I have been reading your column for
the past few months and appreciate your abundant information and wise insights
on alcohol and drug abuse. Alcohol is an ancient drug, and we know – or are at
least learning – about its dangers and how to deal with them. But now that
marijuana has become legal, what are the hidden consequences? Do we have to be
concerned about cannabis-laced brownies at a kiddush or wedding or on the Shabbos table? Will edibles become as
common as sushi and as acceptable as a glass of wine or shot of whisky? Can a
person unknowingly overdose on such edibles and become very sick? Finally, you
wrote a lot last time about the effects of cannabis on teenagers. What about
adults? Is there any difference in the symptoms or rates of addiction? How do
adults react to cannabis, and how would it affect their parenting?
Response:
I
am glad we are getting more questions about cannabis. By the end of next year,
about half of the states in our country will have legalized recreational
cannabis use for adults 21 years or older. We have no choice but to become more
informed about this drug.
It
is a good question to ask how cannabis legalization will impact our community. While
it is unlikely that cannabis-laced brownies or sushi will be featured at most
Shabbat meals, or be offered at shul kiddushes,
I have some worries about those pesky kiddush
clubs, especially when kids are in the vicinity. Our shul rabbis will certainly
need to be more vigilant.
Many
of us have families or friends who live in New Jersey, a state where
recreational cannabis use has been legal for the past year. We have not heard
any horror stories, though the truth is that most Jewish communities are pretty
tight-lipped when it comes to problems with addiction. Like other addictions,
cannabis-related problems will likely develop slowly and secretly, behind the
doors of affected homes.
My
general feeling is that there are no hidden
consequences that will come from legalization of cannabis. We have a pretty
good idea of what to expect based on the experience of states that have already
changed cannabis legislation. As noted before in this column, there is good
news and bad news. The good news is that the rate of cannabis use among
teenagers in these states has not increased. A little over a third of high
school seniors have some experience with cannabis, whether or not they live in
states that have legalized cannabis use for adults. Teenagers need to know that,
while it seems like everyone is smoking pot, abstainers remain in the clear
majority!
The
bad news is that cannabis use and misuse has increased substantially among
adults, especially young adults between the ages of 21 and 30. I believe that
this will have many predictable downstream effects for our community.
The
increase in cannabis use among young adults seems to pose a bigger problem for
our community than for the general population. The reason is that frum Jews tend to get married at a
younger age. Cannabis use will become a prominent issue for many young couples.
Cannabis yields many effects, and one of them is relaxation. The first years of
marriage can exert tremendous pressure on couples, who are dealing with career
development, financial issues, new in-laws, and for those with small kids,
sleep deprivation. They are also just getting to know each other. Some young
adults will perceive cannabis to be a reasonable response to natural stress.
Over
the next few years there will be an explosion of research on the impact of
cannabis use on parenting. We can predict two things: The first is that parents
who smoke pot will believe with an almost religious fervor that cannabis helps
their parenting. The second is that research will demonstrate that they are
wrong. My guess is that cannabis use will lead to parenting inconsistencies and
subtle neglect, a lot of “the kids need to work it out by themselves.” One thing that is already certain is that parents who
smoke pot have a much greater likelihood of having children who will smoke pot.
I
work with some parents who smoke cannabis in front of their children. In many
cases, only one partner smokes pot. Cannabis use becomes a major issue in these
relationships. There is a recurring theme in the family dynamics: The spouse
who smokes pot receives much less respect from the children (and from the
non-smoking partner). It turns out that teenagers and abstinent spouses often
treat the cannabis-using parent as just another teenager.
Another
problem is that more adults in our community will develop cannabis use
disorder. This is already happening in states where cannabis is legal. It is
important to understand what it means to have a disorder. It does not only mean
that the adult is using more of the drug, though that is often part of the
problem, of course. What a disorder almost always signifies is that cannabis is
negatively impacting the course of life. It is harming work or school
productivity, damaging family relationships, and impairing physical or mental
health. An adult with a cannabis use disorder starts to focus more effort and
energy on the drug, talking about it, thinking about it, spending money on it, and
viewing it as a solution rather than a problem. People who develop a disorder
usually require professional treatment to get better.
Legalizing
cannabis will also have a strong impact on risky use. One clear example is the
significant rise of cannabis-related automobile accidents and deaths in states
that have legalized cannabis use. I am pretty sure that no parent wants the
school bus driver to be a pot smoker.
We
don’t yet know much about the impact of cannabis use on other health issues,
though, over time, that data will become available. People who already have
existing mental health conditions tend to do worse if they are smoking pot. Professionals
recognize that it becomes difficult to treat the mental health condition
because the cannabis user almost always believes that the drug is improving
psychiatric symptoms. Yet these symptoms predictably become more severe and
more difficult to treat over time. The same is true about alcohol and other
substances; they provide short-term relief and lead to long-term problems. It
is a shame, because we have wonderful medicines and therapies for people
suffering from mental health conditions.
You
mention cannabis edibles. If you walk into a cannabis dispensary, you might
find all types of foods that contain cannabis: baked goods, crackers, chips,
beverages, gummies, and other candy. There is probably already a competitive
market for kosher products, bringing to mind the Ramban’s famous comments on
the importance of separating from certain behaviors, even when they are
halachically permissible. What makes these foods so dangerous is that, because
they are digested, cannabis intoxication is not perceived immediately but only
after some time has elapsed. It is certainly possible that, with legalization,
more adults or children will have bad experiences with edibles, either by
eating them accidentally or by eating too much. I will also mention that
research at Johns Hopkins shows that the labeling of these products is
routinely inaccurate, underestimating or overestimating the amount of cannabis
in the food.
The
state of Maryland will make a lot of money off of cannabis consumers, another
sad example of financial motives impacting public policy. There is some
consolation in that we already know many of the problems that we are likely to
face. As the saying goes, the consequences of cannabis legalization are hiding
in plain sight. This is why prevention and education remain our most important
tools to address cannabis use before it becomes a community-wide problem.
Michael Kidorf, Ph.D., is a clinical psychologist,
Associate Professor of Psychiatry at Johns Hopkins University School of
Medicine, and Director of Education at Chayeinu. The Where What When welcomes
readers’ questions to this column.
