Study just published on problems related to frequent cannabis use in adolescence

[shoo-bop]

Woke this morning to notice a lot of media coverage on a study just published regarding harms related to heavy adolescent cannabis use. Rather than link to any specific news story (which usually distort or over-simplify the science), I thought I'd go straight to the source and post the link to the study report itself:

http://download.thelancet.com/pdfs/journals/lanpsy/PIIS2215036614703074.pdf?id=eaagBvdXl4F57e0EoTCHu

moderators: please move to drug studies or cannabis discussion if you think either of those are a more appropriate location.

 

[neversickanymore]

I agree that adolescents would be best advised not to use cannabis until later in life.

With drugs and negative outcomes I always feel as if the relationship is never clear. Were the drugs the root of the problem or just a failed attempt at solving a deeper problem. Many people with mental health issues or who have hard lives often turn to drugs to try and feal better, so i often wonder are drugs the cause of there troubles or was it something else.

In a survey of high school students, the National Youth Violence Prevention Resource Center found that almost 1 in 5 teens had thought about suicide, about 1 in 6 teens had made plans for suicide, and more than 1 in 12 teens had attempted suicide in the last year.

http://www.teendepression.org/related/teen-suicide-statistics/

So eight percent of the general population of kids attempts to commit suicide. I think for this study to actually mean anything they would have to consider all these factors in to show if the grass had anything to do with it or if its motivation came from somewhere else. People use drugs because they are unhappy. People kill themselves because they are unhappy. This does not mean that people killed themselves because of the drugs. In order to determine the cause and what part if any marijuana played in it common factors that attribute to suicide would need to be taken into account. Sure we see a link, but what exactly is the link. could it just be that suffering people often take drugs and that suffering people also sometimes take there own lives?

Several factors increase the risk that a teenager will attempt suicide:

Depression or feelings of loneliness or helplessness
Alcohol or drug addiction
A family history of abuse, suicide, or violence
Previous suicide attempts; almost half of teens who commit suicide had attempted suicide previously.
A recent loss such as a death, break-up, or parents’ divorce Illness or disability
Stress over school, relationships, performance expectations, etc.
Fear of ridicule for getting help for problems
Being bullied or being a bully
Exposure to other teens committing suicide, such as at school or in the media
Access to firearms or other lethal objects
A belief that suicide is noble

http://www.teendepression.org/related/teen-suicide-statistics/

I don't know how many daily teen smokers I new, but it really was quite a few. And only two of them ever tried to commit suicide and there reasons had nothing to do with their use.

About 11 percent of adolescents have a depressive disorder by age 18 according to the National Comorbidity Survey-Adolescent Supplement (NCS-A). Girls are more likely than boys to experience depression

.http://www.nimh.nih.gov/health/publications/depression-in-children-and-adolescents/index.shtml

So the grass smokers seem to have about the same rates of depression as the population as a whole, but any real use correlates to a slight increase in depression percentages. With only 14% of daily smokers reporting depression. I guess im pretty unmoved by this data.


I find it interesting that alcohol use was not explored as part of this.. good lord knows it could not have had any effects.. just illicit drugs right??

This study shows links, but what exactly is linked here. I think there are so many things that come into play im not sure if this tells us much with so many areas unkown.

Results:
The paper examines the ways in which the study has been able to examine a wide range of issues. Key issues examined include: (i) measurement of disorder (respondent effects; dimensionality; scales vs categories); (ii) prevalence and treatment of disorder; (iii) stability and continuity of disorders; (iv) the contribution of risk and aetiological factors (e.g. lead exposure, parental divorce, child abuse, family adversity, sexual orientation) to psychosocial adjustment; and (v) the psychosocial consequences of mental health problems in adolescence.

The Christchurch Health and Development Study: review of findings on child and adolescent mental health.

Given that the data is there it would be beneficial if someone looked at other data from these cannabis users lives to try and determine what part the cannabis actually played.

The data pertaining to levels of grass smoking and obtaining a degree seem pretty strong. I do know many people who did get degrees, but I know more who didn't make it or try. I wonder what the data looks like for people who smoked in teen years, but then quit after HS and went for a degree?

