The legalized drug crisis is harming young people far more than most realize→

The data is in and it’s becoming increasingly clear that the impacts of commercial marijuana industry are even worse than we thought, particularly for America’s young people. A new report released by Smart Approaches to Marijuana shows the reality in "pot-legal states" paints a vastly different picture than the common sales pitch of the industry and supporters of legalization. 

The marijuana industry, which spent billions to lobby elected officials and bankroll legalization referendum campaigns, is following the playbook pioneered by Big Tobacco. They recognize that the road to big profits runs through the heaviest users. As such, they have increased potency of the drug by more than four times since 1998, hoping to hook kids while they are young and vulnerable. The numbers show that it’s working. 

Usage rates have reached record highs among those who are most vulnerable to marijuana’s long-term health effects. The National Institute on Drug Abuse warned, "Past-year, past-month, and daily marijuana use (use on 20 or more occasions in the past 30 days) reached the highest levels ever recorded" among those aged 19 to 30. The percentage of 8th, 10th and 12th graders who used marijuana daily has more than tripled between 1991 and 2020. 

Daily marijuana use is indicative of a marijuana use disorder, also known as addiction to marijuana. For all the talk about how pot is not addictive, in 2021, 1.3 million individuals between the ages of 12 and 17 had a marijuana use disorder, accounting for more than 46% of users in that age group. Legalization is also associated with a 25% increase in marijuana use disorder among them as well. 

Jeremy Baldwin tags young cannabis plants at a marijuana farm operated by Greenlight, Oct. 31, 2022, in Grandview, Mo. Voters in North Dakota and Arkansas have rejected measures to legalize marijuana, while those in Maryland have approved legalization. Similar measures also were on the ballot in Missouri and South Dakota. (AP Photo/Charlie Riedel, File)

As usage rates, potency and addiction have increased, the adverse effects have also increased. Though supporters of legalization like to downplay the risks of marijuana, the drug caused more than 70,000 individuals younger than 18 to have marijuana-related emergency department visits in 2021. 

The industry told parents and politicians that they would not target kids. That’s turned out to be false. From "Pot Tarts" to "Stoney Patch Kids," the packaging of edibles laced with high-potency THC often looks like traditional snacks. Not surprisingly, between 2017 and 2021, there was a 1,375% increase in at-home exposures to marijuana edibles involving children younger than 6.  

More minors are driving under the influence of marijuana too. In 2021, 10.67 million people admitted to driving under the influence of marijuana, including 1.36 million who were between the ages of 16 and 20. There were 2.41 times more minors on the road under the influence of marijuana than were under the influence of alcohol. 

Minors have also gravitated toward marijuana vapes, products engineered to include a near-pure form of THC. Between 2017 and 2020, the percentage of 12th graders who vaped marijuana increased from 9.5% to 22.1%. Among 10th graders, it increased from 8.1% to 19.1%, and among 8th graders, it increased from 3.0% to 8.1%. A 2022 study found, "cannabis vaping is increasing as the most popular method of cannabis delivery among adolescents in the United States." and frequent use is increasing faster than occasional use. 

The marketing scheme of the industry has been to engineer a more potent drug, in forms easier to consume and while stoking the perception that it’s harmless. In 1991, 78.6% of 12th graders believed that using marijuana regularly puts one’s health at great risk. But in 2021, only 21.6% held this viewpoint. Those who hold that point of view are six times more likely to use it than individuals who perceive it as being high risk. 

By 2021 nearly seven in 10 12th graders seemingly approve of marijuana use. 

We all want the best future for our children. Yet, the growth of the pot industry has provided kids with greater access to a drug that medical science links to psychosis, depression, suicidality, and lower IQ at a time when the brain is still developing. Regular users are nearly five times more likely to develop a psychotic disorder and users of high-potency marijuana are four times more likely than users of low-potency products to become addicted. 

