Although many people believe that marijuana is nonaddictive, the evidence is stacking up that people can — and do — become dependent on the drug. A study released earlier this year, for example, found that 40 percent of marijuana users in an outpatient treatment program showed signs of withdrawal, a classic indicator of addiction. Now, new research in the journal PNAS sheds light on how lighting up changes the brain — and potentially primes people for withdrawal.
It’s long been known that exposure to THC, the primary psychoactive ingredient in pot, can lead to changes in the brain. Problem is that different studies have shown different structural alterations, making it difficult to pinpoint exactly how marijuana affects people mentally. That’s why a group of researchers decided to use three different magnetic resonance imaging (MRI) techniques to examine the brains of 48 chronic marijuana users and 62 nonusers, while also assessing IQ and negative life consequences of pot smoking.
The most obvious difference: The people who regularly used marijuana had less volume in the orbitofrontal gyri. This brain region is part of the orbitofrontal cortex, “one of the primary areas within the reward system, which is basically a network of brain regions implicated in the addiction process,” said study author Francesca Filbey, an addiction researcher at the Center for Brain/Health at the University of Texas at Dallas. More specifically, the orbitofrontal cortex is important for decision-making. This is the area of the brain that would learn something is good for us or bad for us.
So why does pot cause shrinkage in this area? Simple: The orbitofrontal cortex is highly concentrated with cannabinoid receptors, the places in your brain where THC binds. As a result, it’s much more vulnerable to the effects of a chronic flood of the substance. In animal studies the number of those receptors decreased as a result of THC exposure as a way to regain balance in that system. So too much THC basically leads to lower numbers of those receptors in the brain.
It’s this effect that gives credence to the “marijuana is addictive” camp. The fewer cannabinoid receptors a marijuana user has, the more THC he requires to achieve the desired high. This really describes tolerance. Around 10 percent of users, on average, report changes in tolerance and also increased craving and withdrawal. The marijuana users in this study weren’t just casual smokers — they used the drug at least four times per week.
Although this study may help illuminate the addiction process, the findings are a little hazier when it comes to how these brain changes affect people’s behavior and intelligence, if at all. The researchers did find that marijuana users scored lower on an IQ test than non-users did. But as tempting as it is to link this to the changes in their brains, the researchers weren’t able to firmly establish that connection, suggesting there’s another factor behind the users’ lower IQs. One possibility: “If these individuals were using during their adolescent years, then they may have missed a lot of the verbal knowledge that IQ is testing for,” Filbey said.
And, incredibly, the brain seems capable of compensating for the volume loss associated with consistent marijuana use: The pot smokers showed increased connectivity in the orbitofrontal cortex. What does that mean, exactly? “Structural connectivity refers to the actual white matter tracks that connect the gray areas in our brain,” said Filbey. “Functional connectivity is how well brain regions coactivate — if they respond synchronously. This basically suggests there’s greater communication within the network.” The positive effects on connectivity were greatest in people who’d started using marijuana at a young age.
If this sounds too good to be true, that’s because it is — at least if you’ve been toking up for years. After about six years of chronic pot smoking, these compensatory increases in connectivity began to reverse. “[Connectivity] actually started to decline,” Filbey said. “[The brain] isn’t able to sustain itself past continued use of about six years.”
Thom Kessler, LMFT, RAS
What is drug addiction?
Addiction can be defined as a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite all consequences. It is considered a brain disease because drugs change the brain - they change its structure and how it works. These brain changes can be long lasting, and can lead to harmful behaviors seen in people who abuse drugs.
Why do people take drugs?
In general, people begin taking drugs for a variety of reasons:
To feel good
Most abused drugs produced intense feelings of pleasure. This initial sensation of euphoria is followed by other effects, which differ with the type of drug used. For an example, with stimulants such as cocaine, the “high” is followed by feelings of power, self-confidence, and increased energy. In contrast the euphoria caused by opiates such as heroin is followed by feelings of relaxation and satisfaction.
