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. - --- MAP posted-by: Jay Bergstrom