FOR SOME, MARIJUANA GROWS MEAN

Recently one morning, I received an urgent call from the mother of an
18-year-old named Daniel, whom I treat for marijuana abuse. For most of the
past few years, Daniel had smoked more than a quarter of an ounce of
marijuana daily and was almost always high, except, perhaps, when he was
asleep.

His marijuana problem has led to many others: he has been hospitalized,
fired from jobs and thrown out of high school. He has faced run-ins with
the police and lost the trust of most of his family members and friends.

"Daniel had another relapse," his mother said that morning. Released only a
month earlier from a drug rehabilitation program, Daniel and a friend had
obtained some potent hash-oil-laced blunts, or marijuana-filled cigars, and
smoked themselves into oblivion.

Marijuana, of course, can make one giddy and euphoric but it can also make
one quite paranoid. Instead of the mellow high they were promised, the
young men became enraged and began fighting over who would take custody of
the remaining marijuana.

In an angered haze, Daniel pulled out his jackknife and threatened to use
it if his friend refused to give up the blunts. In reality, he nicked the
other boy's skin. But at the time, Daniel was convinced that he had killed
his friend.

Inebriated and frantic, Daniel ran home to confess his crime to his mother.
When she called me, he was already being evaluated in the emergency room.

Since the 1960's, many Americans have been more lenient in assessing the
risks of marijuana than those of heroin, cocaine or even alcohol.

Marijuana does not destroy the liver, as alcohol does, nor is it as vicious
a drug of abuse as heroin or cocaine. Indeed, the physical manifestations
of dependency on pot are small in comparison.

And because marijuana's active ingredient, tetrahydrocannabinol, or THC, is
lipophilic, it remains in the fat cells of the body for days to weeks,
slowly working itself out without any of the harsh physical withdrawal
symptoms seen in the alcoholic or heroin user who goes cold turkey.

But today marijuana is anywhere from 10 to 20 times as potent as what was
passed around at Woodstock. With that increase in potency, the risks of
daily dependence have increased. In fact, many users are dependent on
marijuana and suffer from all the psychological ramifications, if not the
serious signs physical addiction.

These include feeling a need to use the drug daily to cope with life,
consuming ever-increasing amounts to achieve a high, expending considerable
money and effort to get and use the drug in relation to other needs or
priorities, lying about drug use to family members, and losing loving,
trusting relationships.

With marijuana dependence, these destructive forces can be every bit as
severe as the forces that can bring havoc to the lives of people who rely
on the bottle, the syringe or crack pipe.

Addiction specialists have long understood that some people have a genetic
or neurochemical predisposition to particular drug addictions or dependencies.

One colleague explains it this way: "These people have a light switch in
the brain, and if they come in contact with their substance of abuse, that
switch is turned on and is very hard to turn off." Moreover, marijuana use
is widespread among American teenagers.

In the past year, more than 40 percent of all high school seniors used
marijuana at least once and more than 10 percent of them used it monthly,
or more often. Invariably, some of these young people, like Daniel, are
hard-wired for THC dependence. But we have no diagnostic test to predict
which ones they are.

When I visited Daniel in the hospital, he was relieved that he had not
injured his friend but ashamed about his relapse. "I keep saying I will
quit," he told me, "but every time I begin to do well, I go right back to it."

He is hardly alone. Among addicted teenagers, who do not always think
through the long-term consequences of their actions, well over two-thirds
who try abstinence will relapse.

At the end of our chat, Daniel timidly asked, "Maybe this is just too big
for me to fight, you think?"

As he spoke, I could see more of the 9-year-old I used to reward with
lollipops for taking vaccinations than the troubled young man he is today.

I reassured him that he did not have to fight this alone, that there were
people who cared about him who wanted to help and that he needed to keep
trying. As I left his room with a profound respect for the illness he was
battling, I could only hope that next time he might be able to wrestle it
to a draw.