This week’s scary marijuana headline comes to us compliments of the Medscape.com website. It reads: “Marijuana Tied to Persistent Subclinical Psychotic Symptoms in Teens.”
According to the website, a study found that adolescent boys who regularly use marijuana (once a week or more) are at increased risk of experiencing “persistent subclinical symptoms, particularly paranoia and hallucinations, even after they stop using the drug.”
“Perhaps the most concerning finding is that the effect of prior weekly marijuana use persists even after adolescents have stopped using for 1 year,” said lead investigator Jordan Bechtold, PhD, of the University of Pittsburgh Medical Center’s Department of Psychiatry.
The study was published in the August issue of the American Journal of Psychiatry.
The study’s subjects were 1,009 boys recruited from the Pittsburgh public schools. Self-reported frequency of marijuana use, “subclinical psychotic symptoms,” and other relevant data were collected annually from age 13 to 18 years.
The researchers reported that for each year the teens engaged in weekly marijuana use, their level of subsequent subclinical psychotic symptoms rose by 21 percent. The increase was greatest for paranoia (133 percent) and hallucinations (92 percent), they said.
The effect of prior regular marijuana use on subsequent subclinical psychotic symptoms persisted even after the teens stopped using marijuana for a year, they added.
Pretty scary stuff, huh?
Maybe not.
The first question I would have is WTF does the term “subclinical psychotic symptoms” mean? The term is not defined in the Medscape.com story, nor is it defined in the paper’s abstract. (I don’t know if it is defined in the full article; the text is behind the American Journal of Psychiatry’s firewall.)
Just guessing here, but I bet the term “subclinical” is one of those slippery terms that can cover a lot of human behavior that ordinary mortals would consider not so far removed from normal as to mean much.
Especially ordinary mortals who smoke pot.
Just about everyone who has smoked pot has experienced anxiety or paranoia at some time or another — whether or not you do usually depends on your frame of mind before you smoke. That’s because if you’re anxious or are worried about danger or threats before you smoke there is a chance that smoking will enhance the feeling. (There is also a chance that it will reduce it, especially if you’re ready to quit thinking about the problems of the day before you light up.)
Pot smokers generally refer to this state of mind as feeling paranoid. Question: Is this what Dr. Bechtold and his colleagues mean by “subclinical psychotic symptoms?”
Just as important, what did his young research subjects mean when they self-reported how they felt after getting high. The term “paranoid” is thrown around pretty loosely by stoners; it can mean anything from an anxiety attack to seriously freaking out. Whether the teenagers would have used it to describe their feelings if they knew those feelings were going to be described as “subclinical psychotic symptoms” by the folks conducting the study is another matter.
In other words, it’s not clear Dr. Bechtold has discovered a new marijuana risk factor or whether he’s just renamed something that’s been known to smokers for decades.
A further question I have is whether the kids’ paranoia is being caused by pot or by the war on drugs?
If I were a teenager smoking pot once a week or more I would be constantly concerned about getting caught and the consequences of getting caught. Those feelings would be enhanced if I happened to be a black teenager, because your chances of getting caught would be several times higher than those of white kids.
The Medscape.com article doesn’t report the racial breakdown of the study’s subjects, but it does say they come from the Pittsburgh public schools, which means it wouldn’t be surprising if they were disproportionately black.
It is entirely possible that the teens were experiencing feelings that the good doctor would consider “subclinical” paranoid hallucinations.
But hey, even paranoids have real enemies, and sometimes they’re not imagining it.
The final question I would have about the study is this: How does the prevalence of “subclinical psychotic symptoms” from pot use compare with the prevalence of “subclinical psychotic symptoms” from alcohol use? The answer to that question, if the researchers even bothered to ask it, is pivotal in determining how much weight Dr. Bechtold’s work should be given in the debate of marijuana legalization and regulation.
