The legalization of recreational marijuana use in California has set off an advertising boom on billboards across the state. They promise “Cannabis, the California Way!” and try to suggest that marijuana can help Californians say goodbye to stress or “get rid of pesky hangovers.” Another billboard promises “unrivaled potency” while asking users to “medicate responsibly.”
No doubt the commercialization of cannabis products is in full swing in the Golden State. Nevermind that the cannabis lobby promoted the legalization of both “medical” and recreational marijuana mostly as the decriminalization of users, not as a cash-cow commodity for Weed, Incorporated.
California was the first state in the Union to establish a “medical” marijuana program in 1996. Since January of this year, it is legal to “possess, transport, process, purchase, obtain, or give away, without any compensation whatsoever, no more than one ounce of dry cannabis or eight grams concentrated cannabis to adults the age of 21 or older.”
Legalization and commercialization are based on the burgeoning perception across the nation that using cannabis involves little or no risk. At the same time, a significant number of people started to believe that using cannabis can actually be beneficial to your health, despite a distinct lack of scientific evidence for that contention.
In October 2017, National pollster Gallup found that support for nationwide legalization had jumped to 64 percent, an all-time high. Similar support can be found in other surveys. Favorability toward so-called medical marijuana is even higher. An April 2018 survey from Quinnipiac University found that an astounding 93 percent of respondents supported the idea of physicians being able to prescribe cannabis to patients. Contrary to what many people believe, doctors cannot write prescriptions for marijuana since the FDA has not approved marijuana as a safe and effective drug for any indication. Consequently, doctors can only issue recommendations for “medical” marijuana.
In a 2018 article on theatlantic.com, Annie Lowrey suggests that the US has now replaced one form of reefer madness with another, equally problematic one. After politicians and law enforcement officials argued for decades that smoking marijuana puts you on a highway to the hellish addiction to hard drugs such as heroin and cocaine, “weed” is now widely accepted as treatment for a number of medical conditions. Many Americans believe it cannot cause addiction, some have even suggested it could be used to treat opioid use disorder.
In his book Marijuana, psychiatrist and addiction specialist Kevin Hill, M.D., talks about three popular myths: that cannabis is not harmful, that it cannot lead to addiction, and that stopping the use of marijuana cannot cause withdrawal symptoms.
The perceived harmlessness can backfire, especially on heavy users, as Dr. Kevin Hill writes: “Excellent scientific research shows that regular marijuana use affects the ability to think, can increase feelings of anxiety and depression and increases the odds that one will develop psychotic disorders such as schizophrenia.” And it can result in a cannabis use disorder.
“Cannabis use can cause addictive tendencies and behaviors,” confirms Dr. Nicholas Reeves, a psychiatrist at Muir Wood Adolescent and Family Services. “It can cause academic and motivational decline. Marijuana decreases the motivation to seek meaning and purpose in life; it diminishes occupational or academic achievement. Users may try to alleviate existential distress through emotional numbing which may lead to avoidance of adaptive anxiety and thus avoidance of pursuing life goals that cause worry or existential distress.”
“In adolescents, epidemiologic studies suggest heavy cannabis use greatly increases the risk of developing schizophrenia,” warns Reeves who is an expert psychopharmacologist. “While responsible recreational cannabis use—similar to alcohol—isn’t harmful for most people, cannabis use can be very harmful for those with a genetic predisposition to addiction or those who have other psychiatric disorders. People often try to self-medicate depression and anxiety with cannabis, which may provide temporary relief, but likely exacerbates the underlying anxiety or mood disorder.”
Stanford psychiatry professor Keith Humphreys explains in The Atlantic article that the most compelling evidence of the deleterious effects comes from users themselves. “In large national surveys, about one in 10 people who smoke it say they have a lot of problems. They say things like, ‘I have trouble quitting. I think a lot about quitting and I can’t do it. I smoked more than I intended to. I neglect responsibilities.’ There are plenty of people who have problems with it, in terms of things like concentration, short-term memory, and motivation,” says Professor Humphreys.
Current and former cannabis users told Lowrey about “lost jobs, lost marriages, lost houses, lost money, lost time. Foreclosures and divorces. Weight gain and mental-health problems. And one other thing: the problem of convincing other people that what they were experiencing was real.”
Increased Use With Increasing Legalization
Lowrey found that such negative consequences are increasingly common. The share of adults with a cannabis use disorder has doubled since the beginning of the new century, “as the share of cannabis users who consume it daily or near-daily has jumped nearly 50 percent”—all “in the context of increasingly permissive cannabis legislation, attitudes, and lower risk perception,” as the National Institutes of Health put it.
This is not the legalization that was promised where people (responsibly) smoke the occasional joint to relax after a hard day’s work. In The Atlantic story we meet Evan who “started off smoking with his friends when they were playing sports or video games, lighting up to chill out after his nine-to-five as a paralegal at a law office. But that soon became couch-lock, and he lost interest in working out, going out, doing anything with his roommates. Then came a lack of motivation and the slow erosion of ambition, and law school moving further out of reach. He started smoking before work and after work. Eventually, he realized it was impossible to get through the day without it.”
Evan was able to stop the downward spiral but it took seven hard-fought weeks go get sober. “Seven weeks of sleepless nights, intermittent nausea, irritability, trouble focusing, and psychological turmoil. There were upsides, he said, in terms of reduced mental fog, a fatter wallet, and a growing sense of confidence that he could quit.”
Teenagers at Risk
The massive commercialization paired with a vanishing risk perception is especially problematic for individuals whose brains are not fully developed and who are naturally more inclined to engage in risky behavior—teens!
Marijuana affects brain development, especially in people under 25. When people begin using marijuana as teenagers, the drug may impair thinking, memory, and learning functions and affect how the brain builds connections between the areas necessary for these functions. The drug inhibits the ability to learn at a time when young people need it the most. As the example of Evan shows, using marijuana may depress brain function to the point where chronic use results in lethargy and a reduction in motivation. The more potent the weed, the more lethargic the user—and it’s not your parent’s reefer anymore.
Marijuana growers have been working on increasing the potency of cannabis for over fifty years now. The amount of THC—the chemical responsible for most of the plant’s psychoactive effects—has been increasing steadily over those decades. In the seventies, joints averaged a concentration of about one percent, close to the natural levels of the cannabis plant. In the early nineties, the typical THC concentration had increased to three percent. Now it often exceeds 15 percent.
In addition to that, cannabis is used in an even more concentrated form called hash oil or wax. So-called “dabbing” refers to the inhalation of concentrated THC products created through butane extraction. Butane hash oil (BHO) can reach incredible concentrations of over 50 percent. That is 50 joints of the seventies rolled into one.
Public-health experts are increasingly worried about the potent varieties hitting the legalized market and the rising number of constant users. “Cannabis is potentially a real public-health problem,” Mark Kleiman, a professor of public policy at New York University told The Atlantic.
The teen rehab professionals at Muir Wood know that all too many young Americans no longer believe using marijuana products involves serious risks. The ongoing normalization of marijuana use in the United States has reinforced the belief that cannabis use is neither harmful nor addictive. After all, their parents probably smoked it and state after state is now making it available for recreational use.
The normalization of marijuana use has led to increased use among young people—a troubling trend “given that the data showing the potential harms of marijuana is clear, strong, and growing.” (Marijuana page 174)
At the end of her article, Annie Lowrey suggests that “perhaps most important might be reintroducing some reasonable skepticism about cannabis, especially until scientists have a better sense of the health effects of high-potency products, used frequently. Until then, listening to and believing the hundreds of thousands of users who argue marijuana is not always benign might be a good start.”