Mending the Gaps

Engaging in meaningful dialogue with young people about cannabis

Barbara M. Moffat, MSN, and Joy L. Johnson, PhD, RN, FCAHS

Reprinted from "Mind-Body Connection" issue of Visions Journal, 2014, 10 (2), p. 37

In the film CYCLES, a fictional drama based on research done at the University of British Columbia School of Nursing, we meet Lisa on her first day at a new school. Lisa settles in quickly—she joins the swim team, does well academically and has a boyfriend. Fast forward in time and we see Lisa smoking cannabis. She does this to mask feelings of sadness and depression and to help her get to sleep at night.

Lisa is a film character, but her story is not at all far-fetched. Without question, growing up in today’s complex world presents challenges for many young people. These challenges may include family conflict, significant losses, school demands and fragile peer networks, as well as physical and mental health concerns.

A question we invite the viewer to explore is: How might Lisa have been supported to explore options other than relying on cannabis?

Why cannabis use is a concern

Substances such as cannabis can ‘fill the gap’ for young people when emotional needs are not recognized by adults and when uncomfortable feelings predominate. While adolescents most often use cannabis recreationally, others describe using it to manage depression, anxiety, stress, insomnia, problems with concentration and physical pain. Based on the young people who participated in our earlier research, this is particularly the case when they perceive that there are few other options available.1

The risk of developing problematic substance use increases when young people try to cope with challenging situations in isolation. Using substances like cannabis may well provide temporary relief. However, if the underlying situation isn’t addressed, use can progress to over-dependence on the substance.

Concern about cannabis use by adolescents, particularly early onset and frequent use, is warranted given the recent evidence linking use with negative effects on the physical development of the brain. Regular marijuana use during adolescence can interfere with specific brain development. It can also lead to long-term defects in the parts of the brain involved with learning, attention, memory, problem-solving, abstract thinking and motivation. In addition, there are greater changes in the structure of the brain the more heavily one has used marijuana and the younger one is when beginning to use it.2

Why conversations about cannabis are needed

Given that cannabis is a complex substance, cannabis use is also a complex subject. One young man recently shared, “Between the computer, media and TV, I don’t know what to believe.”

Since the topic seems ever-present in the media, there is easy access to information—and misinformation—from multiple sources. Some people promote the beneficial properties of cannabis, while others focus on the harms associated with the drug. Hearing about its medicinal use and living in a context where recreational use is common, yet illegal, also contributes to misunderstandings.

Additionally, we have found that there is a lack of balanced and meaningful discussion on cannabis use within most classrooms.3 This results in many students taking charge and seeking information independently.

We are all exposed to conflicting messages. Little wonder that there is confusion about the substance. And not surprising that some young people are advised by peers to use the substance to ‘help’ navigate life—particularly when there are complex intersections of physical and emotional pain.

One young woman reflected on her daily use of cannabis, “If you’re depressed about killing yourself, I don’t think that it’s a good idea to smoke pot, because it could bring you down more. It’s hard to say, though; it’s different for every person, right?”

This young woman’s question provides a natural segue into a discussion about the potential physical, emotional and social impacts of using cannabis. Balanced discussion regarding decision-making and cannabis use can be an opening for exploring understandings of potential harms while encouraging personal reflection on choices.

Another young man revealed his struggle with conflicting information: “I know lots of people who would be just a complete wreck if they weren’t smoking pot. But then there’re also people who are a complete wreck because they do smoke pot, so it’s kind of a hard thing.” Being able to talk honestly about the known risks related to cannabis use allowed him to exercise critical thinking.

How conversations can help

In our experience, creating opportunities for open discussion with young people regarding the topic of cannabis use is welcomed and thought provoking.4 Young people are hungry for meaningful dialogue about cannabis. In fact, many youth are looking for such opportunities to talk.

In having such discussion, young people are better equipped to weigh the harms and benefits, and therefore, to make an informed decision about using cannabis for depression or other complex health concerns.

Adults can help bridge the gap by initiating conversations with young people about substance use (see sidebar). Honest conversations with youth are opportunities to explore potential knowledge gaps, specifically about cannabis as a harm-free substance. Exploring with young people their motives behind choosing to use substances like cannabis makes for meaningful dialogue. Not only can this be an opportunity for young people to reflect on personal cannabis use; it may also result in reducing or eliminating cannabis use among those who use the substance frequently.

Our research suggests that creating a “safe space” to discuss cannabis use is important. Providing privacy and respecting confidentiality are key elements of safe space. Listening without judgment can keep the conversation open, and being curious about the content shared raises questions for further discussion.

Another young woman who used cannabis regularly told us: “I have trouble going to sleep and waking up . . . I’ve had these problems since elementary school . . . I can’t go to sleep at night and then I like to sleep during the day.” What else might be going on with this young woman? Are critical issues about her physical, emotional or social well-being being overlooked that could be addressed by caring adults?

A new conversation starter

The film-based resource, CYCLES,* focuses on decision-making and the consequences of cannabis use. The film can be viewed in two ways: an uninterrupted version or an interactive version. In the interactive version, the viewer is invited to engage in decision making alongside the two main characters. The film is accompanied by resource materials designed to support meaningful discussion in classroom settings following the film, facilitated by adult educators.

Earlier in 2014, the CYCLES resource was piloted across Canada. Not only has rich discussion been generated as a result of viewing the film, but many student viewers have emphasized how they felt “relieved” to be able to talk about the topic honestly and without fear of judgment.

Creating that safe space and inviting honest dialogue is the first step toward mending the gaps for young people like Lisa.

*The CYCLES resource will be available in the “Publications & Resources” section of the Centre for Addictions Research of BC website www.carbc.ca in Fall 2014.

 
About the authors

Barbara is Project Director at UBC School of Nursing and Co-Executive Producer of the film CYCLES, a research-based educational resource on marijuana use

Joy is a Professor in the Faculty of Health Sciences at Simon Fraser University and Co-Executive Producer of CYCLES. Her program of research explores the social, structural and individual factors that influence the health behaviour of individuals

Footnotes:
  1. Bottorff, J.L., Johnson, J.L., Moffat, B.M. & Mulvogue, T. (2009). Relief-oriented use of marijuana by teens. Substance Abuse Treatment, Prevention, and Policy, 4(7). doi:10.1186/1747-597X-4-7.

  2. Volkow, N.D., Baler, R.D., Compton, W.M. & Weiss, S.R. (2014). Adverse health effects of marijuana use. New England Journal of Medicine, 370(23), 2219-2227.

  3. Johnson, J.L., Moffat, B., Bottorff, J. et al. (2008). Beyond the barriers: Marking the place for marijuana use at a Canadian high school. Journal of Youth Studies, 11(1), 47-64.

  4. Moffat, B.M., Jenkins, E.K. & Johnson, J.L. (2013). Weeding out the information: An ethnographic approach to exploring how young people make sense of the evidence on cannabis. Harm Reduction Journal, 10(1), 34. doi:10.1186/1477-7517-10-34.

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