I recently saw one of my young patients who had been hospitalized after an acute episode of mental breakdown associated with drug abuse. I had previously asked my patient about drug use, as I do all of my patients, and gotten a definite “NO.” My patient had been using increasing amounts of marijuana (cannabis) which is easy to come by, even in rural Mississippi where this episode occurred.
Approximately 4 percent of the world’s population between 15 and 64 years old has used marijuana in the past year. Use is more common in males and is highest in the 18-25 year old group where it is about 9 percent per year. Long term use may cause intellectual decline. Individuals who use marijuana are more likely to use and abuse alcohol, sedatives, stimulants, and opiates and to smoke tobacco. My patient had been doing all of that as well. But what really caused the mental breakdown was that the marijuana had been cut with a hallucinogen that made my patient psychotic. Marijuana is often cut with other substances that can be toxic and users are unaware of that. From my perspective as a physician, dad and granddad, using marijuana bought on the street and outside of physician supervision for medical purposes reflects extremely poor judgment. If so, why do so many Mississippians use it?
Marijuana is a very seductive drug. It is cheap, available, lots of people (especially young people) are using it and it is portrayed in a positive way on TV, in the movies and in music by pop stars. Marijuana stimulates the chemical (dopamine) system in the pleasure centers of the brain and causes a feeling of pleasant calmness in most users. After using it regularly, abstinence causes an uncomfortable withdrawal syndrome that lasts up to 2 weeks, unless more marijuana is used (Table). There is increasing evidence that the gateway theory of drug abuse is correct. The use of marijuana in young people has been clearly demonstrated to be associated with other substance use at a later age. This has even been confirmed in studies of twins, one of whom used marijuana and one who did not.
So why do people use it in the first place and become habituated to it? Risk factors for marijuana dependence include childhood sexual abuse, parental divorce and parental conflict. Young people often use the drug as a coping mechanism (self-medication) for anxiety, stress release, and for “fitting in” with other users. There is a high correlation between the use of marijuana and other mental health problems. For instance schizophrenia, panic disorder and anxiety coexist in 20 percent or more of marijuana users. Young people with mental health problems should see a mental health professional to prevent drug and alcohol use to deal with their issues. The Mississippi Department of Public Health has a hotline to help at
Marijuana use causes impaired thought, coordination and judgment that persist for up to 24 hours, long after the high of intoxication with its pleasurable feeling that comes on shortly after use is gone. Driving within 24 hours of its use is dangerous. Synthetic marijuana like spice and K2 can cause death. If someone using marijuana develops symptoms of intoxication, cannot be awakened or has trouble breathing, call 911. Please pass this article around so others can get this information.
Not everyone who uses marijuana becomes addicted to it, but we don’t know how to predict who will and who won’t. However, using it is not worth the risk. Exercise is much cheaper, healthier and just as effective way to get a mood lift, deal with stress and anxiety and avoid addiction. Unfortunately, my patient now has permanent mental impairment.
“Southern Remedy” is a multi-platform production of Mississippi Public Broadcasting and is supported with a grant from the University of Mississippi Medical Center. On MPB Think Radio, the program provides health information to listeners weekdays at 11 a.m. In periodic television specials on MPB TV, “Southern Remedy” explores some of the biggest health issues facing our world today. Visit mpbonline.org/southernremedy for more information.
Dr. Rick deShazo, professor of medicine and pediatrics at the University of Mississippi Medical Center and a practicing physician, is the host of “Southern Remedy.” The medical information presented by “Southern Remedy” is meant to provide general information about the topics discussed, and should not be used or relied on for any diagnostic or treatment purposes. The information conveyed does not create any type of patient-physician relationship and should not be used as a substitute for professional diagnosis and treatment. Please consult your health-care provider before making any health-care decisions and for guidance about your specific medical condition.