The middle classes who enjoy a smoke once or twice a week may laugh
at the idea. But doctors who treat the minority of users who have lost
control take it more seriously. The pragmatic question is how big is
this minority and would it expand if the drug was decriminalised or
even legalised? The experience of the Netherlands (see Vraag een Politeagent)
suggests the answer to the second question is "no". The first question
is tougher.
At the very least, NIDA's figure of 120 000 cannot be taken seriously.
It includes people who are arrested for cannabis offences and then given
the chance of going into treatment as an alternative to prosecution,
as well as workers who test positive for cannabis in random urine tests
and opt for rehabilitation rather than being fired. The figures don't
tell us how many people really get hooked.
|
| Denise
Kandel, addiction epidemiologist |
| |
 |
| Days
of depence: marijuana's addictive powers wane with age
|
At
Columbia University in New York, addiction epidemiologist Denise Kandel
has been taking a different tack. She has been analysing data collected
every year in the US National Household Survey on Drug Abuse. And she
concludes that subtle symptoms of dependence are more widespread among
teenage users than previously thought.
Shocking statistic
About 15 per cent of teenagers who smoke marijuana report three or more
"symptoms" of dependence from a list of six possible symptoms. They
range from "feeling dependent" or being unable to cut down on consumption
to using ever larger amounts of cannabis to get the same effect. Applying
these same measures to alcohol, it turns out that marijuana is just
as addictive as alcohol for adults and even more so for teenagers (see
below). That shocks most marijuana users, but not Kandel, who believes
kids may be unusually "sensitive" to marijuana for biological as well
as social reasons. The way she sees it, the reason we have so many alcoholics
is simply that there are so many people drinking.
The problem with this kind of research is that it all depends on what
is meant by addiction. A drug addict is usually seen as a person liable
to both withdrawal symptoms and long-term damage to their health. But
Kandel's self-report criteria are based on a broader definition. If
we applied them to coffee, vast numbers of us would qualify as addicts.
Similarly, many people might describe themselves as "addicted" to shopping
or television or chocolate. Kandel's analysis suggests young marijuana
smokers are more likely to show symptoms of dependence than their beer-swilling
contemporaries, but it doesn't tell us which substance is the more dangerously
addictive.
What is clear is that as users enter their 20s, they report this dependence
far less frequently. And of the people who are still smoking the drug
in their 50s, fewer than one in 30 qualify in her analysis as being
dependent. Addiction rates for nicotine follow the opposite trend.
This leads to what is perhaps the most telling statistic about the addictive
powers of cannabis: more than 90 per cent of people who have ever used
the drug have long since quit. While most people continue drinking and
cigarette smoking long after the first flush of youth, people drop the
weed in droves after the age of 30.