Many young people who smoke marijuana never progress to using other drugs, but some do go on to abuse other harder, illegal substances. Some research suggests that marijuana use is likely to precede use of other For instance, a study using longitudinal data from the National Epidemiological Study of is also linked to other substance use disorders including nicotine addiction. of people who use marijuana do not go on to use other, "harder" substances. Does using marijuana lead to other drug use? who use marijuana do not go on to use other "harder" substances, like cocaine or heroin.
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However, the full range of consequences linked with marijuana's higher potency is not well understood. It is unknown how much people who use marijuana adjust for the increase in potency by using less. The majority of people who use marijuana do not go on to use other "harder" substances, like cocaine or heroin.
However, some research shows that people often try marijuana before trying other substances. It is important to point out, however, that research has not fully explained any of these observations, which are complex and likely to involve a combination of biological, social, and psychological factors.
Studies have not found an increased risk of lung cancer in marijuana smokers compared with nonsmokers. However, marijuana smoke does irritate the lungs and increases the likelihood of other lung and breathing problems. Many people who use the drug long-term and then stop have symptoms that are similar to those of nicotine withdrawal—irritability, sleep problems, anxiety, decreased appetite and various forms of physical discomfort—which may prompt relapse a return to drug use.
Withdrawal symptoms are generally mild and peak a few days after use has stopped. They gradually disappear within about 2 weeks. Because withdrawal is not as obvious or as painful as withdrawal symptoms from some other drugs such as opioids, many people do not realize that stopping marijuana use can cause withdrawal symptoms.
Synthetic cannabinoids, which are sometimes also called K2 or Spice, consist of many human-made mind-altering chemicals that are either sprayed on dried, shredded plant material to be smoked, or sold as liquids to be inhaled in e-vaporizers. These chemicals are called cannabinoids because they have chemicals that act on the same brain cell receptors as THC, but are often much more powerful and unpredictable.
Because of this similarity, synthetic cannabinoids are sometimes misleadingly called "synthetic marijuana" or "fake weed" , and are often labeled "not fit for human consumption.
Their effects, like the ingredients, often vary, but emergency rooms report large numbers of young people appearing with rapid heart rates, vomiting, and negative mental responses including hallucinations after using these substances. Some states are reporting an increased number of overdose cases involving synthetic cannabinoid products where users are experiencing severe bleeding, likely due to product contamination.
Behavioral therapies are available and are similar to those used for treating other drug or alcohol addictions. These include motivational enhancement therapies to develop people's own motivation to stay in treatment; cognitive behavioral therapies to teach strategies for avoiding drug use and its triggers and for effectively managing stress ; and motivational incentives, which provide vouchers or small cash rewards for showing up for treatment and staying drug free.
There are currently no medications approved by the U. However, these medications are not smoked. Parents should be aware of changes in their child's behavior, such as not brushing hair or teeth, skipping showers, changes in mood, and challenging relationships with family members, and a change in friends.
In addition, changes in grades, skipping classes or missing school, loss of interest in sports or other favorite activities, changes in eating or sleeping habits, and getting in trouble in school or with law enforcement could all be related to drug use—or may indicate other problems.
See the list of specific warning signs for marijuana use below. Using cutting-edge imaging technology, scientists from the Adolescent Brain Cognitive Development ABCD Study will look at how childhood experiences, including use of any drugs, interact with each other and with a child's changing biology to affect brain development and social, behavioral, academic, health, and other outcomes.
Doctors are especially worried about adolescent use because a growing body of research links marijuana to a range of negative outcomes. Those who smoke regularly double their risk of reporting psychotic symptoms or being diagnosed with schizophrenia in adulthood, especially when there is a personal or family history with mental illness.
Long-term use is also associated with problems in attention, memory, impulse control, problem solving and emotional regulation. Regular use also affects the very makeup of the brain, which is still developing in youth.
As a result, the Canadian Medical Association urged the federal government to set the legal age for consumption at 21, and restrict the quantity and potency of marijuana for everyone under Instead, Ottawa proposed a legal age of 18 and let the provinces and territories impose stricter standards. For the most part, governments have opted to prohibit access for those under 19 Alberta and Quebec have opted for 18 , which represents a compromise of sorts. Since Canadians under 25 are the biggest consumers of marijuana, restricting access would only further entrench the illicit market and continue to subject young people to criminal prosecution.
