Does legalizing marijuana for adults lead to a tidal wave of teens going to treatment? Not according to a new study out of Temple University, where researchers in fact found decreases in youth admission rates for problem cannabis use in two legal states.
The findings, published this month in the journal Drug and Alcohol Dependence, run counter to speculation from legalization opponents, law enforcement and some public health experts, who have warned that relaxing cannabis laws could lead to an explosion in cannabis use disorders among children. If that’s happening, the study found, treatment admissions data so far show no sign of it.
Examining data from publicly funded substance use treatment facilities, researchers from Temple’s geography and urban studies department, found that youth treatment admissions rates for cannabis use disorder fell sharply between 2008 and 2017, nationally as well as in Colorado and Washington State, which both passed legalization laws in 2012.
“Our results indicate that [recreational marijuana legalization] in Colorado and Washington was not associated with an increase in treatment admissions,” the study concluded. “Rather, we observe a substantial decline in admissions rates across US states, with evidence suggesting a greater decline in Colorado/Washington following RML as compared to non-RML states, though this difference was not significant.”
Co-author Jeremy Mennis, a Temple professor, told Marijuana Moment that the “national decline is pretty dramatic,” noting that on average, youth admissions rates for marijuana fell by nearly half.
“It declined more in Colorado and Washington, but the difference between them and other states was not statistically significant,” he said.
In other words, at least so far, legalization doesn’t seem to have made a particularly big impact on youth admissions rates one way or the other.
“Adolescent treatment admissions for marijuana use did not increase in Colorado and Washington following [recreational marijuana legalization].”
“The admissions rate is initially higher in Colorado/Washington at the beginning of the study period,” Mennis and co-author Gerald Stahler wrote, “but declines more rapidly following [legalization] as compared to the other states.”
As the study notes, if legalizing cannabis for adults were to increase the prevalence of cannabis use disorder among youth, “one potential consequence would be an increased need for treatment.” But that increased need hasn’t been reflected in actual admissions rates.
Still, the researchers are quick to caution that a drop in treatment admissions doesn’t necessarily mean a decrease in problem marijuana use.
“We’re not sure whether cannabis use disorder is declining or just treatment admissions are declining” for some other reason, Mennis said.
Youth cannabis consumption in the U.S. “has not substantially increased over the last 10 years,” he said, but it’s not drastically fallen, either. Yet since about 2011, treatment admissions have steadily declined.
Why the drop in admissions rates? “I don’t know why,” Mennis acknowledged. “This is speculative on my part.”
One possibility is that changing attitudes toward the potential dangers of marijuana have shifted in recent years, making individuals and their loved ones less likely to seek treatment.
“The perception that using marijuana is harmful has declined across the U.S. among youth and adults,” Mennis said, “and this may affect how people view whether their marijuana use is problematic or requires treatment.”
If fewer parents see cannabis as a harmful drug, for example, “they’re probably a lot less likely to see the use of marijuana among their kids as warranting treatment,” he said. “That’s a possibility.”
Reduced stigma around cannabis generally could also be playing a role, he said, with parents perhaps less likely to refer their kids to treatment for simply experimenting with the drug absent other problems connected to such use.
Perhaps the worst-case scenario, the paper says, is that the need for treatment still exists but somehow isn’t being met:
“If [cannabis use disorder] remained stable following [recreational marijuana legalization], or increased, as recent research indicates, the dramatic decline in adolescent treatment admissions we observe in states enacting [recreational marijuana legalization] would suggest an increase in unmet need for treatment, i.e. it may be the case that admissions rates are falling because an increasing proportion of adolescents with CUD are not entering treatment.”
“Cannabis use disorder is a thing, and I think a lot of people are resistant to the idea that it can be a thing. The question is whether cannabis use disorder is actually decreasing,” Mennis said. “If cannabis use is staying the same, then there’s a bigger and bigger gap.”
