title: The consequences of chronic cannabis smoking in vulnerable adolescents.
abstract: Cannabis, like the mythic shape-shifter, presents in various guises, morphing with the perspective and context of the observer. Arguments about cannabis are confused by a myriad of debates-medical, social, ethical and political-as if a single conceptual umbrella can capture the variety and granularity of marijuana-related issues. This paper responds to marijuana use as it is commonly practised by youth in Australia. It has little to say about synthetic cannabinoids, specific medicinal cannabinoids, or medicinal properties of marijuana. We address those adolescents genetically and environmentally vulnerable to mental illness, with specific emphasis on indigenous and neurodevelopmentally impaired young people who show patterns of usage and response very different to adults and more resilient members of the population. Specifically, the practice of mixing tobacco with marijuana by aboriginal youth, and the resultant coalition of dependencies, will likely presage a rise in pulmonary and central nervous system pathology over the coming decades. Aboriginal youth begin using earlier, persist longer, and take greater quantities of cannabis than non-indigenous youth. This paper recommends practical interventions to reduce the multiple health consequences of chronic cannabis use in young people, especially indigenous young people.
authors.affiliation: Department of Respiratory Medicine, The Children's Hospital at Westmead, Sydney, NSW, Australia.
authors.forename: Montaha Al
authors.initials: MA
authors.lastname: Iede
authors.affiliation: Department of Psychological Medicine, The Children's Hospital at Westmead, Sydney, NSW, Australia; Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Nunn
authors.affiliation: Department of Adolescent Medicine, The Children's Hospital at Westmead, Sydney, NSW, Australia.
authors.forename: Bronwyn
authors.initials: B
authors.lastname: Milne
authors.affiliation: Department of Respiratory Medicine, The Children's Hospital at Westmead, Sydney, NSW, Australia; Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, NSW, Australia. Electronic address: Dominic.fitzgerald@health.nsw.gov.au.
authors.forename: Dominic A
authors.initials: DA
authors.lastname: Fitzgerald
mesh_terms: D000293:Adolescent; D001315:Australia / Q000453:epidemiology; D002908:Chronic Disease; D015897:Comorbidity; D020022:Genetic Predisposition to Disease; D006801:Humans; D008171:Lung Diseases / Q000209:etiology / Q000503:physiopathology*; D002189:Marijuana Abuse / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology*; D008385:Marijuana Smoking / Q000009:adverse effects / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology*; D001523:Mental Disorders / Q000235:genetics / Q000523:psychology*; D012306:Risk; D014029:Tobacco Use Disorder / Q000453:epidemiology; D035862:Vulnerable Populations
keywords: Cannabis; adolescents; adverse health outcomes; dependence; indigenous people; neurocognitive impairment