Marijuana

We have a big problem. Too many people think marijuana is harmless, and if we don’t counter that misperception with accurate information, we’ll have major public health costs to pay.

It doesn’t matter how you feel about the debate to legalize marijuana. It doesn’t matter if it’s used for medical or recreational purposes. The reality is that marijuana — like alcohol, opioid's and stimulants — alters the mind and is potentially addictive. Legalization efforts nationwide have given rise to a myth that marijuana is benign. But make no mistake — while research reveals some medical benefits of marijuana, there is ample research showing that it causes problems with brain function and is addictive for about 8% to 10% of the population. As today’s high-potency marijuana and new methods of using the drug, such as vaping, are studied further, the harms will only become clearer.

Too often, marijuana’s addiction potential is minimized or ignored altogether. We were told recently about a patient at a large, well-known hospital. The patient reportedly disclosed previous struggles with addiction and a desire to remain sober. Yet three physicians suggested he be treated for his current malady with medical marijuana. Tales like this are all too common.

A recent Emerging Drug Trends report published by our organization and the University of Maryland School of Public Health says marijuana is not a solution to the current opioid crisis, even though some have attempted to make that case. To the contrary, the report highlights strong research showing marijuana use increases the risk for later prescription opioid misuse.

Addiction, like many other diseases, has both environmental and genetic risk factors, and marijuana needs to be viewed in that context. The main risk factor for addiction, accounting for more than half the risk, is in our genes. If you have the disease in your family, especially the immediate family, you are more likely to develop addiction to marijuana and other substances. For people with a family history of addiction, marijuana may be all it takes to trip the risk for addiction. If it’s one of your parents with the addiction history, you are at least six times as likely as those without addiction in the family to develop the disease. If you have limited genetic risk, significant environmental factors (such as trauma) may be required to tip the balance toward addiction, leaving many people at risk.

Research on regular use of marijuana has shown that certain brain regions are vulnerable and at risk for impairment. One of the primary findings has been an association between frequent use of marijuana during adolescence and into adulthood, with declines in IQ scores. There is also clear evidence of impaired cognitive function during marijuana use and for several days following use, which undermines the ability to learn. School performance suffers when marijuana is used regularly, and regular users are more likely to drop out. The research is suggestive of possible long-term cognitive impairment as well, though additional research is needed.

Several studies show a link between marijuana use and psychosis, especially for those with a family history of psychosis. We see marijuana-induced psychosis in our treatment centers too. Marijuana use can also worsen the symptoms of those with schizophrenia. In addition, we know marijuana use impairs driving capabilities.

Now, more than ever, it is incumbent upon all of us — especially medical and behavioral health professionals — to speak up and tell the entire story in an effort to prevent the risks of expanded marijuana use from turning into regrettable realities.

Marvin D. Seppala, M.D., is the chief medical officer of the Hazelden Betty Ford Foundation, and Michael Mahoney, MSCP, LPC, CADC, is Hazelden Betty Ford’s director of Chicago services.