Pubdate: Sun, 08 Feb 2015
Source: Philadelphia Inquirer, The (PA)
Copyright: 2015 Philadelphia Newspapers Inc
Contact:  http://www.philly.com/inquirer/
Details: http://www.mapinc.org/media/340
Author: Gary A. Emmett
Note: Gary A. Emmett, director of hospital pediatrics at Thomas 
Jefferson University Hospital, wrote this for Philly.com's "healthy kids" blog.
Page: G2

MARIJUANA AND YOUTH: MUCH STILL NOT KNOWN

The American Academy of Pediatrics has issued a new policy statement 
on marijuana and its effects on adolescents and children. Sadly, the 
main theme is, "We don't know."

Among the issues the academy explores:

1) Do decriminalization and legalization lead to higher use by 
children and adolescents? In countries where the law has changed, a 
slight increase has been seen among residents, but "drug tourism" has 
confused the issue, as it has in the Netherlands over the last 25 
years. Though the Dutch did not see a great rise among their 
citizens, they saw a huge jump in outsiders, leading to disruptions 
of the peace. This influx led to the passage of more laws to 
discourage use of Dutch marijuana by outsiders. Early statistics from 
Colorado show that legalized marijuana has not been the gold mine 
everyone worried about, and sales are, if anything, far below expectations.

Before legalization, H)casual use (once a month or less) of marijuana 
among teens had fallen about 30 percent in the United States over 20 
years. But daily use rose about 25 percent, from one in 30 to one in 
24. It is not clear that legalization will make marijuana more 
available. We do know that taxation and raising the price of 
cigarettes and liquor has cut use of both among adolescents. Making 
marijuana available but costly may be useful.

Good data for most adolescents suggest that initial use of marijuana 
is not a fully pleasant experience and that frequent marijuana use is 
often linked to "learning" how to appreciate its effects as part of 
joining a "cool" subculture. Thus, cultural and subgroup approval are 
likely more important for marijuana's wider use than its availability.

2) Is marijuana safe for children and adolescents? The academy says 
smoking marijuana is never safe for anyone. The tars and other 
volatile products can cause cancer, the same way that cigarette smoke 
can. Even the percentage of THC, the primary neuroactive compound, 
varies in marijuana by up to 30 times. So it's hard to generalize.

We do know that the active products in marijuana change the 
adolescent brain with decreases in white matter and increases in gray matter.

Marijuana is also fat-soluble and can stay in the brain for days or 
weeks. So doctors worry about mothers using marijuana while pregnant 
or breast feeding, and we are very worried about the long-term use of 
marijuana in developing brains, which grow and change until the mid-20s.

3) Is marijuana ever a useful medicine for children and adolescents? 
No good, controlled studies have been done. Medicalized marijuana has 
been shown to be useful in adults for relieving nausea from 
anticancer drugs, alleviating anorexia in HIV patients, and, in rare 
cases, as an antianxiety agent. None of these uses has been tested in 
children. Also, we do not know if these neuroactive compounds are 
safe in either the short or long term.

Many parents of children with uncontrolled seizures are using 
marijuana-derived products, but the effectiveness of this has not been shown.

The AAP does recommend that marijuana be decriminalized, and 
reaffirmed its opposition to legalizing marijuana because of its 
potential harm on the developing brains of children and teens. 
Adolescents need to know about these potential dangers, and we should 
also discourage women from using marijuana during pregnancy and while 
breast-feeding.
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MAP posted-by: Jay Bergstrom