To feel better
Some people who suffer from social anxiety, stress related disorders, and depression begin abusing drugs in an attempt to lessen feelings of distress. Stress can play a major role in beginning drug use, continuing drug abuse, or relapse in patients recovering from addiction.
To do better
The increasing pressure that some individuals feel to chemically enhance or improve their athletic or cognitive performance can similarly play a role in initial experimentation and continued drug abuse.
Curiosity and “because others are doing it”
In this respect adolescents are particularly vulnerable because of the strong influence of peer pressure; they are more likely, for example, to engage in “thrilling” and “daring” behaviors.
If taking drugs makes people feel better – what’s the problem?
At first, people may perceive what seem to be positive effects with drug use. They also may believe that they can control their use; however, drugs can quickly take over their lives. Consider how a social drinker can become intoxicated, put himself behind the wheel and quickly turn a pleasurable activity into a tragedy for him and others. Overtime, if drug use continues, pleasurable activities become less pleasurable, and drug abuse becomes necessary for abusers to simply feel “normal.” Drug abusers reach a point where they seek and take drugs, despite the tremendous problems caused for themselves and their loved ones. Some individuals may start to feel the need to take higher or more frequent doses, even in the early stages of their drug use.
Is continued drug abuse a voluntary behavior?
The initial decision to take drugs is mostly voluntary. However, when drug abuse takes over, a person’s ability to exert self-control can become seriously impaired. Brain imaging studies from drug – addicted individuals show physical changes in areas of the brain that are critical to judgment, decision making, learning and memory, and behavior control. Scientists believe that these changes alter the way the brain works, and may help explain the compulsive and destructive behaviors of addiction.
Why do some people become addicted to drugs, while others do not?
As with any disease, vulnerability to addiction differs from person to person. In general, the more risk factors an individual has, the greater the chance that taking drugs will lead to abuse and addiction. “Protective” factors reduce a person’s risk of developing addiction.
What factors determine if a person will become addicted?
No single factor determines whether a person will become addicted to drugs. The overall risk for addiction is impacted by the biological makeup of the individual. Risk of addiction can even be influenced by gender or ethnicity, his or her development stage, and the surrounding social environment (e.g., the conditions at home, at school, and in the neighborhood).
Which biological factors increase risk of addiction?
Scientists estimate that genetic factors account for between 40 and 60 percent of a person’s vulnerability to addiction, including the effects of environment on gene expression and function. Adolescents and individuals with mental disorders are at greater risk of drug abuse and addiction than the general population.
What environmental factors increase the risk of addiction?
Home and Family
The influence of the home environment is usually most important in childhood. Parents or older family members who abuse alcohol or drugs, or who engage in criminal behaviors, can increase children’s risk of developing their own drug problems.
Peer and School
Friends and acquaintances have the greatest influence during adolescence. Drug-abusing peers can sway even those without risk factors to try drugs for the first time. Academic failure or poor social skills can put a child further at risk for drug abuse.
What other factors increase the risk of addiction?
Although taking drugs at any age can lead to addiction, research shows that the earlier a person begins to use drugs the more likely they are to progress to more serious abuse. This may reflect the harmful effect that drugs can have on the developing brain; it also may result from a constellation of early biological and social vulnerability factors, including genetic suspecibility, mental illness, unstable family relationships and exposure to physical or sexual abuse. Still the fact remains that early use is a strong indicator of problems ahead, among them, substance abuse and addiction.
Method of Administration
Smoking a drug or injecting it into a vein increases its addictive potential. Both smoked and injected drugs enter the brain within seconds, producing a powerful rush of pleasure. However, this intense “high” can fade within a few minutes, taking the abuser down to lower, more normal levels. It is a starkly felt contrast, and scientists believe that this low feeling drives individuals to repeated drug abuse in an attempt to recapture the highly pleasurable state.
