• Prioritizing prevention 
• What changes: marijuana laws and culture    
• What remains the same: marijuana from a health perspective
• Still wondering...

During these changing times, many adults are wondering how to approach the topic of marijuana use with the young people in their lives.

This makes sense. Substance use, misuse, and dependence are culturally-bound phenomena: one's religion, politics, morality, nationality, generation, and personal life experience may all play a role in how one feels about alcohol and other drugs. Working in more than 60 countries around the globe, FCD respects the great variety of opinions that our students and schools may express when it comes to substances, their use, and the disease of addiction.

At the same time, there is one prevention perspective with which we might agree - that alcohol and other drug use can be seen as a health issue, crossing all borders, and that it can impact us all, whether personally or in our society. It reasons that, in terms of prevention, marijuana use is first and foremost a health issue, too.

Prioritizing prevention means that, no matter the changing tide of politics, laws, or public opinion, FCD will continue to communicate about the health-based consequences of substance use, and the healthy ways in which communities can nurture and protect their young people. Communicating the health-based risks of marijuana use is no exception.

Read any recent newspaper, watch any news program, watch a sitcom, or check out the latest movie and you are very likely to hear about or see the use of marijuana. And almost certainly, marijuana will be portrayed in a positive manner, whether it is an op-ed about legalization, a news magazine about the benefits of medical marijuana or the latest movie. Kids are inundated with these messages. When working with students, do not be surprised if some of them perceive marijuana use to be harmless. It is no wonder the perceived risk of use is declining.

In the United States, Colorado and Washington are the first states to legalize the sale of recreational marijuana. In Colorado, January 1, 2014, marked the first day marijuana was available for legal sale. While sales are limited to those 21 and older, the relaxation of these laws sends a message to teens that marijuana use is not harmful. Similar to alcohol and tobacco companies, recreational sales of any type might also open a window to gear marketing towards younger age groups.

Internationally, Uruguay is the first country to fully legalize the production, sale, and use of marijuana. Sales are limited in their quantity and restricted to those over the age of 18. The law will go into effect in April 2014.

Despite ever-changing political and cultural norms, kids remain kids. All over the world, child and adolescent development runs a predictable course. Health benchmarks include the maturation of a young person's brain and body well into his or her twenties. We know with clear and compelling evidence that there are multiple health risks for young people when it comes to marijuana.  

The teenage brain

Though cultural influences have contributed to the increasing perception among teenagers that marijuana is harmless, it actually has many harmful effects on the teenage brain.  

Tetrahydrocannabinol (THC) is the primary psychoactive chemical in marijuana. THC is a neurotoxin, a foreign chemical that directly targets the nervous system and disrupts the natural signaling that allows neurons to communicate effectively. Exposure to neurotoxins during adolescent brain development can permanently change the brain's structure and function. This explains why research by NIDA and other reputable research centers has established that when teenagers start using marijuana, their brains may stop functioning normally and may not easily return to normal functioning after marijuana use ends.

Simply put:

* As marijuana is smoked, its psychoactive chemical ingredient THC moves from the lungs to the bloodstream, to the brain's endocannabinoid system, binding to cannabinoid receptors and affecting the growth and connectivity of neurons.

* In the brain, THC over-stimulates cannabinoid receptors, altering teens' judgment, memory, learning, movement, and experience of pleasure.

Research has also shown that when chronic marijuana use begins in adolescence, marijuana's damage to teen learning and memory systems persists for many years. A recent study of teenage marijuana users followed its subjects over time and found large deficits in the connections between brain areas responsible for learning and memory in these individuals. This study showed that these people permanently lost as many as eight IQ points, starting at age 13. 

The risk of addiction

Contrary to popular belief, marijuana is addictive. Research suggests that just under 10% of people who use marijuana are addicted. The younger a person is when he or she starts using, the greater the risk of developing an addiction to marijuana. While less than one in 10 people face marijuana addiction overall, when marijuana use starts young, the odds of addiction increase by 70%. Among people who use marijuana every day, the likelihood of addiction is somewhere between one out of every four people and one out of every two.

After prolonged marijuana use, just like the prolonged use of many other mind-altering substances, withdrawal symptoms occur. These include irritability, sleeplessness, decreased appetite, anxiety, and craving for more of the drug. The contention that marijuana addiction may be psychological, but not physical, is incorrect - chronic marijuana use changes the structure and function of the brain, a physical organ in the human body, and an important one at that! Withdrawal symptoms which inhibit a user from stopping his or her use even when desiring to do so, such as cravings and irritability, are the direct result of physical changes that have occurred in the brain and will influence one's ability to make unbiased choices about continued substance dependence.

Health includes quality of life

The World Health Organization defines "health" as "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity." We want our students and children to do more than survive, we want them to thrive and have the greatest chance to pursue fulfilling lives of their own choosing. Marijuana use can get in the way, both in terms of affecting teens' ability to make the healthiest decisions for themselves in the short term, and also in terms of cutting short our young people's opportunities for their best lives well into the future.

NIDA research has consistently revealed that "marijuana has the potential to cause problems in daily life or make a person's existing problems worse." Their studies have demonstrated that, overall, heavy marijuana users report poorer:

• life satisfaction
• mental health
• physical health
• relationship quality
• academic success
• career success.

Other studies examine the impact of marijuana use on work life and have found that marijuana use is associated with increased:

• absence
• tardiness
• accidents
• job turnover.

Additionally, in-depth research using the United States' National Survey of Drug Use and Health has shown that for adolescents, the negative consequences of even first-time marijuana use are much more damaging than use by adults. Within this research, adolescents who used marijuana for the first time in the past year, compared to adults who used for the first time in the past year, reported that they were:

• five times more likely to be unable to cut down on later use
• two times more likely to suffer emotional problems
• seven times more likely to suffer physical problems.

When we speak about the risks of marijuana use with students, there is no need to compare the consequences of its use to that of any other substance. Instead, we can look to the reality that no child or teenager need engage in potentially harmful marijuana use to relax, have fun, have adventures, explore the world, or mature. In fact, we know that marijuana may be a factor in taking away such opportunities from young people. When we speak about the risks of marijuana use, the alternative by which we measure those risks is the healthy, substance-free life lived by the vast majority of young people we know.