Conference Coverage

Teens smoking more pot than cigarettes


 

EXPERT ANALYSIS FROM AAP 2017

CHICAGO – The challenge of addressing marijuana use by children and teens is increasing with its wider availability; 29 states have now legalized cannabis for medical use, and 8 of them plus the District of Columbia have legalized recreational marijuana use.

“Past-month marijuana use is now higher than past-month use of cigarettes” based on teens’ responses to surveys from the National Institute on Drug Abuse (NIDA), Karen M. Wilson, MD, said at the annual meeting of the American Academy of Pediatrics.

Dr. Karen Wilson division chief of general pediatrics and vice-chair for clinical and translational research at the Icahn School of Medicine at Mount Sinai

Dr. Karen M. Wilson

An estimated 22.5% of high school seniors, 14% of sophomores, and 5.4% of 8th graders reported using marijuana within the past month, in NIDA’s Monitoring the Future Survey. Even though 68.5% of high school seniors said they didn’t approve of regular marijuana use, 68.9% replied they don’t consider it to be harmful.

Dr. Wilson emphasized the importance of discussing drug use and attitudes about drug use with young teens, as well as educating them about risks.

Recent research suggests the brain does not fully mature until the mid-20s, and marijuana has been shown to impair working memory, cognitive flexibility, learning, attention, and verbal functions. Marijuana may alter the developing brain in ways that cannot be repaired in those who halt use at an older age, said Dr. Wilson, division chief of general pediatrics and vice-chair for clinical and translational research at the Icahn School of Medicine at Mount Sinai, New York. Marijuana use becomes an addictive behavior in 9% of users, and this addictive behavior is more likely to persist in those who begin to use marijuana at a young age.

“Whether it’s alcohol or marijuana or tobacco, even if they’re only using it on the weekends,” the behavior can progress to addictive behavior, she said. Discussions should determine how much cannabis is used, how often, and why it is used.

“Kids may be self-medicating if they have depression, anxiety, or chronic pain,” Dr. Wilson said. “That could be something you could provide a more appropriate pharmacological intervention for.”

Motivational interviewing – a collaborative, person-centered form of guiding to elicit and strengthen motivation for change – can be the impetus for discussion about whether young patients can try quitting for a short time to show they can do it.

One challenge of discouraging and reducing teens’ marijuana use is the increasing diversity of products and consumption methods. From candy and baked goods to electronic “vaping” products and dissolvable strips similar to breath mints, it’s difficult to keep up. Dr. Wilson showed an image of a new product that looks exactly like a medical inhaler.

Couse of marijuana with tobacco also presents challenges since researchers have little data on how dual use may affect the ability to quit using either drug. “Joints,” rolled in paper, contain only marijuana, but a “blunt” is marijuana rolled in a tobacco leaf, and “spliffs” contain both marijuana and tobacco. Both blunts and spliffs, therefore, include nicotine which is addictive.

Other inhaled substances that can potentially damage the lungs include “lung juice,” a herbal product marketed to “clean out” the lungs. “We should encourage teens to get clean lungs by not inhaling things that aren’t good for you.”

Dr. Wilson reported having no disclosures, and no external funding was used for the presentation.

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