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Marijuana: harmless indulgence or health threat?


Among Ontario adults, 14.1 percent used cannabis during 2013, according to a recent report from Toronto’s Centre for Addiction and Mental Health (CAMH). In 1997, the equivalent figure was only 9.1 percent. Researchers at CAMH say that the steady increase in cannabis use underscores the need for a public health—rather than a criminal justice—approach to cannabis control.

This statistic, along with the legalization of marijuana in some parts of the U.S. and efforts for the same in Canada, seem to have de-stigmatized its use. The “stoner culture” depicted in popular culture treats marijuana as a comedic device; its users small-minded and detached from reality, but of no threat to themselves or anybody else. Lovable losers. This adds to the cultural acceptance of the drug as a harmless indulgence.

Like many of our colleagues in the scientific and treatment communities, we have a different opinion.

In a recent paper published in the journal Addiction, Wayne S. Hall, Ph.D. studied two decades of research to address the issue of potential adverse health effects of recreational cannabis use. Hall notes that during the past half-century, recreational cannabis use has become almost as common as tobacco use among adolescents and young adults.

Hall concluded that there are consistent associations between regular cannabis use and poor psychosocial outcomes and mental health in adulthood.

Meanwhile, scientists at the Massachusetts General Hospital Center for Addiction Medicine published a recent study in which 84 percent of teenagers seeking treatment for Cannabis Use Disorder (the medical term for what most of us call addiction) at an outpatient clinic met diagnostic criteria for marijuana dependence. For 40 percent of these teens, this dependence included withdrawal symptoms when they stopped using marijuana.

Those who work in the area of addiction treatment are familiar with patient histories whose downward spiral began with “harmless” experimentation with marijuana.  Unfortunately, little about their experience is comedic. In our experience, dependence on marijuana is very real. It tends to be much more difficult to treat because of the depth of depression, impaired motivation and users’ initial inability to form authentic, intimate, trusting relationships with peers as well as therapists.

Chronic marijuana users often display a limited emotional intelligence that compromises their ability to cope with the stresses of daily life. For some, the escape from this functional quagmire is to resort to using stimulants such as ADHD medication, cocaine or crystal methamphetamine. The reliance on external sources of sedation and stimulation is always at the expense of our own natural biological chemicals, which become suppressed. Reliance on external chemical relief is never as effective and efficient as our own naturally occurring substances such as dopamine, serotonin and gamma aminobutyric acid (GABA). The escalating use of marijuana in Ontario will inevitably result in more individuals naively transcending pleasure into pain and problems. The naive belief that there are no negative consequences to the chronic use of cannabis borders on magical thinking.

The Ontario health care community should take such insights seriously as it grapples with the proper response. We should seriously analyze the new federal laws governing medical cannabis that came into effect April 1, 2014. Although further research remains to be done, the implications are serious not only for the public but also for those charged with overseeing the medical treatment of regular marijuana smokers. We must take care to ensure that careless prescribing does not contribute to a repeat of the opioid crisis we now find ourselves in.

A related, and similarly serious, question is whether there might be a link between substance abuse, mental health and suicidality. A future challenge for researchers will be to determine what association, if any, exists between marijuana use and these serious concerns.

Substance abusers in Canada seeking to improve their lives have options for treatment. One is to seek individualized care featuring a holistic treatment plan in order to best support their road to recovery. Facilities exist with teams of skilled physicians, psychiatrists, psychologists, therapists, nurses, nutritionists and physical fitness experts to aid individuals in the recovery process. In our view, the ideal approach utilizes teams of medical professionals as well as the inclusion of the individual’s primary supports, such as family and friends. But while high-quality substance abuse treatment programs exist, it is clear that a more enlightened public policy might drastically reduce the need for such services.

As the debate over marijuana continues to rage and legalization spreads, we must remember to ask the deeper questions about this drug’s ultimate effects. As public attitudes toward marijuana become ever more liberal, and the risk of widespread abuse remains, there is a likelihood that high-quality substance abuse treatment will be in ever-greater demand.

