech, R. A., Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (June 2015). Monitoring the Future national survey results on drug use, 1975–2014: Volume I, Secondary school students. Ann Arbor: Institute for Social Research, The University of Michigan, p. 99.
http://monitoringthefuture.org/pubs/monographs/mtf-vol1_2014.pdf

(Estimated Population of Young Adults in the US With a Parent Who Has Ever Spent Time in Jail or Prison) "The prevalence of any PI [Parental Incarceration] was 12.5% with the 95% confidence interval (CI) of 11.3% to 13.8%. The distribution of incarceration status by category was: neither parent (87.5%, 95% CI: 86.2%–88.7%), father only (9.9%, 95% CI: 8.9%–10.9%), mother only (1.7%, 95% CI: 1.4%–2.0%), and both parents (0.9%, 95% CI: 0.7%–1.2%). A significant association was found between race and PI. Black and Hispanic individuals had the highest prevalence of PI, 20.6% and 14.8%, compared with 11.9% for white individuals and 11.6% for those classified as other. Pairwise comparison indicated the black and white prevalence rates were significantly different."

Note: Regarding study sample size: "The current study used data from the National Longitudinal Study of Adolescent Health (Add Health), a 4-wave longitudinal study following a nationally representative probability sample of adolescents in grades 7 through 12 in the 1994–1995 school year.46 The first 3 waves of Add
Health data were collected from April to December 1995, from April to August 1996, and from August 2001 to April 2002. The fourth wave of data was collected in 2007 and 2008. The full sample for Wave 4 included 15 701 or 80.3% of the eligible participants from Wave 1. The response rates for Waves 1, 2, 3, and 4 were 79.0%, 88.6%, 77.4%, and 80.3%, respectively. The mean ages of participants during the 4 waves of data collection were 15.7 years, 16.2 years, 22.0 years, and 28.8 years, respectively.
"The current study was based on 14,800 participants who were interviewed during Wave 1 and Wave 4 and have a sampling weight. Of the 15,701 participants who participated in both Wave 1 and Wave 4 interviews, 14,800 participants have a sampling weight at Wave 4 interview that could be used to compute population estimates. For data analysis, data describing participants’ sociodemographic characteristics from Wave 1 of the Add Health study were combined with Wave 4 self-reported health outcomes and PI history."

Source:

(Importance of Family Dinners in Substance Use Prevention) "Compared to teens who have five to seven family dinners per week, those who have fewer than three family dinners per week are twice as likely to say they expect to try drugs (including marijuana and prescription drugs without a prescription to get high) in the future (17 percent vs. 8 percent)."

Source:

"The Importance of Family Dinners VIII: A CASAColumbia White Paper," The National Center on Addiction and Substance Abuse (New York, NY: September 2012), p. 7.
http://www.casacolumbia.org/addiction-research/reports/importance-of-fam...

(Illicit Use of Prescription Drugs) "Abuse of prescription medicine [by teens] remains high, but there are signs that it may be plateauing. Close to one in five teens (17 percent) say they have used a prescription medicine at least once in their lifetime to get high or change their mood. This is slightly, although not significantly, down from 22 percent in 2010 and from 20 percent in 2009. Use of prescription pain medicines, specifically Vicodin or OxyContin, is trending downward. One out of ten teens reports using pain medication to get high in the past year and six percent say they used in the past 30 days – down significantly from 2009 levels."

Source:

"The Partnership Attitude Tracking Study: 2011 Parents and Teens Full Report," MetLife Foundation and The Partnership at Drugfree.org (New York, NY: May 2, 2012), p. 13.
http://www.drugfree.org/wp-content/uploads/2012/05/PATS-FULL-Report-FINA...

(Top Concerns Among Adolescents) "Every year teens tell us that tobacco, alcohol and other drugs are the biggest problem facing teens their age. This year, 26 percent of teens surveyed say that alcohol, drugs and tobacco are the most important issue teens face, followed by social pressures [18%] and academic pressures [11%]."

Source:

QEV Analytics, Ltd., "National Survey of American Attitudes on Substance Abuse XVII: Teens" (New York, NY: National Center on Addiction and Substance Abuse, August 2012), p. 25.
http://www.casacolumbia.org/addiction-research/reports/national-survey-a...

(Prevalence of Sadness or Hopelessness Among Students in the US, 2011) "During the 12 months before the survey, 28.5% of students nationwide had felt so sad or hopeless almost every day for 2 or more weeks in a row that they stopped doing some usual activities (Table 21). Overall, the prevalence of having felt sad or hopeless almost every day for 2 or more weeks in a row was higher among female (35.9%) than male (21.5%) students; higher among white female (34.3%), black female (31.4%), and Hispanic female (41.4%) than white male (20.7%), black male (18.0%), and Hispanic male (24.4%) students, respectively;"

Source:

"Youth Risk Behavior Surveillance — United States, 2011," Morbidity and Mortality Weekly Report (Atlanta, GA: Centers for Disease Control, June 8, 2012) Vol. 61, No. 4, p. 10.
http://www.cdc.gov/mmwr/pdf/ss/ss6104.pdf

(Depression and Marijuana Use) “High school students in CASA’s survey who report having ever used marijuana are more likely than students who never used marijuana to report that they feel alone or isolated (26.7 percent vs. 19.9 percent), that they often feel very sad or depressed (27.9 percent vs. 14.0 percent) and that they think they will develop depression during their lifetime (41.0 percent vs. 25.4 percent).7”

Source:

Adolescent Substance Use: America’s #1 Public Health Problem," The National Center on Addiction and Substance Abuse at Columbia University (New York, NY: National Center on Addiction and Substance Abuse at Columbia University, June 2011), p. 46.
http://www.casacolumbia.org/addiction-research/reports/adolescent-substa...

(Prescription Medicine Abuse) "It is important to note that the negative consequences of prescription medicine abuse remain extensive and troubling. Emergency room visits as a result of prescription medications increased 45 percent between 2004 and 2009 among children under 20 years of age1. Admissions to treatment for prescription medicine abuse among adolescents have also increased and deaths caused by drug overdoses, led by prescription medicines, now outnumber traffic fatalities in the United States2."

Source:

"The Partnership Attitude Tracking Study: 2011 Parents and Teens Full Report," MetLife Foundation and The Partnership at Drugfree.org (New York, NY: May 2, 2012), p. 14.
http://www.drugfree.org/wp-content/uploads/2012/05/PATS-FULL-Report-FINA...

(Ease of Getting Drugs) "Younger teens (ages 12 to 13 and 14 to 15) are more likely to say that they can get prescription drugs in an hour, and within a day, compared to marijuana, while older teens (16- to 17) are more likely to be able to get to marijuana within a day."

Source:

QEV Analytics, LTD., "National Survey of American Attitudes on Substance Abuse XVII: Teens," The National Center on Addiction and Substance Abuse at Columbia University (New York, NY: National Center on Addiction and Substance Abuse at Columbia University, August 2012), p. 28.
http://www.casacolumbia.org/addiction-research/reports/national-survey-a...

(Importance of Relationship with Parents) "Teens who have high-quality relationships with Mom and Dad are less likely to use drugs, drink or smoke.
"Compared to teens who say they have an excellent relationship with Dad,* teens who have a less than very good relationship with their father are:
• Almost four times likelier to have used marijuana (23 percent vs. 6 percent);
• Twice as likely to have used alcohol (35 percent vs. 16 percent); and
• Two and a half times as likely to have used tobacco (15 percent vs. 6 percent).
"Compared to teens who say they have an excellent relationship with Mom,† teens who have a less than very good relationship with their mother are:
• Almost three times likelier to have used marijuana (26 percent vs. 9 percent);
• Two and a half times as likely to have used alcohol (45 percent vs.18 percent); and
• Two and a half times likelier to have used tobacco (16 percent vs. 6 percent)."

Source:

"The Importance of Family Dinners VIII: A CASAColumbia White Paper," The National Center on Addiction and Substance Abuse (New York, NY: September 2012), p. 3.
http://www.casacolumbia.org/addiction-research/reports/importance-of-fam...

(Impact of State-Legal Medical Marijuana on Adolescent Marijuana Use) "In conclusion, our study of self-reported marijuana use by adolescents in states with a medical marijuana policy compared with a sample of geographically similar states without a policy does not demonstrate increases in marijuana use among high school students that may be attributed to the policies."

Source:

Choo, Esther K. et al., "The Impact of State Medical Marijuana Legislation on Adolescent Marijuana Use," Journal of Adolescent Health, August 2014, Volume 55, Issue 2, p. 160 - 166.
http://www.jahonline.org/article/S1054-139X%2814%2900107-4/abstract
http://www.jahonline.org/article/S1054-139X%2814%2900107-4/pdf

(Social Networking and Drug Use) "Compared to teens who have never seen pictures on Facebook, MySpace or another social networking site of kids getting drunk, passed out, or using drugs, teens who have seen such pictures are:

• Four times likelier to have used marijuana (25 percent vs. 6 percent);
• More than three times likelier to have used alcohol (43 percent vs. 13 percent); and
• Almost three times likelier to have used tobacco (16 percent vs. 6 percent)."

Source:

(Gangs in Schools)
"• Forty-five percent of high school students say that there are gangs or students who consider themselves to be part of a gang in their school.
"• Thirty-five percent of middle school students say that there are gangs or students who consider themselves to be part of a gang in their school.
"Compared to teens in schools without gangs, those in schools that have gangs are nearly twice as likely to report that their school is drug infected, meaning drugs are used, kept or sold on school grounds (30 percent vs. 58 percent).
"A quarter of public school students (27 percent) say that their school is both drug infected and has gangs."

Source:

Knowledge Networks and QEV Analytics, "National Survey of American Attitudes on Substance Abuse XV: Teens and Parents" (New York, NY: National Center on Addiction and Substance Abuse at Columbia University, August 2010), p. 2.
http://www.casacolumbia.org/addiction-research/reports/national-survey-a...

(Drug-Related ER Visits) "Patients aged 20 or younger accounted for 18.8 percent (922,953 visits) of all drug-related ED visits in 2010. About one half (45.3 percent, or 417,856 visits) of these visits involved drug misuse or abuse, representing a rate of 476.1 ED visits per 100,000 population aged 20 or younger."

Source:

Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. "The DAWN Report: Highlights of the 2010 Drug Abuse Warning Network (DAWN) Findings on Drug-Related Emergency Department Visits," (Rockville, MD: July 2, 2012), p. 2.
http://www.samhsa.gov/data/2k12/DAWN096/SR096EDHighlights2010.pdf

(Early Initiation of Substance Use) “When initiation of substance use occurs in preadolescence or early in adolescence, the risk of addiction is magnified.8 CASA’s analysis of national data finds that individuals‡ who first used any addictive substance before age 15 are six and a half times as likely to have a substance use disorder as those who did not use any addictive substance until age 21 or older (28.1 percent vs. 4.3 percent).”

Source:

"Adolescent Substance Use: America’s #1 Public Health Problem," The National Center on Addiction and Substance Abuse at Columbia University (New York, NY: National Center on Addiction and Substance Abuse at Columbia University, June 2011), p. 38
http://www.casacolumbia.org/addiction-research/reports/adolescent-substa...

(Delay in Onset of Substance Use) “Each year that the onset of substance use is delayed until the mid-20s - about the time when the human brain is more fully developed10 — the risk of developing a substance use disorder is reduced.11 Among people who used any of these substances before age 18, one in four have a substance disorder, compared with one in 25 who started to smoke, drink or use other drugs at age 21 or later.”12

Source:

Adolescent Substance Use: America’s #1 Public Health Problem," The National Center on Addiction and Substance Abuse at Columbia University (New York, NY: National Center on Addiction and Substance Abuse at Columbia University, June 2011), p. 39.
http://www.casacolumbia.org/upload/2011/20110629adolescentsubstanceuse.p...

(Inhalants) "In 2011, there were 719,000 persons aged 12 or older who had used inhalants for the first time within the past 12 months, which was lower than the numbers in prior years from 2002 to 2005 (ranging from 849,000 to 877,000). An estimated 67.1 percent of past year initiates of inhalants in 2011 were under age 18 when they first used. The average age at first use among recent initiates aged 12 to 49 was similar in 2010 and 2011 (16.3 and 16.4 years, respectively)."

Source:

Substance Abuse and Mental Health Services Administration, Results from the 2011 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-44, HHS Publication No. (SMA) 12-4713. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2012, p. 58.
http://www.samhsa.gov/data/NSDUH/2k11Results/NSDUHresults2011.pdf

(Prevalence of Inhalant Use Among US Youth) "Inhalants rank second among the illicit drugs in lifetime prevalence for 8th graders (11%) and 10th graders (8.7%); they rank eighth for 12th graders (6.9%). Inhalants also rank second highest in 30-day prevalence among the illicit drugs for 8th (2.3%) and fourth (1.3%) among 10th graders, but eleventh for 12th graders (1.0%). Note that the youngest respondents report the highest rates of use; this is the only class of drugs for which current use declines with age during adolescence.31"

"31: The seemingly anomalous finding of lifetime inhalant prevalence declining across grade levels could be due to various factors. There might be lower lifetime prevalence at older ages because the eventual school dropout segment is included only in the lower grades. If those who will become dropouts are unusually likely to use inhalants, lifetime use rates could decline with grade level. That would lead to a relatively stable recurring difference between the grades in lifetime use (because dropout rates have been fairly stable in recent years); however, the degree of difference has changed some over time (see Table 2-1), with larger differences emerging in the mid-1990s. Another possible factor is changing validity of reporting with age; but in order to account for the trend data, one would have to hypothesize that this tendency became stronger in the 1990s, and we have no reason to believe that it did. Cohort differences may be a factor, but cannot completely explain the large changes in lifetime prevalence. It seems likely that all of these factors contribute to the differences observed in the retrospective reporting by different ages, and possibly some additional factors as well."

