Another cannabis update!

Greetings, good people of Oregon! I spent today at a continuing education course with Dr. Michael Howard, a 50 year veteran of treating addiction and psychiatric disease. The first part of the class was about opiate abuse, and the current state of the opiate epidemic. The second part, which I will explore in this blog, focused on our current knowledge of cannabis.

I wrote my cannabis position statement last year based on my observations after three years of legalization. My position hasn’t changed… much… in response to this course. It has changed a little, and I will explain. First, because people love bullet points, here are my key takeaways.

  1. Research confirms cannabis is not a gateway drug. In fact, nicotine is far, far more likely to lead to abuse of other substances than cannabis.

  2. Research confirms low rates of addiction with cannabis. BUT low does not mean impossible, and the 1-2% of adult onset users who do become addicted display all the common traits of addicts to other drugs like heroin and meth as far as loss of function, crime, damage to social standing, etc. Rates of addiction for people who start using in adolescence are higher, at about 4%, which is concerning.

  3. Use of cannabis that begins in adolescence is by far the most concerning use of cannabis. The presenter was not concrete as far as how “adolescence” is defined, or what “heavy use” means. However, my impression is that you don’t want teens younger than about 17 using regularly, because of the evidence for long term brain changes and increased risk of addiction.

  4. While there is currently little evidence of cannabis use causing disease, all sort of negative side effects can and do occur, such as anxiety, vomiting, loss of motivation, sleep disturbances, and paranoia. Dr. Howard suspects the reason there is little evidence for cannabis smoking causing lung disease is that, compared to cigarettes, people just don’t smoke that much cannabis. For example, the average cigarette user smokes 19 cigarettes per day; the average cannabis smoker consumes two joints per week.

  5. Edibles are the surest way of having a bad trip, and should be approached with the greatest caution.

As far as my personal position on cannabis, I have revised my earlier statement that the age of recreational use should be raised to 25 to thinking age 21 is just fine. That is well out of the zone where we might see long term damage and increased risk of addiction. Also, my main concern is for teens. The following are my points of advice for people who are active in the lives of kids aged 10-16.

  1. Remember that the years 10-16 are when initial contact with cannabis is both most likely to occur, and most likely to lead to long term damage and development of cannabis addiction.

  2. An adolescent is more likely to use cannabis if someone in the family uses cannabis. In my opinion, parents or parental figures who use cannabis should take pains to keep it well away from the adolescent, and strongly reinforce that cannabis is for adults. Adolescents are also more likely to use if a friend is a chronic user. Find out what your kid’s friends are up to.

  3. Treat regular cannabis use in adolescents seriously. There is evidence chronic use in adolescence reduces IQ 6 to 9 points, and that may not recover fully after use stops.

  4. Adolescents with a family history of addiction, abuse history, ADHD, or antisocial behavior are more likely to develop cannabis addiction than kids without those traits.

  5. HOWEVER, do not panic. Compared to drugs like nicotine, alcohol, meth, and opiates, cannabis remains pretty tame. While parents never want to see their kid be a regular drug user, your family will get through your child’s cannabis use. And it’s key to remember the problems come with regular use, not the occasional smoke with friends.

Large scale research remains hampered by the federal government insisting on keeping cannabis a Schedule I controlled substance. I didn’t know this, but federally-approved research can only be done on the strain available from the University of Mississippi! We need cannabis off the Schedule I list ASAP to get better science.

All things in moderation, dear neighbors.