Autumn 2005
O'Shaughnessy's
Journal of the California Cannabis Research Medical
Group
|
Implications of Early Cannabis
Initiation
By Tom O'Connell, MD
I have been conducting an ongoing clinical study of applicants
seeking “medical” designations
under the aegis of Proposition 215. By encouraging individuals regarded
(perhaps even by themselves) as “recreational” users
to seek recommendations, Prop 215 created the opportunity for physicians
to gather clinical data of a type not previously available.
Over the course of nine months I developed a structured
interview that allowed construction of a user “profile” by relating family
and school histories to initiations and lifetime experiences with alcohol,
tobacco, cannabis and other illegal “drugs of abuse.”
It soon became apparent that the great majority of applicants -whatever
visceral or structural lesions they now cited to justify their use
of cannabis- had first tried it as adolescents. They had been (often
unwittingly) using it over long intervals as safe and effective self-medication
for a panoply of emotional symptoms.
Most of their initiations occurred during junior high or high school
(i.e., the age period at which federal policy is designed to deter
cannabis use).
The relative scarcity of applicants born before 1946 indirectly confirms
that older patients who had not initiated cannabis as adolescents are
very reluctant to even try it. This holds true even when they are experiencing
symptoms known to respond to cannabis (nausea associated with chemotherapy,
for example). Because they had come of age before the hippie/Vietnam
era, tobacco and alcohol had been their only readily available options
for self-medication.
Implications for drug policy
Despite their adverse health and social consequences, alcohol and tobacco
have been essentially receiving preferential endorsement from national
drug policy. Alcohol and tobacco remain legal while cannabis use
is criminalized. Research aimed at exploring medical applications
is stifled.
Symptoms being treated by self-medication are variants of anxiety that
relate to low self-esteem (often associated with physically or emotionally
absent fathers). The aggressive drug initiation patterns exhibited
by these patients suggests that repetitive drug use is an unwitting
search for relief brought on by low self-esteem.
Symptoms being treated by self-medication are variants of anxiety that
relate to low self-esteem
Demographic Notes
Standardized information has now been gathered from approximately 3000
individuals. Chronic cannabis users born before 1946 are very uncommon,
compared with early ‘baby boomers born just in time for the
Vietnam/hippie era. Chronic cannabis use typically begins after initiation
during middle and high school years. The increased availability of
cannabis to adolescents over time is manifested by a decline in average
age at initiation noted after 1975.
The ‘gateway’ hypothesis —that cannabis somehow leads
its youthful initiates to progress to “harder” drugs— was
based on limited observations, made during the mid-1970s, on youths
born in the late ’40s and early ’50s. Demographic data
from that population suggests they were on the leading edge of what
would gradually become today’s huge illegal market. Continuing
Congressional pique at the size of that market has prompted enactment
of “add-on” penalties which apply primarily to adolescents
and young adults convicted of marijuana “crimes.”
For updates on Tom O’Connell, MD’s study and his observations
on cannabis and applicable policy see
http://www.doctortom.org/