Dr. Magryta: ‘Is marijuana safe for use’ 2.0

Published 12:00 am Sunday, February 10, 2019

Dr. Magryta

Last year, I wrote about this topic, laying out the facts for those that are now falling into the “cannabis is safe” camp. Danger danger, Will Robinson!

The American sentiment continues to shift to the “yes, it’s safe” feeling, especially out in the wild west.

When it comes to drugs that affect the brain, we have to be very careful to conclude this on a population level. What happens in adults is vastly different than what happens in teens. Consider the vaping debacle of the last few years when pondering safety. Easy access can explode use and therefore increase the risk of negative outcomes.

At any one time during adolescence, 10-20 percent of teenagers will suffer a mood disorder, like anxiety or depression, that is often self-medicated with drugs. College students have to leave school every year secondary to psychological breaks that are induced by drug use — including marijuana. I witnessed this firsthand as I went to a very small school and things of this nature were hard to hide.

For me, the biggest concern with recreational drug use has always been the long-term effects on the young mind. In the December 2017 edition of Scientific American is an article titled “Marijuana and the Teen Brain,” a good read that I recommend. As author Claudia Wallis points out, parents have been warning teens away from drugs for centuries, only for teens to hide in the woods and smoke. And yes, I do remember those high school students — “burnouts” we called them — who hid in the woods smoking daily behind my school.

Studies have shown that marijuana users have worsened attention, memory and learning. We know that some users can become delusional and even have psychotic breaks. What we don’t know is who will and who won’t. Some college students appear to be able to smoke often and remain fully functional, able to graduate and hold gainful employment. Whether they suffered weakened attention and memory would only be known with a pre- and post-assessment.

In states that have legalized marijuana use, there has been a 0.5 percent increase in the high school dropout rate and a 2 percent decrease in college enrollment. That’s a lot of children, when you look at the number of states that have legalized marijuana and the volume of students overall.

Evidence seems to point to safety for use in adults where the brain is not growing and changing. In a meta analysis from 2012, the authors noted that after 25 days off of the drug, the users had no difference in cognitive function versus the non users. (Schreiner et. al. 2012)

Not so much for teen brains!

Wallis notes, “For one thing, recent studies show that cannabinoids manufactured by our own nerve cells play a crucial role in wiring the brain, both prenatally and during adolescence. Throughout life they regulate appetite, sleep, emotion, memory and movement which makes sense when you consider the effects of marijuana.

“There are ‘huge changes’ in the concentration of these endocannabinoids during the teenage years, according to neurologist Yasmin Hurd of the Icahn School of Medicine at Mount Sinai, which is why she and others who study this system worry about the impact of casually dosing it with weed.” (Wallis 2017)

The body actually makes similar substances naturally all the time. There are receptors in the brain for this family of chemicals, making it a concern for us if teenagers are saturating these receptors beyond what would normally happen in nature.

Some other disturbing findings are noted in the brain scans of users versus non-users. Users have smaller amygdala and hippocampal volumes, which means weakened emotional regulation and memory function. This concern is reinforced through animal studies that have shown that rats exposed to high-dose marijuana during puberty suffered cognitive decline that was not present during adulthood.

This past October in the American Journal of Psychiatry, the authors looked at the affects of alcohol and marijuana in teenagers. They followed 3,826 7th grade students in Montreal, Canada until they completed the 11th grade. Neuro-cognitive testing was performed and analyzed using a Big Data approach. The results were surprising in that alcohol ingestion was less toxic to the brain than marijuana! Only the marijuana users had adverse effects in all cognitive domains tested, especially working memory.

What is clear to me when thinking of the brain and development, is that certain people are predisposed to poorer outcomes when exposed to an abnormal negative external stimulus. Think of concussions here: some people receive the same type of hit, and one suffers a significant concussion where another does not. We know from epigenetic studies that mammals have different responses to external stressors. I assume that this is the same with drugs of recreation like marijuana, in my observational experience.

Many young adolescents use drugs like marijuana to numb a psychological pain or current stressor. Is that persistent experiential negativity at the root of cognitive decline as well? I hypothesize that this is also correct. If you couple stress, epigenetics and drug effects together, I think we can safely say that using these drugs during puberty is not in one’s best interest.

Mitigating the stressors of adolescence is where we should focus our efforts. Provide a true support system for teens before they feel the need to partake in a drug of this nature.

I highly recommend that all teenagers read a few books:
“Extreme Ownership” by Jocko Willink (my favorite)
“Inch and Miles” by John Wooden
“Anything You Wan” by Derek Sivers
“Jonathon Livingston Seagull” by Richard Bach
“The Daily Stoic” by Ryan Holliday
If they are really bold, have them tackle “Atlas Shrugged” by Ayn Rand.

Meditation is a great place to start for stress reduction: look at the Mindfulness for Teens, Headspace or Calm websites.
Daily prayer and gratitude journals are also highly beneficial.
Consider taking your teen to a counselor for life coaching and stress reduction. Visit The Adult Chair website for lessons on parenting a teen.
Consider mission trips and local charity work to keep everything in perspective.
As always, stay in their lives and keep parenting them as long as you can,

Dr. M

Dr. Chris Magryta is a physician at Salisbury Pediatric Associates. Contact him at newsletter@salisburypediatrics.com

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