Source:

Johnston, L. D., O’Malley, P. M., Bachman, J. G., Schulenberg, J. E. & Miech, R. A. (2014). Monitoring the Future national survey results on drug use, 1975–2013: Volume I, Secondary school students. Ann Arbor: Institute for Social Research, The University of Michigan, p. 87.
http://www.monitoringthefuture.org/pubs/monographs/mtf-vol1_2013.pdf

(Inhalants)
"• The percentage of adolescents (i.e., youths aged 12 to 17) who used inhalants in the past year was lower in 2007 (3.9 percent) than in 2003, 2004, and 2005 (4.5, 4.6, and 4.5 percent, respectively)
"• Among adolescents who used inhalants for the first time in the past year (i.e., past year initiates), the rate of use of nitrous oxide or “whippits” declined between 2002 and 2007 among both genders (males: 40.2 to 20.2 percent; females: 22.3 to 12.2 percent)
"• In 2007, 17.2 percent of adolescents who initiated illicit drug use during the past year indicated that inhalants were the first drug that they used; this rate remained relatively stable between 2002 and 2007
(Note: "Inhalants" are defined as: "Aerosol sprays other than spray paint include products such as aerosol air fresheners, aerosol spray, and aerosol cleaning products (e.g., dusting sprays, furniture polish). The aerosol propellants in these products are commonly chlorofluorocarbons. By contrast, nitrous oxide is used as a propellant for whipped cream and is available in 2-inch tapered cylinders called “whippits” that are used to pressurize home whipped-cream charging bottles.")

Source:

Substance Abuse and Mental Health Services Administration, Office of Applied Studies. (March 16, 2009). "The NSDUH Report: Trends in Adolescent Inhalant Use: 2002 to 2007." Rockville, MD, pp. 1 and 3.
http://oas.samhsa.gov/2k9/inhalantTrends/inhalantTrends.pdf

(Impact on Young People of Incarceration of Their Fathers) "Paternal incarceration, however, was found associated with a greater number of health outcomes than maternal incarceration. Also, paternal incarceration was found to be associated with both physical and mental health problems, whereas maternal incarceration was found associated only with poor mental health.
"For paternal incarceration, with the exception of HIV/AIDS, larger associations were found for mental health as compared with physical health outcomes. Caution should be taken in understanding the significance of the finding related to HIV/AIDS, given its low overall sample prevalence and wide CI. If this is a true association, it may be related to paternal HIV/AIDS status and other risk factors related to father absence. Given the high correlation between HIV/AIDS and incarceration, increased odds of HIV/AIDS in offspring could come from perinatal transmission. However, social factors may also explain this relationship."

Source:

(Alcohol Use v Marijuana Use - US Youth and "The Displacement Hypothesis") "Alcohol and marijuana are the two most commonly used substances by teenagers to get high, and a question that is often asked is to what extent does change in one lead to a change in the other. If the substances co-vary negatively (an increase in one is accompanied by a decrease in the other) they are said to be substitutes; if they co-vary positively, they are said to be complements. Note that there is no evidence that the 13-year decline in marijuana use observed between 1979 and 1992 led to any accompanying increase in alcohol use; in fact, through 1992 there was some parallel decline in annual, monthly, and daily alcohol use, as well as in occasions of heavy drinking among 12th graders, suggesting that the two substances are complements. Earlier, when marijuana use increased in the late 1970s, alcohol use also increased. As marijuana use increased again in the 1990s, alcohol use again increased with it, although not as sharply. In sum, there has been little evidence from MTF over the years that supports what we have termed 'the displacement hypothesis,' which asserts that an increase in marijuana use will somehow lead to a decline in alcohol use, or vice versa.8 Instead, both substances appear to move more in harmony, perhaps both reflecting changes in a more general construct, such as the tendency to use psychoactive substances, whether licit or illicit, or in the frequency with which teens party. However, with alcohol use decreasing and marijuana use increasing over the past few years, it is possible that the displacement hypothesis is gaining some support. As a number of states are changing their policies regarding marijuana, our continued monitoring will provide the needed evidence concerning whether alcohol and marijuana are substitutes or complements."

Source:

Miech, R. A., Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2015). Monitoring the Future national survey results on drug use, 1975–2014: Volume I, Secondary school students. Ann Arbor: Institute for Social Research, The University of Michigan, pp. 161-162.
http://monitoringthefuture.org//pubs/monographs/mtf-vol1_2014.pdf
http://monitoringthefuture.org/pubs.html

(Physical and Mental Health Impact of Parental Incarceration on Their Children) "As shown in Table 2, bivariate analyses indicate PI [Parental Incarceration] was significantly associated with 8 of the 16 health conditions (heart disease, asthma, migraines, depression, anxiety, posttraumatic stress disorder [PTSD], HIV/AIDS, and fair/poor health). With the exception of heart disease and HIV/AIDS, individuals who reported neither parent had an incarceration history had the lowest prevalence rates of these 8 health conditions. Individuals who reported father incarceration only had the highest prevalence rates of 3 of the 8 health conditions (heart disease, HIV/AIDS, and fair/poor health); whereas individuals who reported mother incarceration only were highest on 2 conditions (depression and anxiety) and individuals who reported incarceration of both parents were highest on 3 conditions (asthma, migraine, and PTSD)."

Source:

(Reasons for Non-Prescription Use of Prescription Opioids by US High School Seniors) "Approximately 12.3% of the respondents -- high school seniors in the United States -- reported lifetime nonmedical use of prescription opioids and 8.0% reported past-year nonmedical use. Table 1 shows the prevalence of motives for nonmedical use of prescription opioids among high school seniors in the United States. The leading motives included 'to relax or relieve tension' (56.4%), 'to feel good or get high' (53.5%), 'to experiment-see what it's like' (52.4%), 'to relieve physical pain' (44.8%), and 'to have a good time with friends' (29.5%).

Source:

Sean Esteban McCabe, Phd, et al., "Motives for Nonmedical Use of Prescription Opioids among High School Seniors in the United States: Self-Treatment and Beyond," Archives of Pediatric and Adolescent Medicine, 2009 August; 163(8): 739-744. doi:10.1001/archpediatrics.2009.120.
http://www.ncbi.nlm.nih.gov/pubmed/19652106
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2975027/pdf/nihms-164105.pdf

(Pain Relief and Non-Prescription Use of Prescription Opioids by US High School Seniors) "The lifetime medical use of prescription opioids was reported by approximately 14.0% of those who did not engage in past-year nonmedical use of prescription opioids, 76.1% of nonmedical users of prescription opioids motivated only by pain relief, 71.4% of those motivated by pain relief and other motives, and 46.7% of those who reported non-pain relief motives only (p < 0.001). Among past-year nonmedical users of prescription opioids, approximately 56.5% of those motivated only by pain relief as compared to 23.1% of those who reported pain relief and other motives, and 14.2% of those who reported only non-pain relief motives had initiated medical use of prescription opioids before nonmedical use of prescription opioids. In contrast, approximately 19.6% of those motivated only by pain relief as compared to 48.3% of those who reported pain relief and other motives, and 32.5% of those who reported only non-pain relief motives initiated nonmedical use of prescription opioids before medical use of prescription opioids."

Source:

(Children with Parents in Prison) "Since 1991, the number of children with a mother in prison has more than doubled, up 131%. The number of children with a father in prison has grown by 77%. This finding reflects a faster rate of growth in the number of mothers held in state and federal prisons (up 122%), compared to the number of fathers (up 76%) between 1991 and midyear 2007.
"Of the estimated 74 million children in the U.S. resident population who were under age 18 on July 1, 2007, 2.3% had a parent in prison (table 2). Black children (6.7%) were seven and a half times more likely than white children (0.9%) to have a parent in prison. Hispanic children (2.4%) were more than two and a half times more likely than white children to have a parent in prison."

Source:

Glaze, Lauren E., and Maruschak, Laura M., "Parents in Prison and Their Minor Children" (Washington, DC: US Dept. of Justice Bureau of Justice Statistics, Aug. 2008), NCJ222984, p. 2.
http://www.bjs.gov/content/pub/pdf/pptmc.pdf

(Substance Use and Nonfatal Violent Victimization) "Juveniles using drugs or alcohol committed 1 in 10 of the nonfatal violent victimizations against older teens. This was 2-1/2 times higher than the percentage of victimizations against younger teens perceived to be committed by a juvenile who was using drugs or alcohol.
"Younger teens were more likely than older teens to report that their juvenile offender was not using drugs or alcohol. In about 4 in 10 victimizations against younger and older teens committed by juveniles, the victim could not ascertain whether or not the offender was using drugs or alcohol."

Source:

Baum, Katrina, PhD, "Juvenile Victimization and Offending, 1993-2003" (Washington, DC: US Dept. of Justice, Bureau of Justice Statistics, Aug. 2005), p. 8.
http://www.bjs.gov/content/pub/pdf/jvo03.pdf

(Characteristics of Cannabis Users, Other Drug Users, and Abstainers) "Zambon et al also found that having a good relationship with a best friend was related to increased use of cannabis, alcohol, and tobacco. Similarly, Hoel et al39 reported that although abstainers are successful in many social arenas, they socialize less frequently with friends than youth who drink, while a Finnish study40 indicated that moderate use of alcohol among adolescents was associated with a positive self-image in social relationships. Another
study,41 performed in New Zealand, also indicated an association between a high level of connectedness to friends and an increased level of smoking and use of cannabis in the previous month.
"In addition, and contrary to previous research,23 our study does not confirm the negative effect of cannabis on academic performance among COG youth. In our case, they are more likely to be high school students and they report similar grades as abstainers, even though they skip class more often."

Source:

Suris, J. C.; Akre, Christina; Berchtold, Andre´; Jeannin, Andre´; Michaud, Pierre-Andre´, "Some Go Without a Cigarette: Characteristics of Cannabis Users Who Have Never Smoked Tobacco," Archives of Pediatric Adolescent Medicine (Chicago, IL: American Medical Association, November 2007) Vol. 161, No. 11, p. 1046.
http://archpedi.jamanetwork.com/article.aspx?articleid=571420

(Cannabis Users Compared With Abstainers) "Interestingly, our results do not confirm our hypothesis of better overall functioning among abstainers. In fact, what our research indicates is that the main difference between COG [cannabis use only group] youth and abstainers [those abstaining from all drugs] is that the former are more socially driven: they are significantly more likely to practice sports, and they have a better relationship with their peers. Moreover, even though they are more likely to skip class, they have the same level of good grades; and although they have a worse relationship with their parents, they are not more likely to be depressed. Nevertheless, our results seem to indicate that, although typical of the adolescence process, having good support from friends together with a less solid relationship with parents is a risk factor for occasional cannabis use."

Source:

(Teen Marijuana Use in Medical Marijuana States) "Our results are not consistent with the hypothesis that the legalization of medical marijuana caused an increase in the use of marijuana and other substances among high school students. In fact, estimates from our preferred specifications are consistently negative and are never statistically distinguishable from zero."
"There is little evidence that marijuana use is related to the legalization of medical marijuana in either of these data sources [*], a result that is consistent with research showing that marijuana use among adults is more sensitive to changes in policy than marijuana use among youths (Farrelly et al. 1999; Williams 2004)."
[*] data sources are the National Longitudinal Survey of Youth 1997 (NLSY97) and the Treatment Episode Data Set (TEDS)

Source:

Anderson, D. Mark; Hansen, Benjamin; and Rees, Daniel I, "Medical Marijuana Laws and Teen Marijuana Use," Social Science Research Network (May 2012), pp. 18-19.
http://papers.ssrn.com/sol3/Delivery.cfm/SSRN_ID2067431_code1632588.pdf?...

(Adverse Effects of Substance Use on Academic Performance) "In the United States in the 1970s and 1980s, cannabis use appears to have increased the risk of discontinuing a high school education, and of experiencing job instability in young adulthood (Newcombe and Bentler, 1988). The apparent strength of these relationships in cross-sectional studies (e.g. Kandel, 1984) has been exaggerated because those adolescents who are most likely to use cannabis have lower academic aspirations and poorer high school performance prior to using cannabis than their peers who do not (Newcombe and Bentler, 1988). It remains possible that factors other than the marijuana use account for apparent causal relations. To the extent they may exist, these adverse effects of cannabis and other drug use upon development over and above the effect of pre-existing nonconformity may cascade throughout young adult life, affecting choice of occupation, level of income, choice of mate, and the quality of life of the user and his or her children."

Source:

Hall, W., Room, R., & Bondy, S., WHO Project on Health Implications of Cannabis Use: A Comparative Appraisal of the Health and Psychological Consequences of Alcohol, Cannabis, Nicotine and Opiate Use August 28, 1995 (Geneva, Switzerland: World Health Organization, 1998).
http://www.druglibrary.net/schaffer/hemp/general/who-probable.htm

Marijuana Use, Cognition and IQ

(Effect of Marijuana Use by Adolescents on Cognition and IQ Development) "In line with previous work, we found that cannabis users had lower teenage IQ scores and poorer educational performance than teenagers who had never used cannabis. At the same time, cannabis users also had higher rates of childhood behavioural problems, childhood depressive symptoms, other substance use (including use of cigarettes and alcohol) and maternal use of cannabis during pregnancy. After adjustment to account for these group differences, cannabis use by the age of 15 did not predict either lower teenage IQ scores or poorer educational performance. These findings therefore suggest that cannabis use at the modest levels used by this sample of teenagers is not by itself causally related to cognitive impairment. Instead, our findings imply that previously reported associations between adolescent cannabis use and poorer intellectual and educational outcomes may be confounded to a significant degree by related factors."

