Marijuana Legalization: Talking About Pot with Your Kids

For adolescents, marijuana can impair memory and concentration and interfere with learning, and it is linked to lower odds of completing high school or obtaining a college degree.

It's important to talk to your children to explain that just because it's "legal," it certainly doesn't make it good for you.

Seth Ammerman, MD, discusses the AAP's stance on marijuana, its legalization AND its possible health benefits for children with debilitating or life-limiting diseases.
Marijuana Legalization: Talking About Pot with Your Kids
Featuring:
Seth Ammerman, MD
ammermanSethSeth Ammerman, MD, is a Clinical Professor at Stanford University. Dr. Ammerman is the founder and medical director of the Teen Health Van, a mobile clinic program providing comprehensive primary health care services to homeless and uninsured youth. Dr. Ammerman’s research interests include tobacco and substance use in adolescents; at-risk youth; eating disorders; and use of mobile technology for improving adolescent health.
Dr. Ammerman is a Fellow of the American Academy of Pediatrics (AAP), Chair of the northern California chapter of the AAP Substance Abuse Committee, and a member of the national AAP Committee on Substance Abuse. He is a member of the medical honors society Alpha Omega Alpha, and is a Fellow of the Society of Adolescent Health and Medicine. In 2012, Dr. Ammerman received a Silicon Valley Business Journal Health Care Heroes award. He also received the national AAP Founders Award in 2012 for his work in community adolescent health. In 2014 Dr. Ammerman received a Bay Area Jefferson Award for Public Service, and in 2015 received a further honor of a Jefferson Award Silver Medal.
Transcription:

RadioMD Presents: Healthy Children | Original Air Date: February 11, 2015
Host: Melanie Cole, MS
Guest: Seth Ammerman, MD

Melanie: Marijuana is the most commonly used illicit substance among young adolescents and recreational sale and possession of marijuana by adults remains illegal in all but a few states. It remains illegal everywhere under federal law. My guest today is Dr. Seth Ammerman. He’s a clinical professor at Stanford University and he’s the founder and medical director of Teen Health Van, a mobile clinic program providing comprehensive primary health care services to homeless and uninsured youth. Welcome to the show, Dr. Ammerman. Tell us a little bit about the marijuana laws in this country and what the AAP saying about their updated policy about this.

Dr. Ammerman: Thank you for inviting me. In terms of marijuana laws in this country, there are now 23 states, and the District of Columbia, that allow the use of medical marijuana. There are 4 states, and the District of Columbia, that now allow the use of recreational marijuana for adults 21 years of age and older. The American Academy of Pediatrics just released its new position statement, a technical report on marijuana and there are some key findings, key recommendations, in the position statement that include: First, the AAP does remain opposed to the legalization of marijuana use, recreationally, for adults because of the unknown impact that that will have on youth use and access. Additional key recommendations include having medical marijuana be changed from a schedule 1 federal law to a schedule 2 and simultaneously having research on cannabinoids that would hopefully result from that, go through the FDA’s approval process just like any other medication. Additionally the AAP is recommending that simple marijuana possession be decriminalized. In other words, be taken out of the criminal justice system and into the health system so that kids that have problems with marijuana get the help that they need, from a health care prospective.

Melanie: Okay, to summarize this: The AAP is saying that they don’t want parents and adults being able, even in states where it is legal, because of the impact it could have on their children. Just like kids that see their parents drinking may have a tendency towards drinking more. If an adult is somebody that either smokes marijuana, or used to smoke, what do you say to them about being upfront about their use? Being honest about their use with their children?

Dr. Ammerman: Kids don’t need to know all the gritty details about their marijuana use if they have used previously or are current users. Even if the parents are using marijuana medically, I think parents have to remember that their actions speak louder than their words. They are definitely role modeling behavior for their children. It’s fine, if they are using it medically, to explain to their children that they have a very specific medical condition that they are using it for. Like any other medication, you only take the medications for what you have.

Dr. Ammerman: All medications can have side effects and just because they are using it for their condition, doesn’t mean that it’s a safe or benign drug. In terms of the recreational use of marijuana, again, I think from a role modeling perspective parents need to be very careful around their children. If they are using around their children, then their kids get the idea that it is fine to use. Even if most adults do not have problem use with recreational marijuana, we know that some do. We know that, for kids, a lot of research has been done that shows that the younger a person starts using a drug like marijuana the more likely they are to develop problem use. This could affect their ability to finish school or hold down a job. Very significant social and psychological functions can be adversely affected by that.

Melanie: Parents have to get into this discussion Dr. Ammerman. States are legalizing medical marijuana; I understand that they want to decriminalize it and bring it to the healthcare realm, which is definitely where it should be, as a scheduled drug for medical purposes. When parents have the media come forward on both sides of this issue, what do you say to your children about the fact that it’s legal in some states, like Colorado, and medically legal in some other states, but federally illegal? What is a parent to say to their children when they hear this stuff on the media?

Dr. Ammerman: I think that one good tact to take is talking about the developing brain of the adolescent. I find that adolescents are very interested in this topic because their brains are developing and they like to hear about what’s going on with that. We do know that the developing brain is more susceptible to functional impairment than the adult brain. I would have parents explain that even if adults are using it where it’s legal, their brains, for better or worse, are basically finished developing. You want, as a kid or teenager, to get all the brain function that you have the potential to have. You don’t want to use any drugs that may alter and limit that functionality. I find that kids actually respond to that in a very thoughtful manner.

I would also like to clear up a little terminology issue. We’ve already talked about medical marijuana, but medical marijuana is really a misnomer. The cannabis or marijuana plant has active ingredients called cannabinoids, which may have medical benefit. A given plant probably has over 200, minimum, cannabinoids in it. We know very little about the vast majority of them. There are 2 that have been studied, somewhat, in adults. These are the 2 that are used therapeutically in adults with very specific conditions. One is THC, which is a psychoactive cannabinoid. The other is CBD, or cannabidiol, which has shown some benefit as a neural pathway stabilizer, a neuro-stabilizer. Of those two, there have been no formal clinical trials done in the pediatric or adolescent population. Even for those 2, there are very specific, serious medical conditions in adults in which these 2 cannabinoids may have some benefit. We really don’t know a lot about it. I think it’s important to realize that it’s not marijuana, per se, that has therapeutic benefits, it’s the active ingredients inside the cannabinoids. One advantage of changing it from a schedule 1 drug, which states explicitly that there is no medical benefit, to a schedule 2 drug, which states that there may be medical benefit, is that it will help open up research on cannabinoids. Then we can really start seeing what the benefits really are and, I would add, the potential adverse effects or risks, in a standardized fashion.

Melanie: So really it’s just going to take more research in kids to understand. Adults need to understand, as role models, what they are doing and what it reflects to their children. We need to keep an eye on how the research is going. You can read more about the AAP’s updated policy paper on www.aap.org. This is Melanie Cole, thanks so much for listening. You are listening to RadioMD, stay well.