Teenage cannabis use and schizophrenia

With the growing wave of legalizing marijuana use across the US, it is important to fully understand the possible consequences of expected increase in it's unrestricted use, specially amongst the youth. A group of scientist at the Feinberg School of Medicine and Northwestern Memorial Hospital have conducted a study which has found a link between teenage Marijuana (Cannabis) use and schizophrenia. This study was published by Schizophrenia Bulletin

The brains of teenagers smoking cannabis daily for about three years showed significant structural changes affecting memory. Some of those changes appear very similar to those seen in the brains of schizophrenics.These youngsters also performed badly when tested on memory tasks, indicating poor memory functioning.


As reported by Marla Paul for Northwestern University on Futurity;

This is the first study to target key brain regions in the deep sub-cortical gray matter of chronic marijuana users with structural MRI and to correlate abnormalities in these regions with an impaired working memory.
Working memory is the ability to remember and process information in the moment and—if needed—transfer it to long-term memory. Previous studies have evaluated the effects of marijuana on the cortex, and few have directly compared chronic marijuana use in otherwise healthy individuals and individuals with schizophrenia.

According to the lead study author Mathew Smith an assistant research professor in psychiatry and behavioral sciences at Northwestern University Feinberg School of Medicine; 

“The study links the chronic use of marijuana to these concerning brain abnormalities that appear to last for at least a few years after people stop using it. With the movement to decriminalize marijuana, we need more research to understand its effect on the brain.”

 But in contrast to these findings another study conducted at the Institute of Psychiatry at King's College London, has shown a genetic link between cannabis use and schizophrenia. Kate Kelland  reports for Reuters that;

The results chime with previous studies linking schizophrenia and cannabis, but suggest the association may be due to common genes and might not be a causal relationship where cannabis use leads to increased schizophrenia risk. 

 "We know that cannabis increases the risk of schizophrenia. Our study certainly does not rule this out, but it suggests that there is likely to be an association in the other direction as well – that a pre-disposition to schizophrenia also increases your likelihood of cannabis use," said Robert Power, who led the study at the Institute of Psychiatry at King's College London.

But what become evident from both these recent studies is the clear connection between adolescent use of cannabis and the development of schizophrenia. Therefore it is important for parents to discourage their children from getting swept up in this growing wave of legal recreational use of marijuana. We need to educate ourselves and our children on the very real dangers and consequences of indiscriminate use of marijuana.
 



References:

Teen marijuana use linked with schizophrenia (Futurity-January 3, 2014)

Study finds genetic links between schizophrenia and cannabis use (Reuters-June 24, 2014)

Cannabis-Related Working Memory Deficits and Associated Subcortical Morphological Differences in Healthy Individuals and Schizophrenia Subjects  (Schizophrenia Bulletin-December 15, 2013)

Genetic predisposition to schizophrenia associated with increased use of cannabis (Molecular Psychiatry-June 24, 2014)

The damage caused by bullying persists much longer then the bullying itself

According to a longitudinal British study just published in the American Journal of Psychiatry, the detrimental effects of bullying can lasts for decades and influence a person's socioeconomic status, social relationships, often leading to a poorer quality of life as far out as in their 50s.
As reported by the researchers of the study;

The impact of bullying victimization was not limited to indicators of adult health. Children who  were frequently bullied had lower educational levels at midlife, and men in the labor market were  more likely to be unemployed and to earn less than their peers. Social relationships in adulthood were affected too; children who were bullied were at increased risk of living without a spouse or partner at age 50, were less likely to have met up with friends in the recent past, and were less  likely to have access to social support if they were sick. Bullying victimization also affected adult well-being; being bullied was associated with lower perceived quality of  life at age 50 and lower satisfaction with life so far. Cohort members who had been frequently bullied also anticipated less life satisfaction in the years to come. When  controlling for childhood confounders, bullying victimization became marginally associated with unemployment (for men), net pay (for men), and meeting friends in the  last 2 weeks. All other associations remained significant.
 
In this study data was collected from almost 98% of all births in one week of 1958 in Scotland, England and Wales, leading to about 18,000 participants. Subsequent follow-up were then carried out at age 7, 11 and 16 years in their childhood, and then at ages 23, 33, 42, and 50 years in adulthood. To assess presence and frequency of bullying during childhood researchers interviewed parents. Whereas the psychological distress resulting in adult life was assessed through various standardized test.

It is clear from these observations that in addition to effectively reducing incidents of childhood bullying efforts must be made to minimize its effect on mental, emotional and physical.

