Table Of ContentMarijuana
DRUGS OF ABUSE
A Comprehensive Series for Oinicians
Volume 1 MARIJUANA
Mark S. Gold. M.D.
Marijuana
Mark S. Gold, M.D.
Fair Oaks Hospital
Summit, New Jersey
Springer Science+Business Media, LLC
Library of Congress Cataloging in Publication Data
Gold, Mark S.
Marijuana.
(Drugs of abuse; v. 1)
Includes bibliographies and index.
1. Marijuana. I. Title. II. Series. [DNLM: 1. Cannabis. 2. Cannabis Abuse. 3. Can·
nabinoids-pharmacology. WM 276 G618m]
RCS68.C2G64 1989 616.86'3 88-32427
ISBN 978-1-4899-3495-6 ISBN 978-1-4899-3493-2 (eBook)
DOI 10.1007/978-1-4899-3493-2
© Springer Science+Business Media New York 1989
Originally published by Plenum Publishing Corporation in 1989
Softcover reprint of the hardcover 1st edition 1989
All rights reserved
No part of this book may be reproduced, stored in a retrieval system, or transmitted
in any form or by any means, electronic, mechanical. photocopying, microfilming,
recording, or otherwise, without written permission from the Publisher
Preface
Marijuana is the most widely used illicit drug in Amer
ica. Some 40% of the adult population has tried mari
juana at least once. It is the third largest agricultural
commodity in the nation and a $10 billion industry. In
many areas of the country, marijuana production or sale
is the largest moneymaker by far. In Florida, for ex
ample, it ranks ahead of every business except tourism.
It is also a widely misunderstood substance. An en
tire generation of Americans grew up believing that
marijuana was virtually risk-free. This belief persists,
despite growing evidence of physical, psychological,
and social harm that is caused by the drug.
The worst victims of this misinformation are young
people. They, of all groups, are the least equipped to
uncover and objectively evaluate the evidence regarding
marijuana. At the same time, they are the most at risk
for long-term problems resulting from marijuana use.
v
vi
PREFACE
As physicians we must make every effort to guide young
people away from this drug.
There are very significant dangers in young people
experimenting with marijuana. The drug detoxification
center at our hospital-and centers throughout the
country-are packed with middle-class young people
who started out smoking pot. None of them intended
to become addicted, but the fact is that young people
are more vulnerable to the influence of the drugs and
become dependent easily. They may escalate usage, and
progress to use of other drugs.
Teenagers need to understand that addiction and
dependence are not matters of willpower, but are,
rather, functions of body chemistry and psychological
needs that are beyond individual will. Addiction occurs
to people in all walks of life, including highly accom
plished businesspersons, physicians, and even religious
leaders. Many of them started out taking drugs to deal
with painful medical conditions or to cope with stresses
of professional life. A young person who has not yet
developed a strong personality and character can be ex
tremely susceptible.
Studies also indicate that a large percentage of auto
accidents now involve alcohol and/or marijuana use, re
sulting in countless, needless deaths. Especially in the
suburbs, partying with drugs almost always involves
driving.
Young people should be asked; Is it worth getting
high if it means that one, two, or three of your friends
are going to forfeit their lives to addiction or to die in
accidents as a result? Put this way, many decide that it
is not. But for others the threat of death or addiction is
not a deterrent, and may actually encourage drug use.
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PREFACE
Apart from tragic outcomes, adolescence happens
to be the worst time, from a developmental standpoint,
to engage in drug use. Physiologically, pot smoking may
suppress the sex hormones, interfering with growth
processes, sexual maturation, and menstruation. Any
departures from the normal in this area may be acutely
disturbing at an age when a person needs every reas
surance of being physically normal. Long-term effects
in this area of function are impotence, loss of normal
sexual drive, and infertility.
Psychologically, adolescence is a time to develop
self-awareness and a healthy sense of identity. A child
who deals with personal uncertainties by "zonking out"
to a drug-induced grandiosity is avoiding the necessary
process of developing a firm sense of self. If anxieties
about intimacy or confronting others are avoided by
using drugs, the teenager postpones the task of learning
how to become comfortable with others. Achievement
of a sound identity will remain unresolved, which may
be a factor in the prolonged "adolescence" that is so
commonly seen-with individuals in their late twenties
still wondering who they are and what they would like
to do with their lives. Only by confronting fear-inducing
situations can the fear be mastered and self-confidence
nourished.
Using marijuana for performance anxieties related
to schoolwork, or achievement in general, has similarly
long-range repercussions. Students in our treatment
programs sometimes boast that they get high several
nights a week, even before exams, and still earn B
grades. I answer that they are denying themselves the
chance to learn how considerable their potential may
be. Even to the A students, I point out how much more
viii
PREFACE
they might fulfill themselves and contribute to society
if part of their brains were not incapacitated. Few of
them realize, moreover, that the components of mari
juana are stored in fatty tissue, including the brain, for
weeks after ingestion, influencing and possibly impair
ing cognitive skills. I also suggest to these teenagers
that, although they may be holding their own in school
despite smoking pot, a stressful time may come in col
lege or graduate school, when academic demands are
much greater than those they are now experiencing. The
danger lies in having already learned a "solution"
drugs-that the student under stress may then resort
to.
Anyone faced with counseling teenagers about
drug use may expect some clever rationalizations. For
example, teenagers protest that adults can't understand
how pot lets them see things "as they really are," and
how it enhances interpersonal communication. They
should be told that studies indicate just the opposite
that marijuana impairs perception and effective com
munication. One study, for example, involved pot
smoking and nonintoxicated subjects engaging in con
versations. The stoned persons thought that the pairs
were understanding one another profoundly-but they
were generally unable to remember the thread of their
own conversations and uttered non sequiturs that had
nothing to do with their companions' statements. As for
the argument "You don't understand," I point out that
you don't have to have cancer to be an oncologist-or
even the best oncologist. Similarly, you don't have to
use drugs to understand drug abuse-in fact, it's better
if you don't.
Young people might also be asked to evaluate hon-
ix
PREFACE
estly just how enjoyable or frightening the experience
of being high is. Often it is more negative than enjoy
able. The intoxicated person may feel terror about for
bidden or self-destructive impulses. Paranoid states are
common; best friends appear sinister, and every passing
siren is believed to be the police coming to arrest the
person who is high. It is only afterwards, in the com
pany of their friends, that they reinterpret the experi
ence as a "great time."
Young people questioned about the wisdom of
smoking pot are quick to point out that their parents
drink, and that pot is "no worse" than liquor. In the
first place, the statistics on alcohol abuse and alcohol
related traffice fatalities show that alcohol is far from
benign itself. In the second place, the known physical
and psychological effects of marijuana indicate that it is
indeed worse than alcohol.
Unfortunately, too many parents are taken in by
this type of false logic, and reason that if it's okay for
them to have a drink, they can't come down too hard
on their children for smoking marijuana. In doing so,
they abdicate their responsibilities as parents. Teenagers
are not known for their moderation, and the children
will almost certainly try to outdo their parents. If parents
are heavy drinkers themselves, they must consider the
consequences that these actions have for the future of
their children, and reduce their own alcohol (or elimi
nate marijuana) consumption as an example to their
children.
Young people are in the process of graduating from
indulgence and fantasy fulfillment of childhood and
learning to deal with the real world to gain their ends.
They must learn that a sense of well-being comes from
Description:Marijuana is the most widely used illicit drug in Amer ica. Some 40% of the adult population has tried mari juana at least once. It is the third largest agricultural commodity in the nation and a $10 billion industry. In many areas of the country, marijuana production or sale is the largest mone
