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Marijuana addiction has risen in places where it's legal
While legalization has benefits, a new study suggests it may have one big drawback.
- A new study finds that rates of marijuana use and addiction have gone up in states that have recently legalized the drug.
- The problem was most severe for those over age of 26, with cases of addiction rising by a third.
- The findings complicate the debate around legalization.
In a complicating bit of news for proponents of legalization, a new study shows that the rates of Cannabis use disorder have gone up dramatically in states that have legalized weed. The spike was found to be particularly high for people over the age of 26 and under the age of 17.
Cannabis Use Disorder, is that when you get so high you can’t figure out how to smoke anymore?
Cannabis use disorder, also known as CUD or cannabis/marijuana addiction, is a psychological disorder described in DSM 5 as "the continued use of cannabis despite clinically significant impairment." This includes people being unable to cut down on their usage despite wanting to, those who often use it despite finding it severely impairs their ability to function, or those who are putting themselves in danger to secure access to the drug.
While an understanding that marijuana can be addictive has existed for some time, and the image of the pothead who smokes so much they can hardly function is prevalent in our society, the effects of legalization on addiction rates have somehow gone understudied until now. Importantly, previous studies had failed to consider usage rates amongst populations over the age of 25.
In the new study, published in JAMA Psychiatry, focused on self-reported data on monthly drug use in four states where marijuana is now legal, Colorado, Washington, Alaska, and Oregon, from both before and after the drug was legalized in each state and compared it to others which have not yet legalized.
The data gave insights into the drug use habits of the respondents and specifically gave information about if they had smoked at all in the last month, the frequency of their drug use, and if they had ever had issues with how much they were using drugs.The researchers ultimately considered the responses of 505,796 individuals.
The increase in cannabis usage they found was considerable. The number of respondents over the age of 26 who claimed to have used the drug in the last month went up by 23% compared with their counterparts in states that have yet to legalize. Abuse of the drug by this group rose by 37%.
Teen usage rose by 25%, and addiction rates rose as well. This increase was small, though, and the authors have suggested it may be due to an unknown factor. The rate of usage or abuse for respondents between the ages of 18 and 25 did not increase at all.
After breaking the results down by demographics, the primary finding held; adults over the age of 26 are using marijuana more often when it is legalized, and they are starting to use it too much.
The grain of salt
As in any study where findings are self-reported, the exact numbers you see here should be taken with a grain of salt. They could be slightly higher or lower. As this study relies on people self-reporting their usage of a drug that is still illegal in many places, it is very possible that the apparent spike in addiction rates is caused by more accurate reporting, as people who live in an area where pot is still illegal may be less likely to report smoking it every day.
And it should be repeated a thousand times over that correlation and causation are not the same thing. There could be some unknown factor causing these increases in each case.
Despite these qualifications, the study is still useful in giving us a general sense of what may happen in states that have yet to legalize.
What does this mean for society and drug users?
While claims of "reefer madness" are greatly exaggerated, marijuana has several well established and thoroughly studied side effects. While occasional use isn't terribly harmful, addiction can be. Lead author Magdalena Cerdá of New York University explains in the study that heavy marijuana use is associated with "psychological and physical health concerns, lower educational attainment, decline in social class, unemployment, and motor vehicle crashes."
A substantial increase in the number of people who are addicted to the stuff will incur costs to society down the line.
Of course, a 37% increase in problematic usage means that the percentage of adults smoking too much went from .9% to 1.23% of the population responding to the survey. This makes it far less prevalent than issues with alcohol, which affected around 6% of all Americans in 2018.
Recently, Big Think's Philip Perry wrote a piece about how legalization could improve the health of millions by allowing the government to regulate the purity of commercially sold marijuana. This remains true. However, it must be weighed against the findings of this study, which suggests that at least some of these health gains will be wiped out by increased addiction rates.
What does this mean for legalization efforts?
The legalization steamroller will undoubtedly keep rolling along. While health concerns are one factor in the debate over marijuana, it is only one of many. In Illinois, where I live, weed will become legal on January 1st of 2020. The legalization campaign and legislation were more concerned with issues of social justice, the failures of prohibition, and finding a new source of tax revenue (since we're half broke) than with matters of potential addiction.
As Vox reports, the authors of the study aren't suggesting that legalization shouldn't take place; that is another, broader debate. They merely wish to present the fact that legalization has a particular side effect that we should be aware of.
While this study is unlikely to change anybody's stance on if weed should be legalized or not, it does show us a critical element to be considered when discussing drug policy. No drug is perfectly safe, and we have reason to believe that legalizing marijuana will mean that more people will have a hard time with it. Let's hope that legalization proponents keep that in mind as they rack up their victories.
- Millions More Americans Are Using Marijuana, Says New Study ... ›
- Teen marijuana use in all 50 states: Report compares data - Big Think ›
- How legalizing marijuana reduces crime - Big Think ›
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The team caught a glimpse of a process that takes 18,000,000,000,000,000,000,000 years.
- In Italy, a team of scientists is using a highly sophisticated detector to hunt for dark matter.
- The team observed an ultra-rare particle interaction that reveals the half-life of a xenon-124 atom to be 18 sextillion years.
