Will teen abuse increase now that marijuana is legal in burbs?
The opening of medical marijuana dispensaries in the suburbs has some substance abuse prevention experts worried.
Will teens get hold of marijuana meant for medical use and abuse it?
Will the positive message about the drug's benefits for the chronically ill change perceptions about its risks for others?
Experts such as Dr. David Lott, medical director of addiction services at Linden Oaks Behavioral Health in Naperville, think it very well could.
"The more you think (marijuana is) dangerous, the less you're going to use," he said. "By making it more legal, it's inevitable that it's going to seem less risky because it's more available and people are talking about it more in a positive way."
Lott says what's needed to counter the effects of this "positive" message about marijuana is a stronger emphasis on prevention messages in schools and elsewhere.
Other experts, such as Kathleen Kane-Willis of the Illinois Consortium on Drug Policy, agree that fact-based messages that don't demonize or glamorize drug use remain the best prevention method. But new concerns about pot, she says, are "premature and possibly unwarranted."
Research in other states shows perceptions about the dangers of marijuana change come before medical use laws are passed -- not after, Kane-Willis said. So if teens are going to think pot is less risky, chances are their opinions already have shifted.
Furthermore, with so many controls built into Illinois' law allowing medical use, it's unlikely it will cause a jump in teen use. Teens already have an easier time than adults getting illegal marijuana because of their social contacts, she said, so there's little incentive for them to deal with medical program hurdles such as fingerprinting and patient IDs.
Still, some say the beginning of a discourse about the benefits of medical marijuana could lead to higher use among the general population if it's not tempered with caution.
"'It's not a bad drug now, it's a medicine,' is the message people are getting, and it almost makes it sound like it's good for you, therapeutic," Lott said. "It's going to seem less harmful, more positive, and that's automatically going to translate into more use."
The perception shift Lott fears will drive increased marijuana use is already underway, according to results of the Illinois Youth Survey.
In 2008, 27.5 percent of 12th graders statewide said they thought there was "great risk" of harm from smoking marijuana once or twice a week. By 2014, that dropped to 22 percent.
That decrease came as the state's medical marijuana program was discussed and approved in 2013. But Kane-Willis says the changes didn't happen in a vacuum. Influences from other states where recreational pot use is allowed, such as Colorado and Oregon, also color the views of young people here. They're less likely to disapprove of marijuana use.
"These attitudinal changes are part of a larger cultural trend," Kane-Willis said.
Closer to home, a similar shift has been noted. Surveys in Naperville Unit District 203 and neighboring Indian Prairie Unit District 204 show a similar decrease in perceived risk. In 2013, 36 percent of high school students perceived "great risk" from using marijuana; that dropped to 33 percent in 2014.
"We know when perceived risk of harm associated with doing something goes down, the likelihood is eventually behavior will catch up and we would expect use to rise," said Karen Jarczyk, director of prevention for the nonprofit 360 Youth Services. "That is something we are concerned about."
Special risks to teens
Prevention experts say an increase in marijuana use is especially harmful to younger users.
This is mainly because marijuana, and its mind-altering substance called THC, affects sections of the brain responsible for memory, learning, attention and reaction time for up to 28 days after use.
Teenage brains are susceptible, Lott says, because they're not yet fully developed, especially in the prefrontal cortex, which helps control impulses and weigh potential outcomes.
Various studies show:
• One in six teens who use pot will become addicted, compared to one in 10 in the general population, according to a 2002 study cited by Smart Approaches to Marijuana, a bipartisan group of health professionals advocating for policy based on science.
• Heavy use by adolescents can reduce IQ up to eight points, even when IQ is tested well into adulthood, according to a 2012 study cited by Smart Approaches.
• Marijuana use has been linked with mental disorders, including schizophrenia, psychosis, depression and anxiety, according to Smart Approaches.
Lott says he's treated some patients whose schizophrenia set in after heavy marijuana use.
"It's a smaller percentage of users, but it does happen. And sometimes, it's a lifelong psychotic disorder," Lott said. "Some people are developing schizophrenia as a side effect of marijuana."
It's still a crime
In one attempt to stave off an increase in marijuana use, 360 Youth Services last fall distributed to Naperville-area teachers, school nurses and community leaders data describing the downsides of youth marijuana use, effects of the medical program on youths and ways to decrease those effects.
Dangers include higher rates of addiction, lower academic performance, changes in brain development and higher rates of driving under the influence of drugs.
Ways to lessen those dangers include reminding young people that marijuana possession is a crime, talking more about the dangers of driving under the influence, educating medical users about the importance of preventing their doses from getting into the wrong hands and considering whether dispensaries should be required to pay into to a fund to support prevention efforts.
Development of more government-based marijuana prevention programs also could help, and they're likely on the way, said Bill Gentes, project coordinator for the Lake County underage drinking and drug prevention task force.
He says several organizations that receive federal drug-fighting grants began this summer discussing ways to create best practices for marijuana prevention education.
For example, the Ela (Township) Coalition Against Youth Substance Abuse used to focus on marijuana and alcohol prevention, but recently honed in on alcohol.
"I do think that'll change," Gentes said. "We're working with a variety of other drug-free communities and we're working on just such prevention plans."
Just the facts
Prevention efforts, especially for teens, should feature straight talk with none of the hyperbole meant to scare kids away from experimenting with pot, Kane-Willis said.
"I don't think your message should substantially change except it should be more fact-based," she said. "Sometimes the message kids get is if you smoke marijuana you're going to become a heroin addict or your life is going to be ruined."
For most users, that's just not true, she said. Teens will sense the disconnect and the message will be lost.
Instead of scare tactics, Kane-Willis said prevention leaders should teach the signs and symptoms that show the difference between casual use and a true problem. Some such signs, according to the National Institutes of Health, include:
• Episodes of violence or hostility.
• Neglecting to eat or care for physical appearance.
• Secretive behavior.
• Continued use even when alone or even it's harming health, school, family or work.
Family history can be a factor, too, making experimentation riskier for those with kin having addiction or mental illness issues, Kane-Willis said.
Discussions about the medical availability of marijuana might already have shifted views about the purpose, positives and downsides of the drug. But with a focus on facts, those opinions don't have to create dangerous consequences.
"Attitudes can change," Kane-Willis said. "But that doesn't mean they're going to stay changed."
Medical marijuana in the suburbs• Two suburban dispensaries opened last Monday, in Addison and Mundelein. (First patient served in Addison was a 19-year-old from Itasca with multiple sclerosis.)
• A third opened Tuesday in North Aurora.
• A fourth is scheduled to open today in Schaumburg.
• Four other facilities have been licensed to open in Illinois. They are in Canton, Marion, Ottawa and Quincy.