To learn more about bullying and to find help please check Stopbullying.gov


References:
Adult Health Outcomes of Childhood Bullying Victimization: Evidence From a Five-Decade Longitudinal British Birth Cohort (American Journal of Psychiatry)
Mental And Physical Toll Of Bullying Persists For Decades (Health News from NPR)
 

Several studies find further evidence of detrimental effects caused by marijuana smoking

Since this wave of legalization of use of recreational marijuana is spreading gradually but surely to more and more states in the United States, more and more studies funded by medical institutions and organizations are reporting on the very real dangers of frequent marijuana use. I am going to highlight only a few of the studies published on the subject in various medical journals in the past few years.

Journal of Neuroscience (April 16, 2014)

This study conducted by researchers from Harvard University and Chicago's Northwestern Medicine group, using a small sample of 40 individuals between the ages of 18-25 has shown that smoking cannabis ( also known as marijuana) once or twice a week can lead to major changes in brain areas associated with emotions and motivation.

In an article on this study, "Smoking cannabis could change the part of the brain dealing with motivation, according to one new study" published in The Independent ( April 16th 2014), health reporter Charlie Cooper writes;

The researchers used neuroimaging techniques to analyze the brains of cannabis users and non-users.

They found that the nucleus accumbens was unusually large in the cannabis users, while the amygdala also had noticeable abnormalities.
Anne Blood, assistant professor of psychiatry at Harvard Medical School said that the areas affected were "core, fundamental structures of the brain".
"They form the basis for how you assess positive and negative features about things in the environment and make decisions," she said.
The severity of abnormalities in these regions of the brain was directly related to the number of joints a person smoked per week, according to the study, published in the Journal of Neuroscience on Wednesday. The more joints a person smoked, the more abnormal the shape, volume and density of the brain regions, but the effect was noticeable even in those who smoked once or twice a week.
However, experts in the UK said that the study group was small and that more research was needed over a longer timescale to establish whether cannabis smoking caused the unusual brain features, or whether people with such brain features were more likely to smoke cannabis in the first place.
Around one million people aged between 16 and 24 use cannabis in the UK per year, according to the charity DrugScope. Its use has been reported to cause anxiety and paranoia in some users and in rarer cases may be a trigger for underlying mental health problems.
Dr Michael Bloomfield, clinical research fellow at the UK's Medical Research Council (MRC), said that the study added to the MRC's own research which found that heavy cannabis use in adolescence is associated with changes in chemical connections in the brain.

Schizophrenia Bulletin ( December 16, 2013)

Yet another study conducted by Northwestern Medicine and mainly funded by The National Institute of Mental Health and National Institute of Drug Abuse, has shown that heavy use of marijuana (daily for 3 years) in teen years can lead to abnormal changes in the brain structure related to memory. The teens in the study performed poorly on memory tasks.
According to lead study author Matthew Smith, an assistant research professor in psychiatry and behavioral sciences at Northwestern University Feinberg School of Medicine, " The study links the chronic use of marijuana to these concerning brain abnormalities that appear to last for at least a few years after people stop using it, with the movement to decriminalize marijuana, we need more research to understand its effect on the brain."
Chronic use of marijuana may contribute to changes in brain structure that are associated with having schizophrenia, the Northwestern research shows. Of the 15 marijuana smokers who had schizophrenia in the study, 90 percent started heavily using the drug before they developed the mental disorder. Marijuana abuse has been linked to developing schizophrenia in prior research.

As reported in 'Heavy marijuana users have abnormal brain structure and poor memory'

by Eureka Alert online science news service;

"The abuse of popular street drugs, such as marijuana, may have dangerous implications for young people who are developing or have developed mental disorders," said co-senior study author John Csernansky, M.D., chair of psychiatry and behavioral sciences at Northwestern University Feinberg School of Medicine and Northwestern Memorial Hospital. "This paper is among the first to reveal that the use of marijuana may contribute to the changes in brain structure that have been associated with having schizophrenia."
Chronic marijuana use could augment the underlying disease process associated with schizophrenia, Smith noted. "If someone has a family history of schizophrenia, they are increasing their risk of developing schizophrenia if they abuse marijuana," he said.
While chronic marijuana smokers and chronic marijuana smokers with schizophrenia both had brain changes related to the drug, subjects with the mental disorder had greater deterioration in the thalamus. That structure is the communication hub of the brain and is critical for learning, memory and communications between brain regions. The brain regions examined in this study also affect motivation, which is already notably impaired in people with schizophrenia.
"A tremendous amount of addiction research has focused on brain regions traditionally connected with reward/aversion function, and thus motivation," noted co-senior study author Hans Breiter, M.D., professor of psychiatry and behavioral sciences and director of the Warren Wright Adolescent Center at Feinberg and Northwestern Memorial. "This study very nicely extends the set of regions of concern to include those involved with working memory and higher level cognitive functions necessary for how well you organize your life and can work in society."


