Keeping up with marijuana use and its outcomes in kids

tracking marijuana use and outcomes in kids

For the first time since 1937, marijuana is legal for recreational use: adults now can legally possess it in Colorado, Washington, Oregon and Alaska, and there are similar ballot initiatives in many states. With laws at least partially legalizing marijuana in 23 states and the District of Columbia, it’s now a big business. A study comparing 2012-2013 with 2001-2002 found that marijuana use had doubled over the 10 year-period. And that was three years ago.

What are the public health consequences of freely available weed — both acute and long-term? Are we making a big mistake here?

Concerned about potential harms to adolescents, Sharon Levy, MD, MPH and Elissa Weitzman, ScD, Msc, of Boston Children’s Hospital’s divisions of Developmental Medicine and Adolescent/Young Adult Medicine respectively, argue for a better, real-time marijuana surveillance system in this week’s JAMA Pediatrics.

“We call for rapid innovation in creating infrastructure to monitor harms to youth from marijuana — in the context of legalization and fast-paced expansion of a commercial marijuana market,” says Weitzman, also a social-behavioral scientist in the Computational Health Informatics Program at Boston Children’s.

Weitzman and Levy, director of the Adolescent Substance Abuse Program (ASAP) at Boston Children’s, argue that current monitoring systems aren’t good at capturing emerging trends and impacts of marijuana use. “With an accurate assessment of downstream consequences in hand, communities may decide to forgo legalization even where state law permits it, as has occurred in Colorado,” they write.

Following the example of infectious disease tracking, they suggest a number of ways to beef up marijuana surveillance, which they hope (with support) to introduce for adolescents:

  • Mining of social media content and online crowd-sourcing communities for marijuana usage data, contextual information (like product potency, driving under the influence, and settings where marijuana is used) and outcomes (like missing class or unintentional injuries)
  • Engage users and stakeholders across social sectors to gather information on mental health, medical and school outcomes associated with marijuana use
  • Content analysis of communications to understand how opinions and beliefs about marijuana disseminate across social networks

Weitzman is currently testing a model that mines social media data to measure youth alcohol use. In the article, she and Levy cite tobacco as an example of the need for better monitoring:

With no real surveillance system, it took more than 50 years to firmly establish that smoking tobacco causes lung cancer despite the very strong relationship. Delayed response afforded opportunity for youthful cohorts of smokers to mature, to devastating health consequences and profound social cost.