Marijuana

Additional Resources

How to Talk About Marijuana: There isn’t one script for talking about marijuana, but here’s what you’re likely to hear — and a few suggestions for how to respond.
Spotting Drug Use: A few simple tips and guidelines can go a long way toward spotting issues with drug use earlier rather than later.
Prepare to Take Action if You Suspect Teen or Adult Drug Use: Is your child using drugs? Use these tips to prepare for the conversation ahead, and lay the foundation for more positive outcomes.

Impact of Marijuana on Academic Achievement

Amelia M. Arria, Ph.D., from the University of Maryland School of Public Heath gave a compelling research-based presentation at the February, 2017 CADCA conference. Her talk was based on several recent research initiatives,  including an April, 2016 review article published in Biological Psychiatry by Broyd et al. which considered the effect of young people using marijuana and  their ability to be successful students.

This article in Biological Psychiatry, titled Acute and Chronic Effects of Cannabinoids on Human Cognition-a Systematic Review stressed the importance of realizing  that the marijuana that is being used today is significantly more potent than the marijuana in the past.  In 1995 the potency was 3.96% and today it is 11.84%.  In addition, the use of “dabs,” which are more concentrated doses of cannabis that are made by extracting THC and other cannabinoids using a solvent like butane or carbon dioxide, resulting in sticky oils also commonly referred to as wax, shatter, budder, and butane hash oil; edibles can have a higher concentration of THC.  The 2016 Biological Psychiatry article concludes that this increase in potency poses a higher risk for negative consequences to adolescents who use marijuana.

Learning involves many cognitive skills that allows one to focus, memorize, interpret and analyze information and internalize the concepts. Dr. Arria’s  presentation summarized the impact of marijuana on following cognitive and other skills.

Memory

According to the 2016 article in Biological Psychiatry, “Memory function has been the most consistently impaired cognitive domain affected by cannabis, and studies from the past 10 years continue to extend the evidence base. The most extensive evidence for impairment is within verbal learning and memory.” (Broyd et al., 2016)

Verbal Learning and Memory

The same article goes on to say, “Most often measured using word list learning tasks, with several immediate and delayed recall trials and a recognition trial, verbal learning and memory tasks have been identified as particularly sensitive to the acute and chronic effects of cannabis. Impaired verbal learning and memory continues to be consistently observed in chronic cannabis users, including adolescents and young adults with some exceptions and even in only occasional users.  Significant associations between poorer performance in regular users and frequency, quantity, duration, and age of onset of cannabis use have been reported. Consistent with previous findings, long-term users appear to be more affected than short-term users.” (Broyd, et al., 2016)

Attention

“Impaired attention has been considered a hallmark of the intoxicating effects of cannabis” according to the article in Biological Psychiatry They also point out that when there is a decrease in impairment, it might be explained by the development of tolerance among daily users.  Several recent studies report impairment in an adolescent remained even when they had not used cannabis for 30 days.    From that the researchers  drew the conclusion that “cannabis-related attentional impairment may reflect residual effects that dissipate gradually as cannabinoids are cleared from the body.’  (Broyd, et al., 2016)

Inhibition

Inhibition refers to go/no go or stop-signal reaction time.  The use of cannabis has consistently been reported to  increase reaction time in both occasional and heavy cannabis users. (Broyd, et al, 2016)

Psychomotor Function

In terms of psychomotor functioning, “finger tapping, critical tracking, choice reaction time tasks, and digit-symbol substitution tasks have been used to measure psychomotor function. In infrequent users, smoked or vaporized cannabis impaired critical tracking, affected reaction time and motor control in a dose-dependent manner,  and disrupted motor function in a task with a motivational component. In heavy users, high-dose smoked cannabis resulted in more collisions in a virtual maze task but did not affect critical tracking. The weight of evidence suggests that psychomotor function is affected by acute intoxication and that this likely persists for some time after chronic cannabis exposure.”  (Broyd, et al., 2016)

Dr. Arria and  Robert Du Pont, MD discuss the relationship between academics and marijuana in a post for  the Partnership for Drug-Free Kids entitled Commentary: Recognizing the Contribution of Adolescent Substance Use to Poor School Performance.

“Marijuana use negatively impacts academic outcomes by lowering the GPA and those students have higher rates of dropout than students who drink alcohol.” The authors speculate that this might be due to differences in the patterns of consumption between alcohol which is typically consumed on weekends and marijuana which is consumed throughout the week among adolescents. In addition, studies show that in recent years, as perceived risk of harm from marijuana has declined, marijuana use among youth has increased.