Journal of Chemical Research in Toxicology (May 18, 2009)

The study Dr. Michael Bloomfield mentions was conducted by  Leicester University’s Rajinder Singh, Jatinderpal Sandhu, Balvinder Kaur, Tina Juren, William P. Steward, Dan Segerback and Peter B. Farmer from the Cancer Biomarkers and Prevention Group, Department of Cancer Studies and Molecular Medicine and Karolinska Institute, Sweden. This research was funded by MRC, European Union Network of Excellence (ECNIS) and Cancer Research UK. The findings were published in the Journal of Chemical Research in Toxicology.
In this case researchers found "convincing evidence" that cannabis smoke damages DNA in ways that could potentially increase the risk of cancer development in humans.  

Lead author Dr Singh said:
“There have been many studies on the toxicity of tobacco smoke. It is known that tobacco smoke contains 4000 chemicals of which 60 are classed as carcinogens. Cannabis in contrast has not been so well studied. It is less combustible than tobacco and is often mixed with tobacco in use. Cannabis smoke contains 400 compounds including 60 cannabinoids. However, because of its lower combustibility it contains 50% more carcinogenic polycyclic aromatic hydrocarbons including naphthalene, benzanthracene, and benzopyrene, than tobacco smoke.” 
The authors added: “It is well known that toxic substances in tobacco smoke can damage DNA and increase the risk of lung and other cancers. Scientists were unsure though whether cannabis smoke would have the same effect. Our research has focused on the toxicity of acetaldehyde, which is present in both tobacco and cannabis.”
The researchers add that the ability of cannabis smoke to damage DNA has significant human health implications especially as users tend to inhale more deeply than cigarette smokers, which increases respiratory burden.
"These results provide evidence for the DNA damaging potential of cannabis smoke," the researchers conclude, "implying that the consumption of cannabis cigarettes may be detrimental to human health with the possibility to initiate cancer development."

Although in each case marijuana use supporters will argue the sample sizes are too small or the study was biased, the results of each of these researches were very real. If anything further promotion of the idea that recreational use of marijuana is completely harmless should be discouraged more aggressively.


References:

Cannabis Use is Quantitatively Associated with Nucleus Accumbens and Amygdala Abnormalities in Young Adult

Recreational Users (The Journal of Neuroscience-April 16, 2014)

Smoking cannabis could change the part of the brain dealing with motivation, according to one new study(The Independent April 16, 2014)
Cannabis use increases cancer risk study suggests (MRC News & Publications)
Marijuana May Hurt The Developing Teen Brain(Health News NPR-March 3, 2014)
Heavy Marijuana Use Alters Teenage Brain Structure(Psychology Today-March 30, 2014)

Heavy marijuana users have abnormal brain structure and poor memory (Northwestern University on Eureka Alert-December 16, 2013)

Cannabis-Related Working Memory Deficits and Associated Subcortical Morphological Differences in Healthy Individuals and Schizophrenia Subjects (Schizophrenia Bulletin- Published 12/15/13) 

Evaluation of the DNA Damaging Potential of Cannabis Cigarette Smoke by the Determination of Acetaldehyde Derived N²-Ethyl-2′-deoxyguanosine Adducts(Chemical Research in Toxicology-May 18, 2009)

 

A Survey for all parents of teenagers : Monitoring the Future 2013 Survey Results

I am sharing some informational posters on NIDA ( National Institute on Drug Abuse) to help all parents better understand the degree to which our kids are exposed to drugs and how prevalent the use of illicit drugs in youngsters is. Knowledge and information are power, the more we understand the seriousness of this problem, the less likely we will be to support such crazy legislation as the legalization of Marijuana. Please if you come across this post, do share it with your teenagers and middle schoolers.

Description: Monitoring the Future is an annual survey of 8th, 10th, and 12th-graders conducted by researchers at the University of Michigan, Ann Arbor, under a grant from the National Institute on Drug Abuse, part of the National Institutes of Health. Since 1975, the survey has measured drug, alcohol, and cigarette use and related attitudes in 12th-graders nationwide. Eighth and 10th graders were added to the survey in 1991. Overall, 41,675 students from 389 public and private schools participated in the 2013 survey.

Description: Last Two Decades of Alcohol, Cigarette, and Illicit Drug Use*
*Past 30 day use.
This graphic illustrates past 30 day alcohol, cigarette, and illicit drug use among 8th, 10th, and 12th graders from 1993 through 2013. In general, alcohol and cigarette use has decreased, and illicit drug use, which declined in the late 1990s and early 2000s, has been increasing in recent years.