More young people are becoming addicted to marijuana, and it is sending more of them to the hospital. More of them are using a more potent form of the drug. It is past time for our nation to reverse course and advance drug policies that protect our children, rather than allow them to be collateral damage for another Big Tobacco. 

Are scientists missing the forest for the trees on youth marijuana use?→

Are scientists missing the forest for the trees?
Last week, the Journal of the American Medical Association published a study by DM Anderson and colleagues, scientists from universities in Montana, Spain, and San Diego, California. The study finds that legalization does not increase adolescent marijuana use. The researchers analyzed the Youth Risk Behavior Surveillance System (YRBSS) which the Centers for Disease Control and Prevention (CDC) began conducting in 1991.

Youth Risk Behavior Surveillance System (YRBSS)
YRBSS collects data from high school students every two years about behaviors that contribute to unintentional injuries and violence, sexual behaviors related to unintended pregnancy and sexually transmitted infections, alcohol and other drug use, tobacco use, unhealthy dietary behaviors, and inadequate physical activity. Not all states participate in YRBSS, and those that do participate periodically, although in the 2019 YRBSS all but five states did so. Minnesota, Oregon, and Washington State have never participated in YRBSS. The survey asks three questions about marijuana: ever use, current use, and what age students were when they started using marijuana. It began asking about vapor product use in 2015, but never asks what students are vaping.

So far as these limited data are concerned, the researchers’ findings seem true. But two other national surveys show us something more.

The National Survey on Drug Abuse/National Survey on Drug Use and Health
The National Survey on Drug Abuse is the oldest. It began in 1971 and was financed by the National Institute on Drug Abuse (NIDA). Its first two surveys were done under the auspices of the National Commission on Marihuana and Drug Abuse. It began publishing annual data in 1976 and was transferred to the newly created Substance Abuse and Mental Health Services Administration (SAMHSA) in 1992. Technological innovations enabled the survey to be redesigned in 1999 and its name was changed to the National Survey on Drug Use and Health (NSDUH) in 2002. However, the redesign of the renamed survey resulted in an inability to compare its results with findings from the National Household Survey on Drug Abuse.

The NSDUH collects data annually on the use of alcohol, tobacco, marijuana, and other drugs from adolescents (ages 12-17), young adults (ages 18-25), and older adults (ages 26 and older). It combines two years of data to report drug use among these age groups by state but unfortunately not before 2002. RTI is the contractor responsible for administering this survey, which also collect data on the mental health of Americans.

Monitoring the Future (MTF)
The third national survey is Monitoring the Future (MTF), which began in 1975. Financed by NIDA, MTF is the only survey that can give us continuous data from 1976 through today. It collects data about the lifetime, past-year, past-month, and daily use of alcohol, tobacco, marijuana, and other drug by students in grade 12. It added students in grades 8 and 10 in 1990. In 2015, MTF began asking about vaping and two years later asked specifically what kids were vaping – nicotine, marijuana, or just flavoring. Unfortunately, it does not report its data by state. The University of Michigan Institute for Social Research administers this survey.

The chart above shows that drug use among high school seniors peaked in 1978-1979. A 1977 study called Highlights from the National Survey on Drug Abuse estimates that in 1962, less than 2 percent of the US population and less than 1 percent of adolescents had ever tried an illicit drug. Over the next 16 years, “ever-tried” use rose among seniors to 60.4 percent, while 50.8 percent of seniors used the drug in the past year, 37.1 percent used it in the past month, and 10.7 percent used it daily. What drove that astonishing escalation in use among 18-year-olds?