- The half-life of a process is how long it takes for half of the radioactive nuclei present in a sample to decay.
Gender and sexual minority populations are experiencing rising anxiety and depression rates during the pandemic.
- Anxiety and depression rates are spiking in the LGBTQ+ community, and especially in individuals who hadn't struggled with those issues in the past.
- Overall, depression increased by an average PHQ-9 score of 1.21 and anxiety increased by an average GAD-7 score of 3.11.
- The researchers recommended that health care providers check in with LGBTQ+ patients about stress and screen for mood and anxiety disorders—even among those with no prior history of anxiety or depression.
Study findings<p>For the study, <a href="https://link.springer.com/article/10.1007/s11606-020-05970-4" target="_blank">published in the Journal of General Internal Medicine</a><em>, </em>Flentje and her team evaluated survey responses from nearly 2,300 individuals who identified as being in the lesbian, gay, bisexual, transgender, and queer (LGBTQ+) community. Most of the participants were white, while nearly 19 percent identified as a racial or ethnic minority. Multiple genders were represented with cisgender women (27.2 percent) and men (24.6 percent) making up a majority of the participants. Sixty-three percent had been assigned female at birth. For the most part, participants identified their sexual orientations as queer (40.3 percent), gay (36.5 percent), and bisexual (30.3 percent).</p><p>The JGIM study participants were recruited from the 18,000-participant <a href="https://pridestudy.org/" target="_blank">PRIDE Study</a> (Population Research in Identity and Disparities for Equality), which is the first large-scale, long-term national study focusing on American adults who identify as LGBTQ+. It conducts annual questionnaires to understand factors related to health and disease in this population. </p><p>Participants filled out an annual questionnaire (starting in June 2019) and a COVID-19 impact survey this past spring. Flentje noted that on an individual level, some people may not have experienced a big change in anxiety or depression levels, but for others there was. Overall, depression increased by a <a href="https://patient.info/doctor/patient-health-questionnaire-phq-9" target="_blank">PHQ-9 score</a> of 1.21, putting it at 8.31 on average. Anxiety went up by a <a href="https://www.mdcalc.com/gad-7-general-anxiety-disorder-7" target="_blank">GAD-7</a> score of 3.11 to an average of 8.89. Interestingly, the average PHQ-9 scores for those who screened positive for depression at the first 2019 survey decreased by 1.08. Those who screened negative for depression saw their PHQ-9 scores increase by 2.17 on average. As for anxiety, researchers detected no GAD-7 change among the study participants who screened positive for anxiety in the first survey, but did see an overall increase of 3.93 among those who had initially been evaluated as negative for the disorder. </p>
Risks among gender and sexual minorities<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="fc3fd1ae68b77bbbf58a6995638d6d65"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/EnUqDjCqg0A?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><p>The LGBTQ+ community is a vulnerable population to mental health concerns because of their fear of stigmatization and previous discriminatory experiences.</p> <p>Previous research by the Human Rights Campaign has found "that LGBTQ Americans are more likely than the <a href="https://medicalxpress.com/tags/general+population/" target="_blank">general population</a> to live in poverty and lack access to adequate medical care, paid <a href="https://medicalxpress.com/tags/medical+leave/" target="_blank">medical leave</a>, and basic necessities during the pandemic," said researcher Tari Hanneman, director of the health and aging program at the campaign.</p> <p>"Therefore, it is not surprising to see this increase in anxiety and depression among this population," Hanneman said in the release. "This study highlights the need for <a href="https://medicalxpress.com/tags/health+care+professionals/" target="_blank">health care professionals</a> to support, affirm and provide <a href="https://medicalxpress.com/tags/critical+care/" target="_blank">critical care</a> for the LGBTQ community to manage and maintain their mental health, as well as their physical health, during this pandemic."</p>
What should health care providers do?<p>The authors of the study recommend that health care providers check in with LGBTQ+ patients about stress and screen for mood and anxiety disorders in members of that community—even among those with no prior history of anxiety or depression.</p><p>As cases of COVID-19 continue to mount, the sustained social distancing, potential isolation, economic precariousness, and personal illness, grief, and loss are bound to have increased and varied impacts on mental health. Effective treatments may include individual therapy and medications as well as more large-scale coronavirus support programs like peer-led groups and mindfulness practices. </p><p>"It will be important to find out what happens over time and to identify who is most at risk, so we can be sure to roll out public health interventions to support the mental health of our communities in the best and most effective ways," said Flentje.</p>
What we know about black holes is both fascinating and scary.
- When it comes to black holes, science simultaneously knows so much and so little, which is why they are so fascinating. Focusing on what we do know, this group of astronomers, educators, and physicists share some of the most incredible facts about the powerful and mysterious objects.
- A black hole is so massive that light (and anything else it swallows) can't escape, says Bill Nye. You can't see a black hole, theoretical physicists Michio Kaku and Christophe Galfard explain, because it is too dark. What you can see, however, is the distortion of light around it caused by its extreme gravity.
- Explaining one unsettling concept from astrophysics called spaghettification, astronomer Michelle Thaller says that "If you got close to a black hole there would be tides over your body that small that would rip you apart into basically a strand of spaghetti that would fall down the black hole."