American College of Orgonomy - Marijuana Use By Adolescents

The use of marijuana by developing adolescents is a phenomenon of serious concern on an individual, community, and societal level. It is the most widely used illicit drug in the United States (1). The incidence of regular marijuana use during the period of adolescence rose steadily through the 1970's and 1980's, and despite a slight drop in reported use in the late 80's, has now continued its steady increase in terms of number of adolescents reporting its use (2). Over the past twenty-five years, the proportion of pupils age fourteen to fifteen who knew someone using marijuana more than quadrupled from 15% to 65%, and the proportion who had been offered drugs increased nine--fold from 5% to 45% by 1994. Both of these proportions more than doubled over the past five years (3). Alarmingly, age of initial use has consistently decreased over time to younger students (4). In one sample of adolescents in treatment for substance abuse, the average age of onset of marijuana use was 12.75 years for outpatients and 11.75 years for inpatients (5). Current estimates suggest that among high school students, 12% of all twelve to seventeen year olds are regular users of marijuana. This increases to 22% for eighteen to twenty-five year olds (6). These estimates are applicable to all strata of society: in a recent survey at a private preparatory school, over 20% of the students characterized themselves as either moderate or heavy users of marijuana. Eleven percent preferred marijuana over alcohol, the most predominant drug among teenagers (7). These facts all probably underestimate actual levels of use because of well-documented inaccuracies in such epidemiological data due to under-reporting or complete denial (8). It appears that use of marijuana has become so much a part of everyday adolescent culture that adolescents and even their parents have been desensitized to its presence and are accepting of its use as a normal part of "adolescent experimentation."

Particularly confusing/vexing has been the commonly observed discrepancy between the students' perception of the effects of smoking marijuana on their functioning and the observations of others. It has been clearly demonstrated that regular use of marijuana seriously affects the individual, his health, family, school, and society in terms of problem behavior and other indications of psychopathology and social dysfunction. Many students, otherwise bright and capable, appear unaware or unconcerned about these data, or dismiss them contemptuously as "biased propaganda from the establishment."

A review of this literature follows. We will then see from an orgonomic perspective that these and other important phenomena, and even an adolescent's lack of concern for the drug's adverse effects, can be better understood by identifying their function within the living organism as a whole.

Unlike alcohol, a water-soluble molecule which is metabolized and passes out of the body fairly quickly, the psychoactive ingredient of marijuana (tetrahydrocannabinol-THC) is a fat-soluble molecule whose metabolites may remain in the body for as long as a month after a single exposure. THC metabolites are stored in the brain, testes, ovaries, and other fatty tissues. Thus, with even so-called "mild use" of marijuana smoking once or twice a week, THC will be continually present in the body and slowly released, affecting overall functioning to some degree. This is true whether or not the individual experiences being "high." It is noteworthy that, despite statements to the contrary, marijuana users, especially with more frequent use, do develop physiological tolerance to the drug (9), which necessitates higher "doses" to achieve the same subjective experience of intoxication. Thus, over time, without necessarily a concurrent increase in intensity or frequency of the sensation of intoxication, increasing levels of the psychoactive substance will be stored in the body.

It is clear that marijuana smoke has long-term adverse effects on the lungs and throat. Marijuana smokers have a higher prevalence of abnormal airways than non-smokers do even when they do not also smoke tobacco (10). Daily smoking of even small amounts of marijuana without tobacco has been associated with chronic respiratory symptoms and tracheobronchial epithelial histopathology of frequency and extent similar to that noted in daily smokers of more than twenty tobacco cigarettes without marijuana. Marijuana has twice as much "tar" as cigarette smoke. The respiratory retention of particulates (a burden on respiration) inhaled from marijuana smoke is actually 40% greater than from the smoke of tobacco (11). Marijuana smoking with and without cigarette smoking significantly reduces gas (including carbon monoxide) exchange capacity, forms toxic hydrocarbons (the most studied compounds with regard to their mutagenic and carcinogenic properties), and has been linked to increased risk of lung cancer, bronchitis, and emphysema (12, 13, 14). Marijuana use also increases heart rate by up to 50% during acute intoxication, presenting a risk for anyone with heart disease.

THC readily crosses the blood-brain barrier directly affecting the biochemistry and neurophysiology of the brain and central nervous system. An impressive array of central biochemical processes (neurotransmitters, enzymes, receptors, etc.) have been shown to be altered by the natural cannabinoids as well as by their synthetic analogs (15, 16). For example, Tripathi et. al. (I 7) demonstrated that the most consistent effect of cannabinoids, both psychotomimetic (capable of producing symptoms of psychosis) and non-psychotomimetic, was to increase acetylcholine levels and to decrease acetylcholine turnover in the hippocampal region of the brain, a part of the limbic system that has been identified as one site of interaction between the perceptual and memory systems (18). Other researchers have reported a twelvefold increase in the levels of dopamine without any alterations in dopamine metabolite levels (19). Strong evidence from animal studies suggests that perturbations of central dopamine mechanisms significantly influence the development of hyperactive motor behavior and cognitive difficulties (20). While the precise process which produces these changes is not yet understood, it is clear that THC is a potent agent and produces profound alterations in the deli-cate balance of natural brain chemistry.