Studies on cannabis use disorder have arrived at mixed conclusions about whether it’s becoming more or less common as legalization spreads to more states. A study published last year found that, contrary to the expectations of some health experts, the prevalence of cannabis use disorder among frequent cannabis users has actually decreased in recent decades.
Cannabis use disorder “decreased significantly across all ages reporting daily/almost daily cannabis use between 2002-2016,” that study found. “Cannabis dependence prevalence decreased for adolescents and young adults and was stable only among adults ages 26+ reporting daily/almost daily cannabis use.”
Photo courtesy of Martin Alonso
Military Invests $27M To Develop New Class Of Psychedelics-Inspired Drugs
The successful use of controlled substances such as ketamine and psilocybin mushrooms to treat mental health issues like depression and anxiety has ushered in a new era of interest in psychedelic drugs. But for researchers and clinicians eager to expand such therapies, an obvious question remains: Does treatment with psychedelics necessarily require a psychedelic experience?
An international research team hopes to answer that question by researching and developing a new class of drugs that offers the same fast-acting mental health benefits as traditional psychedelics without the disorienting, sometimes uncomfortable effects of a full-blown trip. Funded by $26.9 million from the U.S. Department of Defense’s Defense Advanced Research Projects Agency (DARPA), a new project announced this month “aims to create new medications to effectively and rapidly treat depression, anxiety, and substance abuse without major side effects,” according to a University of North Carolina (UNC) School of Medicine press release.
“Although drugs like ketamine and potentially psilocybin have rapid antidepressant actions, their hallucinogenic, addictive, and disorienting side effects make their clinical use limited,” said Bryan L. Roth, a professor of pharmacology at UNC School of Medicine and the research project’s leader. “Our team has developed innovative methods and technologies to overcome these limitations with the goal of creating better medications to treat these neuropsychiatric conditions.”
Research into the possible therapeutic effects of currently illicit drugs such as ketamine, psilocybin, MDMA and others has expanded tremendously during the past decade. Nonprofit groups such as the Multidisciplinary Association for Psychedelic Studies have led the way, with university researchers and drugmakers entering the mix more recently.
In September of last year, Johns Hopkins University announced the launch of the nation’s first-ever psychedelic research center, a $17-million project to study the use of psychedelics to treat conditions such as opioid use disorder, Alzheimer’s disease, depression, anxiety and post-traumatic stress disorder (PTSD).
Government interest in psychedelic drugs has also grown. Also in September, DARPA, a federal agency that exists to support the development of emerging technologies for use by the U.S. military, announced its Focused Pharma program, meant to develop drugs “that work quickly and deliver lasting remedies for conditions such as chronic depression and post-traumatic stress.”
While that DARPA announcement didn’t mention specific substances or even use the word “psychedelics,” it referred to “certain Schedule 1 controlled drugs that engage serotonin receptors” and that have “significant side effects, including hallucination.”
The press release for the new DARPA-funded project, lead by Roth at UNC, mentions ketamine and psilocybin specifically. The team will use both biological modeling and sophisticated computational approaches in an effort to design fast-acting drugs inspired by psychedelics but free from what researchers call “disabling side effects.”
“Depression, anxiety, and substance abuse affect large segments of the population,” Roth said. “Rapidly acting drugs with antidepressant, anti-anxiety, and anti-addictive potential devoid of disabling side effects do not exist, not even as experimental compounds for use in animals. Creating such compounds would change the way we treat millions of people around the world suffering from these serious and life-threatening conditions.”
At DARPA, Dr. Tristan McClure-Begley, Focused Pharma’s program manager, said last fall that the agency’s interest in developing such drugs is due to the country’s large number of veterans with PTSD and other mental health conditions.
“It is research we need to undertake given the scale of the mental health crisis our veterans face,” he said in September, “and if it works, the payoff is a completely new, safe, and effective therapeutic option that transforms complex and previously intractable mental conditions into something more acutely treatable.”
Along with Roth at UNC Chapel Hill, the newly announced research project includes members Georgios Skiniotis and Ron Dror of Stanford University, Jian Jin of Icahn School of Medicine at Mt. Sinai, Brian Shoichet and Nevan Krogan of University of California at San Francisco and William Wetsel of Duke University.