Source:

C Mokrysz, R Landy, SH Gage, MR Munafò, JP Roiser, and HV Curran, "Are IQ and educational outcomes in teenagers related to their cannabis use? A prospective cohort study," Journal of Psychopharmacology, 0269881115622241, first published on January 6, 2016 doi:10.1177/0269881115622241
http://jop.sagepub.com/content/early/2016/01/06/0269881115622241.full.pd...
http://jop.sagepub.com/content/early/2016/01/06/0269881115622241.abstrac...

(Effect of Marijuana Use by Adolescents on Cognition and IQ) "In summary, the notion that cannabis use itself is causally related to lower IQ and poorer educational performance was not supported in this large teenage sample. However, this study indeed has limitations, in particular the young age of outcome assessment. While we have demonstrated that confounding may be an explanation for links between cannabis use and poorer outcomes, large prospective cohorts tracking young people prior to, during and after stopping cannabis use, using more objective measures of drug use (e.g. the new NIH-funded ‘ABCD study’ in the United States; National Institute on Drug Abuse, 2015) are required before we can make strong conclusions. Cigarette smoking in particular has once again (Hooper et al., 2014; McCaffrey et al., 2010; Silins et al., 2014; Stiby et al., 2014) been highlighted as an important factor in adolescent outcomes, as well as a robust independent predictor of educational performance, and the reasons for this need to be elucidated."

Source:

(Effect of Cannabis Use by Adolescents on Cognition and IQ and the Potential Influence of Tobacco) "Compared with those in our sample who had never tried cannabis, teenagers who had used cannabis at least 50 times were 17 times more likely (84% vs. 5%) to have smoked cigarettes more than 20 times in their lifetime. Accounting for group differences in cigarette smoking dramatically attenuated the associations between cannabis use and both IQ and educational performance. Further, even after excluding those who had never tried cannabis, cigarette users were found to have lower educational performance (adjusted performance 2.9 percentage points lower, approximately equivalent to dropping two grades on one subject taken at GCSE) relative to those who had never tried cigarettes. A relationship between cigarette use and poorer cognitive (Chamberlain et al., 2012; Hooper et al., 2014; Weiser et al., 2010; Whalley et al., 2005) and educational (McCaffrey et al., 2010; Silins et al., 2014; Stiby et al., 2014) outcomes has been noted previously, and may have a number of explanations. Cigarette use may have a negative impact on cognitive ability. However, this is not supported by the experimental psychopharmacology literature, which robustly shows that acute nicotine administration results in transient cognitive enhancement (Heishman et al., 2010). Alternatively, reverse causality may contribute to this relationship, for example performing poorly at school may lead to increased engagement in risky behaviours such as cigarette smoking. Further, residual confounding may contribute to this link: cigarette smoking may be a marker of unmeasured factors, for example social adversity during adolescence, that influence both IQ and educational attainment."

Source:

(IQ Decline Among Adolescent-Onset Marijuana Users) "In the present study, the most persistent adolescent-onset cannabis users evidenced an average 8-point IQ decline from childhood to adulthood. Quitting, however, may have beneficial effects, preventing additional impairment for adolescent-onset users. Prevention and policy efforts should focus on delivering to the public the message that cannabis use during adolescence can have harmful effects on neuropsychological functioning, delaying the onset of cannabis use at least until adulthood, and encouraging cessation of cannabis use particularly for those who began using cannabis in adolescence."

Source:

Madeline H. Meier, Avshalom Caspi, Antony Ambler, HonaLee Harrington, Renate Houts, Richard S. E. Keefe, Kay McDonald, Aimee Ward, Richie Poulton, and Terrie E. Moffitt, "Persistent Cannabis Users Show Neuropsychological Decline from Childhood to Midlife, Proceedings of the National Academy of Sciences, www.pnas.org/cgi/doi/10.1073/pnas.1206820109, 2012, p. 6.

(Cognitive Deficit Among Adolescent-Onset Marijuana Users) "Our findings suggest that regular cannabis use before age 18 y predicts impairment, but others have found effects only for younger ages (10, 15). Given that the brain undergoes dynamic changes from the onset of puberty through early adulthood (37, 38), this developmental period should be the focus of future research on the age(s) at which harm occurs."

Source:

Young People and Marijuana

(Vulnerability of Teens to Effects of Drugs) "The teen brain is a work in progress, making it more vulnerable than the mature brain to the physical effects of drugs. The potential for developing substance abuse and dependence is substantially greater when an individual’s first exposure to alcohol, nicotine and illicit drugs occurs during adolescence than in adulthood."

Source:

Steinberg, L., Distinguished University Professor and Laura H. Carnell Professor of Psychology, Department of Psychology, Temple University and author of You and Your Adolescent: The Essential guide for ages 10 to 25 (personal communication, June 9, 2011), as quoted in "Adolescent Substance Use: America’s #1 Public Health Problem," The National Center on Addiction and Substance Abuse at Columbia University (New York, NY: National Center on Addiction and Substance Abuse at Columbia University, June 2011), p. 13.
http://www.casacolumbia.org/addiction-research/reports/adolescent-substa...

(Early Use of Marijuana) "The younger and more often teens use marijuana, the more likely they are to engage in other substance use and the higher their risk of developing a substance use disorder. Among high school students, 7.5 percent used marijuana for the first time before the age of 13. CASA’s analysis of national data finds that the average age of initiation of marijuana use among high school students is 14.3 years old. Compared to those who began using marijuana after age 21, those who first used it before age 15 are:
• More likely to have ever smoked a cigarette (93.3 percent vs. 86.4 percent);
• More than twice as likely to have ever misused controlled prescription drugs (56.5 percent vs. 22.9 percent); and
• Two and a half times as likely to have ever used other illicit drugs (70.2 percent vs. 27.8 percent)."

Source:

"Adolescent Substance Abuse: America's #1 Public Health Problem," National Center on Addiction and Substance Abuse at Columbia University, June 2011, p. 27.
http://www.casacolumbia.org/addiction-research/reports/adolescent-substa...

(Prevalence and Perceived Risk of Marijuana Use) "Marijuana use, which had been rising among teens for the past four years, continued to rise in 2011 in all prevalence periods for 10th and 12th graders; but in 2012 these increases halted. The recent rise in use stood in stark contrast to the long, gradual decline that had been occurring over the preceding decade. (Although use among 8th graders had been rising, annual prevalence decreased after 2010.) It is relevant that perceived risk for marijuana has been falling for the past six years, and disapproval declined for the past three to four years. These changes would normally portend a further increase in use."

Source:

Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2013). Monitoring the Future national results on adolescent drug use: Overview of key findings, 2012. Ann Arbor: Institute for Social Research, The University of Michigan, p. 5.
http://www.monitoringthefuture.org/pubs/monographs/mtf-overview2012.pdf

(Marijuana Use vs. Tobacco Use) "High school students are more likely to use marijuana than to smoke cigarettes. High school students are:
"• More likely to have tried marijuana than tobacco (24 percent vs. 15 percent); and
"• More likely to say their close friends use marijuana than smoke cigarettes (51 percent vs. 39 percent)."

Source:

QEV Analytics, LTD., "National Survey of American Attitudes on Substance Abuse XVII: Teens," The National Center on Addiction and Substance Abuse at Columbia University (New York, NY: National Center on Addiction and Substance Abuse at Columbia University, August 2012), p. 30.
http://www.casacolumbia.org/addiction-research/reports/national-survey-a...

(Marijuana Use by Peers and Perception of Harm) "Teens also say they are seeing more peers in school smoking marijuana and more teens (73 percent) report having friends who smoke marijuana regularly (71 percent) – significantly higher than four years ago. Since 2008, there have also been significant declines in teen perceptions that they will lose respect, harm themselves, or mess up their lives if they use marijuana."

Source:

"The Partnership Attitude Tracking Study: 2011 Parents and Teens Full Report," MetLife Foundation and The Partnership at Drugfree.org (New York, NY: May 2, 2012), p. 7.
http://www.drugfree.org/wp-content/uploads/2012/05/PATS-FULL-Report-FINA...

(Adolescent Motivation) "The apparent strength of these relationships in cross-sectional studies (e.g. Kandel, 1984) has been exaggerated because those adolescents who are most likely to use cannabis have lower academic aspirations and poorer high school performance prior to using cannabis than their peers who do not (Newcombe and Bentler, 1988). It remains possible that factors other than the marijuana use account for apparent causal relations. To the extent they may exist, these adverse effects of cannabis and other drug use upon development over and above the effect of pre-existing nonconformity may cascade throughout young adult life, affecting choice of occupation, level of income, choice of mate, and the quality of life of the user and his or her children."

Source:

(Number of Juveniles Held in Adult Jails in the US) "About 4,200 juveniles age 17 or younger were held in local jails at midyear 2014. They accounted for 0.6% of the confined population, down from 1.2% at midyear 2000. Nearly 90% or 3,700 juvenile inmates were tried or awaiting trial in adult court. The number of juveniles not charged as an adult declined by 74% between midyear 2010 and 2014 (from 1,900 to 500 inmates)."

Source:

Todd D. Minton and Zhen Zeng, PhD, "Jail Inmates at Midyear 2014," Bureau of Justice Statistics (Washington, DC: Department of Justice, June 2015), NCJ248629, p. 4.
http://www.bjs.gov/index.cfm?ty=pbdetail&iid=5299
http://www.bjs.gov/content/pub/pdf/jim14.pdf

Sociopolitical and Health-Related Research

(Risk Factors for Substance Use Among Youth) "The risk factors were stronger predictors of substance use outcomes compared to the protective factors, regardless of grade level or substance use type. In particular, the individual and peer risk factors were strongly related to lifetime and recent use of cigarettes, alcohol, and marijuana. Among the protective factors, the strongest associations with substance use were found in the community domain. Several age-related differences in the associations were also found, suggesting that family and community factors were more salient among younger grades whereas peer and school factors were stronger among older adolescents."

Source:

Michael J. Cleveland, Ph.D; Mark E. Feinberg, Ph.D.; Daniel E. Bontempo, Ph.D.; and Mark T. Greenberg, Ph.D., "The Role of Risk and Protective Factors in Substance Use across Adolescence," Journal of Adolescent Health, (August 2008); 43(2): 157–164.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2518980/pdf/nihms59797.pdf

(Addiction and Adolescent Brain Development) "Addictive substances also adversely affect brain development and maturation in the areas related to motivation, judgment, inhibition and selfcontrol.26 As a result, addictive substances impair the judgment of teens in the face of potential rewards, leading not only to their engagement in risky behaviors--such as driving while under the influence of alcohol or other drugs or participating in unsafe sexual practices--but also to continued use of addictive substances despite negative consequences.27”

Source:

Adolescent Substance Use: America’s #1 Public Health Problem," The National Center on Addiction and Substance Abuse at Columbia University (New York, NY: National Center on Addiction and Substance Abuse at Columbia University, June 2011), p. 13.
http://www.casacolumbia.org/addiction-research/reports/adolescent-substa...

(Predictors of Substance Use) "Social learning variables, peer attitudes (prevalence of norms favourable to deviant behaviour), personal approval (adoption of deviant norms), and peer behaviour have an effect on frequency of alcohol use and alcohol abuse. Alcohol expectancies and peer delinquency predict alcohol consumption of adolescents.
"Going out most evenings and the use of cannabis by peers and older siblings is associated with adolescents’ use of cannabis.
"Having school-related problems is a strong predictor in all stages of cannabis involvement (initiation of experimental use, initiation of regular use, progression to regular use, failure to discontinue, experimental use, failure to discontinue, regular use)."

Source:

European Monitoring Centre for Drugs and Drug Addiction, "Preventing later substance use disorders in at-risk children and adolescents: a review of the theory and evidence base of indicated prevention" (Luxembourg: Office for Official Publications of the European Communities, 2009) , p. 15.
http://www.emcdda.europa.eu/attachements.cfm/att_69429_EN_EMCDDA-TB-indi...

(Risk Taking and the Adolescent Brain) "In sum, risk taking declines between adolescence and adulthood for two, and perhaps, three reasons. First, the maturation of the cognitive control system, as evidenced by structural and functional changes in the prefrontal cortex, strengthens individuals’ abilities to engage in longer-term planning and inhibit impulsive behavior. Second, the maturation of connections across cortical areas and between cortical and subcortical regions facilitates the coordination of cognition and affect, which permits individuals to better modulate socially and emotionally aroused inclinations with deliberative reasoning and, conversely, to modulate excessively deliberative decision-making with social and emotional information. Finally, there may be developmental changes in patterns of neurotransmission after adolescence that change reward salience and reward-seeking, but this is a topic that requires further behavioral and neurobiological research before saying anything definitive."

Source:

Steinberg, Laurence, "A Social Neuroscience Perspective on Adolescent Risk-Taking," Developmental Review: Perspectives in Behavior and Cognition (May 27, 2008), Vol 28, Issue 1, p. 18.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2396566/pdf/nihms33852.pdf

(Depression, Mood Disorders, and Marijuana Use) "Depressive disorders have an association with alcohol abuse or dependence and cannabis dependence. There are also reciprocal effects of suicidality and substance use. Mood disorders (including bipolar disorders — hypomania and mania) predict increased rates for cannabis use and cannabis use disorder. For anxiety disorders, results were variable."