Decriminalization and Drug Paraphernalia
The National Organization for the Reform of Marijuana Laws (NORML) formed in the early 70s and initiated a movement to decriminalize marijuana. Decriminalization then was defined as reducing criminal penalties for possessing an ounce or less of marijuana, enough for personal use. In 1973, NORML persuaded Oregon to decriminalize marijuana and in rapid succession over the next five years,10 more states decriminalized. By 1978, eleven states had reduced marijuana penalties to that of a traffic ticket. Along with decriminalization emerged the drug paraphernalia industry called by some “little learning centers for young drug abusers.” Head shops (shops for “heads” as the industry called drug users) selling child-appealing toys and gadgets to enhance drug use opened in urban and suburban communities across the US throughout the 70s, leaving no doubt in parents’ minds that a drug paraphernalia industry was coming after their kids. Studies showed that children reasoned a government would not reduce penalties for a drug that could hurt them.

The Parent Movement
This gave rise to a national Parent Movement which began in Atlanta in 1976 and spread across the nation. The movement was based on three goals: join with other parents to protect kids from becoming drug users, shut down headshops, and stop decriminalization. Some 3,000 parent groups from the mid-70s to the early 90s formed parent peer groups to protect their children and their children’s friends from using drugs. Many, usually in state capitals, became politically active. Their efforts to persuade legislators to pass laws outlawing drug paraphernalia drove the industry out of business. No more states decriminalized marijuana over the next several decades. NORML’s funding nosedived forcing the organization to severely curtail its decriminalization crusade.

Between 1978-79 and 1992, high school seniors’ marijuana use plummeted:

• Lifetime use was cut nearly in half from 60.4 percent to 32.6 percent.

• Past-year use dropped by more than half from 50.8 percent to 21.9 percent.

• There was a three-fold decrease in past-month use, and a

• five-fold decrease in daily marijuana use.

The first two directors of the National Institute on Drug Abuse, Robert DuPont, MD, and William Pollin, MD, credit the Parent Movement with bringing about this significant reduction in marijuana use among adolescents. But in just four years, these gains reversed:

• Seniors’ lifetime marijuana use rose from 32.6 percent in 1992 to 44.8 percent in 1996-1997.

• Their past-year use nearly doubled over those four years, from 21.9 percent to 38.5 percent.

• Past-month use among seniors did double, and

• Daily use rose more than three-fold.

What made that happen?

Medical Marijuana
In 1992, three billionaires began pumping money into a by-then moribund NORML as well as into two new groups, the Marijuana Policy Project, and a coalition of other groups that became the Drug Policy Foundation. They targeted states that allow ballot initiatives, made unsubstantiated claims about the healing powers of marijuana, bought voters’ signatures, and placed measures to legalize marijuana as medicine on the ballots of states few lived in, leaving taxpayers to pay for the consequences of their actions. A steady stream of media stories across the nation educated children that pot is medicine and they responded in kind. If a government wouldn’t reduce penalties for a drug that could hurt you, that drug surely couldn’t hurt you if it was medicine! The national cacophony that led up to the first state legalizing pot as medicine – California in November 1996 – carried that message and kids heard it loud and clear.

The National Household Survey on Drug Abuse shows much of these same patterns for both adolescents and young adults during the 70s, 80s, and 90s. But since that survey’s data cannot be compared to NSDUH’s, the best we can do is look at the most recent survey, which is the 2018-2019 state estimates. The following two charts are created on the same vertical axis of 0 percent to 60 percent. The first one shows past-year marijuana use among adolescents, the second among young adults.

No, not all of the blue bars are recreational states and yes, some of the yellow bars are. But 36 of these states have legalized marijuana for medical use and that has influenced young people ages 12 to 25 to engage in its use. Like decriminalization in the 70s, the novelty of turning pot into medicine with an intensive four-year campaign championed by national media has not only had a profound effect on the nation’s young people but also introduced a unique way to approve medicines by ballot-iinitiative and, later, legislative fiat rather than through the Food and Drug Administration. Should we worry that advocates are now applying that pattern to other drugs?

Access these graphics here.
Access YRBSS here.
Access NSDUH here.
Access MTF here.
Read National Survey on Drug Use and Health: Summary of Methodological Studies, 1971-2014 [Internet] here.