The brain continues to develop into adulthood and undergoes dramatic changes during adolescence. One of the brain areas still maturing during the adolescence is the prefrontal cortex – the part of the brain that enables us to assess situations, make sound decisions, and keep our emotions and desires under control. The fact that this critical part of an adolescent’s brain is still a work-in-progress puts them at increased risk for poor decisions (such as trying drugs or continued abuse). Thus, introducing drugs while the brain is still developing may have profound and long lasting consequences.
Thom Kessler, LMFT, RAS
Alcohol abuse is a significant problem among young people and a solution needs to be found. As children approach their teen years, they begin to experience many emotional and physical changes that are not always easy. The teen years are challenging and confusing time.
Youth often is thought of as a time for trying new things, but trying alcohol at a young age can be riskier than you might think. More than two decades of research from the American Medical Association (AMA) shows that alcohol causes severe and possibly lasting brain damage in people under the age of 21. This is of great concern because children now try alcohol for the first time at the age of 12, and nearly 30 percent of 12- to 20-year-olds report binge drinking (having 4 to 5 drinks in a row).
The average age of a child’s first drink is now 12 and nearly 30 percent of 12 to 20 year-olds are considered binge drinkers. While many believe that underage drinking is an inevitable "rite of passage" that adolescents can easily recover from because their bodies are more resilient, the opposite is true.
For most children, it's not just one thing that influences them to drink, but a combination of factors.
Kids who start drinking AT AGE 14 have a 45% -55% CHANCE of developing a dependence on alcohol in early adulthood.
DEFINITION: Binge drinking is (Male) 5 or 4 (Female) standard drinks in 2 hours based on average weight and height.
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A major source of the normalization of alcohol use by children and youth is alcohol advertising. Television networks and cable stations have profited tremendously from the alcohol industry’s aggressive marketing to underage drinkers. These ads are proven to heavily influence the normalization and glamorization of drinking in the minds of children, and television has continued to endanger the health of these young viewers in spite of such findings.
As children begin spending more time with their peers and less time with their parents, this increased freedom can lead to drinking.5 While it's important to give your child space, keep track of where they are and who they're with. If they are at a friend's house, make sure a responsible adult is nearby or accessible.
Children who are disruptive, hyperactive, or depressed are at a higher risk for alcohol problems. If you feel that your child's social issues could lead him or her to abuse alcohol, consider having your child see a drug and alcohol counselor.
Children who come from a family with a history of alcoholism are at an increased risk for alcohol dependence. If alcoholism runs in your family, have an honest discussion with your child, and make sure he or she understands the seriousness of the disease.
Taking chances and trying new things are a normal part of growing up. For some children, this exploration includes experimenting with alcohol.6 Remind your child about the real risks of underage drinking, and make sure he or she knows how you feel about underage drinking.
When children worry about things like grades, fitting in, and physical appearance, they may use alcohol as a way to escape their problems. Encourage your child to get involved in sports or other extracurricular activities as a healthier way to cope.
Life events, like going from middle school to high school, breaking up with a significant other, moving, or divorce, can cause a child to turn to alcohol. Reassure your child that things will get easier, and make sure he or she knows that drinking isn't a solution.
If children grow up in an environment where adults drink excessively, they are more likely to drink themselves. If you choose to drink, set a good example by drinking in moderation, and make sure your child knows that underage drinking is not acceptable
PEOPLE WHO INFLUENCE OUR KIDS
Family, peers, school, and the community all play a role in your child's decision to drink.
In fact, most children who use alcohol get it from a friend or family member. To ensure these people become positive role models for your child, let them know how you feel about underage drinking.
Over 70% of eighth graders said alcohol is easy to get.
National Institute on Alcohol Abuse and Alcoholism, "Make a Difference: Talk to Your Child about Alcohol," 2009.
30% of children age 12-14 get alcohol from a family member.
Substance Abuse and Mental Health Services Administration, "Underage Alcohol Use: Findings from the 2002–2006 National Surveys on Drug Use and Health," 2008.
