Northwestern University study: Young adolescent use of marijuana results in changes to the brain structure

23 Dec

Often children who evidence signs of a substance abuse problem come from homes where there is a substance abuse problem. That problem may be generational. eMedicineHealth lists some of the causes of substance abuse:

Substance Abuse Causes
Use and abuse of substances such as cigarettes, alcohol, and illegal drugs may begin in childhood or the teen years. Certain risk factors may increase someone’s likelihood to abuse substances.
Factors within a family that influence a child’s early development have been shown to be related to increased risk of drug abuse.
o Chaotic home environment
o Ineffective parenting
o Lack of nurturing and parental attachment
Factors related to a child’s socialization outside the family may also increase risk of drug abuse.
o Inappropriately aggressive or shy behavior in the classroom
o Poor social coping skills
o Poor school performance
o Association with a deviant peer group
o Perception of approval of drug use behavior

http://www.emedicinehealth.com/substance_abuse/article_em.htm

Substance abuse is often a manifestation of other problems that child has either at home or poor social relations including low self-esteem. Dr. Alan Leshner summarizes the reasons children use drugs in why do Sally and Johnny use drugs? http://archives.drugabuse.gov/Published_Articles/Sally.html

Anahad O’Connor reported in the New York Times article, Increasing Marijuana Use in High School Is Reported:

A new federal report shows that the percentage of American high school students who smoke marijuana is slowly rising, while the use of alcohol and almost every other drug is falling.
The report raises concerns that the relaxation of restrictions on marijuana, which can now be sold legally in 20 states and the District of Columbia, has been influencing use of the drug among teenagers. Health officials are concerned by the steady increase and point to what they say is a growing body of evidence that adolescent brains, which are still developing, are susceptible to subtle changes caused by marijuana.
“The acceptance of medical marijuana in multiple states leads to the sense that if it’s used for medicinal purposes, then it can’t be harmful,” said Dr. Nora D. Volkow, director of the National Institute on Drug Abuse, which issued the report. “This survey has shown very consistently that the greater the number of kids that perceive marijuana as risky, the less that smoke it.” Starting early next year, recreational marijuana use will also be legal in Colorado and Washington.
Experts debate the extent to which heavy marijuana use may cause lasting detriment to the brain. But Dr. Volkow said that one way marijuana might affect cognitive function in adolescents was by disrupting the normal development of white matter through which cells in the brain communicate.
According to the latest federal figures, which were part of an annual survey, Monitoring the Future, more than 12 percent of eighth graders and 36 percent of seniors at public and private schools around the country said they had smoked marijuana in the past year. About 60 percent of high school seniors said they did not view regular marijuana use as harmful, up from about 55 percent last year.
The report looked at a wide variety of drugs and substances. It found, for example, that drinking was steadily declining, with roughly 40 percent of high school seniors reporting having used alcohol in the past month, down from a peak of 53 percent in 1997. Abuse of the prescription painkiller Vicodin is half what it was a decade ago among seniors; cocaine and heroin use are at historic lows in almost every grade.
Cigarette smoking has also fallen precipitously in recent years. For the first time since the survey began, the percentage of students who smoked a cigarette in the past month dropped below 10 percent. Roughly 8.5 percent of seniors smoke cigarettes on a daily basis, compared with 6.5 percent who smoke marijuana daily, a slight increase from 2010.
Studies show that the concentration of THC in marijuana, its psychoactive ingredient, has tripled since the early 1990s, and Dr. Volkow said there was concern that the rising use and increased potency could affect the likelihood of car accidents and could lower school performance.
“What is most worrisome is that we’re seeing high levels of everyday use of marijuana among teenagers,” Dr. Volkow said. “That is the type that’s most likely to have negative effects on brain function and performance.”

http://well.blogs.nytimes.com/2013/12/18/growing-marijuana-use-among-teenagers-spurs-concerns/?_r=1

Northwestern University researchers studied the effect of early marijuana use on adolescent brains.

Citation:

Cannabis-Related Working Memory Deficits and Associated Subcortical Morphological Differences in Healthy Individuals and Schizophrenia Subjects
Matthew J. Smith*,1,
Derin J. Cobia1,
Lei Wang1,2,
Kathryn I. Alpert1,
Will J. Cronenwett1,
Morris B. Goldman1,
Daniel Mamah3,
Deanna M. Barch3–5,7,
Hans C. Breiter1,6,7 and
John G. Csernansky1,7
+
Author Affiliations
1 Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL;
2 Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL;
3 Department of Psychiatry, Washington University, St Louis, MO;
4 Department of Psychology, Washington University, St Louis, MO;
5 Department of Radiology, Washington University, St Louis, MO;
6 Warren Wright Adolescent Center, Northwestern University Feinberg School of Medicine, Chicago, IL
7Denotes shared senior authorship on this article.
↵*To whom correspondence should be addressed; Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 710 N. Lake Shore Drive, 13th Floor, Abbott Hall, Chicago, IL 60611, US; tel: 1-312-503-2542, fax: 1-312-503-0527, e-mail: matthewsmith@northwestern.edu
Abstract
Cannabis use is associated with working memory (WM) impairments; however, the relationship between cannabis use and WM neural circuitry is unclear. We examined whether a cannabis use disorder (CUD) was associated with differences in brain morphology between control subjects with and without a CUD and between schizophrenia subjects with and without a CUD, and whether these differences related to WM and CUD history. Subjects group-matched on demographics included 44 healthy controls, 10 subjects with a CUD history, 28 schizophrenia subjects with no history of substance use disorders, and 15 schizophrenia subjects with a CUD history. Large-deformation high-dimensional brain mapping with magnetic resonance imaging was used to obtain surface-based representations of the striatum, globus pallidus, and thalamus, compared across groups, and correlated with WM and CUD history. Surface maps were generated to visualize morphological differences. There were significant cannabis-related parametric decreases in WM across groups. Similar cannabis-related shape differences were observed in the striatum, globus pallidus, and thalamus in controls and schizophrenia subjects. Cannabis-related striatal and thalamic shape differences correlated with poorer WM and younger age of CUD onset in both groups. Schizophrenia subjects demonstrated cannabis-related neuroanatomical differences that were consistent and exaggerated compared with cannabis-related differences found in controls. The cross-sectional results suggest that both CUD groups were characterized by WM deficits and subcortical neuroanatomical differences. Future longitudinal studies could help determine whether cannabis use contributes to these observed shape differences or whether they are biomarkers of a vulnerability to the effects of cannabis that predate its misuse.

http://schizophreniabulletin.oxfordjournals.org/content/early/2013/12/10/schbul.sbt176.abstract

Here is the press release from Northwestern University:

Marijuana Users Have Abnormal Brain Structure and Poor Memory
Drug abuse appears to foster brain changes that resemble schizophrenia
December 16, 2013 | by Marla Paul
• The younger drug abuse starts, the more abnormal the brain
CHICAGO — Teens who were heavy marijuana users — smoking it daily for about three years — had abnormal changes in their brain structures related to working memory and performed poorly on memory tasks, reports a new Northwestern Medicine® study.
A poor working memory predicts poor academic performance and everyday functioning.
The brain abnormalities and memory problems were observed during the individuals’ early twenties, two years after they stopped smoking marijuana, which could indicate the long-term effects of chronic use. Memory-related structures in their brains appeared to shrink and collapse inward, possibly reflecting a decrease in neurons.
The study also shows the marijuana-related brain abnormalities are correlated with a poor working memory performance and look similar to schizophrenia-related brain abnormalities. Over the past decade, Northwestern scientists, along with scientists at other institutions, have shown that changes in brain structure may lead to changes in the way the brain functions.
This is the first study to target key brain regions in the deep subcortical gray matter of chronic marijuana users with structural MRI and to correlate abnormalities in these regions with an impaired working memory. Working memory is the ability to remember and process information in the moment and — if needed — transfer it to long-term memory. Previous studies have evaluated the effects of marijuana on the cortex, and few have directly compared chronic marijuana use in otherwise healthy individuals and individuals with schizophrenia.
The younger the individuals were when they started chronically using marijuana, the more abnormally their brain regions were shaped, the study reports. The findings suggest that these regions related to memory may be more susceptible to the effects of the drug if abuse starts at an earlier age.
“The study links the chronic use of marijuana to these concerning brain abnormalities that appear to last for at least a few years after people stop using it,” said lead study author Matthew Smith, an assistant research professor in psychiatry and behavioral sciences at Northwestern University Feinberg School of Medicine. “With the movement to decriminalize marijuana, we need more research to understand its effect on the brain.”
The paper was published Dec. 16 in the journal Schizophrenia Bulletin.
In the U.S., marijuana is the most commonly used illicit drug and young adults have the highest — and growing — prevalence of use. Decriminalization of the drug may lead to greater use.
Because the study results examined one point in time, a longitudinal study is needed to definitively show if marijuana is responsible for the brain changes and memory impairment. It is possible that the abnormal brain structures reveal a pre-existing vulnerability to marijuana abuse. But evidence that the younger a subject started using the drug the greater his brain abnormality indicates marijuana may be the cause, Smith said.
The groups in the study started using marijuana daily between 16 to 17 years of age for about three years. At the time of the study, they had been marijuana free for about two years. A total of 97 subjects participated, including matched groups of healthy controls, subjects with a marijuana use disorder, schizophrenia subjects with no history of substance use disorders, and schizophrenia subjects with a marijuana use disorder. The subjects who used marijuana did not abuse any other drugs.
Few studies have examined marijuana’s effect on the deep regions in the brain — the ‘subcortical gray matter’ below the noodle-shaped cortex. The study also is unique in that it looked at the shapes of the striatum, globus pallidus and thalamus, structures in the subcortex that are critical for motivation and working memory.
The Marijuana and Schizophrenia Connection
Chronic use of marijuana may contribute to changes in brain structure that are associated with having schizophrenia, the Northwestern research shows. Of the 15 marijuana smokers who had schizophrenia in the study, 90 percent started heavily using the drug before they developed the mental disorder. Marijuana abuse has been linked to developing schizophrenia in prior research.
“The abuse of popular street drugs, such as marijuana, may have dangerous implications for young people who are developing or have developed mental disorders,” said co-senior study author John Csernansky, M.D., chair of psychiatry and behavioral sciences at Northwestern University Feinberg School of Medicine and Northwestern Memorial Hospital. “This paper is among the first to reveal that the use of marijuana may contribute to the changes in brain structure that have been associated with having schizophrenia.”
Chronic marijuana use could augment the underlying disease process associated with schizophrenia, Smith noted. “If someone has a family history of schizophrenia, they are increasing their risk of developing schizophrenia if they abuse marijuana,” he said.
While chronic marijuana smokers and chronic marijuana smokers with schizophrenia both had brain changes related to the drug, subjects with the mental disorder had greater deterioration in the thalamus. That structure is the communication hub of the brain and is critical for learning, memory and communications between brain regions. The brain regions examined in this study also affect motivation, which is already notably impaired in people with schizophrenia.
“A tremendous amount of addiction research has focused on brain regions traditionally connected with reward/aversion function, and thus motivation,” noted co-senior study author Hans Breiter, M.D., professor of psychiatry and behavioral sciences and director of the Warren Wright Adolescent Center at Feinberg and Northwestern Memorial. “This study very nicely extends the set of regions of concern to include those involved with working memory and higher level cognitive functions necessary for how well you organize your life and can work in society.”
“If you have schizophrenia and you frequently smoke marijuana, you may be at an increased risk for poor working memory, which predicts your everyday functioning,” Smith said.
The research was supported by grants R01 MH056584 and P50 MH071616 from the National Institute of Mental Health and grants P20 DA026002 and RO1 DA027804 from National Institute of Drug Abuse, all of the National Institutes of Health.
– See more at: http://www.northwestern.edu/newscenter/stories/2013/12/marijuana-users-have-abnormal-brain-structure–poor-memory.html#sthash.coRZr6cm.dpuf