Marijuana has also been demonstrated to alter the natural "bioelectric" processes of the brain. Upon electroencephalographic (EEG) analysis, daily marijuana smokers demonstrated altered brain wave activity when contrasted with subjects who did not use marijuana (21). Users of marijuana could be discriminated from non-users with 95% accuracy. Other studies have demonstrated that in long-term marijuana users, in an un-intoxicated state, the cognitive abilities to focus and direct attention and filter out irrelevant information were progressively impaired with the number of years of use but unrelated to frequency of use (22). Data also suggest that heavy use of marijuana seems to suppress the immune system, which may make it more difficult to fight off colds, flu viruses, and other illnesses (8, 23).

Frequent use of marijuana has also been linked to a decreased sperm count and sperm motility in men, and irregular ovulation in the menstrual cycles of women (8). Exposure of human lung explants to marijuana smoke has been demonstrated to result in alterations in DNA and chromosome complement (24). Higher doses of marijuana have been found to be sevenfold more mutagenic than either tobacco or low-dose marijuana (both of which were also, but more weakly, mutagenic) (25). As THC readily crosses the blood-brain barrier, it also crosses the placenta and enters the fetus. Research with rhesus mon-keys administered THC early in pregnancy found higher rates of spontaneous abortion, still birth, and lowered birth weight (26). THC and its metabolites have been found in the breast milk of nursing mothers who smoke marijuana daily. They have also been found in the body fluids of their infants (27), indicating that THC is concentrated in human milk and can be transferred through nursing. Significant negative effects of prenatal marijuana exposure in the first and second trimesters of pregnancy have been demonstrated in the performance of three-year-old children on the Stanford-Binet Intelligence Scale (28).

There is no doubt that marijuana interferes with complex mental functioning, with emotional processes, and with behavior. Striking differences have been demonstrated between marijuana users and non-users across various variables, with the degree of difference usually directly correlated with increased involvement with marijuana. Marijuana users have been characterized as displaying greater use of other illicit substances, more frequent association with other marijuana users, and lower participation and greater instability in conventional roles of adulthood (29). Cessation of use has been positively associated with, compared to continuing users, higher rates of establishment of adult social roles with a partner/spouse and/or having children, and with long-term employment (30). The reported use of stimulants, hallucinogens, narcotics (heroin), and sedatives is almost entirely restricted to those adolescents who also reported using marijuana (31). Research has demonstrated that heavy users are more likely to experience psychopathological consequences, including personal problems of identity diffusion, low self-esteem, an "amotivational syndrome," interpersonal problems with peers and parents, and difficulty with the law. Over time, these problems were likely to be severe, chronic, and progressive (32). Adolescents who continue smoking into adulthood are more likely to have adolescent children who also use marijuana, due to a greater tolerance of deviance (poor limit-setting, licentiousness misperceived as freedom), poor behavioral control, greater regard for the perceived coping function of the abused substance, more negative life events, and more affiliation with peer users (33).

Several studies provide more direct data on the effects of marijuana use on the adolescent's cognition. "Heavy" marijuana use (defined as use seven or more times weekly) was associated with deficits in mathematical skills and verbal expression on the Iowa Test of Educational Development and with selective impairments in memory retrieval processes in Buslike's Test (34). Drug abusers achieved lower numbers correct and made more errors on Benton's Revised Visual Retention Test, which assesses visuographic functions (35). Marijuana use was proportionately higher for students who have learning disabilities 1 (36). Not surprisingly, marijuana users displayed overall poorer school performance, spent less time on homework, and had more school absenteeism than non-users (31).

Research has also demonstrated that among young or new users of marijuana, performance was mildly impaired on some but not all neuropsychological tests (37). The authors hypothesized that some tests were unaffected or mildly affected because (1) lifetime use was as yet limited, and (2) in adolescents the toxic effects of drug abuse might also be manifested as a decrease in the rate of cognitive devel-opment rather than simply a general cognitive decline. On the other hand, most recent data have demonstrated a "drug residue" effect on attention, psychomotor tasks, and short-term memory during the twelve to twenty-four hour period immediately after cannabis use (38) (recall that THC metabolites are stored in the body for up to one month). Traditional research evidence is as yet insufficient to support or refute as fact either a more prolonged "drug residue" effect, or a toxic effect on the central nervous system that persists even after drug residues have left the body.

Regarding more specific effects on emotional functioning, positive correlations have been found for drug use with anxiety and depression (39). Use of multiple drugs at age fifteen has been associated with concurrent conduct problems for both males and females, and both conduct problems and depressive symptoms at age fifteen were found to be associated with concurrent "self-medication" among females (40). On the other hand, among adolescents incarcerated for juvenile delinquency, the diagnosis of conduct disorder increased significantly with the occurrence of substance abuse, and the number of symptoms for conduct disorder, anxiety, and depression increased with substance abuse (41). This discrepancy between perceived attempts at "self-medication" and the actual effects on functioning will be considered below from an orgonomic perspective.

Interestingly, while consistent cannabis use among high school stu-dents has been found to be significantly associated with self-rated poor academic performance and self-reported poor mental health, perceived harmfulness did not appear to serve as a sufficient deterrent against further substance abuse in the student population (42).

1. John J. Ratey, M.D., co-author of Driven to Distraction.- Recognizing and Coping With Attention Deficit Disorder from Childhood through Adulthood, recently stated that smoking marijuana is probably the worst possible thing someone diagnosed with ADD can do for their symptoms (personal communication). back to text