Several studies note that sometimes the use of marijuana precedes academic failure and other times early academic failure leads to use. There are many pathways that lead to negative outcomes from substance use during adolescence.

Students that show early signs of academic difficulties should be specifically screened for drug and alcohol use. Steps should be taken to ensure that at-risk students become and stay drug-and alcohol-free. Proper management must be comprehensive and may include assessments and interventions for behavioral problems and mental health disorders.

Cessation of substance use following treatment is associated with improvement in academic performance. This evidence shows that doing something about substance use is an important way to promote and improve academic success.  (2016, Biological Psychiatry.)

New neurobiological research tells us that there are short and longer-term effects of drug use on students’ ability to learn. Certainly, learning is compromised if students come to class under the influence. Motivation to study and achieve declines as the use becomes more regular. Too often, students with alcohol or drug problems aren’t even making it to the classroom.”

Dr Arria stressed in her présentation the concept of the brain being “hijacked” by the use of substances including marijuana.  Academic potential is much more than a GPA. It’s the ability to maintain interest and curiosity and continue to be motivated to succeed despite disappointment or failure.  It is the ability to be able to communicate the need for help from school personnel or other resources.

Source: Patricia M. Warble, CMSW, CPP

Many people who use marijuana, including teenagers, mistakenly regard this substance as a benign drug. In addition, the legalization of marijuana in many states for both medical and recreational use has increased the perception that marijuana is not harmful and is helpful to alleviate health problems.

However, a report  that was released in January commissioned by the National Academy of Sciences, Engineering and Medicine tells a very different story.  The report shows that there is evidence that heavy marijuana use, a long history of use and the age at the beginning of use may all be risk factors that can trigger a first episode of psychosis.

Studies conducted over the past ten years have shown that marijuana  use during adolescence can be a contributing factor to both triggering or worsening mental illnesses including schizophrenia. These same studies have shown that a young person with a predisposition of developing a mental illness may be more likely to use marijuana at an earlier age than other adolescents.

Dr. Michael Birnbaum, a child and adolescent psychiatrist at Northwell Heath said that we do not have a lot of research on the effects of marijuana on the developing brain of adolescents. “If pot turns on that switch,  it’s not something that can be easily turned off.  Marijuana could effectively trigger a primary psychotic disorder, meaning that even once the substance is removed, the symptoms are still there.” However, in his experience when working with young people who have mental illness, he says that “inevitably pot, and drugs and alcohol become part of the conversation.

Developing mental illness cannot be related to one thing so according to Dr. Birnbaum one cannot say that using marijuana causes schizophrenia.  However, he goes on to say  that “evidence suggests that pot smoking can lead to earlier onset (of psychosis)- that it can develop sooner that it would have otherwise.  In addition, pot is also associated with development of illness in otherwise healthy individuals, meaning it is possible that psychosis would not have developed in that person if they had never smoked pot.”

Michael Compton, MD, MPH a professor of clinical psychiatry at Columbia University has also conducted several studies considering the association between first episode psychosis and cannabis use.  The studies showed as reported by an article by Jukian Garey,  “an association between the escalation of marijuana use and an earlier age of onset of prodromal symptoms and an earlier age at onset of psychotic symptoms.”

Dr. Compton says that “These findings suggest that adolescent/premorbid marijuana use is not only a risk factor for the later development of primary psychotic disorders (which has been shown in prior studies), but is also a risk factor for an earlier onset of those disorders.”

The issue of onset is important because the long-term outlook for someone with schizophrenia is better, the later the disorder develops. Another issue of concern is that the risk of a first psychotic episode is lower if a young person uses marijuana less frequently, however, once it occurs, stopping the use of marijuana does not eliminate the mental illness.

As Dr Brinbaum observed, “If pot turns on that switch,  it’s not something that can be easily turned off.  Marijuana could effectively trigger a primary psychotic disorder, meaning that even once the substance is removed, the symptoms are still there.”

Dr. Birnbaum suggests that it is impossible to tell what risk a teenager is taking by smoking marijuana on a regular basis.  He goes onto say that if an adolescent has hallucinations or other psychotic-like experiences while using, that is an indicator that they may have a predisposition to some kind of psychotic illness. In this situation, it would be prudent for that teen to avoid substances.

It is important for parents to share this latest research with their children. Let them know that using marijuana could be setting them up for trouble. And that scientists do not know enough about the risks of marijuana to the developing brain. Starting to use marijuana at a young age increases the risk of dependency which negatively impacts a young person’s ability to perform well in school and have meaningful relationships.

Source: Parenting for Prevention, Patricia M Warble, LCSW, CPC