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Comment by kalessin | Hacker News Reader

I am not a doctor but from what I have been reading, consuming THC on a regular basis before 21 (the commonly accepted age for the latest stage of brain development) is definitely a bad idea, as it will prevent the endocannabinoid system to develop correctly. I would not dismiss teen smoking/vaping as a public health concern, it's not just about counterfeiting, I think we need better education about the risks and benefits.

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I'm very much for pro-fact-based drug education. Not just for THC, but for the most common things that folks can come into contact with. No scare tactics, just answering questions like what happens to one's body, what "high" feels like, realistic methods of ingestion, and benefits.

Unfortunately, the greater public - the government at least - hasn't been so keen on such things because the focus is more on keeping drugs a scary evil. Even current drug education is such, though thankfully it isn't so "Drugs are bad, mkay?" as it was during the 'just say no' heydays in the 80's and 90's.

Seriously, apart from just cultural ideas at this point, it would be so easy to at least start to study it in a more fact-based way by just removing weed from schedule 1.

Indeed, we seem to have ample evidence that Tylenol seems to be strongly associated with autism[1] and weakly with ADHD[2], yet its use is not only widespread but unquestioned. The problem, of course, is that it's complicated; correlation isn't necessarily causation. So how to respond? Should all high school students be taught how to think critically of bioscience results? It's not easy to distill down to distinct usable facts. Suggesting at all that it is safe for teens to vape THC is a very dangerous proposition. I think you'd have to at least prove that it is safer than lead in gasoline, and that is not easy.

[1] https://www.ncbi.nlm.nih.gov/pubmed/18445737 [2] https://pediatrics.aappublications.org/content/early/2017/10...

Your first source is a bad one but here is a review: [1] The association is really not strong but the authors do advice against indiscriminate paracetamol use.

[1] https://www.ncbi.nlm.nih.gov/pubmed/29341895 [2] https://www.ncbi.nlm.nih.gov/pubmed/26930528

Tylenol/paracetamol use should be sparing to begin with just because of its harsh effect on the liver.

While the liver toxicity alone would seem to argue against indiscriminate acetaminophen (google tells me that is the same as "paracetamol" but that is a new name to me) use, I would expect common sense to argue against indiscriminate use of anything that is not simply food. I'd look to evidence like you provide to advise me as to how, exactly, I should discriminate. But indiscriminate use of most things seems inadvisable.

Is there any alternatives suggested for this medicine?

Naproxen is far, far better for pain, and doesn't have anywhere near the possibility of cooking your liver.

Umm NSAIDs like Naproxen have their own list of issues which may be worse than Tylenol. Another issue is that Tylenol is often used because it does not interact with other NSAIDs so if you are not sure if someone has taken medication with a NSAID in it, you can safely give them Tylenol, generally speaking, where as if you give them more NSAIDs you could potentially risk an overdose. So its not as simple as Napoxen is superior to Tylenol. IANAD,

Trying to compare Tylenol (Paracet) to drug education is silly. Few folks take Tylenol recreationally and we don't have decades of propaganda around it.

Others have already addressed the veracity of your links: But honestly, we already know of the dangers of tylenol. Liver damage with high use. But it isn't always so simple - it doesn't react with drugs as much as NSAID's do, and for some, it is really the only appropriate option for pain relief.

I'm not suggesting at all that it is safe for teens to vape THC either. I'm not sure where you got this information from my writing. Fact-based education would mean things like telling teens that it is probably best to wait until one is older to start smoking regularly, if one smokes regularly at all. At the same time, we could explain that it if one is going to make a habit of a drug, they could do worse. Alcohol and tobacco are both more difficult for most people to quit and alcohol tends to destroy lives at a greater pace (folks can still lead normal lives while stoned).

You can do all of this without proving that it is safer than lead in gasoline. I don't even know why this is mentioned as it isn't remotely the same category of things. Few folks are going to huff gasoline at the rates folks do other drugs.

Ok, I like your message and tone but I have to point out a couple of things where are not quite communicating. You are absolutely right that people can do worse than THC, e.g. alcohol and tobacco. (Although it is unclear if nicotine itself is worse. Worn as a patch it might be as harmless as caffeine.)

The potential dangers of Tylenol/Paracet is not about liver damage. There is an unexplored correlation with behavioral disorders in pregnancy that is not entirely explained away by assuming that people with behavioral problems take more Tylenol. Yet in the widespread population Tylenol is basically considered completely safe, as safe as apple juice.

My point is that drug education is not trivial and is full of unfinished threads, and there is plenty of room for abusing the messages.