Photo courtesy of Wikimedia/Workman
Do Highly Potent Marijuana Concentrates Get Users More High? Not Exactly, Study Finds
High-potency marijuana concentrates on today’s legal markets can contain upwards of 90 percent THC, so one might reasonably expect them to pack a greater psychoactive punch than typical flower, which tops out around 30 percent.
But that may not be the case, according to a new study out of the University of Colorado at Boulder.
Researchers found that while THC blood levels spiked after users consumed concentrates, impairment levels didn’t significantly differ from participants who used flower.
“Surprisingly, we found that potency did not track with intoxication levels,” said lead author Cinnamon Bidwell, an assistant professor in CU’s Institute of Cognitive Science. “While we saw striking differences in blood levels between the two groups, they were similarly impaired.”
The study, published Wednesday in JAMA Psychiatry, involved 121 Colorado adults who were regular marijuana consumers. Participants were randomly assigned to consume either relatively low-THC marijuana flower, which ranged from 16-24 percent THC, or higher-potency concentrates, which ranged from 70-90 percent. At various points, researchers tested participants’ blood plasma THC levels, surveyed their mood and subjected them to an array of neurobehavioral tasks meant to test attention, memory, inhibitory control and balance.
Researchers used a mobile pharmacology lab they dubbed the “cannavan” to study participants’ cannabis while complying with federal law, the University of Colorado said.
“Most neurobehavioral measures were not altered by short-term cannabis consumption,” the study found. “However, delayed verbal memory and balance function were impaired after use. Differing outcomes for the type of product (flower vs concentrate) or potency within products were not observed.” Impairment faded after about an hour.
“Despite differences in THC exposure, flower and concentrate users showed similar neurobehavioral patterns after acute cannabis use.”
A University of Colorado at Boulder press release calls the paper “the first to assess the acute impact of cannabis among real-world users of legal market products” and says the findings “could inform everything from roadside sobriety tests to decisions about personal recreational or medicinal use.”
Lawmakers and police departments who assume higher THC blood levels correlate with greater impairment, for example, may need to re-educate themselves on how to measure impaired driving. Consumers hoping that high-THC products will mean more mind-blowing highs, on the other hand, may ultimately be putting that extra THC—and the money spent on it—to waste.
“It raises a lot of questions about how quickly the body builds up tolerance to cannabis and whether people might be able to achieve desired results at lower doses,” Bidwell said.
As more states have opened legal marijuana markets, high-potency concentrates have become more widely available. Critics of marijuana legalization, as well as some health experts, have worried that those products could unleash health hazards on both individual users and broader society. While the University of Colorado paper doesn’t answer questions about potential long-term side effects of THC exposure, its findings indicate short-term impacts of concentrates don’t necessarily warrant additional concern.
“People in the high concentration group were much less compromised than we thought they were going to be,” said co-author Kent Hutchison, a professor of psychology and neuroscience at CU Boulder who also studies alcohol addiction. “If we gave people that high a concentration of alcohol it would have been a different story.”
One reason that higher THC blood levels didn’t translate to higher highs could be that the body’s finite number of cannabinoid receptors, which THC molecules bind to, become saturated regardless of whether higher- or lower-THC products are used. Any excess THC in consumers’ blood plasma, in that case, would be metabolized and not contribute to further impairment.
“Cannabinoid receptors may become saturated with THC at higher levels,” the study says, “beyond which there is a diminishing effect of THC.”
That’s not to forget the “striking differences in blood levels” the study observed between the two groups of participants. Researchers cautioned that while short-term effects of higher-potency cannabis consumption don’t seem to differ much from more traditional methods, we still don’t know much about how elevated cannabinoid levels affect health over time.
“Does long-term, concentrated exposure mess with your cannabinoid receptors in a way that could have long-term repercussions?” asked Hutchison. “Does it make it harder to quit when you want to? We just don’t know yet.”
