Thursday, January 3, 2013

Marijuana dependence and treatment

As we, as a state, move forward with creating a commercial marijuana market, it is important that we understand marijuana, its use, and consequences.  While this blog mostly focuses on substance abuse prevention, it's useful to take a look at intervention, harm reduction, and treatment, too.  A 2007 article from the Addiction Science and Clinical Practice journal entitled "Marijuana Dependence and Its Treatment" is a good starting point.

Here are a few excerpts:

Adolescent marijuana use
Approximately half of the individuals who enter treatment for marijuana use are under 25 years of age. These patients report a distinctive profile of associated problems, perhaps due to their age and involvement in other risky behaviors (Tims et al., 2002). Adolescents who smoke marijuana are at enhanced risk of adverse health and psychosocial consequences, including sexually transmitted diseases and pregnancy, early school dropout, delinquency, legal problems, and lowered educational and occupational aspirations.

Racial disparities
During the past decade, marijuana use disorders have increased in all age groups. Contributing factors may include the availability of higher potency marijuana and the initiation of use at an earlier age. Among adults, marijuana use disorders increased despite stabilization of rates of use. An increased prevalence of disorders among young adult African-American and Hispanic men and African-American women appears to account for the overall rise among youth ()

Is marijuana unique? A large part of the general population has had personal experience with marijuana, and most have not become addicted. (Ten percent of the U.S. population reports using marijuana in the past year and 6% report using within the past month.) Many find it perplexing to contemplate how someone else could become addicted to a drug they themselves have tried and can easily set aside or stop using. Accordingly, they think marijuana dependence must qualitatively differ from dependence on other drugs, such as heroin and cocaine, and require unique treatment approaches.

People who develop problems with marijuana may indeed be different from those who do not, but this phenomenon has been observed with other substances of abuse. A comparison with alcohol use and dependence provides a case in point. The great majority of Americans have tried alcohol and continue to drink alcoholic beverages regularly. However, only an estimated 10 to 15 percent of alcohol drinkers develop problems, and only some of these problem drinkers seek treatment. This is also true of those who have tried cocaine or heroin (Anthony, Warner, and Kessler, 1994).

Note: Two of this article's authors conduct research with the University of Washington's Teen Marijuana Check-Up.

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