Pubdate: Fri, 02 Sep 2016
Source: Los Angeles Times (CA)
Column: California Journal
Copyright: 2016 Los Angeles Times
Contact:  http://www.latimes.com/
Details: http://www.mapinc.org/media/248
Author: Robin Abcarian

CANNABIS NOT ALWAYS A BENIGN BUD

As Voters Ponder Prop. 64, Experts Cite the Effects Pot Can Have on 
Young Users.

SAN JUAN CAPISTRANO - Devan Fuentes made it all the way through San 
Clemente High School without drinking or using drugs. He vividly 
remembers the first time he smoked pot. He was visiting a friend at 
Occidental College, and decided the moment had come.

"They brought out a giant three-foot bong," Fuentes told me the other 
day in a rustic coffee shop tucked into this town's historic Los Rios 
neighborhood. "I heard a lot of people don't get high their first 
time, so I held it in for a long time, one large hit. Immediately, I 
couldn't feel my legs."

This was not an entirely unpleasant sensation for Fuentes, 23, who 
described his younger self as quiet, prone to depression and even 
"sort of an outcast."

Pot made him feel more extroverted.

"And that," he said, "kind of opened the door."

Hoping to launch a music career, he moved with friends to Oakland in 
the summer of 2012.

"But my focus wasn't on music and meeting people," he said. "It was 
on making enough money to get by, and smoking." He worked at a 
Starbucks and a Japanese restaurant. He got to know the local 
cannabis dispensaries, where, eventually, he was spending between 
$120 and $160 each week.

In March 2013, less than a year after moving north, he crashed.

He vividly remembers the moment he was in full-blown psychosis: "I 
was thinking so hard, my mind started traveling so fast, until I 
experienced a big, bright light flashing in front of my eyes, like 
being shot from the base of the Earth into the universe, to outer 
space, and then coming to a final epiphany. And then I am back inside 
my body, and I start running around my room to find pieces of paper 
to write on."

Terrified, he called 911. "I feel schizophrenic," he told the 
dispatcher. "I am afraid I am going to hurt myself."

Could pot have triggered Fuentes' psychosis? Or could it have 
exacerbated an underlying predisposition to mental illness?

As Californians ponder whether to vote for Proposition 64, the 
November ballot initiative that would legalize marijuana for adult 
use, it's important to own up to the fact that marijuana is not 
always the benign bud that many advocates would have us believe, 
particularly for teens and young adults, whose brains are still developing.

Proposition 64 proposes safeguards against sales to those under 21, 
but the minimum age for obtaining a doctor's recommendation for 
medical marijuana is 18, and that will not change with legalization. 
Opponents say delivery services such as Eaze, which have sprouted all 
over the state, will make it easy for minors to skirt the law.

And yet, in states such as Colorado, where recreational marijuana was 
legalized in 2012, there does not appear to have been a spike in teen 
use. A 2015 survey by the Colorado Department of Public Health found 
that 21.2% of Colorado high school students reported using marijuana 
the previous month, a rate slightly below the national average of 
21.7%. (There are some reports that show higher use.)

Still, apart from some very specific medical uses for conditions such 
as childhood epilepsy, kids have no business using pot, especially 
today's stuff, which is way more potent than it used to be.

"We have a child/adolescent unit that treats kids to age 17, and an 
adult unit for 18 and older, and we see young people in both age 
groups who come to the emergency room with florid symptoms of 
psychosis that appear to be associated with heavy use of marijuana," 
said Tom Strouse, medical director of UCLA's Resnick Neuropsychiatric 
Hospital. "Sometimes they have a known, preexisting illness, but many do not."

Marijuana, he said, can cause psychosis. For some, it will be 
fleeting. But for those with a genetic or biological risk for a 
chronic illness such as schizophrenia, Strouse said, "heavy marijuana 
use may hasten or intensify the manifestation, and lead to a worse 
course than if you never used marijuana at all."

Strouse's colleague, Mark De Antonio, director of Resnick's Inpatient 
Child and Adolescent Psychiatric Service, often sees young patients 
who are having what he called "a brief psychotic reaction" to pot.

"They are intoxicated, and may be hallucinating," De Antonio said. 
"They become anxious, and incredibly confused. It's not 
life-threatening. We don't see that many kids that require 
hospitalization just because they are stoned out of their minds."

Still, both De Antonio and Strouse, who has no problem with his 
cancer patients using marijuana for nerve pain, said they worry about 
the toll that pot takes on developing brains.

"It's clear that acute intoxication impairs learning and memory, and 
if you are stoned every day as a high school student, you will be 
less good as a student," said Strouse.

"The conservative, safe answer is that kids should avoid marijuana," 
said De Antonio. "The realistic answer is probably that intermittent 
use of marijuana - and I mean intermittent, like monthly - is not 
going to be harmful. But if you 'wake and bake' - use it when you 
wake up and all day till you go to sleep - I don't think good things 
come from that."

After his psychotic break, Fuentes ended up hospitalized for nearly two weeks.

Before that, he said, he'd been smoking pot constantly and drinking 
as much as a whole pot of coffee a day. He had also experimented with 
salvia, a psychoactive plant, and magic mushrooms.

There had been warning signs; for a couple of months, he said, he'd 
been having what he described as "pre-psychotic symptoms," which 
included delusions, manic behavior and disassociation. He was 
diagnosed with schizoaffective disorder, and he has been slowly 
tapering off mood-stabilizing medication.

Now sober for about two years, he's decided to talk about his 
experience, to destigmatize mental illness but also to help others 
understand the role that psychoactive drugs may have played in his 
deterioration.

He does not entirely blame cannabis for his psychosis. But, he said, 
"pot definitely played a part."

As we face the possibility of plunging headlong into the brave new 
world of recreational marijuana, we have to be certain that the 
barriers to teen and adolescent use will be high, no pun intended.

In the next few weeks, I'll be taking a close look at how the Adult 
Use of Marijuana Act proposes - paradoxically - to make it harder for 
kids to get their hands on pot, while making it easier for everyone else.
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MAP posted-by: Jay Bergstrom