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It's getting easier to obtain marijuana in America. Legalization of cannabis (marijuana) in the U.S. has been moving at breakneck speed. Over the past 20 years, there have been substantial changes to the cannabis policy landscape. To date, 28 states and Washington, D.C., have legalized cannabis for the treatment of medical conditions. Eight of these states and Washington, D.C., have adopted regulations to allow adult-use recreational cannabis. In 2016, cannabis legalization reached a tipping point with more than half of the 50 states approving medical or adult recreational use.
These landmark changes in policy have markedly changed cannabis use patterns and perceived risk. Based on a recent nationwide survey, 22.2 million Americans 12 years of age and older reported using cannabis in the past 30 days. Between 2002 and 2015, the percentage of past cannabis users in this age range has increased steadily from 6.2 percent to 8.3 percent.
Remember, at the federal level, based on the Comprehensive Drug Abuse and Control Act of 1970, cannabis remains a Schedule 1 drug, meaning it has a high potential for abuse, no currently accepted medical treatment use and lack of accepted safety. Despite the extensive changes in policy at the state level and the rapid rise in the use of cannabis, both for medical purposes and recreational use, conclusive evidence regarding the short- and long-term health effects (harms and benefits) of cannabis use remains elusive. A lack of scientific research has resulted in the absence of information on the health implications of cannabis use, which is a significant public health concern for vulnerable populations such as adolescents and pregnant women.
Unlike other substances, such as alcohol or tobacco, whose use may confer risk, no accepted standards exist to help guide individuals as they make choices regarding the issues of when and how to use cannabis safely, and in regard to medical uses, effectively.
What do we tell our children?
Government data show that almost 40 percent of U.S. high school students have tried cannabis; about 20 percent are current users and close to 10 percent first tried it before age 13. Use has increased in recent years among those aged 18 and older, but not among young teens. Yet, according to surveys, kids aged 12-17 increasingly think cannabis use is not harmful. Pediatricians report that cannabis "is the drug of choice" for many teens. Some teens believe that daily use is safe, noting that their parents and grandparents smoked pot in college and they turned out OK.
Yet, the human brain continues to develop until the early 20s, raising concerns about the potential short- and long-term effects of mind-altering drugs. The endocannaboid neurotransmitters and their respective receptors in the human brain and in the body's periphery only recently were discovered. These brain receptors are the sites stimulated by the psychoactive cannaboid delta 9-THC, which, by the way, is only one of 60 or more active cannabinoids in marijuana.
Studies suggest that teens using cannabis develop changes in the brain regions affecting memory, the ability to plan and decision making. Some changes may be permanent.
What do you tell your children? That's easy: the truth. There are many unknowns involving psychoactive drugs. Cannabis appears to have a negative impact on adolescent developing brains. The risk of injuring a developing brain cannot be justified. Impaired decision making under the influence of psychoactive drugs may lead to injuries, permanent disability and, at worst, loss of life. Recreational use is illegal for those under 21, even in the states that allow adult use.
To ensure parental credibility, be sure to do what you say.
C. Clark Milton, D.O., is the medical director of Corporate Health at Wheeling Hospital.