Lead in gasoline is my benchmark for how hard it is to know that a drug (atmospheric lead) is having a negative widespread effect in the population (violence and IQ reduction). In that case, it took decades before the data was there, and decades more to build political action on the issue.

Yes, drug education is a good thing, but we also have to know that messages can and must change when data comes back. At what point is the data strong enough to put in high school literature? For example, the research showing a correlation between chronic marijuana use and testicular cancer[1]; should we put that in the literature? It is impossible to say at this point whether that is causal or simply related to a behavior that occurs when using marijuana, or perhaps even hormonal (people that like marijuana have a body chemistry that also maybe produces testicular cancer)? We simply have no idea. So yes, drug education is good, and we need more research on the effects of marijuana, and I don't think we can really speak authoritatively on its risks relative to nicotine or even alcohol. (No, not everyone can lead a normal life while stoned. Learning is most certainly inhibited, and a normal life involves learning things.)

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4642772/

>before 21 (the commonly accepted age for the latest stage of brain development)

Last I remember from my psychology classes, it was 25 to 28. 21 feels like a number picked to reflect law and cultural norms, not the science. But my information is a decade out of date and there could have been new findings since.

I thought 25 was chosen because that's when brain development is mostly completed.

This has become quite the meme lately as a pop-neurology fact, but its... clearly untrue the ways people try to apply it. It creates a sort of fatalism about being able to improve or change your mind that in no way reflects whats actually possible.

I haven't seen studies supporting 25-28. Most studies support a slightly lower number than 21, but not much lower.

25 to 28 is when the myelination of the brain finishes.

https://www.sciencedirect.com/topics/medicine-and-dentistry/...

>Further myelination of subcortical and cortical tracts continues in the posterior to anterior direction well into the third decade of life, consistent with the time course of maturation of cognitive functions in children and adolescents.

Mish Shoykhet, Robert S.B. Clark, in Pediatric Critical Care (Fourth Edition), 2011

Agree. Here's one:

http://m.pnas.org/content/109/40/E2657.full (2012)

"Persistent cannabis users show neuropsychological decline from childhood to midlife"

It's certainly not a good thing. Is it comparatively better than other risky activities associated with young adults, such as binge drinking? I think yes.

that oil-causing-lung-failure thing was no joke

The deaths caused by the THC oil are definitely nothing to scoff at, but they are more reflective of cannabis' 70+ years as a black market product than they are of the effects cannabis has on the human body. The CDC has determined that a high concentration of Vitamin E was the likely cause of lung failure for the afflicted [1].

In my opinion, this reinforces how important regulatory bodies are when it comes to things that we put into our bodies. If we choose to continuously gravitate towards giving citizens greater bodily autonomy, it is extremely important that we ensure people know what's going into their body and the risks associated with it.

The deaths were caused because vitamin E acetate requires bile salts to be absorbed, which are not present in the lungs. It had nothing to do with THC.

https://www.sciencedirect.com/book/9780124166875/essentials-...

Looking back at my comment I see how my language wasn’t as clear as I thought. Thank you for clarifying, this is what I was trying to say.

THC/Cannabinoids weren’t the issue, contaminants in the oil were.

these are teens, it will always be a black market product for them, though. Even if you regulate it, no one should be selling it to teens period. There is no solution to this.

If there is a regulated market for adults, then the black market for teens will source from that, and thereby benifit from the regulations.

Take alchohol for example. Teen drinking is a problem, but teen methonol poisoning isn't.

Give it to teens for free, sell it to adults?

But that wasn't from marijuana, it was from dodgy chinese carts

Pro-legalization activists always over-claim marijuana's safety which has led to the claimed safety entering pop culture and becoming widely believed. The truth is that there is little solid research into the question.

Hard to do research when marijuana is illegal.

The brain's corpus callosum continues developing into a person's mid 20's.

What have you been reading? Can you share some of that data with us so we can come to a common understanding? I was under the impression that this was not a fact, just a supposition; I would love to be enlightened!

> The team found that persistent marijuana use was linked to a decline in IQ, even after the researchers controlled for educational differences. The most persistent users — those who reported using the drug in three or more waves of the study — experienced a drop in neuropsychological functioning equivalent to about six IQ points (PNAS, 2012). "That's in the same realm as what you'd see with lead exposure," says Weiss. "It's not a trifle."

