The Spanish teens hooked on hash

It all starts with a furtive joint in the schoolyard handed round among nervous giggles and coughs. Later, when these teenagers have become frequent users, they will tell you: ¡°Cigarettes are much worse for you than marijuana. It¡¯s straight from a plant so it¡¯s more natural.¡±

They¡¯re partly right. Marijuana is natural, but that doesn¡¯t make it harmless. Scientists at the US National Institute on Drug Abuse (NIDA) have just sounded the alarm over the risks to mental health and cognitive skills in adolescents outlined in research that has just been published in the medical journal JAMA Psychiatry. Effects of Cannabis Use on Human Behavior highlights the link between neuro-psychological damage from cannabis and starting to smoke the drug at an early age.

Implications

According to the NIDA, substances such as cannabis can damage the structure and connectivity of adolescents¡¯ central nervous system, which in turn can lead to loss of concentration and memory that affects academic performance. Cannabis use also alters normal reflexes and triggers Amotivational Syndrome, characterized by apathy and disinterest in schoolwork and the world in general.

More seriously, the current levels of tetrahydrocannabinol (THC) present in marijuana raise the risk of acute psychotic episodes, depersonalization disorder, anxiety, identity disorder, paranoia and, where there is a genetic link, schizophrenia, says the NIDA in its report.

The message we need to get across to the young is that if they are going to use cannabis, they should do so as late as possible when their brain is largely developed

Marta Torrens of the Psychiatry Department of Barcelona¡¯s Autonomous University and director of the city¡¯s Hospital de Mar addiction program, agrees that the chance of developing psychosis or schizophrenia is higher in people with a family history of mental health problems, but points out: ¡°This is where we come up against the stigma of mental illness; no one talks about members of the previous generations who suffered psychiatric disorders.¡±

Torrens says that she knows of youngsters with a family history of mental illness who might not have developed psychiatric disorders if they hadn¡¯t used cannabis. She also points out that when mental illness manifests itself in adolescence, it affects not only academic performance, but teenagers¡¯ overall personal development.

She argues that by eliminating the use of cannabis, the rate of schizophrenia would fall by 8%, adding that if a teenager becomes a frequent user before reaching the age of 15, they are four times more likely to develop some kind of mental illness before the age of 26. ¡°The message we need to get across to the young is that if they are going to use cannabis, they should do so as late as possible when their brain is largely developed, in order to avoid serious problems,¡± she says.

Surge of cannabis use among Spanish youth

Worryingly, the most recent study by the World Health Organization (WHO) on adolescent behavior in 42 countries (Health Behavior in School-aged Children) found that between 2013 and 2014, Spanish teenagers had one of the highest cannabis consumption ratess in Europe.

According to the report, 20% of 15-year-old boys and 18% of 15-year-old girls in Spain had smoked hashish, compared to the international average of 15%. Of these, 11% of boys and 9% of girls had done so in the last 30 days, placing them in ninth place. One in four students had smoked it in the last year and 22% of 15- to 24-year-olds consumed quantities large enough to cause addiction and poor academic performance. The report also found that teenagers were starting to smoke earlier, exacerbating mental health risks.

One piece of positive data unearthed by Spain¡¯s State Survey on the Use of Drugs among Secondary School Students (ESTUDES) from the National Plan on Drugs is that, although 146,200 14- to 18-year-olds started using cannabis last year, with 53,000 consuming a problematic amount, there has been a slight drop in general consumption since 2012.

¡°Although the last few surveys show a slight drop in consumption, the figures are pretty bad,¡± says Elena Mart¨ªn, a government advisor to the National Plan on Drugs. ¡°But if we keep selling cannabis as a cure-all for aches and pains, of course teenagers are going to see the drug in a positive light. They don¡¯t differentiate between medical and recreational use. One thing is the controlled therapeutic use of THC, measured and prescribed to alleviate specific pains such as muscle spasms related to scoliosis. Another thing is marijuana, where there is no control over the levels of THC and which also contains 500 other components with psychoactive effects that still need further research. The idea that cannabis is harmless is spread by people with big economic interests in the industry.¡±

If we keep selling cannabis as a cure-all for aches and pains, of course teenagers are going to see the drug in a positive light

Elena Mart¨ªn, government advisor to the National Plan on Drugs

Aggravating the situation is the tendency to genetically modify marijuana seeds, a practice monitored by the Spanish Society of Research into Cannabinoids (SEIC), which has found they contain an increasingly high concentration of THC ¨C to trigger a greater high ¨C and less Cannabidiol (CDB), a chemical found in the plant that may arrest the psychoactive effects of THC.