PEER PRESSURE / OTHER KIDS / PEERS
Most children feel pressure to be popular and fit in. Many try alcohol when they are in a social setting where "everyone else is doing it."7 Help boost your child's confidence by helping them learn different ways to say "no," and reminding them that real friends wouldn't pressure them to drink. If your child's friends use alcohol, your child is more likely to drink, too. During adolescence, a child's friends impact a lot of his or her decisions, including whether or not to try alcohol. Since children want to fit in with their peers, they might try alcohol just because everyone else is doing it.
What to do: Get to know your child's friends. If you feel they are a negative influence, try pointing out your reservations about them to your child, or limit the amount of time he or she spends with them. You should also discuss ways your child can avoid drinking when he or she feels pressure from peers
Parents have the greatest influence on a child's decision to drink. Children not only model their actions and attitudes toward alcohol after their parents, they look to their parents to set rules and expectations about drinking. Poor and inconsistent parenting has been associated with early and excessive drinking among children.
Between the ages of 9 and 13, children start to think differently about alcohol. Many children begin to think underage drinking is OK and some even start to experiment. It's never too early to talk to your children about alcohol, and encourage them to talk with you.
Over 70% of children say parents are the leading influence in their decision to drink or not
What you can do: Provide your child with clear, consistent rules, and make it a point to be involved in his or her life. If you drink, set a good example by drinking in moderation.
TALK EARLY / TALK OFTEN
What you can do: Provide your child with clear, consistent rules, and make it a point to be involved in his or her life. If you drink, set a good example by drinking in moderation.
The good news is that parents can help their teens make healthy choices when it comes to drugs and alcohol. Know where your child is, whom he is with, and what he is doing. Take time to talk to him each day about his activities and ideas, and listen to what he tells you. Discuss your expectations for him, and praise behavior you want him to repeat.
SMALL CONVERSATIONS CAN MAKE A BIG IMPRESSION
Short, frequent discussions can have a real impact on your child's decisions about alcohol.
Talking to your child at an early age about drinking is the first step toward keeping them alcohol-free. But as they enter junior high and high school, the pressure to try alcohol increases. It's important to continue the conversation throughout adolescence.
Talking often builds an open, trusting relationship with your child.
Children are more likely to avoid drinking when they have a strong, trusting relationship with their parents.2 Get into the habit of chatting with your child every day. It will make it easier to have serious conversations about things like alcohol, and will make your child more comfortable coming to you for advice.
Lots of little talks are more effective than one "big talk."
Sitting down for the "big talk" about alcohol can be intimidating for both you and your child. Try using everyday opportunities to talk – in the car, during dinner, or while you and your child are watching TV. Having lots of little talks takes the pressure off trying to get all of the information out in one lengthy discussion, and your child will be less likely to tune you out.
When you do talk about alcohol, make your views and rules clear.
Take the time to discuss your beliefs and opinions about alcohol with your child. Be honest and express a clear, consistent message that underage drinking is unacceptable. When they feel that you're being real and honest with them, they'll be more likely to respect your rules about underage drinking.
As children get older, the conversation changes.
What you say to a 9-year-old about alcohol is different from what you say to a 15-year-old. Children also can't learn all they need to know from a single discussion. Make sure that the information you offer your child fits their age. As they get older, you can give them more information and reinforce your rules.
Remember that the conversation goes both ways.
Although talking to your child about your thoughts about alcohol is essential, it's also important to hear their point of view. Give your child the opportunity to ask you questions, and listen to what they have to say. Children who have parents who listen to their feelings and concerns are more likely to say "no" to alcohol.
What you do is just as important as what you say.
In addition to talking often with your child about alcohol, it's important to set a good example. If you choose to drink, you can positively influence your child by drinking in moderation and NEVER driving when you've been drinking. Be aware of where you keep your alcohol, and always remind your child that the alcohol in your house is off-limits.
