Inconclusive evidence regarding the short- and long-term health implications — beneficial or harmful — of cannabis use have health officials hesitant to welcome the substance.
Unlike tobacco and alcohol, which have undergone decades of research and regulation, no widely accepted standards exist regarding how, where and when — if at all — individuals can safely consume cannabis. Furthermore, evidence suggesting the drug has therapeutic qualities must be balanced with concerns regarding the substance's effects on adolescents, one of the most vulnerable user groups.
"We have a deficit in baseline data about [cannabis] usage and its effects," Van Do-Reynoso, director of the Santa Barbara County Public Health Department, said of the challenge the lack of scientific consensus poses to awareness efforts planned for Santa Barbara County. "We won’t have good data until 2020 — it’s really far out."
While lawmakers and municipalities grapple with regulating the budding cannabis industry, Do-Reynoso and other Santa Barbara County health officials will be working to review and reconcile evidence-based research to determine the best message and ways to deliver it to adolescents and young adults — two of the most vulnerable subgroups.
More than 100 naturally occurring cannabinoids, the active compounds that have an effect on an individual, can be found in an average cannabis strain. Within that group, two cannabinoids — cannabidiol and THC, the primary psychotropic component — are thought to produce the majority of the observed effects of cannabis use.
Research suggests cannabidiol could possess analgesic and anti-inflammatory properties, and is also believed to reduce anxiety and lower the incidence of seizures. While cannabidiol has grown popular among medicinal cannabis users, cannabidiol-dominant strains were not historically produced in the U.S. due to higher demand for the potent psychotropic effects found in THC-rich strains.
Users typically pursue the euphoric and hallucinatory effects of THC, the psychotropic substance found in cannabis, when seeking a strain to consume.
Ongoing research on the effects THC has on a developing brain suggests cannabis use impacts short- and long-term cognitive function — specifically memory, learning and problem-solving skills — and may contribute to the onset of depression or schizophrenia. Researchers caution that the effects of THC may manifest to varying degrees and are largely dependent on the age of the individual combined with the frequency, quantity and potency of cannabis use.
Consensus regarding the addictive qualities of cannabis has yet to be reached, but both the American Psychiatric Association and World Health Organization recognize chronic consumption (especially in users under 25 years-old) can result in the development of a substance use disorder.
Described as the repeated and continued use of cannabis despite significant impairment or distress, data provided by the U.S. Department of Health and Human Services indicates approximately 2.6 percent of adolescents (roughly 650,000 individuals) between 12- and 17-years-old suffered from a cannabis use disorder in 2015. Incidence rates more than double in adults 18 to 25-years-old, where 5.6 percent of young adults (or 1.8 million users) reported developing a cannabis use disorder.
Educating vulnerable populations
A 2015 study sponsored by the National Institute of Health indicates the perceived risk of cannabis use among eighth-, 10th- and 12th-grade students is at the lowest level in four decades. Similar trends are reported within Santa Barbara County public schools, where 4 in 10 11th-grade students see no or slight harm in consuming marijuana once or twice per week.
Attributing the decline in perceived risk to the changing legal and cultural status of cannabis, Do-Reynoso believes the key to developing effective education campaigns geared toward youth and young adults is understanding how the research and conversation about the once-prohibited drug has shifted.
"At the local level, we've been talking [about] how to collect, synthesize and process the data we currently have," Do-Reynoso said. "We want to make sure that [youth and young adults] have the best possible access to information about what cannabis can do to a developing body and brain."
Alex de Jounge, coordinator of Hancock College's student health and wellness programs, underscored the importance of involving Hancock's unique student body (roughly 60 percent of students can legally consume cannabis) in conversations surrounding the drug.
"Our role at the student health center is to stay in tune and in touch with the larger community," de Jounge said. "We focus on harm reduction and education [and] want to get good, evidenced-based information about cannabis out for students."
Post-legalization surveillance and data collection is key to crafting their education campaigns, they explained, pointing to Colorado, where officials have been collecting data regarding use and exposure since recreational cannabis sale began four years ago.
Borrowing ideas from statewide campaigns introduced by the Colorado Department of Public Health and the Environment, Do-Reynoso hopes to engage a diverse coalition of individuals, educators and community organizations to develop a comprehensive framework and response.
"Our vision and desire is to build the capacity in our community to have these conversations," she said. "These are good opportunities for parents and trusted adults to have a conversation [about cannabis] with youth. That's what part of a good education effort is — it’s both an opportunity and challenge."