Source:

European Monitoring Centre for Drugs and Drug Addiction, "Preventing later substance use disorders in at-risk children and adolescents: a review of the theory and evidence base of indicated prevention" (Luxembourg: Office for Official Publications of the European Communities, 2009) , p. 20.
http://www.emcdda.europa.eu/attachements.cfm/att_69429_EN_EMCDDA-TB-indi...

(Risky Behavior and Substance Use) "In commenting on problem behaviors among youth, Jessor and Jessor (1975) and later Jessor (1984) argued that adolescence is a period in which youth reject conventionality and traditional authority figures in an effort to establish their own independence. For a significant number of adolescents, this rejection consists of engaging in a number of 'risky' behaviors, including drug and alcohol use. Within the past few years, researchers and practitioners have begun to focus on this tendency, suggesting that drug use may be a 'default' activity engaged in when youth have few or no opportunities to assert their independence in a constructive manner (Benard 1994; gentler 1992; Carnegie Council on Adolescent Development 1992; Cato 1992; Maddahian et al. 1988; Pransky 1991). They note that in contemporary American society, youth have very few opportunities to participate in activities that allow them to develop a sense of independence and assume significant responsibilities. Such efforts must allow youth to exercise considerable control over activity development and implementation."

Source:

Maria Carmona and Kathryn Stewart, A Review of Alternative Activities and Alternatives Programs in Youth-Oriented Prevention (National Center for the Advancement of Prevention, under contract for the Substance Abuse Mental Health Services Administration (SAMHSA), Center for Substance Abuse Prevention, 1996), p. 5.
http://vvv.dmhas.state.ct.us/sig/pdf/CSAPTechReport13.pdf

(Monitoring The Future Survey on the Potential Impact of Legalization On Youth Marijuana Use) "Marijuana is one drug that is affected by some very specific policies, including medicalization and legalization of recreational use by adults. The effects on youth behaviors and attitudes of recent changes in a number of states will need to be carefully monitored in future years. Currently, marijuana does not hold the same appeal for youth as it did in the past, and today’s annual prevalance among 12th graders of 36% is considerably lower than rates exceeding 50% in the 1970s (documented by this project). However, if states that legalize recreational marijuana allow marijuana advertising and marketing, then prevalence could rebound and approach or even surpass past levels."

Source:

Johnston, L. D., O’Malley, P. M., Miech, R. A., Bachman, J. G., & Schulenberg, J. E. (2014). Monitoring the Future national results on drug use: 1975-2013: Overview, Key Findings on Adolescent Drug Use. Ann Arbor: Institute for Social Research, The University of Michigan, p. 49.
http://www.monitoringthefuture.org//pubs/monographs/mtf-overview2013.pdf

(Family Risk and Protective Factors) "Family risk factors in the development of adolescent substance use are: known familial substance use or abuse, and a lack of parental supervision. Protective factors are: warm and supportive family environment, prosocial family processes (rules, monitoring) and attachment."

Source:

(Zero Tolerance Policies) "The disciplinary policies in effect in many schools today apply zero tolerance to public school students in three draconian ways. First, they are blind to the most basic distinctions between types of offenses. In many schools, dangerousness is irrelevant; the penalties are the same for weapons and alcohol, sale and possession, robbery, and disorderly offenses. Offenses that used to be resolved informally with an apology or an after-school detention now lead to formal disciplinary hearings. Second, they require a severe sanction, typically suspension or expulsion, for all of these offenses, regardless of the circumstances of the offense or the intent, history and prospects of the offender. Third, these policies generally mandate some degree of information-sharing with law enforcement. This multiplies the consequences of student misconduct in two directions: out-of-school offenses referred to the child’s school may result in suspension or other sanctions,18 and in-school infractions referred to law enforcement agencies may result in juvenile or criminal prosecution."

Source:

Eric Blumenson, Eva S. Nilsen, "How to Construct an Underclass, or How the War on Drugs Became a War on Education," The Journal of Gender, Race & Justice, (May 2002), p. 65.
http://lsr.nellco.org/cgi/viewcontent.cgi?article=1005&context=suffolk_f...

(Generational Forgetting) "Another point worth keeping in mind is that there tends to be a continuous flow of new drugs onto the scene and of older ones being rediscovered by young people. Many drugs have made a comeback years after they first fell from popularity, often because knowledge among youth of their adverse consequences faded as generational replacement took place. We call this process 'generational forgetting.' Examples include LSD and methamphetamine, two drugs used widely in the 1960s that made a comeback in the 1990s after their initial popularity faded as a result of their adverse consequences becoming widely recognized during periods of high use. Heroin, cocaine, PCP, and crack are some others that have followed a similar pattern. LSD, inhalants, and ecstasy have all shown some effects of generational forgetting in recent years — that is, perceived risk has declined appreciably for those drugs — which puts future cohorts at greater risk of having a resurgence in use. In the case of LSD, perceived risk among 8th graders has declined noticeably, and more students are saying that they are not familiar with the drug. It would appear that a resurgence in availability (which declined very sharply after about 2001, most likely due to the FDA closing a major lab in 2000) could generate another increase in use."

Source:

(Alcohol Prevalence Among US Adolescents, 2013)
"• Alcohol and cigarettes are the two major licit drugs included in the MTF surveys, though even these are legally prohibited for purchase by those the age of most of our respondents. Alcohol use is more widespread than use of illicit drugs. About seven out of ten 12th-grade students (68%) have at least tried alcohol, and approximately four out of ten (39%) are current drinkers—that is, they reported consuming some alcohol in the 30 days prior to the survey (Table 4-2). Even among 8th graders, more than a quarter (28%)report any alcohol use in their lifetime, and one in ten (10%) is a current (past 30-day) drinker.34
"• Of greater concern than just any use of alcohol is its use to the point of inebriation: In 2013 one eighth of all 8th graders (12%), one third of 10th graders (34%), and about a half of all 12th graders (52%) said they had been drunk at least once in their lifetime. The prevalence rates of self-reported drunkenness during the 30 days immediately preceding the survey are strikingly high—4%, 13%, and 26%, respectively, for grades 8, 10, and 12.
"• Another measure of heavy drinking asks respondents to report how many occasions during the previous two-week period they had consumed five or more drinks in a row. Prevalence rates for this behavior, which is also referred to as binge drinking or episodic heavy drinking, are 5%, 14%, and 22% for the three grades, respectively."

Source:

Johnston, L. D., O’Malley, P. M., Bachman, J. G., Schulenberg, J. E. & Miech, R. A. (2014). Monitoring the Future national survey results on drug use, 1975–2013: Volume I, Secondary school students. Ann Arbor: Institute for Social Research, The University of Michigan, pp. 90-91.
http://www.monitoringthefuture.org/pubs/monographs/mtf-vol1_2013.pdf

(Exposure to Prevention Messages by Youth In and Outside of School, 2012)
"• In 2012, 75.9 percent of youths aged 12 to 17 reported having seen or heard drug or alcohol prevention messages in the past year from sources outside of school, such as from posters or pamphlets, on the radio, or on television. This rate in 2012 was similar to the 75.1 percent reported in 2011, but was lower than the 83.2 percent reported in 2002 (Figure 6.6). In 2012, the prevalence of past month use of illicit drugs among those who reported having such exposure (9.4 percent) was not significantly different from the prevalence among those who reported having no such exposure (10.0 percent).
"• In 2012, 75.0 percent of youths aged 12 to 17 enrolled in school in the past year reported having seen or heard drug or alcohol prevention messages at school, which was similar to the 74.6 percent reported in 2011, but was lower than the 78.8 percent reported in 2002 (Figure 6.6). In 2012, the prevalence of past month use of illicit drugs or marijuana was lower among those who reported having such exposure in school (8.9 and 6.7 percent for illicit drugs and marijuana, respectively) than among youths who were enrolled in school but reported having no such exposure (12.3 and 9.7 percent)."

Source:

Substance Abuse and Mental Health Services Administration, Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-46, HHS Publication No. (SMA) 13-4795. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2013, p. 72.
http://www.samhsa.gov/data/NSDUH/2012SummNatFindDetTables/Index.aspx
http://www.samhsa.gov/data/NSDUH/2012SummNatFindDetTables/NationalFindin...

(Non-Recreational Adolescent Marijuana Use) "The findings of this study provide one of the first in-depth descriptions of youths' use of marijuana for non-recreational purposes, adding to the growing body of research on the use of drugs to self-medicate among young people. Teens involved in regular and long-term use of marijuana for relief constructed their use of marijuana as essential to feeling better or 'normal' in situations where they perceived there were few other options available to them. Unlike the spontaneity typically involved in recreational use, these youth were thoughtful and prescriptive with their marijuana use – carefully monitoring and titrating their use to optimize its therapeutic effect. The findings also point to important contextual factors that further support youth's use of marijuana for relief that extend beyond the availability of marijuana and dominant discourses that construct marijuana as a natural product with medicinal properties."

Source:

Bottorff, Joan L , Johnson, Joy L, Moffat, Barbara M, and Mulvogue, Tamsin, "Relief-oriented use of marijuana by teens," Journal of Substance Abuse Treatment, Prevention, and Policy (Vancouver, BC: April 2009), doi:10.1186/1747-597X-4-7.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2683812/pdf/1747-597X-4-7.pd...

(Impact of Medical Marijuana Laws (MMLs) on Cannabis Use by Youth) "We replicated the findings of Wall et al. (2) that marijuana use was higher in states that have passed MMLs, and our analysis suggests this is unlikely to be a causal association. Our difference-in-differences estimates suggest little detectable effects of passing MMLs on marijuana use or perceived riskiness of use among adolescents or adults, which is consistent with some limited prior evidence on arrestees and emergency department patients (17). Future analyses that take advantage of additional policy changes may provide further evidence on this question, but our results suggest that such analyses should adequately control for potential confounding by unmeasured state characteristics."

Source:

Sam Harper, Erin C. Strumpf, and Jay S. Kaufman, "Do Medical Marijuana Laws Increase Marijuana Use? Replication Study and Extension," Annals of Epidemiology, March 2012 (Vol. 22, Issue 3, Pages 207-212, DOI: 10.1016/j.annepidem.2011.12.002).
http://download.journals.elsevierhealth.com/pdfs/journals/1047-2797/PIIS...

(Youth Medical Marijuana Use and Unmet Health Needs) "Of key importance in the findings are the unmet health needs of these youth. Health issues such as depression, insomnia, and anxiety were significant problems that interfered with these youths' ability to function at school, maintain relationships with family and friends, and feel that they could live a normal life. The level of distress associated with these health concerns, along with the lack of effective interventions by heath care providers and family members appeared to leave them with few alternatives. Researchers have reported that when adolescents in rural communities experience barriers to seeking health care, they think they can take care of the problems themselves [30]. Similarly, our study participants believed that their best option was to assume responsibility for treating their problems by using marijuana. Unpleasant side effects with prescribed medications and long, ineffective therapies resulted in little hope that the medical system could be counted on as beneficial. In contrast, marijuana provided these youth with immediate relief for a variety of health concerns. Nevertheless, the regular use of marijuana put youth at risk. Cannabis use has been identified as a risk factor for mental illness such as psychosis, schizophrenia [21,31,32] and psychiatric symptoms such as panic attacks [33]. Teens who smoked marijuana at least once per month in the past year were found to be three times more likely to have suicidal thoughts than non-users [34], and there is evidence that exposure to cannabis may worsen depression in youth [35]. Marijuana use among youth has also been associated with other substance use and school failure [36]. What is interesting is that the findings of this study suggest that youth have little awareness of some of these risks; rather, some are using marijuana to counteract these very problems (e.g., depression, school failure). Teens' perceptions that their health concerns were not addressed suggest that more attention is needed to assess these issues and ensure that other options are available to them. Parents and health care providers need to make a concerted effort to not only understand the pressures and influences on youth [37], but also gain a better understanding of the effect of youths' health problems on their ability to engage in healthy lifestyle choices."

Source:

(Youth Medical Marijuana Use and Reasons for Self-Medication) "Underlying problems related to youth health concerns also need to be addressed. In many situations, the participants' symptoms appeared to be directly related to their life circumstances. Along with the challenges inherent in being an adolescent in today's complex world, some teens were also trying to deal with significant losses (death of a close friend or family member), extremely difficult family relationships, disappointments with friends, school and sports, and a fragile family and peer support network. The risk of substance use increases substantially when youth are attempting to deal with these kinds of situations in isolation. Although marijuana provided the youth with temporary relief, the underlying situation often went unattended – leading the teens into a regular pattern of use. Appropriate guidance and targeted support from counselors and health care providers must be sensitive to meeting the needs of youth as they work through such situations and life altering events. In addition, adults working with youth must find better ways to talk with young people about how they are coping with their health issues, including their marijuana use. Based on the experiences of youth in this study, there is a wide range of support that may benefit youth including counseling, stress management, social skills training, anger management, study skills, pain management, and sleep hygiene. The youth in this study had minimal access to these types of resources."

