When young people with chronic medical conditions use marijuana, they often do so to help alleviate symptoms or side effects of treatment, a small study suggests. Researchers examined data on 451 teens 14 to 18 years old who were being treated for chronic medical conditions and enrolled in a clinical trial designed to test an intervention to prevent alcohol misuse. The current analysis focused on 73 participants who reported having used marijuana in the previous 12 months in a series of surveys on their behavior and health beliefs. Among these marijuana users, 22 teens (30.1%) reported using the drug to address symptoms or treatment side effects, which researchers described as "instrumental use." The remaining 51 adolescents (69.9%) were recreational users. Instrumental users most often reported using marijuana for anxiety (68.2%), pain (50%), appetite (45.5%), and nausea or upset stomach (40.9%). "In the short run, marijuana can offer temporary relief for a number of physical and mental health symptoms the youth might be struggling with, such as mood, anxiety, appetite and pain, especially if these symptoms aren't being addressed via some other intervention, for example psychotherapy," said lead study author Joe Kossowsky, an assistant professor of anesthesiology at Harvard Medical School and Boston Children's Hospital. "On the flipside, it can cause short-term paranoia, panic, and sleep disturbances that can increase pain levels," Kossowsky said by email. Beyond these problems, teens often feel worse when they stop using marijuana, which can lead to more frequent and heavier marijuana use," Kossowsky added. This heightens the risk for marijuana dependence, as well as more severe psychiatric symptoms and non-adherence to their prescribed treatment. The participants' mean age was 17.2 years, too young to buy marijuana legally. However, most (70.8%) reported buying it themselves or having someone buy it for them, the authors report in Pediatrics. A substantial proportion of the teens (40.3%) said they got marijuana at a party or from friends. Some got the drug from a person at school (16.7%), from a sibling or relative (6.9%), or from a parent or guardian (1.4%). A few of the teens (6.9%) also reported taking marijuana from their house without asking. In adjusted analyses, younger age at first marijuana use, higher frequency of marijuana use in the past three months, substituting marijuana for alcohol because of a medical condition, greater likelihood of using marijuana in the next three months, and monthly or more frequent tobacco use were all associated with increased odds of instrumental marijuana use, the study team found. Beyond its small size, other limitations of the study include the predominantly white study population and the reliance on data from a single institution. Larger, more diverse studies are needed to get a more accurate picture of how youth may use marijuana to help manage chronic medical conditions, the authors note. It also isn't clear from the study to what extent clinicians treating the teens, or their parents or guardians, might be aware of their marijuana use or recommend it for symptoms, said Rebekah Levine Coley, a professor of counseling and developmental and educational psychology at Boston College, who wasn't involved in the study. "Although marijuana use has decreased among adolescents in recent years, it remains a very popular drug, and use of other substances such as e-cigarettes is rising rapidly," Coley said by email. "As such, clinicians should include discussions of marijuana, tobacco, and other substance use as part of regular care." —Lisa Rapaport Source