> a number of studies have found evidence of brain changes in teens and young adults who smoke marijuana. In 2013, Rocío Martín-Santos, MD, PhD, at the University of Barcelona, and colleagues reviewed 43 studies of chronic cannabis use and the brain. They found consistent evidence of both structural brain abnormalities and altered neural activity in marijuana users.

https://www.apa.org/monitor/2015/11/marijuana-brain

Given that they use IQ as a measure also goes to show how little they understand the effects at this point. So take this all with a grain of salt. The best evidence at this point is that adolescent use has some effect on long term memory formation, but even that needs much more study to be understood it. Nothing in the brain works on a simple better/worse scale.

Yeah, I’m highly skeptical that marijuana makes you legitimately more dumb. If I had to guess, I’d suspect that there are other factors that lead to this result. I’m skeptical because I have seen friends and acquaintances who were “dulled out” by drugs during this period of their life. While many of them were “heavy users” of marijuana, all of them were dulled from other psychotropic drugs(ecstasy being the big one), and most of them lost more than 6-8 IQ points. More like 20+ points.

If anything, I’d say that marijuana use tends to make the brain more doubtful, even of itself. In real life this is a mostly positive trait, but it is punished by the IQ test I think.

That's great, but what does that actually mean for someone? Does it mean that they are less happy? Does it mean that they earn less money? Does it mean they have less meaningful relationships?

I understand the mechanisms behind marijuana use, but what is the real effect on a person's life?

You can't really A/B test humans. Best thing that could be done is twin studies and even those have flaws.

By the way your line of questioning implies an agenda. I don't have an issue with that, but thought I'd highlight that for you.

Everyone has an agenda. What agenda do you think I'm pursuing?

Do you think it's one of harm-reduction? Or legalization in pursuit of business opportunities? Or legalization for recreation? Or for medicinal use? Or is my agenda that I have another product in mind that solves all of these things without the side effects of marijuana?

I can appreciate the perspective of "everyone has an agenda".

Some people attempt a almost a fact based conversation that is an exploration of a topic. Others have an opinion they want to push on others. I don't even try to figure out what someone agenda is. I look that there is one and stop focusing too hard right there and then.

I also suspect, I'm not the only one who operates like this.

If I have an agenda, it is to limit emotion in communication and make things more fact based.

This communication is likely to fail.

To reiterate, many people don't care to figure out what the agenda is and just ignore those who has one. Here i'm using agenda to stand for the typical partisan politics or other "normative" behavior.

From the linked article

> Heavy marijuana use in adolescence or early adulthood has been associated with a dismal set of life outcomes including poor school performance, higher dropout rates, increased welfare dependence, greater unemployment and lower life satisfaction.

Considering that Marijuana is illegal, this seems impossible to prove.

Show me the development of a teen in a society where open marijuana consumption is a non-issue to compare against.

Right - you can't use drug tests to unfairly weed people out of employment, then list drugs as the cause of unempoyment and poor life outcomes.

https://www.amazon.com/dp/B00RTY0LPO/

What are the side effects of this system developing incorrectly?

Those who use heavily in Adolescence can lose something like 6 or 8 IQ points, among other negative effects. Those who start as adults and stop don't seem to have the same effects[1], but it is unclear how much that reflects lower baseline IQ of users vs. the impact of marijuana itself.

[1] https://www.drugabuse.gov/publications/research-reports/mari...

I would like some perspective on what a 6-8 IQ point difference actually means in real life.

I know IQ is on a curve so if I'm on the lower end and dope up I might not qualify for the military against had I not doped up by such a margin window.

For an average person, what can the person sitting next to me do +8 IQ that I can't? What can the person sitting in front of me not do at -8 IQ that I can?

Granted I've encountered "slow" and "fast" people in my life, but I have little idea how to relate that to an IQ number besides "higher" and "lower" like a water faucet for temperature.

This is a genuine, honest question.

If we think in terms of a race -- an IQ of 100 puts you at the 50th percentile -- so half of the contestants are faster than you, and the other half are slower.

A loss of 6-8 points puts you at about at about the 35th percentile -- meaning 65 percent of the people in the race will be running more faster than you. Or (back in real life terms) be that much more likely to get admitted to college, get a decent job / spouse, and so on.

That is, to the extent that definitions of IQ are valid and can be measured accurately, and so on. But given the amount of research that has gone into this -- and we know a lot more now that we did a few decades ago -- it seems the risks (of heavy cannabis use) are potentially quite serious.

(BTW, as to how one gets from "6-8 points" to "35th or 40th percentile": it has to do with how the IQ scale is defined. By the traditional scale approximately two-thirds of the population scores are between IQ 85 and IQ 115. Meaning (on a scale from 1 to 100) 15 points of IQ equals a difference of about 33 percent. So 6-8 points is about half that, or very roughly 15 percent).

