The expanding number of states legalizing marijuana for medical and/or recreational use reflects a growing acceptance of the drug in the United States as an alternative therapy for specific medical conditions as well as a perceived legitimate drug for recreational use more akin to alcohol or cigarettes than heroin or cocaine. To date, 23 states and Washington, DC, have legalized marijuana for medical use, and 4 states and Washington, DC, for recreational use. As such, marijuana is increasingly being seen as a safe drug (albeit similar to the way alcohol and cigarettes are perceived), and legitimate access to it is growing.
However, is it safe? Also, what are the ramifications of easier access? Answers to these questions remain important as more states consider legalization, and evidence mounts on the pros and cons of marijuana use, especially for medicinal use.
Of particular interest is understanding and recognizing the effect of both short-term and long-term marijuana use in young persons as marijuana use among adolescents has increased over the years. Data show that 5.4 million persons aged 12 years or older used marijuana every or nearly every day during 2012 compared with 3.1 million persons during 2006.1 In addition, a Monitoring the Future survey funded by the National Institute on Drug Abuse (NIDA) in 2013 found that among 8th, 10th, and 12th graders, 12.7%, 29.8%, and 36.4%, respectively, had used marijuana at least once in 2012, and 7%, 18%, and 22.7%, respectively, had used marijuana in the last month.2
These increased numbers run parallel to, and appear to reflect, the diminishing perception over time of the risks of marijuana use, with the survey data showing a perceived risk among 12th graders at a nearly historic low of 36%, with 21% using marijuana in the past month.2 Undoubtedly, legalization is contributing to this increased use of marijuana in adolescents as well as the diminishing perception of its harms.
Despite the changing perception of the diminishing risks of marijuana, however, data still show that this drug is anything but benign and, in young minds in particular, still poses a danger that warrants clear education on its use. As such, the American Academy of Pediatrics (AAP) recently published a policy statement3 and technical report4 in which it opposes legalization of marijuana and supports further study to better define the best ways to reduce marijuana use among adolescents.
Given the increased number of adolescents using marijuana, along with the increased perception of its safety and easier access through state legalization, it is critical that parents and adolescents receive guidance on what the evidence on marijuana use actually shows. Pediatricians play an important role in providing this guidance.
At the recent AAP National Conference and Exhibition in Washington, DC, Miriam A. Schizer, MD, MPH, staff physician in the Adolescent Substance Abuse Program, Division of Developmental Medicine, Boston Children's Hospital, and instructor of Pediatrics at Harvard Medical School, Boston, Massachusetts, spoke on what pediatricians need to know when counseling teenagers and families about marijuana.
This article provides a summary of Schizer’s presentation, highlighting the misperceptions among adolescents and their parents about marijuana, particularly in the current climate of legalization for medical and/or recreational use in many states in which marijuana may increasingly be seen as a benign substance. Schizer provides data countering that perception and details the many adverse effects of marijuana, particularly on the adolescent brain. Finally, she provides resources for pediatricians to help educate themselves and their patients on both marijuana use and treatment options for marijuana use.