 

[shoo-bop]

In this case, they did actually try to statistically control for the effects of other things (e.g. depression in early adolescence, school problems in high school, other substance use in adolescence, parents' issues, etc.) to try to isolate the part of the association with cannabis that wasn't simply due to other things that correlated with both. They give an account of their whole approach in the appendices, including the variables they tried to control for (in "table 4.1"):

http://download.thelancet.com/mmcs/...36614703074/mmc1.pdf?id=iaatXzJv8muBTgXDZCDHu

It's not perfect (particularly the measures they used of other substance use, which I agree needs examination - i.e. only one of he three studies they drew on used what I'd consider a satisfactory measure of early adolescent alcohol consumption for this purpose), and it's still obviously correlational, but the fact that they did try various ways of controlling for many of the obvious factors that could influence both cannabis use and the outcomes they tested does strengthen their conclusion somewhat.

 

[neversickanymore]

Depression and welfare dependence were not significantly associated with adolescent cannabis use after adjustment. This finding is consistent with previous reviews, which concluded that the effect of cannabis use on these psychosocial outcomes could plausibly be explained by potential confounding factors that had not been adequately controlled for in studies to date.

From the discussion

The suicide attempt rate of daily smokers is 4%. this is pretty much in line with non and once in a blue moon smokers while the people who smoke rarely and moderately jumps significantly. What conclusions do we come to from that data? Your fine if you abstain or if your lit all day long, but no moderation?

Cannabis addiction rates go up with more intense use, or is it more intense use goes up with cannabis addiction. No matter that seems like no brainer. But there is the significant difference between eventual addiction rates later in life which seems significant.

So we have the results of cannabis use in teens showing no correlation to welfare and depression. We have a no brainer showing that addicts smoke more. We have an interesting suicide outcome that shows abstinence and heavy smoking have relatively the same incidence of suicide while occasional and moderate are doubled. All produced by a study that we already pointed mostly failed to include alcohol use.

Alcohol consumption has been found to be associated with suicide attempts that are both planned and impulsive (Conner
et al. 2006). In an impulsive situation alcohol may precipitate an attempt; during planned attempts it may be used to
facilitate it. Case-crossover studies have found that there is an association between drinking alcohol and subsequent
suicide and that this is most pronounced during the first hour after drinking (Borges et al. 2004). The dis-inhibiting features
of alcohol may compel individuals to progress from suicide ideation to a suicide attempt. In addition impaired judgment
and problem-solving abilities and alcohol-associated depression may make suicide seem like a valid solution to their
problems for intoxicated individuals who are experiencing underlying suicide risk factors. Autopsy studies have produced
varying results due to methodological and geographical differences. A review of research by Cherpitel et al. (2004) found
on average 37% of suicides involved acute alcohol use, although the range was 10% to 69%.

The review found a range of 10% to 73% of suicide attempts involved acute alcohol use, with an average of 40%.
It has also been hypothesised that small amounts of alcohol may serve to decrease anxiety and distress and perhaps
reduce suicide attempts. Fidalgo et al. (2009) found some evidence for self-medication with alcohol to have this effect
however further research is needed as the risks of alcohol consumption outweigh the possible benefits.

Factors which Increase Suicide Risk among
those with Alcohol Disorders

Mental illness is a substantial risk factor for suicidality thus the co-morbidity of an alcohol disorder with another mental
disorder confers significant risk. Alcohol abuse regularly occurs alongside other mental disorders. Of the people who
report that they drink every day, more than one in five (21%) have a 12-month mental disorder (ABS 2008). Depression
is frequently diagnosed among people who abuse alcohol (Murphy 2000), with studies showing that those who are
depressed are more likely to consume alcohol (Lamis et al. 2010) and those who consume alcohol are more likely to
be depressed (Fidalgo et al. 2009). Such co-morbid conditions increase the likelihood of relapse for alcohol abuse and
higher numbers of disorders are associated with greater impairment and a higher risk of suicidality (ABS 2008).

The relationships between depression, alcohol and suicide are not clear, yet they all share some common intervening
variables (Frances et al. 1987). Yaldizli et al. (2010) found that among those who abused alcohol and were depressed,
hopelessness, delusions and hallucinations were the most common predictors of a suicide attempt. Furthermore
Conner et al. (2003a) reported that people who abused alcohol and who died by suicide were more likely to have major
depression or bipolar disorder, be male, older and have interpersonal relationship problems than people who abused
alcohol but did not attempt suicide. In addition, personal loss or threat of loss (Murphy 2000), anti-social personality
disorder (Conner et al. 2003b), prior history of suicide attempts and aggression (Buri et al. 2009), low education,
unstable work environments, family history of suicide (Giupponi et al.
2010) and impulsivity (Hufford 2001) have all been linked to suicide among
individuals with an alcohol disorder.