100 is defined as an "average" IQ, yet I suspect everyone on this site is quite a bit above that, likely in the 110-120 range and skewed heavily upwards, and have not actually interacted constantly on a long term with someone who has a ~100 IQ, much less a ~92 IQ.

It's actually somewhat amazing how isolated you can get from the average person if you stick to settings & persuits associated with "intellectuals". I recall ended up in a friend group of 8 people once that included 3 geniuses.

Sometimes you really have to take a step back and realise that you're not as normal as you feel. You can spend your time on hackernews feeling very insecure and then apply 5% of what people talk about here and then the average person will treat you like you invented fire.

Fun fact: Ivy League students who attended public high schools hold sharply lower opinions of what "average people" are able to do than do students who attended private high schools.

To this end: I’ve astonished a number of peers who did the straight to a 4-year track with a anecdote about only 22% of my community college “Critical Thinking” class passing the first midterm, which covered very simple truth functions and negation. To this day it sticks with me.

Remember the 100 includes those with mental disabilities or borderline disabled. If you are in a building without people with mental disabilities then the IQ is likely some amount above 100.

So when you think of your highschool class you shouldn't think 100, but rather 105. So even though 100 is the average of the population it can be on the lower end in a professional or academic setting.

Based on my own reading of IQ and general heuristics I've developed from observing people (i.e. this is my folk wisdom, I am not sharing links), on a team of SDEs, the one SDE who is really really sharp, not just due to tenure, but generally just grasps things faster and earns the intellectual respect of his peers, is probably about 8-15 points higher than the average IQ of the SDEs around. Again, this is super heuristic, as IQ is non-linear.

A population average loss doesn't even mean that I'll deterministically lose 6 to 8 IQ points. But it's strong enough evidence that it severely fucks with the brain for me to stay the hell away. The direct effect of the loss of a few IQ points is not the issue.

It's a good question. Arguably more important, are the side-effects permanent? Or has this IQ drop only been measured during cannabis consumption?

The theory is that heavy use during adolescence leaves permanent changes in adulthood. Heavy usage that starts in adulthood doesnt' seem to have the same level of permanent effects.

If you smoke heavily and quit, your endocannabinoid system underperforms by about 20% for two or three weeks. It basically dulls pleasure in everything, producing anhedonia, depressed appetite and irritability. It impacts sleep negatively too.

How long does it take for full recovery?

Each time I've quit for an extended period of time it's taken me about three weeks to feel normal. During those weeks I definitely feel more grumpy and irritable. I'm also curious as to whether THC or other chemicals in the smoke have any effect on the body's thermoregulation, because each time I've quit I've also woken up drenched in sweat every night for about the first week or so. Crazy dreams as well.

These have all been me going cold turkey after heavy daily use for extended periods of time.

I find sleep changes really noticeable, so so everyone else. Dreams become very vivid for couple of days to a point of discomfort.

When you smoke i never dream. When you stop body overcompensates.

I wonder if it's suppressing REM sleep like alcohol does

It does. My understanding is that THC inhibits REM sleep, and as a result the chemicals that are usually released during the REM phase that cause you to dream do not get released. Once you quit and start having REM sleep again, there's a "backlog" so to speak of the chemicals and more than usual are released, thus causing the extremely vivid dreams.

As he said, a couple weeks.

> I am not a doctor but from what I have been reading, consuming THC on a regular basis before 21 (the commonly accepted age for the latest stage of brain development) is definitely a bad idea, as it will prevent the endocannabinoid system to develop correctly.

I've been smoking every day since I was 19 (currently 31), and my endocannabinoid system seems perfectly fine. Most of my peers have the same story, or have been smoking daily for longer. I think what you've been reading is incorrect. For future reference, I've noticed when people begin a sentence with "I am not a [lawyer|doctor|engineer]", they are typically incorrect.

Weed can trigger latent schizophrenia if used at a younger age. It is not a good idea to use before the brain is developed, especially if one is predisposed to mental illnesses like schizophrenia. It also alters testosterone synthesis, so there’s that too.

Leaving home to go to college can trigger latent schizophrenia too. So can a bad breakup with a girl or boyfriend. I’m not sure how useful that actually is.

This is just my experience, but my endocannabinoid system is just flourishing. I, unfortunately, started smoking cannabis at age 16 and was using daily by age 18. I quit for 5 or so years in my mid-twenties and picked it up again in my early 30s.

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