What Steps Should a Parent Take?

The Drug Enforcement Agency (DEA) has a series of questions parents should ask http://www.getsmartaboutdrugs.com/content/default.aspx?pud=a8bcb6ee-523a-4909-9d76-928d956f3f91
If you suspect that your child has a substance abuse problem, you will have to seek help of some type. You will need a plan of action. The Partnership for a Drug Free America lists 7 Steps to Take and each step is explained at the site. http://www.drugfree.org/intervene
If your child has a substance abuse problem, both you and your child will need help. “One day at a time” is a famous recovery affirmation which you and your child will live the meaning. The road to recovery may be long or short, it will have twists and turns with one step forward and two steps back. In order to reach the goal of recovery, both parent and child must persevere.

Questions to Ask a Treatment Facility

The U.S. Department of Health and Human Services, Center for Substance Abuse Treatment (Center), lists the questions that should be asked of a treatment center. http://findtreatment.samhsa.gov/faq.htm Assuming you are not one of those ill-advised parents who supply their child with alcohol or drugs like marijuana in an attempt to be hip or cool, suspicions that your child may have a substance abuse problem are a concern. Confirmation that your child has a substance abuse problem can be heartbreaking. Even children whose parents have seemingly done everything right can become involved with drugs. The best defense is knowledge about your child, your child’s friends, and your child’s activities

Related:

University of Washington study: Heroin use among young suburban and rural non-traditional users on the increase http://drwilda.com/2013/10/13/university-of-washington-study-heroin-use-among-young-suburban-and-rural-non-traditional-users-on-the-increase/

Resources

Adolescent Substance Abuse Knowledge Base

http://www.crchealth.com/troubled-teenagers/teenage-substance-abuse/adolescent-substance-abuse/signs-drug-use/

Warning Signs of Teen Drug Abuse http://parentingteens.about.com/cs/drugsofabuse/a/driug_abuse20.htm?r=et

Is Your Teen Using?

http://www.drugfree.org/intervene

Al-Anon and Alateen

http://www.al-anon.alateen.org/

WEBMD: Parenting and Teen Substance Abuse http://www.webmd.com/mental-health/tc/teen-substance-abuse-choosing-a-treatment-program-topic-overview

The U.S. Department of Health and Human Services has a very good booklet for families What is Substance Abuse Treatment? http://store.samhsa.gov/home

The National Institute on Drug Abuse (NIDA) has a web site for teens and parents that teaches about drug abuse NIDA for Teens: The Science Behind Drug Abuse http://teens.drugabuse.gov/

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One Response to “Northwestern University study: Young adolescent use of marijuana results in changes to the brain structure”

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  1. University of Pennsylvania Annenberg Public Policy Center study: Drug testing high school students might not be effective | drwilda - January 14, 2014

    […] University study: Young adolescent use of marijuana results in changes to the brain structure http://drwilda.com/2013/12/23/northwestern-university-study-young-adolescent-use-of-marijuana-result… Resources Adolescent Substance Abuse Knowledge Base […]

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