Description: Marijuana: As Perceived Harm Drops, Use Goes Up
* Past-year use in 12th graders.
Three points in time are shown—1993, 2003, 2013— for marijuana use and the perception of risk (saw great risk in smoking marijuana occasionally) among 12th graders.

 Description: 60% of high school seniors do not view regular marijuana use as harmful, which is nearly double from 20 years ago. The potency of marijuana, as measured by THC content, has steadily increased over the last few years, which means that daily use of today’s marijuana may have greater health consequences than use of marijuana from 10 to 20 years ago.

Description: Prescription/Over-the-Counter vs. Illicit Drugs
After marijuana, prescription and over-the-counter medications account for most of the top drugs abused by 12th graders in the past year.

Description: Abuse of Some Synthetic Drugs is Down.
These are substances that are chemically similar to and/or mimic the effects of illicit drugs. This year, 7.9% of high school seniors reported past-year use of K2/Spice (sometimes called synthetic marijuana), down from last year’s number of 11.3%. Past-year use of the substances called “bath salts” was low for all three grades - at or below 1%.

P.S:Monitoring the Future 2013 Survey Results(NIDA)

The truth about addiction; ruthless, honest, and extremely insightful....

"The mind of a heroin addict: the struggle to get clean and stay sober" on The Guardian is a collection of comments by recovering sober addicts and some using addicts on how they struggle and how Philip Seymour Hoffman's death from heroin overdose after 23 years of sobriety affected them. 

As I read this post, I was not only shocked and troubled by the very truthful and blatantly honest responses but also got a better understanding of how they struggle or relapse and how terribly hard it is to fight the addict inside them. I am not totally unaware of what goes into rehabilitation, I worked with addicts during my one year psychiatry job. Yet I found these comments revealing and poignant. 

One of the comments which stood out to me was by Danny from Ireland, who has been ten years sober; "My father died from addiction, we lost a cousin, I myself had numerous overdoses and helped prevent siblings from OD-ing (all of who are now clean thanks to the process of one addict helping another that Russell Brand spoke of). Hearing about Hoffman affects me the same way as if it were a friend. I didnt know he was an addict untill he died, but when I heard of his story and addiction I immediatly identified with him. We work the same way in our minds. I know what happened to him before he picked up. I know how he felt. I'm pretty sure it started the same way most relapses do. "

Read all the responses...

Some drug facts in the US:

According to NIDA ( National Institute on Drug Abuse) "Illicit drug use in America has been increasing. In 2012, an estimated 23.9 million Americans aged 12 or older—or 9.2 percent of the population—had used an illicit drug or abused a psychotherapeutic medication (such as a pain reliever, stimulant, or tranquilizer) in the past month. This is up from 8.3 percent in 2002. The increase mostly reflects a recent rise in the use of marijuana, the most commonly used illicit drug."

 Most people use drugs for the first time when they are teenagers. There were just over 2.8 million new users (initiates) of illicit drugs in 2012, or about 7,898 new users per day. Half (52 per-cent) were under 18.

More than half of new illicit drug users begin with marijuana. Next most common are prescription pain relievers, followed by inhalants (which is most common among younger teens).

In 2009, there were nearly 4.6 million drug-related Hospital Emergency Department (ED) visits nationwide. These visits included reports of drug abuse, adverse reactions to drugs, or other drug-related consequences. Almost 50 percent were attributed to adverse reactions to pharmaceuticals taken as prescribed, and 45 percent involved drug abuse.

The majority of drug-related ED visits were made by patients 21 or older (80.9 percent, or 3,717,030 visits). Of these, slightly less than half involved drug abuse. Patients aged 20 or younger accounted for 19.1 percent (877,802 visits) of all drug-related visits in 2009; about half of these visits involved drug abuse.

In 2009, almost one million visits involved an illicit drug, either alone or in combination with other types of drugs. The rates of ED visits involving cocaine, marijuana, and heroin were higher for males than for females. Rates for cocaine were highest among individuals aged 35–44, rates for heroin were highest among individuals aged 21–24, stimulant use was highest among those 25–29, and marijuana use was highest for those aged 18–20.

 Illicit drug use among teenagers remains high, largely due to increasing popularity of marijuana. Marijuana use by adolescents declined from the late 1990s until the mid-to-late 2000s, but has been on the increase since then. In 2013, 7.0 percent of 8th graders, 18.0 percent of 10th graders, and 22.7 percent of 12th graders used marijuana in the past month, up from 5.8 percent, 13.8 percent, and 19.4 percent in 2008. Daily use has also increased; 6.5 percent of 12th graders now use marijuana every day, compared to 5 percent in the mid-2000s.

P.S:

The mind of a heroin addict: the struggle to get clean and stay sober

Trends and Statistics on Addiction (NIDA)