No jurisdiction has proposed to limit the quantity and potency of marijuana to Canadians under 25, however, and some doctors have slammed the federal government for failing to set national standards.
Levitt, for one, is concerned that health warnings from the CMA and other bodies are lost in the conversation around legalization. He sees a very different reality in his role as medical director of the Family Navigation Project at Sunnybrook. The program helps families with youth between 12 and 26 dealing with mental health or addiction issues find appropriate care. When families call about an addiction issue, the substance is marijuana in the overwhelming majority of cases.
If confronted about anything—quitting marijuana, getting a job, returning to school—the youth would lash out with threats, he says, throwing furniture or kicking holes in the walls. Family members start to feel trapped in their own homes, afraid to stoke a confrontation. The Diagnostic and Statistical Manual of Mental Disorders sets out a definition for cannabis dependence, including a strong desire to use marijuana, unsuccessful attempts to cut back and failure to fulfill obligations at work, school or home as a result.
Michael, who asked that his last name not be used, first tried cannabis when he was 14, and continued to use multiple times a day for nearly 30 years.
Over time, he organized his life around marijuana, choosing a career editing music videos, where marijuana use was acceptable, and turning down more lucrative job offers. His dependence contributed to the end of his first marriage. Michael told his ex-wife he would stop using but ended up buying marijuana a few days later.
His memory was spotty, and he recalls struggling to spell even simple words in his head. Michael tried quitting numerous times, and even attended Alcoholics Anonymous meetings. Michael better related to the stories he heard, and decided to get more involved in the organization. When I was a pothead in my basement, I felt like I had no purpose. While marijuana comes with its own set of risks, it is obviously not as destructive or addictive as alcohol or other substances.
But that fact can become a justification to keep using rather than address the problem. Stefan, who lives in London, Ont. Eventually, he felt he needed marijuana to feel normal. Stefan constantly thought about quitting. Sometimes, he picked up the habit again out of boredom. Chronic users can experience withdrawal symptoms, which can cause some people to start again.
In this analysis, we a used a total sample of 11, observations with complete survey weights and information across all four waves. We created a two-level outcome measure for each psychoactive substance used from older adolescence Wave 2 to adulthood Waves 3 and 4. Respondents reporting not using a substance served as the reference.
These were measured with two items, one stating if respondents had used any of these substances and the follow-up question asking the age at which they started using each substance for the first time. These two items were combined to create the age of use for the following substances: In a separate analysis we specifically examined changes in the gateway drug exposures in adolescence and changes in the pattern of illegal drug use in adulthood.
These include age ranges 12—19, 18—26 and 26—32 at respective Waves 2, 3 and 4 , race Black, White and Hispanics and current substance used marijuana, illegal drugs and cocaine at a particular survey period to control for potential influences on early drug use and later substance use. Higher CES-D scores indicate negative emotions or negative affect. The consistency of the 9-item scale in measuring depressive symptomatology has been affirmed in numerous studies Levine, , Zhang et al.
Across all four waves we created comparable 9-item CES-D scales to assess depressive symptoms. Response to mental using the mental health services item in the instrument was used as a measure of access mental health services across waves of data collection. We evaluated cohort-specific analysis to determine the relationship between initial drug intake and later illicit drug progression across different waves of data collection.
These models were estimated with generalized estimating equation GEE for repeated measures using cumulative logit link function and simultaneously adjusting for multiple covariates. To model the relationship between early substance used and later substance use as exhibiting a change over time, the variation in early exposures and changes in later drug use escalation were examined.
Baseline characteristics of Add Health study participants according to early drug use, — These plots reveal strong correlations among cigarette smoking That is, gateway substance users are over time more likely to report depressive symptoms as measured with CES-D. However, both cigarette smokers and alcohol users are over time more likely to report relatively higher depressive symptoms than marijuana users.
Associations of baseline characteristics with psychoactive substance use over the period of follow-up data are shown in Table 2. More than half of marijuana users in this age category used marijuana a year later but the usage of other illicit drugs was not consistent over time.
Overall, illegal drugs and cocaine in particular were least likely to be used from adolescence to adulthood. Distribution of population characteristics by early psychoactive drug use a among Add Health participants, baseline in , follow-up in — Relationships among various psychoactive substance uses with the baseline age of substance use measured at 3 different survey waves are shown in Table 3.
Tobacco, marijuana, any illegal drugs and age at cocaine use in adolescence was significantly associated with marijuana use, illegal drugs and cocaine in older adolescence, but over time these relationships were not consistent as expected from the gateway hypothesis.
