The National Institutes of Health are a kind of clinical national treasury, staffed by researchers who may be motivated to make a name for themselves, but at least not by a need to make a profit for a pharmaceutical company or other greed-driven enterprise. Based on what they pay my daughter, who is currently involved in a post-baccalaureate research fellowship there, they are certainly not doing it for the income.
The two particular institutes that I follow most closely are the National Institute on Alcohol Abuse and Alcoholism, now celebrating its 40th anniversary, and the National Institute on Drug Abuse, which recently published the latest revision of its “Research Report Series” on Marijuana Abuse (http://www.nida.nih.gov/PDF/RRMarijuana.pdf).
These plainly worded summaries of the current state of knowledge on various substance-related topics are so valuable as relatively objective sources of information. It is easy, on the web and elsewhere, to find those who celebrate the wonderfulness of marijuana and its medicinal uses, or, on the other hand, those who warn us vehemently of its dangers (reminding me of the narcotics officers at assemblies in my Baby Boomer high school, who assured us that this “gateway drug” would lead inevitably to cooking heroin in rusty spoons).
As usual, reality is somewhere in between. Marijuana certainly can be addictive, and can also produce adverse effects including psychosis, impaired learning/memory, and possible negative impact on the body’s immune system. On the other hand, it also appears to have some legitimate medical uses, and certainly its negative impact on the body is much less than that of drugs such as alcohol. (Speaking of high school talks, I myself once acknowledged, in response to a question, that alcohol could be regarded as the more dangerous of the two drugs – and was never invited to speak there again.)
As in the case of alcohol, someone who uses marijuana on an occasional basis, perhaps less than once a week, with no distressing symptoms or impairment, can probably be regarded as a non-problem “social” user (though often less social in behavior than a drinker). Let us not deny that. But let us also not deny that many of our peers use marijuana daily, or more or less continuously, and have great difficulty coping with life without it. Their drug use is more than a casual choice, and their ability to assess its impact is probably compromised. With all such substances, a particular concern is that use begins, often heavily, among individuals in their teens and early twenties, whose brains have not yet fully developed – further development may well be altered by the drug, in ways not yet fully understood.
It is very difficult to “treat” marijuana abuse or dependence, because the negative consequences of use are so often less than catastrophic, i.e., providing quite limited incentive for change. Though I approve of the moves toward decriminalization, those changes have only increased the difficulty of developing “healthy fear” of marijuana dependence. That is one of many factors to be taken into account in the assessment of each individual, as an individual.