Source:

(Effects of State Medical Marijuana Laws (MMLs) on Youth Marijuana Use) "We found no evidence of intermediate-term effects of passage of state MMLs on the prevalence or frequency of adolescent nonmedical marijuana use in the states evaluated, with 2 minor exceptions. From 2003 through 2009, adolescent lifetime prevalence of marijuana use and frequency of daily marijuana use decreased significantly in Montana, as compared with a more modest decrease in lifetime prevalence and an increase in daily frequency observed in Delaware (Ps = .03). These 2 statistically significant findings do not appear to represent real effects. Our difference-in-differences study design involved 40 planned comparisons (before---after differences in treatment vs comparison states), and naturally 2 significant results (at the P < .05 level) of a possible 40 can be expected according to chance alone.
"Moreover, the pattern is not consistent with an effect of MMLs. A significant effect was found for lifetime marijuana use but not past-month marijuana use. Self-reported lifetime use requires a much longer recall period than past-month use and is characterized by higher measurement error.13 Also, one would expect the 30-day use measure to be more sensitive than lifetime use to the effects of a change in MMLs, because most of the period covered by respondents’ lifetime reports occurred before passage of an MML.
"Finally, the significant increase in daily marijuana use was observed for the comparison state of Delaware, which had not enacted an MML during the years under evaluation, whereas the frequency of daily marijuana use in Montana decreased. This is the opposite of
what would be expected if MMLs had the deleterious effect of increasing the frequency of nonmedical marijuana use.
"Conversely, the significant effects observed were found between the 2 states that differed the most on the timing of MML enactment, maximizing the length of the follow-up period. Hence, it is reasonable to suspect that enacting an MML may influence the prevalence and frequency of adolescent nonmedical marijuana use half a decade later, despite no evidence of more proximal effects."

Source:

Sarah D. Lynne-Landsman, PhD, Melvin D. Livingston, BA, and Alexander C. Wagenaar, PhD, "Effects of State Medical Marijuana Laws on Adolescent Marijuana Use," American Journal of Public Health, June 13, 2013.
Abstract at: http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2012.301117

(Alcohol Use Among US Youth, 2014)
"• Alcohol and cigarettes are the two major licit drugs included in the MTF surveys, though even these are legally prohibited for purchase by those the age of most of our respondents. Alcohol use is more widespread than use of illicit drugs. About two thirds of 12th-grade students (66%) have at least tried alcohol, and more than one third (37%) are current drinkers — that is, they reported consuming some alcohol in the 30 days prior to the survey (Table 4-2). Even among 8th graders, more than a quarter (27%) reported any alcohol use in their lifetime, and one in eleven (9%) is a current (past 30 day) drinker.4
"• Of greater concern than just any use of alcohol is its use to the point of inebriation: In 2014 one ninth of all 8th graders (11%), three tenths of 10th graders (30%), and half of all 12th graders (50%) said they had been drunk at least once in their lifetime. The levels of selfreported drunkenness during the 30 days immediately preceding the survey are strikingly high — 3%, 11%, and 24%, respectively, for grades 8, 10, and 12."

Source:

Miech, R. A., Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (June 2015). Monitoring the Future national survey results on
drug use, 1975–2014: Volume I, Secondary school students. Ann Arbor: Institute for Social Research, The University of Michigan, p. 85.
http://monitoringthefuture.org/pubs/monographs/mtf-vol1_2014.pdf

(Cigarette Use Among US Youth, 2014)
"• Prevalence of cigarettes is generally higher than for any of the illicit drugs, except for marijuana. About one third (34%) of 12th graders reported having tried cigarettes at some time, and one seventh (14%) smoked in the prior 30 days. Even among 8th graders, about one seventh (14%) reported having tried cigarettes and 4% reported smoking in the prior 30 days. Among 10th graders, 23% reported having tried cigarettes, and 7.2% reported smoking in the prior 30 days. The percentages reporting smoking cigarettes in the prior 30 days are actually lower in all three grades in 2014 than the percentages reporting using marijuana in the prior 30 days: 4.0% for cigarettes versus 6.5% for marijuana in 8th grade; 7.2% versus 16.6% in 10th grade; and 13.6% versus 21.2% in 12th grade. These numbers reflect mostly the considerable decline in cigarette use that has occurred in recent years, though the recent increase in marijuana use has contributed to their standing relative to each other as well. Among 8th, 10th and 12th graders, lifetime prevalence of marijuana use in 2014 was also higher than lifetime prevalence of cigarette use. (Annual prevalence of cigarettes is not assessed.) As noted below, however, daily use in the prior 30 days was higher for cigarettes than for marijuana or alcohol in 8th and 12th grades. For 10th graders marijuana daily use was higher than daily cigarette use (3.4% versus 3.2%)."

Source:

Miech, R. A., Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (June 2015). Monitoring the Future national survey results on drug use, 1975–2014: Volume I, Secondary school students. Ann Arbor: Institute for Social Research, The University of Michigan, p. 85.
http://monitoringthefuture.org/pubs/monographs/mtf-vol1_2014.pdf

(Attitudes of Young People Toward Legalization of Marijuana)
"• Table 8-8 lists the proportions of 12th graders in 2013 who favor various legal consequences for marijuana use: making it entirely legal (42%), a minor violation like a parking ticket but not a crime (25%), or a crime (21%). The remaining 13% said they 'don’t know.' It is noteworthy just how variable attitudes about this contentious issue are.
"• Asked whether they thought it should be legal to sell marijuana if it were legal to use it, about three in five (61%) said 'yes.' However, about 85% of those answering 'yes' (52% of all respondents) would permit sale only to adults. A small minority (9%) favored the sale to anyone, regardless of age, while 29% said that sale should not be legal even if use were made legal, and 10% said they 'don’t know.' Thus, while the majority subscribe to the idea of legal sale, if use is allowed, the great majority agree with the notion that sale to underage people should not be legal."

Source:

Johnston, L. D., O’Malley, P. M., Bachman, J. G., Schulenberg, J. E. & Miech, R. A. (2014). Monitoring the Future national survey results on drug use, 1975–2013: Volume I, Secondary school students. Ann Arbor: Institute for Social Research, The University of Michigan, p. 400.
http://www.monitoringthefuture.org/pubs/monographs/mtf-vol1_2013.pdf

(Trends in Attitudes of US 12th Graders Toward Legalization of Any Illegal Drugs)
"• From 1975 through 1978, there were modest declines (shifts of five to seven percentage points, depending on the substance) in the proportions of 12th graders who favored legal prohibition of private use of any of the five illicit drugs (see Table 8-7). But by 1990 (12 years later), all of these proportions had increased substantially, with shifts of 8 to 31 percentage points. The proportion who thought marijuana use in private should be prohibited by law more than doubled, from 25% in 1978 to 56% in 1990—a dramatic shift.
"• Then, between 1990 and 1997, positions on prohibition of all illicit drug use softened once again, particularly in the case of marijuana use in private. After 1997 these attitudes were fairly stable, or continued to soften slightly. For example, in 2013, 69% thought taking amphetamines or sedatives (barbiturates) in public should be prohibited, down from 77% in 1997.
"• One important change in these attitudes that occurred after 2006 is increased tolerance for the use of marijuana in private, as the proportion favoring prohibition declined from 42% in 2006 to 32% in 2013. Tolerance for public use of marijuana increased after 2008, when 70% thought such use should be prohibited, dropping to 61% by 2013.
"• The proportions favoring prohibitions on the use in private of some other drugs have also declined since about 2007, including LSD (from 64% to 58% in 2013), amphetamines or sedatives (barbiturates) (from 54% to 49%), and heroin (from 73% to 71%)."

Source:

Johnston, L. D., O’Malley, P. M., Bachman, J. G., Schulenberg, J. E. & Miech, R. A. (2014). Monitoring the Future national survey results on drug use, 1975–2013: Volume I, Secondary school students. Ann Arbor: Institute for Social Research, The University of Michigan, pp. 399-400.
http://www.monitoringthefuture.org/pubs/monographs/mtf-vol1_2013.pdf

(Attitudes of US 12th Graders Toward Legalization of Marijuana, 2013)
"• Table 8-8 lists the proportions of 12th graders in 2013 who favor various legal consequences for marijuana use: making it entirely legal (42%), a minor violation like a parking ticket but not a crime (25%), or a crime (21%). The remaining 13% said they 'don’t know.' It is noteworthy just how variable attitudes about this contentious issue are.
"• Asked whether they thought it should be legal to sell marijuana if it were legal to use it, about three in five (61%) said 'yes.' However, about 85% of those answering 'yes' (52% of all respondents) would permit sale only to adults. A small minority (9%) favored the sale to anyone, regardless of age, while 29% said that sale should not be legal even if use were made legal, and 10% said they 'don’t know.' Thus, while the majority subscribe to the idea of legal sale, if use is allowed, the great majority agree with the notion that sale to underage people should not be legal.
"• Most 12th graders felt that they would be little affected personally by the legalization of either the sale or the use of marijuana. Over half (56%) of the respondents said that they would not use the drug even if it were legal to buy and use, while others indicated they would use it about as often as they do now (15%) or less often (1.5%). Only 9% said they would use it more often than they do at present, while 10% thought they would try it. Another 9% said they did not know how their behavior would be affected if marijuana were legalized. Still, this amounts to 19% of all seniors, or about one in five, who thought that they would try marijuana, or that their use would increase, if marijuana were legalized.
"A study of the effects of decriminalization by several states during the late 1970s found no evidence of any impact on the use of marijuana among young people, nor on attitudes and beliefs concerning its use.88 However, it should be noted that decriminalization falls well short of the full legalization posited in the questions here. Moreover, the situation today is very different from the one in the late 1970s, with more peer disapproval and more rigorous enforcement of drug laws, at least until very recently. Some recent studies suggest that there might be an impact of decriminalization, because 'youths living in decriminalized states are significantly more likely to report currently using marijuana. As more states adopt decriminalization or full legalization for adults, (as occurred in 2012 in Colorado and the state of Washington), it seems quite possible that attitudes about and use of marijuana will change. Declines in perceived risk and disapproval of marijuana would seem the most likely attitudinal changes, and such changes may well lead to increased use among youth."

"89: Chaloupka, F. J., Pacula, R. L., Farrelly, M. C., Johnston, L. D., O’Malley, P. M., & Bray, J. W. (February 1999). Do higher cigarette prices encourage youth to use marijuana? (NBER Working Paper No. 6939). Cambridge, MA: National Bureau of Economic Research."

Source:

Johnston, L. D., O’Malley, P. M., Bachman, J. G., Schulenberg, J. E. & Miech, R. A. (2014). Monitoring the Future national survey results on drug use, 1975–2013: Volume I, Secondary school students. Ann Arbor: Institute for Social Research, The University of Michigan, pp. 400-401.
http://www.monitoringthefuture.org/pubs/monographs/mtf-vol1_2013.pdf

(Effectiveness of Supply Reduction) "Overall, supply reduction — that is, reducing the availability of drugs — does not appear to have played as major a role as many had assumed in four of the five most important downturns in illicit drug use that have occurred to date, namely, those for marijuana, cocaine, crack, and ecstasy (see, for example, Figures 8-4, 8-5, and 8-6). In the case of cocaine, perceived availability actually rose during much of the period of downturn in use. (These data are corroborated by data from the Drug Enforcement Administration on trends in the price and purity of cocaine on the streets.96) For marijuana, perceived availability has remained very high for 12th graders since 1976, while use dropped substantially from 1979 through 1992 and fluctuated considerably thereafter. Perceived availability for ecstasy did increase in parallel with increasing use in the 1990s, but the decline phase for use appears to have been driven much more by changing beliefs about the dangers of ecstasy than by any sharp downturn in availability. Similarly, amphetamine use declined appreciably from 1981 to 1992, with only a modest corresponding change in perceived availability. Finally, until 1995, heroin use had not risen among 12th graders even though availability had increased substantially.
"• What did change dramatically were young peoples’ beliefs about the dangers of using marijuana, cocaine, crack, and ecstasy. We believe that increases in perceived risk led to a decrease in use directly through their impact on young people’s demand for these drugs and indirectly through their impact on personal disapproval and, subsequently, peer norms. Because the perceived risk of amphetamine use was changing little when amphetamine use was declining substantially (1981–1986), other factors must have helped to account for the decline in demand for that class of drugs—quite conceivably some displacement by cocaine. Because three classes of drugs (marijuana, cocaine, and amphetamines) have shown different patterns of change, it is highly unlikely that a general factor (e.g., a broad shift against drug use) can explain their various trends.
"• The increase in marijuana use in the 1990s among 12th graders added more compelling evidence to this interpretation. It was both preceded and accompanied by a decrease in perceived risk. (Between 1991 and 1997, the perceived risk of regular marijuana use declined 21 percentage points.) Peer disapproval dropped sharply from 1993 through 1997, after perceived risk began to change, consistent with our interpretation that perceived risk can be an important determinant of disapproval as well as of use. Perceived availability remained fairly constant from 1991 to 1993 and then increased seven percentage points through 1998."

Source:

Johnston, L. D., O’Malley, P. M., Bachman, J. G., Schulenberg, J. E. & Miech, R. A. (2014). Monitoring the Future national survey results on drug use, 1975–2013: Volume I, Secondary school students. Ann Arbor: Institute for Social Research, The University of Michigan, p. 461.
http://www.monitoringthefuture.org/pubs/monographs/mtf-vol1_2013.pdf

(Drug Use Comparisons Between EU and US) "On average, 7% of the ESPAD students stated that they had used marijuana or hashish during the past 30 days. As a proportion of the group reporting lifetime use, this corresponds to roughly four in ten. The highest rates of past-30-days cannabis use are found in the two neighbouring countries of France and Monaco (24% and 21%, respectively), followed by the United States (not an ESPAD country) (18 %) and the Czech Republic and Spain (not an ESPAD country) (15% each). In these top countries, about 10% of all students had used cannabis at an average frequency roughly corresponding to at least once a week during the period in question (3–5 times or more in the past 30 days). This proportion is considerably larger than the average for all ESPAD countries (4%)."

Source:

"The 2011 ESPAD Report: Substance Use Among Students in 36 European Countries" (Stockholm, Sweden: Swedish Council for Information on Alcohol and Other Drugs, May 2012), p. 88.
http://www.espad.org/Uploads/ESPAD_reports/2011/The_2011_ESPAD_Report_FU...