A previous suicide attempt is a major risk factor for subsequent suicidality; a risk
that is elevated in people with an alcohol disorder due to their particularly high
rate of repetition of attempts. Hawton et al. (1997) found that 53% of those with
an alcohol disorder who attempted suicide had a history of previous attempts,
compared to 29% of those who attempted suicide but did not have an alcohol
disorder. Furthermore, the risk of subsequent attempts within 12 months was
17% and 11% respectively. Previous attempts and risk of subsequent attempts
were even higher for people who abused other substances.

http://suicidepreventionaust.org/wp...Alcohol-Drugs-and-Suicide-Prevention-2011.pdf

For people aged 18 years and under:

The risks of accidents, injuries, violence and self-harm are high among drinkers
aged under18 years (Chikritzhs et al 2003; Stephens 2006; Miller et al 2007).

• Risk-taking behaviour (Miller et al 2007), unsafe sex choices (Coleman & Cater
2005), sexual coercion (Abbey et al 2003a; Davis et al 2006) and alcohol
overdose (Cheng et al 2006) increase when adolescents drink alcohol.

• Initiation of alcohol use at a young age may increase the likelihood of negative
physical and mental health conditions, social problems and alcohol dependence
(Hemmingsson & Lundberg 2001; Hingson et al 2003; Guilamo-Ramos et al
2004; Toumbourou et al 2004; Wells et al 2004; Jefferis et al 2005).

• Regular drinking in adolescence is an important risk factor for the development of
dependent and risky patterns of use in young adulthood (Bonomo et al 2001;
Australian Institute of Family Studies 2004; Wells et al 2004; Hingson et al 2003;
Hingson et al 2006; Toumbourou et al 2004; Warner et al 2007; Pitkanen et al
2005).

• Childhood and adolescence are critical times for brain development and the brain
is more sensitive to alcohol-induced damage during these times, while being less
sensitive to cues that moderate alcohol intake (Kelly & Witkiewicz 2003; Brown &
Tapert 2004; White & Schwartzwelder 2004; De Bellis et al 2005.

• Self-reported harm scores show that drinkers under the age of 15 years are much
more likely than older drinkers to experience risky or antisocial behaviour
connected with their drinking, with the rates also somewhat elevated among
drinkers aged 15−17 years

National Binge Drinking Campaign
Backgrounder: Young Australians and Alcohol

In comparison, OLS provides conservative estimates of the causal impact
of heavy drinking on dropping out, implying that binge or frequent drinking among 15 16 year old
students lowers the probability of having graduated or being enrolled in high school four years later
by at least 11 percent.

The OLS results imply that past month binge and frequent drinking at age 15–16 bring
about 11–13 percent declines in the likelihood of still being enrolled in or having completed high
school four years later

ADOLESCENT DRINKING AND HIGH SCHOOL DROPOUT

You also have over a 14 percent of these kids useing illicit drugs other than cannabis. How did they adjust for that?

I found it interesting that almost a quarter (23%) of the daily smokers who could have attended UNI ended up with degrees. I wonder how many of them attempted?

This study is sketchy realy.

My conclusions from this study.

With over 33% of Aussie adolescents smoking pot to some degree and over 15% smoking monthly I'm not sure why they are worried about negative effects of legalizing it as it seems to be readily available and in significant use. Once again prohibition seems not to be prohibiting anything.

With 15% of your teenagers useing other illicit drugs I'm not sure your focusing in the right thing here.

With alcohol seeming so commonplace and accepted that it was not even taken into consideration I know your focused in the wrong place.

Its harder to finish UNI if your baked all day and impossible if you cant hack high school

Waiting until your brain has developed is a good idea to avoid addiction.

 

[Screaming_Skull]

I started in HS, first time I smoked I was 13 though I didn't smoke everyday(unless it was summertime) until I was 17 though. Before weed I was drinking everynight by myself(first time I got drunk I was twelve). I really don't think I was deppressed in HS..or maybe I was? I mostly just drinked and popped some benzo's outta bordeom..then started smoking ALL the time for about a year and left the booze behind senior year. It wasn't until I was 19 that I got REALLY deppressed, I had dabbled in opiates a little bit, but I must say that I think opiates saved me from being a suicidal/deppressed person, why I got addicted. I noticed a pattern where the periods I wasn't using opiates I would be very isolated/deppressed/didn't care about anything, and with them I would be doing okay with everything except in the money department.