NEUROLOGICAL PROBLEMS / BRAIN
Researchers compared the brains of 14- to 21-year-olds who drank alcohol with those who didn't. Teens who drank had smaller hippocampus (the area deep in the brain that handles memory and learning), and they also had damage to part of the cerebral cortex, the prefrontal cortex (an area tucked behind the forehead that is used to make decisions and to reason). The AMA found that teens that used alcohol scored worse on vocabulary, visual-spatial tests (the ability to think in pictures and images), and memory tests. They also were more likely to perform poorly in school and suffer from social problems, depression, suicidal thoughts, and violence.
Alcohol can be harmful to people of any age, but it takes a greater toll on brain development in those under 21 than in any other age group. Findings show that adults would have to consume twice as many drinks to suffer the same damage as teens and that even some heavy drinking injures young brains. The AMA report points out that, no matter what many people might think, youth do not tolerate the effects of alcohol better than adults.
The Adolescent Brain
The brain goes through dynamic change during adolescence, and alcohol can seriously damage long- and short-term growth processes. Frontal lobe development and the refinement of pathways and connections continue until age 16, and a high rate of energy is used as the brain matures until age 20. Damage from alcohol at this time can be long-term and irreversible.3 In addition, short-term or moderate drinking impairs learning and memory far more in youth than adults. Adolescents need only drink half as much to suffer the same negative effects.4
Drinkers vs. Non-Drinkers: Research Findings
Adverse Effects of Alcohol on the Brain: Research Findings
Youth who drink can have a significant reduction in learning and memory, and teen alcohol users are most susceptible to damaging two key brain areas that are undergoing dramatic changes in adolescence:
Compared to students who drink moderately or not at all, frequent drinkers may never be able to catch up in adulthood, since alcohol inhibits systems crucial for storing new information as long- term memories and makes it difficult to immediately remember what was just learned.
Additionally, those who binge once a week or increase their drinking from age 18 to 24 may have problems attaining the goals of young adulthood—marriage, educational attainment, employment, and financial independence.12 And rather than “outgrowing” alcohol use, young abusers are significantly more likely to have drinking problems as adults.
For information about how to talk to your child, visit Underage and Under the Influence of Alcohol (hyperlink to article) and Talk to Your Child About Alcohol for information about how to talk to your child. You also may want to use ads on TV to start a conversation with your child about alcohol and drug use.
LEARN TO ANSWER TOUGH QUESTIONS
As your child becomes more and more curious about alcohol, he or she may turn to you for answers and advice. Use this opportunity to start an open, honest conversation about drinking. Since some questions can be difficult to answer, it's important to be prepared.
YOU DRINK SO WHY CAN’T I
Remind your child that underage drinking is against the law – for good reason. Point out that adults' bodies are full-grown, so they can handle drinking; but children's bodies are still growing, so alcohol can have a greater impact on their judgment and health.2
WHY DO YOU DRINK
Explain to your child your reasons for drinking – whether it's to enhance a meal, share good times with friends, or celebrate a special occasion. Point out that if you choose to drink, it's always in moderation. Tell your child that some people shouldn't drink at all, including children who are underage.
DID YOU DRINK AS TEENAGER
If you drank as a teenager, experts recommend that you give an honest answer.1 Explain why you were tempted to try alcohol and why underage drinking is dangerous. You could even give your child an example of an embarrassing or painful moment that occurred because of your drinking.
WHAT IF A FRIEND ASKS ME TO DRINK
Helping your child say "no" to peer pressure is one of the most important things you can do to keep him or her alcohol-free. Work with your child to think of a way for them to handle this situation, whether it's simply saying "no" or suggesting an alternative activity for them to do.
I GOT INVITED TO A PARTY CAN I GO?
Ask your child if an adult will be present at the party, or if he or she thinks children will be drinking. Remind your child that even just being at a party where underage people are drinking can get them in trouble. Use this time to establish or reinforce your rules about alcohol, and what behavior you expect.