(Any Drug Use vs Specific Drug Use) "Overall, these data reveal that, while use of individual drugs (other than marijuana) may fluctuate widely, the proportion using any of them is much more stable. In other words, the proportion of students prone to using such drugs and willing to cross the normative barriers to such use changes more gradually. The usage rate for each individual drug, on the other hand, reflects many more rapidly changing determinants specific to that drug: how widely its psychoactive potential is recognized, how favorable the reports of its supposed benefits are, how risky its use is seen to be, how acceptable it is in the peer group, how accessible it is, and so on."

Source:

Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2013). Monitoring the Future national results on adolescent drug use: Overview of key findings, 2012. Ann Arbor: Institute for Social Research, The University of Michigan, p. 10.
http://www.monitoringthefuture.org/pubs/monographs/mtf-overview2012.pdf

Adolescents and Crime

("School-to-Prison Pipeline") "The “School to Prison Pipeline” and similar concepts are used to describe how some youth are seemingly on a one-way path that begins with becoming disconnected with school, then continues to dropping out, and later entering the justice system. School policies that rely on overly punitive responses to student behavior and a reliance on law enforcement to address school discipline have led to increases in suspensions, expulsions, and referrals to the juvenile justice system for even minor infractions. As a result, students are taken out of school, missing important educational opportunities and, in some cases, made unable to return to school. The School to Prison Pipeline not only sends students directly into the justice system, but missed educational opportunities are linked to increased risk that a student will one day be involved in the justice system."

Source:

Petteruti, Amanda, "Education under Arrest: The Case Against Police in Schools," Justice Policy Institute (Washington, DC: November 2011), p. 19.
http://www.justicepolicy.org/uploads/justicepolicy/documents/educationun...

(Arrests for Drug Abuse Violations) There were an estimated 195,700 arrests of young people for drug abuse violations in 2007.
"Between 1990 and 1997, the juvenile arrest rate for drug abuse violations increased 145%. The rate declined 21% between 1997 and 2007, but the 2007 rate was still almost double the 1990 rate.
"Over the 1980–2007 period, the juvenile drug arrest rate for whites peaked in 1997 and then held relatively constant through 2007 (down 10%). In contrast, the rate for blacks peaked in 1995, then fell 49% by 2002. Despite the recent increase—23% since 2002—the rate in 2007 was 37% less than the 1995 peak."

Source:

Puzzanchera, Charles, "Juvenile Arrests 2007" (Washington, DC: US Department of Justice, Office of Justice Programs, Office of Juvenile Justice and Delinquency Prevention, April 2009), p. 10.
http://www.ncjrs.gov/pdffiles1/ojjdp/225344.pdf

(Arrests for Drug Abuse Violations) The Office of Juvenile Justice and Delinquency Prevention estimated that in 2007 there were 195,700 arrests of juveniles for drug abuse violations out of a total 2,180,500 juvenile arrests. By comparison, there were 97,100 violent crime index offense arrests and 419,000 property crime index offense arrests of juveniles that year.

Source:

Annual Prevalence of Use of Various Drugs by US Youth in Grades 8, 10, and 12 Combined, 1998-2014 (Entries are Percentages)
Year	1998	1999	2000	2001	2002	2003	2004	2005	2006	2007	2008	2009	2010	2011	2012	2013	2014

Any Illicit Drug	32.2	31.9	31.4	31.8	30.2	28.4	27.6	27.1	25.8	24.8	24.9	25.9	27.3	27.6	27.1	28.6	27.2

Marijuana/Hashish	28.2	27.9	27.2	27.5	26.1	24.6	23.8	23.4	22.0	21.4	21.5	22.9	24.5	25.0	24.7	25.8	24.2
Cocaine	4.5	4.5	3.9	3.5	3.7	3.3	3.5	3.5	3.5	3.4	2.9	2.5	2.2	2.0	1.9	1.8	1.6
Crack	2.4	2.2	2.1	1.8	2.0	1.8	1.7	1.6	1.5	1.5	1.3	1.2	1.1	1.0	0.9	0.8	0.7
Heroin	1.2	1.3	1.3	0.9	1.0	0.8	0.9	0.8	0.8	0.8	0.8	0.8	0.8	0.7	0.6	0.6	0.5
Hallucinogens	6.3	6.1	5.4	6.0	4.5	4.1	4.0	3.9	3.6	3.8	3.8	3.5	3.8	3.7	3.2	3.1	2.8
Ecstasy	2.9	3.7	5.3	6.0	4.9	3.1	2.6	2.4	2.7	3.0	2.9	3.0	3.8	3.7	2.5	2.8	2.2
Tranquilizers	4.4	4.4	4.5	5.5	5.3	4.8	4.8	4.7	4.6	4.5	4.3	4.5	4.4	3.9	3.7	3.3	3.4
Amphetamines	9.3	9.0	9.2	9.6	8.9	8.0	7.6	7.0	6.8	6.5	5.8	5.9	6.2	5.9	5.6	7.0	6.6
Methamphetamine	-	4.1	3.5	3.4	3.2	3.0	2.6	2.4	2.0	1.4	1.3	1.3	1.3	1.2	1.0	1.0	0.8

Any Illicit Drug Other Than Mariuana	15.8	15.6	15.3	16.3	14.6	13.7	13.5	13.1	12.7	12.4	11.9	11.6	11.8	11.3	10.8	11.4	10.9
Alcohol	59.7	59.0	59.3	58.2	55.3	54.4	54.0	51.9	50.7	50.2	48.7	48.4	47.4	45.3	44.3	42.8	40.7
Been Drunk	35.5	36.0	35.9	35.0	32.1	31.2	32.5	30.8	30.7	29.7	28.1	28.7	27.1	25.9	26.4	25.4	23.6

Source:

Johnston, L. D., O’Malley, P. M., Miech, R. A., Bachman, J. G., & Schulenberg, J. E. (February 2015). Monitoring the Future national survey results on drug use: 1975-2014: Overview, key findings on adolescent drug use. Ann Arbor: Institute for Social Research, The University of Michigan, Table 2, p. 56.
http://monitoringthefuture.org//pubs/monographs/mtf-overview2014.pdf

	Estimated Daily Prevalence of Use of Various Drugs By US Youth In Grades 8, 10, and 12 Combined, According to the Monitoring the Future Survey (Entries in Percentages)
	1998	1999	2000	2001	2002	2003	2004	2005	2006	2007	2008	2009	2010	2011	2012	2013	2014
Marijuana	3.4	3.5	3.5	3.7	3.5	3.4	3.0	2.9	2.8	2.7	2.8	2.8	3.4	3.6	3.6	3.7	3.3
Alcohol	2.2	2.0	1.7	2.0	1.9	1.7	1.5	1.5	1.5	1.6	1.4	1.3	1.4	1.0	1.2	1.1	1.0
5+ Drinks in a Row in Last 2 Weeks	21.5	21.7	21.2	20.4	18.9	18.6	18.8	17.5	17.4	17.2	15.5	16.1	14.9	13.6	14.3	13.2	11.7
Been Drunk	0.8	0.9	0.8	0.7	0.6	0.7	0.7	0.6	0.7	0.6	0.6	0.5	0.6	0.5	0.6	0.5	0.5
Cigarettes	15.4	15.0	13.4	11.6	10.2	9.3	9.0	8.0	7.6	7.1	6.4	6.4	6.4	5.7	5.2	4.7	3.6

Source:

Johnston, L. D., O’Malley, P. M., Miech, R. A., Bachman, J. G., & Schulenberg, J. E. (February 2015). Monitoring the Future national survey results on drug use: 1975-2014: Overview, key findings on adolescent drug use. Ann Arbor: Institute for Social Research, The University of Michigan, Table 4, p. 58.
http://monitoringthefuture.org//pubs/monographs/mtf-overview2014.pdf

(Alcohol and Other Drug Involvement in Criminal Offenses at Schools and Colleges) "Table 9 provides the reported instances in each offense record in which the offenders were suspected of using alcohol, computers, and/or drugs.22 The data show that such use was minimal in situations occurring at schools during the 5-year study period. Of the 589,534 offense records, reports of offenders suspected of using drugs totaled 32,366, while reports of alcohol use totaled 5,844."

Source:

Noonan, James H., Vavra, Malissa C., "Crime in Schools and Colleges: A Study of Offenders and Arrestees Reported via National Incident-Based Reporting System Data," United States Department of Justice, Federal Bureau of Investigation, Criminal Justice Information Services Division (Washington DC: October 2007), p. 14.
http://www.fbi.gov/about-us/cjis/ucr/nibrs/crime-in-schools-and-colleges...

(Arrests at Schools and Colleges) "The most common offense code reported in arrestee records was simple assault – a crime against persons, followed by drug/narcotic violations – a crime against society. These two arrest offense codes were reportedly associated with more than half (52.2 percent) of the total arrestees. Destruction/damage/vandalism of property accounted for a relatively small portion of arrestees (6.6 percent). All other larceny and burglary, both crimes against property, involved 5.8 and 5.0 percent of the arrestees, respectively. Each of the remaining arrest offense codes accounted for less than 5.0 percent of the arrestees. Note that the arrest code does not necessarily match an
y of the offense codes in an offense segment in the same incident."

According to the data on Table 10 of the report, there were 51,462 "Simple Assaults" and 43,294 "Drug/Narcotics Violations" reported by Schools and Colleges over the five year period from 2000-2004. Other violations during that time frame included 5,108 "Drug Equipment Violations", 594 "Liquor Law Violations", 202 for "Drunkenness", and 95 for "Driving Under the Influence".

Source:

Noonan, James H., Vavra, Malissa C., "Crime in Schools and Colleges: A Study of Offenders and Arrestees Reported via National Incident-Based Reporting System Data," United States Department of Justice, Federal Bureau of Investigation, Criminal Justice Information Services Division (Washington DC: October 2007), pp. 14-17 and Table 10, pp. 15-16.
http://www.fbi.gov/about-us/cjis/ucr/nibrs/crime-in-schools-and-colleges...

(Historical Trends in Juvenile Drug Arrest Rates, by Race) "In contrast to the 1980-1993 period, the overall juvenile drug arrest rate increased by 77% in the short period between 1993 and 1997. Large increases were also seen in the rates of juvenile subgroups: male (72%), female (119%), white (109%), American Indian (160%), and Asian (105%). The black juvenile arrest rate for drug abuse violations, which had increased dramatically in the earlier period, increased an additional 25% between 1993 and 1997. Between 1997 and 2003, the juvenile drug arrest rate fell marginally (22%), with most of the overall decline attributable to a drop in arrests of blacks (41%) and males (24%)."

Source:

Snyder, Howard N., and Sickmund, Melissa, "Juvenile Offenders and Victims: 2006 National Report" (Washington, DC: U.S. Department of Justice, Office of Justice Programs, Office of Juvenile Justice and Delinquency Prevention, March 2006), p. 144.
http://www.ojjdp.gov/ojstatbb/nr2006/downloads/NR2006.pdf

(Historical Trends in Juvenile Arrest Rates) "In 1980, there were an estimated 1,476 arrests of persons ages 10-12 for every 100,000 persons in this age group in the U.S. population. By 2003, this arrest rate had fallen to 1,296, a decline of 12%. In 1980, 9.5% of all juvenile arrests were arrests of persons under age 13; in 2003, this percentage had decreased to 8.5% -- with the majority of the decrease occurring during the mid-1990s."

- See more at: http://www.drugwarfacts.org/cms/Adolescents#sthash.g2ZB8rU0.6xnb5yIk.dpuf

13 Myths about Substance Abuse Treatment - Resources - The Wayside House, Inc.

http://www.waysidehouse.org/index.asp?Type=B_BASIC&SEC=%7B8749B141-0CA5-40A8-BF47-BB97F1E279B7%7D&DE=%7B9546BA50-47BF-4284-BD49-DBCFFEDBFA72%7D

13 Myths about Substance Abuse Treatment

Myth #1: Drug addiction is voluntary behavior.

A person starts out as an occasional drug user, and that is a voluntary decision. But as times passes, something happens, and that person goes from being a voluntary drug user to being a compulsive drug user. Why? Because over time, continued use of addictive drugs changes your brain -- at times in dramatic, toxic ways, at others in more subtle ways, but virtually always in ways that result in compulsive and even uncontrollable drug use.

Myth #2: More than anything else, drug addiction is a character flaw.

Drug addiction is a brain disease. Every type of drug of abuse has its own individual mechanism for changing how the brain functions. But regardless of which drug a person is addicted to, many of the effects it has on the brain are similar: they range from changes in the molecules and cells that make up the brain, to mood changes, to changes in memory processes and in such motor skills as walking and talking. And these changes have a huge influence on all aspects of a person's behavior. The drug becomes the single most powerful motivator in a drug abuser's existence. He or she will do almost anything for the drug. This comes about because drug use has changed the individual's brain and its functioning in critical ways.

Myth #3: You have to want drug treatment for it to be effective.

Virtually no one wants drug treatment. Two of the primary reasons people seek drug treatment are because the court ordered them to do so, or because loved ones urged them to seek treatment. Many scientific studies have shown convincingly that those who enter drug treatment programs in which they face "high pressure" to confront and attempt to surmount their addiction do comparatively better in treatment, regardless of the reason they sought treatment in the first place.

Myth #4: Treatment for drug addiction should be a one-shot deal.

Like many other illnesses, drug addiction typically is a chronic disorder. To be sure, some people can quit drug use "cold turkey," or they can quit after receiving treatment just one time at a rehabilitation facility. But most of those who abuse drugs require longer-term treatment and, in many instances, repeated treatments.

