29.10.11

Teens who smoke pot at risk for psychosis

By Marilyn Linton, QMI Agency, October 24, 2011
With names like Panama red, stink, and bhang, it's not just new words that today's parents may need to learn when talking to their kids about marijuana. It's also about what's in today's pot.

For while many adults remember (some more fondly than others) the highs of their own youth, today's marijuana is not what it used to be. Not only are we learning that what our kids are smoking may be particularly potent, but doctors are also warning that marijuana can trigger psychosis in vulnerable young people.
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Marijuana today is stronger than 20 years ago, notes Dr. James Kennedy, director of the neuroscience research department at Toronto's Centre for Addiction and Mental Health (CAMH). In the 1960s, marijuana had an active component of THC of four to five percent.

Currently, THC is about 12% and in some samples found in British Columbia, the level is as high as 20%. Modern growing techniques have resulted in potent strains with higher THC, the main psycho-active or mind-altering substance of marijuana, hash and hash oil (all derived from the Cannabis sativa plant.)

The link between marijuana use and mental illness may not be well enough appreciated by parents and teachers, says Dr. Kennedy. "The research I've done is on the use of marijuana and schizophrenia. (That research) and research done by other groups over the past ten years is progressively showing that the use of marijuana in the teen years increases the severity of and lowers the age of onset of schizophrenia."

Vulnerable teens who smoke "up" regularly (several times a week) may be at risk for what's known as a psychotic break: "The young person will start to have trouble with social relationships, become more isolated due to paranoia, suspiciousness and strange ideas," explains Dr. Kennedy. They may think they have special communications coming to them through channels such as the TV, they may exhibit increased religiosity, and they may hear voices outside their head, some of which may command them to act out.

If no help is sought, the psychotic symptoms get worse and worse. Marijuana does not cause schizophrenia per se, but it brings it on earlier and more severe in those who are susceptible. The trouble is, there's no way of telling who is susceptible or not.

In Dr. Kennedy's view, teens between the ages of 12 and 20 could be at risk. While the average age of onset of schizophrenia is 18, psychotic episodes can start as young as 14. "The key factor here is that a teen's brain has not finished developing yet. The front of the brain is the last to mature and that's where marijuana seems to have its greatest disruptive effect."

That's also the part of the brain where the COMT gene is most active.

COMT (the enzyme it produces) is part of the dopamine system, and marijuana disturbs the balance of dopamine in the brain, he adds. One New Zealand analysis of a longitudinal study of 1,037 people showed that cannabis users by age 15 were four times as likely to have a diagnosis of schizophrenia at age 26 than controls.

Cannabis is the most commonly used illicit drug in the world, and it is consistently linked with an increased risk for mental illnesses which include schizophrenia and depression. "The depression is usually not permanent, but schizophrenia is. It's a very serious disease and it impairs the person for the rest of their life. The treatment only reduces symptoms, there is no cure."

Many of us don't fully appreciate that the brain is still developing between the ages of 14 and 20 and remains vulnerable to outside influences like marijuana. That information needs to be emphasized more by parents and teachers, says Dr. Kennedy. "People often think, 'Oh well, pot didn't hurt me much.' But people of a generation ago didn't have access to it in high school to the extent that today's students do. Times have changed."

What's up front?

The front of the brain, called the prefrontal cortex, is a region involved with personality, planning, inhibition, emotion and short-term memory. Its wiring and circuits are not is not fully laid down until early adulthood, says Dr. James Kennedy.

Strong evidence

Mental health surveys have repeatedly found more substance use among people with a diagnosis of a psychotic disorder, says a report published in Science Daily. Australia's Dr. Matthew Large and his colleagues identified 83 studies involving 8,167 participants who used cannabis or other substances and 14,352 people who did not. The meta-analyis found that individuals who used pot developed psychosis almost three years younger than those who did not use cannabis. The authors conclude that cannabis precipitates schizophrenia and other psychotic disorders, perhaps through an interaction between genetic and environmental disorders or by disrupting brain development.

Going to pot

The June, 2011, survey of Ontario adults from the Centre for Addiction and Mental Health CAMH shows that the prevalence of cannabis use has been steadily increasing from 8.7% in 1996 to 13.3 percent in 2009 among all age groups. "These increases are a concern to us," says Dr. Robert Mann of CAMH. "We know that cannabis use may increase the risk of psychosis for people who are predisposed to schizophrenia, and may worsen the symptoms of other mental illnesses."

No dope!

At www.nationalantidrugstrategy.gc.ca, you can increase your drug knowledge on everything from cannabis to LSD, from drug laws to talking with your teen. Find out more at www.camh.net.

http://www.torontosun.com/2011/10/19/teens-who-smoke-pot-at-risk-for-psychosis

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