Despite several attempts by the media and policy makers to associate the rising number of state regulated medical marijuana programs (and popular legalization efforts) with a rise in use and a drop in associated risk, the 2012 Monitoring the Future Survey reports that there was no rise in daily or annual marijuana use among teens. According to the report, “annual marijuana use [among 8th, 10th and 12th graders] showed no further increase in any of the three grades surveyed in 2012… [And the] daily use of marijuana…remained essentially flat.” Also of note, despite the sharp decline in perceived risk of marijuana use across all three grades, there was a statistically significant decline of use among 8th graders. These numbers are consistent with other recent studies showing that states with regulated marijuana programs have not seen an increase in teen use. Some have even seen a decrease in pot use among their youth population.
“This study suggests that exposure among teens to the concept of marijuana regulation policies (one third of whom live in such states) does not cause an increase in use. It is also important to consider that a drop in perceived risk is likely associated with their rejection of the overzealous scare tactics used in most schools’ drug education programs” said Sabrina Fendrick of the NORML Women’s Alliance.
It is important to note, however, that marijuana use rates and availability nationwide remain at relatively high levels, while alcohol use rates remain historically low. This is most likely due to the fact that the former is illegal and thereby not subject to government controls, while the latter substance is legally restricted to adults only. The same goes for tobacco. We did not have to outlaw cigarettes to reduce the use among minors. A policy of education and regulation (not prohibition) has created an environment in which cigarette usage has fallen to an all time low. According to the principal investigator of the study, Lloyd Johnston, “[A] lowering teen smoking rates…likely…depend[s] on…changes such as raising cigarette taxes, further limiting where smoking is permitted, bringing back broad-based anti-smoking ad campaigns, and making quit-smoking programs more available.” It has been proven that age restrictions, coupled with the imposition of government regulation and education are the most effective at reducing youth access to adult-only recreational substances. According to the 2011 MFS report, the drop in alcohol use can be attributed to a strict regulation scheme that include educational campaigns focusing on responsible use and age restrictions which, in turn, lowers availability.
The report concluded; “In the 1980’s a number of states raised their minimum drinking age to twenty-one, which these researches were able to demonstrate reduced drinking.” It goes on to say “the proportion of 8th and 10th graders who say they could get alcohol ‘fairly easily’ or ‘very easily’ had been declining since 1996 and continued to drop in all three grades in 2011. Various other factors of likely importance include…higher beer taxes and restrictions on alcohol promotion to youth.” The 2012 survey reported that again, “there was no increase in perceived availability of alcohol.”
One can therefore conclude that the only sensible answer to restricting marijuana access to [as well as use among] minors is through state and local government regulation and a message of moderation.
Three quarters of medical cannabis consumers report using it as a substitute for prescription drugs, alcohol, or some other illicit substance, according to survey data published in the journal Addiction Research and Theory.
An international team of investigators from Canada and the United States assessed the subjective impact of marijuana on the use of licit and illicit substances via self-report in a cohort of 404 medical cannabis patients recruited from four dispensaries in British Columbia, Canada.
Researchers reported that subjects frequently substituted cannabis for other substances, including conventional pharmaceuticals. Authors reported:
“Over 41 percent state that they use cannabis as a substitute for alcohol (n=158), 36.1 percent use cannabis as a substitute for illicit substances (n=137), and 67.8 percent use cannabis as a substitute for prescription drugs (n=259). The three main reasons cited for cannabis-related substitution are ‘less withdrawal’ (67.7 percent), ‘fewer side-effects’ (60.4 percent), and ‘better symptom management’ suggesting that many patients may have already identified cannabis as an effective and potentially safer adjunct or alternative to their prescription drug regimen.”
Overall, 75.5 percent (n=305) of respondents said that they substitute cannabis for at least one other substance. Men were more likely than women to report substituting cannabis for alcohol or illicit drugs.
Authors concluded: “While some studies have found that a small percentage of the general population that uses cannabis may develop a dependence on this substance, a growing body of research on cannabis-related substitution suggests that for many patients cannabis is not only an effective medicine, but also a potential exit drug to problematic substance use. Given the credible biological, social and psychological mechanisms behind these results, and the associated potential to decrease personal suffering and the personal and social costs associated with addiction, further research appears to be justified on both economic and ethical grounds. Clinical trials with those who have had poor outcomes with conventional psychological or pharmacological addiction therapies could be a good starting point to further our under- standing of cannabis-based substitution effect.”
Previous studies have similarly demonstrated cannabis’ potential efficacy as an exit drug. A 2010 study published in the Harm Reduction Journal reported that cannabis-using adults enrolled in substance abuse treatment programs fared equally or better than nonusers in various outcome categories, including treatment completion. A 2009 study reported that 40 percent of subjects attending a California medical cannabis dispensary reported using marijuana as a substitute for alcohol, and 26 percent used it to replace their former use of more potent illegal drugs. A separate 2009 study published in the American Journal on Addictions reported that moderate cannabis use and improved retention in naltrexone treatment among opiate-dependent subjects in a New York state inpatient detoxification program.
Full text of the study, “Cannabis as a substitute for alcohol and other drugs: A dispensary-based survey of substitution effect in Canadian medical cannabis patients,” appears online in Addiction Research and Theory. NORML Advisory Board Member Mitch Earleywine is a co-author of this study.