Myth #5: We should strive to find a "magic bullet" to treat all forms of drug abuse.

There is no "one size fits all" form of drug treatment, much less a magic bullet that suddenly will cure addiction. Different people have different drug abuse-related problems. And they respond very differently to similar forms of treatment, even when they're abusing the same drug. As a result, drug addicts need an array of treatments and services tailored to address their unique needs.

Myth #6: People don't need treatment. They can stop using drugs if they really want to.

It is extremely difficult for people addicted to drugs to achieve and maintain long-term abstinence. Research shows long-term drug use actually changes a person's brain function, causing them to crave the drug even more, making it increasingly difficult for the person to quit. Especially for adolescents, intervening and stopping substance abuse early is important, as children become addicted to drugs much faster than adults and risk greater physical, mental and psychological harm from illicit drug use.

MYTH #7: Treatment just doesn't work.

Treatment can help people. Studies show drug treatment reduces drug use by 40 to 60 percent and can significantly decrease criminal activity during and after treatment. There is also evidence that drug addiction treatment reduces the risk of HIV infection (intravenous -drug users who enter and stay in treatment are up to six times less likely to become infected with HIV than other users) and improves the prospects for employment, with gains of up to 40 percent after treatment.

MYTH #8: Nobody will voluntarily seek treatment until they hit ‘rock bottom.’

There are many things that can motivate a person to enter and complete substance abuse treatment before they hit "rock bottom." Pressure from family members and employers, as well as personal recognition that they have a problem, can be powerful motivating factors for individuals to seek treatment. For teens, parents and school administrators are often driving forces in getting them into treatment once problems at home or in school develop but before situations become dire. Seventeen percent of adolescents entering treatment in 1999 were self- or individual referrals, while 11 percent were referred through schools.

MYTH #9: You can't force someone into treatment.

Treatment does not have to be voluntary. People coerced into treatment by the legal system can be just as successful as those who enter treatment voluntarily. Sometimes they do better, as they are more likely to remain in treatment longer and to complete the program. In 1999, over half of adolescents admitted into treatment were directed to do so by the criminal justice system.

MYTH #10: There should be a standard treatment program for everyone.

One treatment method is not necessarily appropriate for everyone. The best programs develop an individual treatment plan based on a thorough assessment of the individual's problems. These plans may combine a variety of methods tailored to address each person's specific needs and may include behavioral therapy (such as counseling, cognitive therapy or psychotherapy), medications, or a combination. Referrals to other medical, psychological and social services may also be crucial components of treatment for many people. Furthermore, treatment for teens varies depending on the child's age, maturity and family/peer environment, and relies more heavily than adult treatment on family involvement during the recovery process. "[They] must be approached differently than adults because of their unique developmental issues, differences in their values and belief systems, and environmental considerations (e.g., strong peer influences)."

MYTH #11: If you've tried one doctor or treatment program, you've tried them all.

Not every doctor or program may be the right fit for someone seeking treatment. For many, finding an approach that is personally effective for treating their addiction can mean trying out several different doctors and/or treatment centers before a perfect "match" is found between patient and program.

MYTH #12: People can successfully finish drug abuse treatment in a couple of weeks if they're truly motivated.

Research indicates a minimum of 90 days of treatment for residential and outpatient drug-free programs, and 21 days for short-term inpatient programs to have an effect. To maintain the treatment effect, follow up supervision and support are essential. In all recovery programs the best predictor of success is the length of treatment. Patients who remain at least a year are more than twice as likely to remain drug free, and a recent study showed adolescents who met or exceeded the minimum treatment time were over one and a half times more likely to abstain from drug and alcohol use. However, completing a treatment program is merely the first step in the struggle for recovery that can extend throughout a person's entire lifetime.

MYTH #13: People who continue to abuse drugs after treatment are hopeless.

Drug addiction is a chronic disorder; occasional relapse does not mean failure. Psychological stress from work or family problems, social cues (i.e. meeting individuals from one's drug-using past), or their environment (i.e. encountering streets, objects, or even smells associated with drug use) can easily trigger a relapse. Addicts are most vulnerable to drug use during the few months immediately following their release from treatment. Children are especially at risk for relapse when forced to return to family and environmental situations that initially led them to abuse substances. Recovery is a long process and frequently requires multiple treatment attempts before complete and consistent sobriety can be achieved.

Data is available regarding Marijuana use throughout San Diego County at http://www.mpisdcounty.net/ and selected from the San Diego County Marijuana Prevention Initiative are tables below on Non Traditional (Continuation School, etc.) student usage rates. Continuation School student marijuana usage is higher than traditional schools. Escondido High School notes 26% daily usage, often on school property and 36% starting before age 13.

Table 1. Continuation Schools Participating in the California Healthy Kids Survey (CHKS)

Source: CHKS, 2010/11; County 2009/11 Report School District	Continuation Schools Surveyed	School Enrollment
Carlsbad Unified	Carlsbad Village Academy	127
Escondido Union High	Valley High	377
Fallbrook Union High	Ivy High	143
Grossmont Union High	Chaparral High	257
Oceanside City Unified	Ocean Shores High	215
Poway Unified	Abraxas Continuation High	220
San Diego Unified	Garfield High	305
San Diego Unified	Twain High	305
San Dieguito Union High	Sunset High	132
San Marcos Unified	Twin Oaks High	202
Sweetwater Union High	Alta Vista High	61
Sweetwater Union High	Palomar High	398
Vista Unified	Major General Raymond Murray High	232

Table 3. Percent of Non-Traditional (NT) Students Reporting Marijuana Use School District	Lifetime Use	Current Use	Daily Use	Use on School Property (Past 30 Days)
Escondido Union High	75%	52%	26%	25%
Fallbrook Union High	58%	29%	8%	15%
Grossmont Union High	63%	38%	16%	11%
Oceanside City Unified	74%	24%	17%	16%
Poway Unified*	83%	51%	--	6%
San Diego Unified	40%	24%	7%	7%
San Marcos Unified*	77%	46%	--	17%
Sweetwater Union High *	58%	34%	--	15%
Vista Unified*	61%	34%	--	11%
*San Diego County*	*71%*	*47%*	*18%*	*15%*

Findings from Table 3 show that use among NT students is particularly high in Poway Unified, San Marcos Unified, Escondido Union High, and Oceanside City Unified. In these districts, over 70% of NT students reported that they used or tried marijuana. Daily use is particularly high in Escondido Union High, where approximately one in four NT students reported using marijuana daily. In over half of the districts with participating continuation schools, 15% or more NT students reported using marijuana on school property in the past 30 days.

Table 5. Percent of NT Students Reporting Age of Onset School District	Before Age 13	Before Age 15
Escondido Union High	36%	56%
Fallbrook Union High	12%	33%
Grossmont Union High	26%	50%
Oceanside City Unified	20%	49%
Poway Unified	--	--
San Diego Unified	12%	27%
San Marcos Unified	--	--
Sweetwater Union High	--	--
Vista Unified	--	--
*San Diego County*	*23%*	*48%*

The following link provides additional information from the Healthy Kids survey about drug use of teens in San Diego County.

http://www.mpisdcounty.net/wp-content/uploads/2014/03/CCR_SNAPSHOT_District-Level-CHKS-Data.pdf

See the link below for the source of the information that follows the link.

http://m.gazette.com/teen-colorado-voters-were-duped-into-legalizing-recreational-marijuana/article/1548420

Advocates for drug abuse prevention say many Americans — including and especially those making public policy and influencing public opinion from massive media platforms — either have been duped by or are caught up in the hype generated by an industry that derives its chief profits from addiction.

“People are voting without the knowledge,” Dr. Nora Volkow, director of the National Institute on Drug Abuse, told hundreds of people gathered in February 2014 in Washington, D.C., for an annual meeting of the Community Anti-
Drug Coalitions of America. “We have to counter investments of individuals wanting to change the culture and (promote beliefs that) it (marijuana) is a safe drug.”

And while no, most people who use marijuana — and alcohol for that matter — aren’t addicts, Kaleb says, “You just have to be intoxicated, not an addict, to cause serious damage. And yeah, getting sober in Colorado is really hard because drugs and media telling you why they’re so great are everywhere all the time now.”

Indeed, while the state reports that about 485,000 Coloradans 18 and older are regular marijuana users (defined as using at least once a month), state auditors examining marijuana sold in state-licensed facilities found that about 106,000 Coloradans — or nearly
2 percent of the state’s population — drove more than two-thirds of demand for the drug. Reports from the Colorado Department of Revenue refer to those people as the “heaviest users” because they consume cannabis daily or near daily — behavior consistent with substance addiction.

“We’re mortgaging our future for the almighty dollar,” said Kevin Sabet, a former senior White House drug policy adviser who teamed with former Democratic U.S. Rep. Patrick Kennedy and political pundit David Frum to start Smart Approaches to Marijuana, a national, nonprofit group that advocates for marijuana policy reform but does not support the drug’s legalization. “Make no mistake,” Sabet said. “Legalization is about cranking up the number of heavy users, targeting the most vulnerable — as every industry selling an addictive drug does — and making money. That’s it. If it were about getting people out of prison or increasing science-based prevention, there are myriad ways to do those things without ushering in Big Tobacco 2.0.”

In December, the National Survey on Drug Use and Health delivered more troubling news reinforcing the cacophony of late-night jokes that Colorado has a drug problem and plenty of enablers. Pick a substance — alcohol, abused prescription painkillers, cocaine, heroin, marijuana or tobacco — and the state ranks above the national average.

But it is marijuana use that Colorado works hardest on these days. The need to explain spiking drug-use rates while implementing legalization of retail marijuana sales is increasingly pressing: The state’s 2013 past-month marijuana use rate was the nation’s second highest, coming in at 12.7 percent of Coloradans age 12 and older. That is up from 10.41 percent in 2012, when voters sanctioned recreational marijuana use, and from 7.8 percent in 2000, when they sanctioned marijuana for medical use. With the January 2014 rollout of retail marijuana, Colorado usage rates are likely to increase.

Use of alcohol and nonmedical painkillers also increased in Colorado between 2012 and 2013. While marijuana legalization’s impact on the consumption of other drugs is the subject of heated debate among economists and drug-policy advocates, the connection is much more straightforward for Kaleb.

Dr. Christian Thurstone, an associate professor of psychiatry at CU and also a medical director of the state's largest adolescent-substance addiction-treatment program weighs in on young people and addiction.

“The weed, not alcohol or tobacco, came first, and the more I used, the more I drank, and the more pills I eventually popped,” he said. “That (progression) doesn’t happen to everyone who uses weed, but it happens to enough of us. It’s a gateway.”

The trends in marijuana use and addiction specifically among Colorado’s youths are also disturbing — if for no other reason than the state has kept poor data and now finds itself building a baseline by which marijuana’s impact on youth can be determined.

The 2013 Healthy Kids Colorado Survey, administered to youths enrolled in public schools, is the state’s most robust evaluation of students’ marijuana use and attitudes about the drug, said Alyson Shupe, chief of the health statistics and evaluation branch of the Colorado Department of Public Health and Environment. Comparing the 2013 state-survey data to the much smaller samples collected from students in previous years for a federally funded study released by the Centers for Disease Control and Prevention is difficult. “The actual percentages aren’t affected so much as the confidence with which you can say you have a clear picture of what has happened and can detect meaningful change over that time,” Shupe said. The state now wishes to press on with a more robust survey, but it will be years before researchers can determine use trends — a lag in information that could keep a response years behind any problems.

74 percent of Denver teens in substance treatment and 18 percent of Denver teens not in substance treatment reported getting the drug from people with a state-issued license. (Thurstone is the husband of reporter Christine Tatum, who worked on this project for The Gazette.)

Of the 2.4 million Americans who try cannabis for the first time each year, about 57 percent are younger than 18, according to the NSDUH. Peak use among Americans is at age 20 — followed by ages 19 and 18. One of every six adolescents who try marijuana becomes addicted to the drug — a rate medical experts say was determined decades ago when marijuana was far less potent than it is today.

Nearly 10 percent of U.S. teens -- about 1.5 million youth -- smoked marijuana heavily, some 20 times in the past month, according to the Partnership Attitude Tracking Study, sponsored by MetLife Foundation.

http://www.health.harvard.edu/blog/teens-who-smoke-pot-at-risk-for-later-schizophrenia-psychosis-201103071676

In one recent study that followed nearly 2,000 teenagers as they became young adults, young people who smoked marijuana at least five times were twice as likely to have developed psychosis over the next 10 years as those who didn’t smoke pot.

In comparison, youths in families unaffected by psychosis have a 7 in 1,000 chance of developing it. If they smoke pot regularly, the risk doubles, to 14 in 1,000.

So far, this research shows only an association between smoking pot and developing psychosis or schizophrenia later on. That’s not the same thing as saying that marijuana causes psychosis.

But it’s not clear how marijuana use might lead to psychosis. One theory is that marijuana may interfere with normal brain development during the teenage years and young adulthood.

http://www.sandieguitoalliance.org/marijuanaandteens.html

Marijuana and Mental Health

 Download and print "Marijuana and Mental Health" [DOC 32KB]

Youth marijuana use is risky and can lead to serious consequences, including mental health problems. Researchers have long known that marijuana use has been associated with psychopathology. In the past decade, research on the psychiatric implications of the drug has increased dramatically. In the past three years, in particular, evidence has been accumulating that regular marijuana use can not only aggravate already existing mental illness, but that it may precede, or act as a catalyst, in mental health problems, including depression, suicidal thoughts and schizophrenia. This new research also identifies two crucial risk factors:

The age when marijuana is first smoked has a major impact on the later development of mental health problems. The earlier the use, the greater the implications.
There is an increased risk of depression, suicidal thoughts and schizophrenia as a result of marijuana use, even among people with no prior history of a disorder. However, those with a predisposition for mental illness are particularly vulnerable. In the case of psychotic disorders, this is estimated to be about one in four people.

