Adolescent Marijuana Use May Rise Following Legalization of Drug for Recreational Use

A study published today in JAMA Pediatrics has found that marijuana use increased and the perceived risks of using the drug decreased among eighth and 10th graders in Washington following the state’s legalization of the drug for recreational use in 2012. No such differences were observed in students in Colorado—which also legalized recreational marijuana use in 2012—and students in other U.S. states that had not legalized the drug. 

The findings raise questions about how the legalization of marijuana for adult recreational use might change behavior in adolescents.

For the study, Magdalena Cerdá, Dr.P.H., M.P.H., of the University of California Davis School of Medicine and colleagues analyzed survey data from 253,902 students in eighth, 10th, and 12th grades from 2010 to 2015 in U.S. schools. The authors compared changes in past-month marijuana use and perceived harmfulness of marijuana use in Washington and Colorado prior to recreational marijuana legalization (2010-2012) with post-legalization (2013-2015) and compared these findings with trends in states that did not legalize recreational marijuana use.

In Washington, marijuana use increased 2.0% and 4.1% among eighth and 10th graders, respectively, from 2010-2012 to 2013-2015 while perceived harmfulness declined by 14.2% and 16.1%. In contrast, among states that did not legalize recreational marijuana use, marijuana use decreased by 1.3% and 0.9% among eighth and 10th graders, respectively, while harmfulness decreased by 4.9% and 7.2% over the same period. These trends were significantly different from those seen in states that did not legalize marijuana. No changes were seen in marijuana use or perceived harmfulness among Washington 12th-graders or students in the three grades in Colorado.

“Although further data will be needed to definitively address the question of whether legalizing marijuana use for recreational purposes among adults influences adolescent use, and although these influences may differ across different legalization models, a cautious interpretation of the findings suggests investment in evidence-based adolescent substance use prevention programs in any additional states that may legalize recreational marijuana use,” the authors concluded. 

“Differences in overall use rates before and after changes in legal status, while important and perhaps the easiest change to monitor, are but one aspect of the marijuana use puzzle that merits study,” wrote JAMA Pediatrics Associate Editor Alain Joffe, M.D., M.P.H., of Johns Hopkins University in a related editorial. “Changes in who uses and how frequently use occurs also merit careful assessment. Data from the study by Cerdá et al suggest increases in use were limited to younger (eighth and 10th grade) compared with older (12th grade) adolescents in Washington; this is particularly worrisome, as the adverse effects of marijuana use are generally believed to be greater for younger teenagers, especially those younger than 16 years.”

For related information, see the Psychiatric News article “What You Should Know About Marijuana Use in the United States,” by Michael T. Compton, M.D., M.P.H., chair of the Department of Psychiatry at Lenox Hill Hospital in New York and a professor of psychiatry at Hofstra Northwell School of Medicine.

(Image: iStock/francisblack)

Psychiatrist Takes Less-Traveled Route to Integrated Care

Lori Raney, M.D., of Dolores, Colo., advocates integrating psychiatry with primary care, just like many of her psychiatrist colleagues do. Working closely with a social worker and a psychologist, Raney offers support and consultation to the primary care clinicians at a federally qualified health center in southwest Colorado.

That's the traditional model of integrated care: moving the psychiatrist into the primary care clinic. However, at the same time, Raney approaches integration from the other direction. At the Cortez Integrated Health Center, she designed a facility for people with serious mental illness that also addresses their general medical needs. In addition to “consultation and education” rooms for psychiatric care, the facility has rooms for basic physical exams. “We’re open to everyone in the community for primary care,” Raney said at APA’s Institute on Psychiatric Services in New York. Every patient gets screened for factors such as cholesterol level, high blood pressure, diabetes, and smoking, as well as for psychiatric illnesses.

“It makes me feel like a more-well-rounded physician,” said Raney. “We psychiatrists are the only ones in the room trained in both worlds.”

To read more about integrated care, see Psychiatric News here.

(Image: Lori Raney, M.D.)

Colorado Gunman Kills 12 in Crowded Theater

A gunman wearing a bullet-proof vest opened fire in a crowded movie theater in Aurora, Colo., during a midnight showing of "The Dark Knight Rises" last night. At least 12 people were killed and as many as 50 others are being treated for injuries. The suspect is a 24-year-old male who entered the theater through an emergency door that had been propped open. He was reportedly wearing riot gear and threw a tear-gas canister into the theater before opening fire with an automatic weapon. He was apprehended in the parking lot of the shopping center where the theater is located and is in police custody.

Aurora, a Denver suburb, is about 13 miles from Littleton, Colo., site of the April 1999 Columbine High School massacre in which teenage students Dylan Klebold and Eric Harris killed 13 people and wounded 23 others before killing themselves. 

Read about how Virginia psychiatrists responded to the more recent mass shooting at Virginia Tech University in 2007, in Psychiatric News, here. 

(Image: Luis Louro/Shutterstock.com)