WHY IS ALCOHOL BAD FOR ME
Don't try to scare your child about drinking or tell him or her, "You can't handle it." For example, you should tell him or her, "Alcohol can be bad for your growing brain, interferes with your judgment, and can make you sick." Once children hear the facts and your opinions about them, it's easier for you to make rules and enforce them.
UNDERAGE DRINKERS WHO DRANK IN THE PAST MONTH (I.E., CURRENT DRINKERS) OBTAINED THEIR LAST ALCOHOL DRINK AS FOLLOWS:
WHERE DO THEY DRINK
OTHER FAMILY MEMBERS
Children who have older brothers or sisters who drink are more likely to use alcohol.3
An older brother or sister often serves as a mentor whom the younger children look up to and want to emulate. If the older child drinks, he or she sends the message that underage drinking is OK, and might even provide alcohol for the younger child.
What to do: Remind your older child that he or she serves as a role model for the younger brother or sister, and that your rules and expectations about drinking apply to all underage family members. If the older sibling is of legal drinking age, ask him or her to always drink in moderation, and to never encourage drinking or offer their underage sibling alcohol.
30% of children age 12–14 get alcohol from a family member.4
As children get older, they tend to think their relatives are somehow a bit cooler than their parents. Since family members like uncles and cousins don't set the rules about underage drinking, they might not think about how their drinking behavior may influence your child or they may even offer him or her a drink.
What to do: Talk to them about what your rules and expectations about drinking are for your child, and ask them to help enforce these rules. If they choose to drink around your child, ask them to always drink in moderation.
Every family has different values and rules when it comes to underage drinking. Some parents might allow their children to drink, or even provide alcohol to their child's friends.
What to do: Get to know the parents of your child's friends – and their views on underage drinking. While they might have different rules for their own children, make it clear what your rules are for your child. If you feel they won't uphold your values, don't let your child go to their house.
People such as teachers, coaches, and clergy are around your child on a regular basis. They can help reinforce expectations and penalties regarding alcohol use by students, and can also notice changes in your child's behavior.
What to do: Have a one-on-one conversation with your child's teacher, coach, or religious figure about how important it is that your child abstains from underage drinking. Ask them to let you know if they notice changes in your child's behavior, or if they suspect your child might be drinking.
Thom Kessler, LMFT, RAS
As youth drug and alcohol abuse continues to grow, many parents say they are uninformed — and largely unconcerned — about the threat to their children.
So finds a new nationwide survey commissioned by the Hazelden Betty Ford Foundation, the nation’s largest nonprofit addiction treatment provider.
“These startling findings suggest that some parents are under-concerned about the dangers of alcohol and other drug use by their children and are overly confident they would recognize signs of their children’s use,” said Audrey Klein, PhD, executive director of Hazelden Betty Ford Foundation’s Butler Center for Research. “This is particularly worrisome given the consequences of teen alcohol and other drug abuse — including poor performance in school, a higher rate of accidents, unintentional overdoses, violence, sexual trauma and legal issues — and, unfortunately in some cases, even death.”
Research has shown that parental involvement is an effective way to prevent chemical use and addiction among you. Yet this national survey revealed a remarkable lack of parental awareness and concern about this important issue. Among the key findings of the poll are:
Most doctors lack training in identifying substance abuse. Less than 20 percent of primary care physicians consider themselves “very prepared to identify alcohol or drug dependence,” compared to more than 80 percent who are very comfortable diagnosing hypertension and diabetes, according to the National Center on Substance Abuse at Columbia University.
Resources are available for parents to educate themselves on how to recognize signs of drug use and discuss the issue with their kids on the Hazelden webpage: •Adolescent and Young Adult Addiction Handouts •Talking with kids about alcohol and drugs
Thom Kessler, LMFT, RAS
Marriage & Family Therapist and Registered Addiction Specialist