William Jacyk, M.D. is medical director at GreeneStone Healthcare Corporation, which operates a residential treatment center in Muskoka, Ontario. Anita Teslak, Psy.D., a registered psychologist, is Vice President of Operations of GreeneStone Healthcare Corporation.

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11 comments

  1. Carol M

    As the mother of a teen age boy living in downtown Toronto; I find this proliferation in marijuana very concerning. As a parent, I feel powerless. It is readily available not only from under-ground drug dealers in the neighbourhood, but also the equipment is show cased in convenience store windows in our local communities. What a confusing message to give our children……….I am very resentful of the mixed messages that are portrayed by people such as Obama, Trudeau etc….that this is no big deal! It is a really big deal and we need to get on it or we will have a generation of kids who will fail to thrive to their true potential because any ounce of motivation they had has been eroded by the effects of this drug.

  2. Jordan A

    Unlike many articles on this site which I thoroughly enjoy, I feel this article presents but a single viewpoint of the issue. While there are obviously more ideal sources for recreation than cannabis use, I feel the loosely drawn association between coping with emotional stress and limited emotional intelligence may be falling victim to the classic cause and effect paradigm. There is evidence demonstrating that the most likely users of recreational cannabis use among adults are in fact those with higher education. However, among young adults, it may possibly be a lack of attention to all social determinants of health and not simply the use of mild (comparatively) recreational drugs.

    I agree that more attention needs to be given to reduce the affects of chronic use as well as addiction in younger populations, and that the long term effects of chronic use will become a public health concern down the road. However, it is important to remember that just as one glass of wine with dinner doesn’t make you an alcoholic, occasional use of recreational cannabis does not a stoner make.

    • Delia

      Couldn’t agree more. The approach this article took was indeed one-sided and that isn’t normally the approach I have come to expect from these articles.

      I am very interested in the proliferation of use and the effectsnon different groups of people and I am inclined to support an approach to drugs and addiction that looks at the entire picture. As seen in Dr. Carl Hart’s research, what is in the cage with the rat influences the rat’s relationship with whatever drug is available. The network and environment around a person is where we need to focus. Community over poor public policy.

  3. Heenen

    One thing I’ve never understood is how adamant the marijuana-using community defends the use of the drug and champions for its decriminalization.

    What’s so damn special about it?

    • Gerry Goldlist

      Probably nothing that special. Human beings will always find ways to relax. It seems to me that cannabis use should be regulated similarly to how alcohol is regulated. It should not be illegal.

      Certainly driving under the influence of alcohol or marijuana should both be illegal and strictly punished.

  4. Gerry Goldlist

    re: “84 percent of teenagers seeking treatment for Cannabis Use Disorder at an outpatient clinic met diagnostic criteria for marijuana dependence.”

    This is a circular argument as those who think they are sick are usually the ones who have signs and symptoms. Sort of like:

    Of those presenting to emergency thinking they have a broken leg, 80% have a broken leg.

  5. Lyn black

    This article makes me doubt the compentency of this entire site. Even as an opinion peice, it seems to indicate a willingness to publish predjudiced nonsense, for example: “reliance on external chemical relief is never as effective and efficient as our own naturally occurring substances such as dopamine, serotonin and gamma aminobutyric acid (GABA).” what? Based on the recommendation of a friend, i was looking forward to some actual fact based debate about the emerging marijuana treatment trend in addictions care. This is very disappointing.

  6. Josh

    Abuse of marijuana causes physical and psychological dependence. At first you do not understand this, this understanding comes later. Then treatment is already required. I smoked marijuana for 5 years and thought that I’m not a drug addict and I can quit it. But no! When I decided to quit – I could not !!!! We all need to think about this beforehand! Now I’m on rehabilitation in Ontario https://canadiancentreforaddictions.org/on/ontario-drug-rehab/. And my doctor says that the addicts say that they are not addicts and can quit)) but this is not so. Take this into account when you start smoking weeds!

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