Depression and Suicidal Thoughts
Several recent studies have linked youth marijuana use with increases in depression and suicidal thinking.

Teens age 12 to 17 who smoke marijuana weekly are three times more likely than non-users to have thoughts about committing suicide.
Some research shows that marijuana use can precede symptoms of depression. Girls (ages 14-15) who used marijuana daily were five times more likely to face depression at age 21. Weekly use among all teens studied doubled the risk for depression.
A study of adults found that marijuana use quadrupled the risk of later major depression.
A study of 1,265 children over a 21-year period found that marijuana use, particularly heavy or regular use, was associated with later increases in depression, suicidal thoughts and suicide attempts.
Past-year marijuana use has been linked to social withdrawal, anxiety, depression, attention problems and thoughts of suicide in adolescents.
Research with twins found that the twin who was dependent on marijuana was almost three times more likely to think about suicide and attempt suicide than his/her non-marijuana dependent co-twin.

Schizophrenia
Marijuana use has been linked to early-onset schizophrenia, and several recent studies show that marijuana use during adolescence increases the risk of psychotic disorders in adulthood.

Heavy marijuana users are almost seven times more likely than non-users to be diagnosed with schizophrenia later in life.
Among men suffering from schizophrenia, those who had used marijuana were much more likely to experience their first psychotic episode at an early age.
A recent study found that that the earlier the use of marijuana (age 15 vs. age 18), the greater the risk of schizophrenia.
A study published in 2005 found that regular use of marijuana may double the risk of developing psychotic disorders and that marijuana causes chemical changes to the brain. The study maintains that smoking marijuana causes symptoms even when other factors are taken into consideration.

Genetic Predisposition
Recent evidence suggests that some people's genetic make-up may predispose them to be particularly vulnerable to the effects of marijuana on mental health.

An analysis of 2,437 young people found that marijuana use moderately increases the risk of psychopathology. The risk for those with a predisposition for psychopathology was much higher.
A study published in spring 2005 found that as many as one in four people may have a genetic profile that makes marijuana five times more likely to trigger psychotic disorders.

Parents Can Make a Difference
Parents can make a difference by talking to their teens about the risks of marijuana and by monitoring their behavior. They can also take early action if they see signs of drug use or emotional problems.

Parents are the most powerful influence on their kids when it comes to drugs. A report from the National Household Survey on Drug Abuse showed that the rate of past-month marijuana use was lower among kids who believed their parents would disapprove.

http://www.schizophrenia.com/prevention/cannabis.marijuana.schizophrenia.html

Overview: Use of street drugs (including LSD,methamphetamine,marijuana/hash/cannabis) have been linked with significantly increased probability of developing schizophrenia. This link has been documented in over 30 different scientific studies (studies done mostly in the UK, Australia and Sweden) over the past 20 years. In one example, a study interviewed 50,000 members of the Swedish Army about their drug consumption and followed up with them later in life. Those who were heavy consumers of cannabis at age 18 were over 600% more likely to be diagnosed with schizophrenia over the next 15 years than those did not take it. (see diagram below). Experts estimate that between 8% and 13% of all schizophrenia cases are linked to marijuna / cannabis use during teen years.

(Image Above: Source: Cannabis and schizophrenia. A longitudinal study of Swedish conscripts, Lancet, 1987)

Many of these research studies indicate that the risk is higher when the drugs are used by people under the age of 21, a time when the human brain is developing rapidly and is particularly vulnerable.

People with any biological predisposition towards schizophrenia are at the highest risk -- unfortunately its impossible to accurately identify this predisposition beforehand ( a family history of mental illness is just one indicator of such a predisposition). [see causes and prevention of schizophrenia for more information on all risk factors linked to a person developing schizophrenia]

Researchers in New Zealand found that those who used cannabis by the age of 15 were more than three times (300%) more likely to develop illnesses such as schizophrenia. Other research has backed this up, showing that cannabis use increases the risk of psychosis by up to 700% for heavy users, and that the risk increases in proportion to the amount of cannabis used (smoked or consumed). Additionally, the younger a person smokes/uses cannabis, the higher the risk for schizophrenia, and the worse the schizophrenia is when the person does develop it. Research by psychiatrists in inner-city areas speak of cannabis being a factor in up to 80 percent of schizophrenia cases.

Professor Robin Murray (London Institute of Psychiatry) has recently (2005) completed a 15-year study of more than 750 adolescents in conjunction with colleagues at King's College London and the University of Otago in New Zealand.

Overall people were 4.5 times more likely to be schizophrenic at 26 if they were regular cannabis smokers at 15, compared to 1.65 times for those who did not report regular use until age 18.

Many researchers now believe that using the drug while the brain is still developing boosts levels of the chemical dopamine in the brain, which can directly lead to schizophrenia.

Professor John Henry, clinical toxicologist at Imperial College London said research has shown that people with a certain genetic makeup who use the drug face a ten times (1000%) higher risk of schizophrenia. (for example - if your risk of schizophrenia was 6% (due to a family history of mental illness) prior to taking cannabis, it could be 60% -- or more likely than not - after taking cannabis). Every person is different (i.e. has different genes and different environments) - so this "10 Times Higher Risk with cannabis use"- is just a generalization, and it may or may not apply to a given person.

The increased risk applies to people who inherit variants of a gene named COMT and who smoked cannabis as teenagers. About a quarter of the population have this genetic make-up and up to 15 per cent of the group are likely to develop psychotic conditions if exposed to the drug early in life. Neither the drug nor the gene raises the risk of psychosis by itself.

A recent Dutch study showed that teenagers who indulge in cannabis as few as five times in their life significantly increase their risk of psychotic symptoms.

The increase in evidence during the past decade could be tied to the increased potency of marijuana. A review by the British Lung Association says that the cannabis available on the streets today is 15 times more powerful than the joints being smoked three decades ago.

Schizophrenia can sometimes be triggered by heavy use of hallucinogenic drugs, especially LSD; but it appears that one has to have a genetic predisposition towards developing schizophrenia for this to occur. There is also some evidence suggesting that people suffering from schizophrenia but responding to treatment can have an episode as a result of use of LSD. Methamphetamine and PCP also mimic the symptoms of schizophrenia, and can trigger ongoing symptoms of schizophrenia in those who are vulnerable.

Melbourne University's Professor David Castle stated in a February, 2005 interview that heavy drug use during formative times of life, such as the years at school, could affect the way a teenager or young adult thought, impairing cognitive ability and having a long-term impact on job prospects. Victorian studies had revealed that regular use of cannabis by adolescent girls could trigger long-term depression. And for those vulnerable to a psychotic disorder, even a small amount of cannabis could pose a threat.

Professor Castle, author of the book Marijuana and Madness, has said that those people with this "psychotic proneness" were those who had a family history of mental illness or who had had a bad response on their first use of cannabis or to a tiny amount. Others at risk included those who had experienced a psychotic episode where they had paranoid thinking or heard a voice calling their name. Professor Castle said experiencing such a one-off episode was far more common than people thought.

"People with such a vulnerability should avoid cannabis like the plague," he said.

Without the effects of the drug, such a person might live their whole life without ever experiencing mental health problems. It has been estimated, for example, that between 8% and 13% of people that have schizophrenia today would never have developed the illness without exposure to cannabis.

Professor Castle compared the effect to feeding sweets to a diabetic. While high sugar content foods did not cause too many problems for most people in the short term, they could be catastrophic for diabetics.

He said there was an accumulative effect when it came to cannabis use and schizophrenia. Those who used the drug more than once a week were more prone to needing hospitalisation and often suffered other associated problems such as the breakdown of relations with their family, isolation, crime and violence.

* Cannabis impacts on neurotransmitters that regulate how arousal and stress are managed in the brain. Cannabis takes a long time to metabolise, and can quickly build up to high levels in the body. Once you get to this point, there is a real risk of depression or schizophrenia being triggered.

* A Swedish study of 50,000 military conscripts found heavy use of cannabis increased the risk of suicide by four times (400%). A Victorian study of 2332 adolescents found weekly use increased the risk of suicide attempts among females by five times. Weekly use as a teenager doubled the risk of depression and anxiety. Daily use at the age of 20 boosted the risk of depression and anxiety by five times (500%).

Helpful Actions: If you want to avoid getting schizophrenia - research suggests that the number one thing you should avoid are street drugs (especially marijuana/cannabis - but because you never know what someone has put into a street drug, all of them are dangerous). By avoiding use of all street drugs research suggests that you can greatly reduce the chance (by as much as 50% to 80% if you are biologically predisposed) that you'll develop schizophrenia. Avoiding marijuana after developing schizophrenia also helps reduce relapse rates. Some people with schizophrenia suggest that it makes them feel better, but if depression is an issue we recommend these people talk to their Psych-Doc about possible anti-depressant use rather than street drugs.

Do not use even small amounts of cannabis if you have any family history of mental illness, have had an episode of paranoid thinking or hearing voices or had a bad response when first using cannabis or when using a small amount.

Other street drugs are also very dangerous - partly because they are produced in home laboratories with virtually any possible combination of additional substances mixed in with the drugs. See: Crystal Meth & Schizophrenia

Schizophrenia and Cannabis Video Report:

A recent Internet video report on schizophrenia and cannabis has recently become available. To play the video go to the following link - and then click on "Play" button to view any of the 6 different sections of the video report: Messing with Heads: New Research into the longterm effects of Cannabis (Internet Video, 2005) from the Australian Broadcasting Company

She said studies of children whose mothers used marijuana during pregnancy suggest that the drug elevates the risk of hyperactivity, attention deficit disorder, lack of motor coordination and poor academic achievement during the first two decades or so of life.

Researchers said studies indicate that medical marijuana is most effective at fighting muscle spasms caused by multiple sclerosis and at combating the neuropathic pain that cancer patients often suffer.

There is also evidence, though less robust, of cannabis’ effects on nausea caused by chemotherapy, in promoting weight gain for HIV-infected patients and in easing sleep disorders.

Heavy, persistent pot use linked to economic and social problems at midlife

Posted on March 23, 2016 by MPI-Media

A research study that followed children from birth up to age 38 has found that people who smoked cannabis four or more days of the week over many years ended up in a lower social class than their parents, with lower-paying, less skilled and less prestigious jobs than those who were not regular cannabis smokers. These regular and persistent users also experienced more financial, work-related and relationship difficulties, which worsened as the number of years of regular cannabis use progressed.

Marijuana use may reducedopamine in the brain

Written by Marie Ellis

Published: Friday 15 April 2016 Published: Fri 15 Apr 2016

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Dopamine is a transmitter in the brain that is important for movement, thinking and memory, but it is also known as the "reward chemical" for its role in pleasure. Now, a recent study reveals that heavy marijuana use could compromise the dopamine system.

The researchers, who publish their work in the journal Molecular Psychiatry, say that heavy cocaine and heroin use have been shown to decrease dopamine release, but until now, such data regarding cannabis was notably absent.

Lead author Dr. Anissa Abi-Dargham, of the Columbia University Medical Center (CUMC) in New York, says the recent "widespread acceptance and use of marijuana" makes looking into the effects of cannabis on the brain extremely important.

She and her team explain that most drug addictions blunt dopamine release during the chronic phase of drug dependence, which results in poor outcomes.

To further investigate whether marijuana dependence is linked with similar effects, the researchers conducted their study in 11 adults aged 21-40 years who were heavily dependent on marijuana, and they matched them with 12 healthy controls.

The adults in the marijuana group started using it at around age 16 on average, became dependent by age 20 and had been dependent for around 7 years.

Nearly all users in the study smoked marijuana daily in the month leading up to the study, the researcher say. Heavy use may negatively affect learning and behavior'

The researchers used positron emission tomography (PET) scans to track a radiotracing molecule that binds to the brain's dopamine receptors. From this, they were able to measure the release of dopamine in the striatum, which is a brain region involved in memory, impulsive behavior and attention.

Additionally, the team was able to track dopamine release in other brain regions, including the thalamus, midbrain and globus pallidus.

During the study, the marijuana users stayed in the hospital for a week, during which they abstained from using it. This was to ensure that the scans were not measuring the drug's effects.

Both before and after being given oral amphetamine to draw out dopamine release, the participants' brains were scanned. The researchers used the percent change in the binding of the radiotracer as a sign of dopamine release capacity.

Results showed that, compared with the control group, the marijuana users' striatum had lower dopamine release. There was also lower release in subregions that play a role in associative and sensorimotor learning, as well as in the globus pallidus.

Upon investigating the link between dopamine release in the striatum and cognitive performance on learning and working memory tasks, the researchers did not observe a difference in performance between the two groups.

However, they do note that among all participants, those who had lower dopamine release performed worse on both tasks.

Commenting on the findings, Dr. Abi-Dargham says:

 "We don't know whether decreased dopamine was a preexisting condition or the result of heavy cannabis use. But the bottom line is that long-term, heavy cannabis use may impair the dopaminergic system, which could have a variety of negative effects on learning and behavior."

The researchers conclude their study by noting that the lower dopamine release is linked with inattention and negative symptoms in marijuana users, and with "poorer working memory and probabilistic category learning performance" in both groups.

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				*Dr Don Miller* *TEEN RESCUE*



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