Using marijuana at baseline appeared to be consistently associated with increased likelihood of using other psychoactive substances in late adolescence and in young adulthood compared with non-users. Alcohol use in Wave I was less likely to be associated with any psychoactive substances in older adolescence and over time, but tobacco use greatly increased the odds of using marijuana, cocaine and illegal drugs in older adolescence.
Cigarette smoking greatly increased the odds of using cocaine in early adulthood among all age groups reporting smoking in Wave I. Adjusted odds ratios of all later psychoactive substance use versus non-use according to baseline characteristics among National Longitudinal Study of Adolescent to Adult Health Add Health participants, baseline in , follow-up in — Multivariable analyses adjusted for demographic characteristics, access to mental health, and previous wave of psychoactive drug use.
Bold-faced indicate statistically significant differences. The pattern consistent with the gateway hypothesis was not present across the waves of data collection in to adulthood. However, among the three gateway substances initiated in early adolescence marijuana appeared somehow to have a greater and consistent effect in determining the likelihood of using other psychoactive substances over time in adulthood.
There were significant interactions between the three gateway drugs and depressive symptoms for marijuana, illegal drugs and cocaine used in older adolescence and adulthoods results not shown. Table 4 shows results from changes in the use of three gateway drugs in adolescence and the likelihood of using illegal substances in adulthood. Only heavy alcohol users were at increased odds of using marijuana in early adulthood and higher odds of using illegal drugs and cocaine in young adulthood.
Reference group is non-users of a particular gateway drug at the respective developmental stage. We next investigated whether the observed effects resulting from the changes in the gateway drug use in adolescence and depressive symptoms CES-D were consistent determinants of illegal drug use in adulthood.
Non-smokers in Waves 1 and 2 and reporting high depressive symptoms in Wave 3 had 1. In this prospective cohort study, early use of psychoactive substances — smoking cigarette, alcohol and illegal drugs as earlier defined was associated with increased likelihood of using marijuana, illegal drugs and to a large extent cocaine use in older adolescence. First, early exposure to marijuana and illegal substances was also positively associated with illegal substance and cocaine use in young adulthood.
Our finding that early exposure to cigarette smoking and alcohol use was positively associated with later almost However, our findings showed that over a relatively longer period of time from adolescence to adulthood , early use of marijuana and other illegal drugs rather than tobacco or alcohol greatly increases the likelihood of using cocaine and other illegal drugs.
A co-twin study in Australia found early cannabis use as a consistent predictor for other psychoactive substance use and in development of drug dependence Lynskey et al. Contrary to our findings, Tarter et al. Participants in this study started using marijuana before tobacco or alcohol.
However, this prior finding reflects ease of access to marijuana or other commonly available drugs rather than a defined pattern of drug escalation within a framework of causality.
This needs further investigations. Our data reveal that early use of psychoactive substances is associated with increased likelihood of using further illicit substances during adolescent period, but effects of these substances on later illicit drug use are inconsistent. These findings are remarkable in view of the current debates on legalizing marijuana for recreational and medical uses, and the fact that our sample is population-based.
Clearly, marijuana use in early adolescence enhances increased likelihood of continuing use of other psychoactive substances, and may be further compromised by underlying mental health condition. Both heavy and moderate users of alcohol as well as adolescents using marijuana of different amounts in Waves I and II were at increased odds of using illegal drugs and cocaine in young adulthood.
The idea of gateway substance use among adolescents actually assumes that once consumption of psychoactive substance is initiated the trend is to escalate and suggests that adolescent behaviors are immutable.
Availability and inclusion of current drugs used in statistical models across each wave enabled ascertainment of effects of earlier drugs used on current illicit drugs while controlling for previous drugs. Given the relatively large sample size, we were able to model changes in drug use during adolescence and likelihood of using other drugs in adulthood — a feature that has not been applied in numerous studies.
Is Cannabis a ‘Gateway Drug’?
There's a lot of debate about whether cannabis could lead to harder the use of “less harmful” substances is a risk factor for using “harder This support enables us to keep working as we do – but we must 16 Apr Tarter et al. Predictors of marijuana use in adolescents before and The point of the matter is that cannabis use does NOT cause one to try harder drugs. . Does using marijuana lead to the use of more dangerous drugs. Research simply does not support the theory that marijuana is a “gateway” drug – that is, one whose use results in an increased likelihood of using “more.