Regular Marijuana Use in Teens on the Rise

Deborah Brauser

December 18, 2013

The majority of teens in the United States who view regular marijuana use as harmful has dropped dramatically in the past decade, and their use of the drug has increased, a phenomenon that experts attribute to its legalization in several states.

The results of this year's Monitoring the Future (MTF) survey, which measures drug use and attitudes among the nation's 8th, 10th, and 12th graders, show that regular marijuana use continues to grow in all age groups, with 6.5% of 12th graders and 4% of 10th graders reporting smoking it daily. In addition, 60.5% of 12th graders did not view its use as harmful, which is the highest rate found in the last 2 decades.

Presenting the findings at a press conference today, Nora Volkow, MD, director of the National Institute on Drug Abuse (NIDA), told Medscape Medical News that healthcare providers have a significant role to play in drug use prevention.

"Screening for use and asking about potential use or if they're receiving a prescription for [cannabis] for medical purposes is very important," she said.

Gil Kerlikowske, director of the White House Office of National Drug Control Policy (ONDCP), added that the MTF findings are especially alarming in light of recent marijuana legislation.

"For some to say that marijuana is less dangerous than other substances is a ridiculous statement," he said.

Good News, Bad News

Kerlikowske added that although this year's survey contains some good news, including a drop in teen binge drinking, it also highlights some serious challenges.

Dr. Nora Volkow

"President Obama has outlined his vision of…a nation where an educated, skilled workforce has the knowledge, energy, and expertise to compete in a global marketplace. Yet, for too many Americans, that vision is limited by drug use," he said.

The survey included 41,675 students from 389 private and public schools across the United States who filled out anonymous questionnaires in their classrooms.

Dr. Volkow reported that overall abuse of stimulants by teens grew this year, with teens using the drugs not just to "get high" but because they thought it would help them to improve test scores. In fact, 7.4% of the 12th graders reported using dextroamphetamine/amphetamine (Adderall, Teva Pharmaceuticals USA), a stimulant commonly prescribed for the treatment of attention- deficit/hyperactivity disorder (ADHD), for nonmedical reasons.

But both Dr. Volkow and Kerlikowske were even more emphatic with their disappointment in the increase in teen marijuana use.

"Science clearly demonstrates that marijuana is not a benign substance," said Kerlikowske.

Dr. Volkow added that the teen brain is still developing and that cannabinoid receptors are intimately involved in the connectivity of the brain. Interference in this process through marijuana use can lead to problems in memory and in learning.

"We also know from epidemiological studies that the earlier that you start using a drug, the greater the risk of addiction," she said.

In addition, she noted that the increased rate of daily use by 12th graders from 2.4% in 1993 to 6.5% in 2013 is troubling.

"It is important to remember that over the past 2 decades, levels of THC [tetrahydrocannabinol] ― the main psychoactive ingredient in marijuana ― have gone up a great deal, from 3.75% in 1995 to an average of 15% in today's marijuana cigarettes," said Dr. Volkow in a release.

Access to Medical Marijuana

Interestingly, 34% of the 12th graders who used marijuana and lived in states with medical marijuana laws reported that they obtained the drug through someone else's prescription ― and 6% said they had their own prescription.

"Today…there is evidence suggesting that regulation schemes that have been promoted by the marijuana legalization lobby are not succeeding in preventing the diversion of marijuana into the hands of young people, as was promised to the voters," said Kerlikowske.

Gil Kerlikowske

"But we're not powerless against this challenge. Education is our most powerful tool. Put simply, prevention saves lives, and it cuts costs."

Results also showed that more than 12% of the 8th graders surveyed reported using marijuana in the previous 12 months, and 21.4% of 12th graders smoked tobacco with a hookah, as compared with 18.3% in 2012.

However, the report also showed that the percentage of students in all 3 grades who reported past-month cigarette smoking dropped below 10% for the first time ever. Daily smoking dipped to 8.5% for 12th graders, 4.4% for 10th graders, and 4.4% for 8th graders.

Use of synthetic marijuana dropped from 11.3% last year to 7.9% this year. "This is very good news and reflects that attention from the media on the adverse consequences of synthetic marijuana may have changed attitudes about it," said Dr. Volkow during today's press conference.

Other positive survey results include the following:

  • Binge drinking dropped to the lowest level ever surveyed, including a decrease from 15.6% of 10th graders last year to 13.7% this year.

  • Inhalant use by all 3 grades decreased.

  • Use of the pain reliever hydrocodone/acetaminophen (Vicodin, Abbott Laboratories) by 12th graders declined from 7.5% in 2012 to 5.3% in 2013.

  • Use of the herb salvia by 12th graders declined from 5.9% in 2011 to 3.4% in 2013.

  • Use of so-called "bath salts" decreased to less than 1% for all 3 grades surveyed, and knowledge of its adverse risks increased.

"Each year, our questionnaires have gotten longer as the number of drugs we ask about grows and very few, such as PCP [phencyclidine], leave the scene," said MTF's principal investigator Lloyd Johnson, MD, during the presentation.

The key take-home message for clinicians, said Dr. Volkow, is to ask their patients about potential drug use, including marijuana.

"That's something that the healthcare system has not been paying too much attention to. It's also important to know how marijuana interacts with other medications. There are some questions for which we have very little information because we're facing a new change in policy," she said.

The complete report is available online at MTF's Web site.

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