The controversy—and uncertainty—around how cannabis affects driver safety has long been a sticking point for legalization. And given the ongoing difficulty in associating THC levels with impairment, it’s unlikely to be resolved anytime soon.
As legalization spreads, however, more and more studies are examining marijuana-related impairment. A study published last year found that drivers who tested at the legal limit in many states (2-5 nanograms THC per milliliter of blood) were statistically no more likely to cause a crash than people who had not consumed cannabis, concluding that “the impact of cannabis on road safety is relatively small at present time.”
Earlier this month, Democratic leadership in a House committee introduced a bill that would require states with legal cannabis programs to consider creating programs “to educate drivers on the risks associated with marijuana-impaired driving and to reduce injuries and deaths resulting from individuals driving motor vehicles while impaired by marijuana.”
A congressional report from a year earlier, however, suggested that much of the alarmism about cannabis-impaired driving was unfounded.
“Although laboratory studies have shown that marijuana consumption can affect a person’s response times and motor performance,” the Congressional Research Service wrote, “studies of the impact of marijuana consumption on a driver’s risk of being involved in a crash have produced conflicting results, with some studies finding little or no increased risk of a crash from marijuana usage.”
Proof Of Marijuana Use Discovered At Ancient Biblical Site In Israel
An ancient biblical tribe in Israel likely used marijuana to produce hallucinogenic effects as part of cultic rituals, according to a new study that identified cannabis resin on an alter in a shrine built around 750 BCE.
Two alters that appeared near the entrance of the “Holy of Holies” in the Judahite shrine were excavated about 50 years ago and now an analysis of the materials on top of the alters turned up evidence of marijuana combustion at the site.
The study, published Thursday in the journal Tel Aviv, states that “cannabis inflorescences were burnt there, conceivably as part of a ritual that took place in the shrine.”
“It seems feasible to suggest that the use of cannabis on the Arad altar had a deliberate psychoactive role,” the study concluded.
“Cannabis odors are not appealing,” the researchers opined, “and do not justify bringing the inflorescences from afar. The frequent use of hallucinogenic materials for cultic purposes in the Ancient Near East and beyond is well known and goes back as early as prehistoric periods.”
However, this is the first time physical evidence has been identified that indicates the tribe of Judah participated in marijuana-infused ceremonies. Evidence of frankincense being burned was also found at the site.
The team behind the study, from the Israel Museum and the Volcani Center, relied on two common methods of identifying cannabinoids: liquid chromatography and gas chromatography. They found components of marijuana known widely today such as THC, CBD, CBN and various terpenoids.
Researchers said it’s unclear where the ancient tribe obtained cannabis, but they suspect that it “may have been imported from distant origins and were transported as dried resin (commonly known as hashish).”
To burn the marijuana and let out the smoke, it was apparently mixed with animal feces “to enable its mild heating,” the study states.
“It seems likely that cannabis was used at Arad as a deliberate psychoactive, to stimulate ecstasy as part of cultic ceremonies,” it continues. “If so, this is the first such evidence in the cult of Judah.”
“The discovery of cannabis on the smaller altar was a surprise. Arad provides the earliest evidence for the use of cannabis in the Ancient Near East. Hallucinogenic substances are known from various neighboring cultures, but this is the first known evidence of hallucinogenic substance found in the Kingdom of Judah.”
Eran Arie, a curator at the Israel Museum where the excavated shine is housed, told CNN that they “never thought about Judah taking part in these cultic practices.”
“The fact that we found cannabis in an official cult place of Judah says something new about the cult of Judah,” he said.
A separate study released last year documented how people from a diverse range of cultures have been using marijuana for thousands of years—in different forms and for different purposes. For example, cannabis was considered a “holy plant” in Tibet and was used in Tantric Buddhism to “facilitate meditations.” It was also used in Arabic medicine to treat ear infections, skin diseases, flatulence, intestinal worms, neurological pain, fever and vomiting.
Photo courtesy of Brian Shamblen.