Kids Today Pay a Higher Price for Getting High

By Woodson Merrell, M.D.

I am deeply concerned about the increasing incidence of recreational drug use in younger adults and teens causing significant, sometimes permanent, psychological (or physical) damage. I am well aware drug use in this age group has been around in earnest since the 1960s. But in my experience as a physician, the medical and psychological harm associated with youthful experiments with drugs (and alcohol) have become more prevalent even in the past 5 years. I have been asking myself, what is different about these kids?

Now new information and recent events shed light on some answers that make much sense: illicit drugs now are different, often much stronger, than what's been available for many decades. And genomic research shows it is very likely there are changes taking place within the human genome as a result of generations of drug use that may be making kids more susceptible to use-related problems.Pineapple Express made it funny, but scientists are uncovering a much darker side of being stoned.

A recent Wall Street Journal article about the so-called "Legal High" business details how these stronger, potentially more harmful substances are getting into kids hands. In terms of alcohol, we know from recent publicized incidences of near-fatal alcohol poisoning that the new spate of alcohol-energy drinks (which can contain the alcohol-equivalent of 4 bottles of beer plus 3 shots of espresso in a single can!!) are a disastrous choice for a young person on a Saturday night.

While it seems the alcohol energy drinks may be banned out of existence (today, New York state Washington state, Michigan, Oklahoma, Utah and the Chicago City Council in imposing bans) banning so-called designer drugs is tougher. Illicit manufacturers are always trying to stay one step ahead of the Feds by inventing new substances not yet declared illegal. "Probably five years ago, the appearance of a new drug was notable-we'd all get together and talk about it-whereas last month, we found six," John Ramsey, a toxicologist at St. George's University in London told The Wall Street Journal. When even the experts are often stumped by the new designer drugs, we certainly can't expect kids to know what they are getting into.

Purchasing recreational drugs has always been a "caveat emptor" situation--meaning buy at your own risk--but today there are many more synthetic psychoactive compounds in circulation than at any time in history. Some of the substances start with one of the plethora of new legal psychoactive drugs such as Ritalin, which has been tweaked by black market drug labs into something resembling cocaine. All of these have potent effects on the brain and nervous system.

Marijuana (botanical name cannabis sativa), which many people think of as a soft drug--and which when medically supervised has a number of legitimate uses for people with chronic problems (notably chronic pain)--has become more and more perilous over the years in its black market incarnations. The northern California sensimilla commonly produced in the U.S. has been hybridized to be more than 300 times more potent (for its psychoactive compounds) than the marijuana common in the 60s. As if this weren't scary enough, now there are at least four different illicit synthetic cannabis compounds manufacturers spray onto herbs and sell as recreational drugs, sometimes called Spice or K2, sometimes just called pot. The illicit lab-made substances have many of the pharmacological properties of cannabis, except for one crucial difference.

There's clear evidence that black market synthetic marijuana (these are versions of cannabinoids--based on the most powerful, tetra-hydro-cannabinol (THC)--which are synthesized in illegitimate labs) is potentially more damaging than regular pot made from marijuana plants. Marijuana leaves contain an anti-psychotic chemical, cannabidiol (CBD), which counteracts the psychoactive properties of THC and other cannabinoids.(Black market plants, not grown for medical purposes but to increase a "high," have been bred to have much higher amounts of THC and lower amounts of CBD than marijuana plants twenty years ago.) Black market synthetic cannabis products, according to chemists who have analyzed them, lack similar anti-psychotic components. Psychiatrists who have treated people for psychosis developed after taking synthetic cannabis bought on the street have suggested that this important difference may make black market synthetic cannabis even more likely to induce psychosis than natural cannabis.

The potential potency of these drugs can turn youthful experimentation into a dangerous game. The typical age of drug use has been dropping over the years so that even 12 year olds are abusing substances. The effects on the developing brain, from fetal life to the early twenties especially, can be catastrophic. (The more mature brain--roughly after age 23--has more resilience to these effects.) But as far as youthful experimentation, messing with newer, high-potency marijuana and its black market synthetic cousins is becoming an increasingly bad idea.

For decades marijuana has been associated with problems with short-term memory and male fertility, but emerging research has identified adolescent use of the most widely used illicit drug as an environmental factor consistently associated with increased risk of schizophrenia and bipolar disorder. There is evidence that early marijuana use of all types can alter gene expression of the developing brain, most notably through the epigene region. This is the area just next to the DNA that not only helps direct DNA's activities, but can become permanently programmed within one generation to alter the way DNA behaves (and pass this on to the next generation). One of the things that recent research has shown is that especially cannabis can change the epigenes and predispose a young brain to major psychiatric disorders that become manifest in the teens and early twenties.

The newly documented mechanisms for permanent hereditary genetic changes resulting from "recreational drug use" has certainly increased by concerns about the innocence of adult--much less youthful--drug experimentation. Having a parent use a drug prenatally (and the more use, the greater risk)  can mean greater susceptibility in the child not only to more drug-seeking behavior but also to greater risks of sometimes permanent psychological damage. Scientists now believe this is likely due to a trait created through epigenetic pathways by the drugs themselves. The original sinner may have been chasing dopamine, but successive generations will do the same at a higher cost.

Now, with these more powerful agents, kids with no family history of schizophrenia or any other psychological disorder are reporting frightening experiences of dissociation after partaking. I personally have seen a number of young adults become dissociative (unable to pull their psychological state together) for weeks after a single use of what they believe to have been "ordinary" marijuana. The majority of people recover from these incidences, but some don't.

Talk to your kids about the dangers. Understand that illicit drugs are different today, and sadly, some kids may have more vulnerable neurological pathways than kids 30 or 40 years ago. Some parents, remembering their own youthful explorations, are inclined to be casual about their budding adolescent's experiments with drugs and alcohol, but the stakes today are too high. They just don't make drugs like they used to.

This article was published simultaneously in Dr. Merrell's blog, The Source of Healing, at psychologytoday.com.