Great news. According to a recent federal report, the percentage of youths ages 12 to 17 who smoke, drink, or abuse most drugs has fallen since 2002. Tobacco use has dropped from 15.2 to 7 percent. Those who reported having had a drink within the previous month decreased from 17.6 to 11.5 percent. Even illicit painkiller use has declined from 3.2 to 1.9 percent, according to a 2014 annual survey of around 67,500 teens by the U.S. Substance Abuse and Mental Health Services Administration.
But marijuana use is edging upward, from 6.2 percent in 2002 to 8.4 percent in 2014. Experts believe adults in these youths' lives who may have indulged and suffered no ill effects may be partly to blame.
Yet, the drug kids are smoking today is not your father's marijuana.
Recently, we saw a 17-year-old who'd been coming to our office for over a decade. Whiskers now obscure his dimpled cheeks. But what struck us most was his gaze.
The boy who used to talk about dreams that wavered between the NBA and practicing law now just looked at the floor or at his phone, annoyance etched on his face. His mother was concerned that he was smoking weed with his friends and wanted him "tested."
The main chemical responsible for most of marijuana's effects is tetrahydrocannabinol, or THC. In the 1970s, THC levels in confiscated marijuana were around 1 percent. By 2010, however, potency had jumped to 11 percent - the equivalent of a can of beer soaring from 3 percent alcohol to 33 percent.
In 2013, marijuana was the most-used illicit drug in the U.S., with 6,600 new users a day nationwide.
Nearly 4.5 million people ages 12 and up used marijuana almost daily in 2002. Today, it's more than eight million. A recent study in the journal Lancet Psychiatry showed that teens who smoke marijuana almost daily were 60 percent less likely to graduate from high school than those who don't smoke and were seven times more likely to commit suicide.
In a recent study of why teens use marijuana, most said they used it for pleasure; 16 percent said for coping or self-medicating.
Some teens may think marijuana is safer than cigarettes, but that is untrue. Marijuana has three times the tar and 50 percent more carcinogens than cigarettes. Research suggests pot would be related to more cancers if users smoked it in quantities similar to cigarettes.
Some teens may also believe marijuana is not addictive. However, in a 2008 study, 9 percent of users became addicted to marijuana. That rose to 17 percent if they started as teens, and up to 50 percent for those who smoked daily.
A 2014 study published in the International Journal of Drug Policy found that about 10 percent of high school students who would otherwise be at a low risk for smoking marijuana - including those who don't smoke cigarettes, students with strong religious beliefs, and those with non-marijuana-smoking friends - say they would use it if it were legal. Are politicians in the U.S. putting even more youths at risk of smoking marijuana by legalizing pot? What happens to these developing bodies as more and more smoke marijuana?
Cannabinoid receptors (CB1 and 2) are found throughout the body, with highest concentrations in the brain. The euphoria users feel has a high price. Activated CB receptors cause altered judgment, slowed reaction times, paranoia, and impaired memory and coordination. That alters the ability to make good decisions behind the wheel or at a party, recall concepts in classrooms, and feel safe in one's neighborhood.
Studies have also shown that with long-term use there are higher rates of schizophrenia and a decrease of eight IQ points if one started using marijuana as a teen.
Then there is the matter of synthetic marijuana.
K2, spice, black mamba, bliss, dank, ultra chronic - are all alluring nicknames for man-made chemicals functionally similar to natural cannabinoids. They are dissolved in volatile solvents, sprayed on plant leaves, and marketed as incense or potpourri, labeled "not for human consumption."
Yet almost 8 percent of high school seniors and 4 percent of eighth graders have used synthetic marijuana within the preceding month, according to a multiyear study from the University of Michigan.
The Drug Abuse Warning Network (DAWN), which monitors drug-related ER visits, started noticing visits related to K2 climbing in 2010. That year, 11,406 visits were logged. In 2011, the group registered 28,531 visits. Seizures, delusions, loss of consciousness, and loss of muscle tone are the symptoms hospitals are seeing. But it gets worse: A 2014 study in the American Journal of Cardiology showed a 4.8 times increased risk of a heart attack within 60 minutes of natural marijuana use.
In Philadelphia, there is help available. At cap4kids.org/philadelphia, look for the "parent handout" on addiction, and you'll find a comprehensive list of resources for youths and parents, including the SPARC program, where we sent our 17-year-old patient.
Times are changing, and more teens and adults need help. They can't wait.
Daniel R. Taylor, D.O., FAAP, is an associate professor at Drexel University College of Medicine, and Stacey A. Engster, M.D., is a third-year pediatric resident at St. Christopher's Hospital for Children.