Another piece of data highlighted by the latest studies is that 70% of adolescents can buy cannabis within 24 hours. ¡°The highest consumption of cannabis happens in regions such as the Basque Country, Catalonia and Valencia where there is a permissive attitude towards cannabis clubs that promote the benefits of the drug,¡± Mart¨ªn says. ¡°The combination of a perceived lack of risk, easy access and positive publicity has pushed consumption sky-high.¡±

Meanwhile, Koldo Callado, Professor of Pharmacology at the University of the Basque Country and a member of SEIC, doesn¡¯t think high consumption among teens is related to cannabis clubs at all, but to the general perception of cannabis as a low-risk option ¨C teenagers generally see it as less dangerous than tobacco.

¡°By giving young people scientific data on the negative effects of cannabis, we aim to reduce the potential for mental health problems,¡± says Callado. ¡°What worries us most is that teenagers are starting to consume at a younger and younger age. In the last few years, the focus has been on alcohol and tobacco, with laws making it harder to smoke and drink in public places. This has been effective in bringing down consumption in those areas but there hasn¡¯t been a similar campaign against cannabis.¡±

Callado accepts that not everyone who tries hashish becomes a heavy user. ¡°For an adolescent to move from sporadic to frequent use there needs to be a genetic predisposition to substance abuse or a certain set of social circumstances. Not all adolescents who smoke once or twice become addicts.¡±

Tools to battle addiction

As advice and punishment have rarely been found to work with adolescents, other approaches need to be explored, say the experts. The EDEX Foundation has developed an educational approach with programs such as Unplugged and ??rdago! (Challenge!), aimed at 12- to 16-year-olds, programs that work on life skills to help adolescents cope without resorting to drug use. EDEX has also produced a guide called Drugs: Know More / Risk Less, which offers tools to parents to improve their communication with their children.

¡°Our aim is to improve skills in areas of cognition and emotion, reconciliation, self-knowledge, empathy, self-assertion, relationships, problem solving and conflicts, critical thought and stress management,¡± says Roberto Flores, director of EDEX. ¡°But both ??rdago! and Unplugged do need teachers who are capable of creating an environment conducive to personal and group reflection; a place teenagers can feel safe to express their opinions and feelings.¡±

The EDEX approach is already producing results. Assessed by the Italian Osservatorio Epidemiologico delle Dipendenze del Piemonte, participation in the Unplugged program was found to make daily cigarette smoking and inebriation 30% less likely while participants were 23% less likely to have smoked cannabis in the previous month than adolescents who had not taken part.

Experts recommend parents watch out for mood swings, short-term memory problems, changes to eating or sleeping habits, and a sudden drop in academic performance

Prevention may be the best policy, but what if a teenager is already using cannabis? The experts recommend parents watch out not just for red eyes and the smell of marijuana on clothes but also mood swings, short-term memory problems, changes to eating or sleeping habits, a sudden drop in academic performance and a loss of interest in hobbies, activities and old friendships. But they also warn about policing adolescents, instead recommending dialogue to find solutions.

As part of the National Drug Program, drug abuse help centers (Centros de Atenci¨®n Integral al Drogodependiente, or CAID) have been set up throughout the country. Among them is Los Mesejo in Madrid, which is geared specifically to adolescents and now deals with 17% of cases across the country.

¡°Since opening in January 2015, we¡¯ve dealt with almost 200 cases, involving both families and teenagers who are looking for a solution to the problem of abuse,¡± says Alfonso Poza, director of Los Mesejo. ¡°Around 90% of these cases are related to cannabis. Some of them come with mental health problems and need to be hospitalized. Cannabis is here to stay and is easily available to this vulnerable tier of society. Some believe that cannabis will help their concentration when the exact opposite is true. So it¡¯s important not to demonize it but to give kids all the information they need so they can make their own decisions. You don¡¯t need to raise the alarm because you¡¯ve found a joint in their pocket, you just need to know what¡¯s going on.¡±

English version by Heather Galloway.