Dr. Mitch Rosenthal on the Need to Emulate Effective Overdose Prevention Programs from Dayton, Ohio
The Rosenthal Report - July 2019
SPECIAL REPORT: TEENS AND THE NEW ERA OF POWERFUL, LEGAL MARIJUANA
Cannabis is now legal in 43 states plus Washington, D.C., including 33 for medical marijuana use alone and 11 for recreational. Polling shows strong public support and politicians increasingly endorse legalization based largely on the widespread belief that marijuana and other pot-related products are relatively benign—or even beneficial for a host of ailments—with few, if any, potential risks. But what, in fact, has been the impact of this new era of easily accessible, highly potent pot—especially on such vulnerable groups as teenagers?
To find out, we spoke to a dozen teens between the ages of 14 and 17 at Outreach, an adolescent treatment center on Long Island. What the youngsters told us—about how they started using, the constant peer pressure they face, their progression to stronger drugs, and their struggles trying to stop—painted a disturbing portrait of a younger generation caught up in a new and dangerous level of substance abuse.
For the young people at the Outreach facility, their first exposure came as early as middle school, where they would, for example, gather in bathrooms to use e-cigarettes and vape nicotine as well as cannabis. “You easily get pulled into something new because everyone is doing it,” one girl recalled. In addition to the nicotine cartridges that come in such wildly popular e-cigarette brands such as Juul, the students would vape pre-packaged, liquid-filled pods containing up to 90 percent THC (the psychoactive component of cannabis). These products are currently illegal in New York State but can be easily obtained through intermediaries in states where recreational marijuana has been legalized, the teens said.
The impact of vaping today’s stronger pot is immediate. “You get really high, really fast, and you just want to stay high,” one teen said. And as tolerance builds, users turn to any number of new cannabis offerings that pack an even stronger punch. These include wax or dabs, as well as Moon Rocks—a potent strain of cannabis dipped in hash oil and sprinkled with cannabis resin. Noted one boy, “If the drugs don’t work anymore you move on to the next strongest thing—to whatever messes you up.”
The teens at Outreach talked about what it’s like to get high using these more concentrated marijuana products, with symptoms including blackouts, racing heartbeat and difficulty breathing. One girl stole money from her parents to buy the drugs, and many withdrew from their normal teenage routines and friendships, and eventually even gave up going to school. Teens are brought to Outreach by their parents, by referral from the juvenile justice system, or by their school—both institutions are becoming more and more concerned about teen marijuana use.
Research confirms what the young people at Outreach described. Vaping nicotine is surging in popularity in this age group, with more than one-third of 12th graders reporting having vaped in 2018, up 10 percent from the previous year, according to the Monitoring the Future Survey. In addition, more than 13 percent of these 12th graders vaped cannabis compared to 9.5 percent in 2017. As legalized marijuana becomes more accessible and new products flood the market, “[the drug] is increasingly the first substance in the sequence of adolescent drug use,” a 2018 Columbia University study reported in the journal Drug and Alcohol Dependence.
John Venza, vice president of residential and adolescent services at Outreach, said the teens’ experience with marijuana follows a new pattern of earlier onset and faster progression. “There is a quick introduction through vaping nicotine and then THC and then a comfortable progression to products that hit like a ton of bricks,” Venza explained. These include edibles such as Pot Tarts, a pot-filled version of the popular packaged pastry, or candies with wrappers designed to look like such common confections as Snickers bars or Reese’s peanut butter cups.
Parents have traditionally been the first line of defense against teen drug addiction. Today, however, many of them take a more hands-off approach. “They think it’s just pot and so not a big problem, and that sets the tone for not getting involved,” Venza said. What’s more, many parents underplay the difference between what drugs are now and what they were when they were adolescents. With legalization, according to Venza, ”pot has been normalized.”
Listening to these remarkably smart and self-aware young people is moving and provides hope they will succeed.
It is now our responsibility to take action. While pro-marijuana legislation has recently stalled in New York and New Jersey, the legalization trend is likely to continue. The Rosenthal Center supports a comprehensive strategy to deal with the availability of new cannabis products and the resultant uptick in teen marijuana use:
Education and Prevention Programs:
Focused on students, parents, teachers, school officials, social workers, therapists, and anyone who regularly interacts with young people, these programs must make people fully aware of the risks and dangers of today’s more-powerful marijuana and its impact on the developing brain, the warning signs of drug use, as well as the specific harms from vaping cannabis.
As legalization moves ahead, we must insist on strict rules and regulations for how and where marijuana is sold, including what products are available; age limits; clear and concise warning labels and information about dosage and interactions. We will need adequate safeguards to prevent it from being explicitly marked to young people.
While our main focus today has largely been on the devastating opioid epidemic, we must now allocate additional financial resources and manpower to significantly expanding access to specialized treatment options for teenagers. And because it is unlikely we will be able to prevent the legalization of marijuana in New York State, we should also aim to educate parents, teachers, young people and the general public on how teen drug use remains a real and critical problem—one that would be tragic to ignore.