THE BETTERMENT OF ONE'S LIFE

A Single Mom Tries To Get Off Pot

A common student question asked at Canterbury High School focuses upon the
melange of moral, ethical and consequential aspects of smoking cannabis.

A previous column focused on the physiological and psychological effects of
drug use, especially marijuana/cannabis. After my column about the latest
research on the effects of cannabis --
http://members.rogers.com/barrydworkin/medical_marijuana.html -- many
readers wrote to express their opinion about the issue. One e-mail caught
my attention.

Deborah is a 37 year-old single woman with three boys aged 10, 12 and 14.
She first tried marijuana at age 11 and started regular use by the time she
was 15. She quit during the five years encompassing her pregnancies but
restarted after her youngest son's first birthday. She smokes an average of
four to 10 joints daily. She does not drink or smoke cigarettes.

She comes "from a good upper middle class family." Her father was in the
armed forces and her mother worked for the government. Her sister works at
the Department of National Defence and is active in her church. Deborah
works for several physicians and was a registered practical nurse for 15 years.

Deborah says, "I have always been very ambitious, adventurous and seemed to
have excelled in everything I have attempted; drama, track and field,
horseback riding, skiing, skydiving, rock climbing, guitar, keyboards,
drums and singing."

Her concern was that her marijuana use was jeopardizing her health. Her
feelings of shame prohibited her from discussing this issue with her family
doctor. She feared "what she might think of me, as a person, a mother, and
a professional."

She often feels pressure or pain in her chest and cannot breathe as easily
as before. She worries that she may have cancer of the mouth, throat, lungs
or stomach from her smoking.

She asked if I might help her quit using cannabis. (There was no
precondition that her story would be published.)

She had three goals: to show teens the long-term physical and psychological
effects of cannabis; to discourage its use; and to "get some much needed
help so that three beautiful little boys will have a mom around for a long
time."

In addition to her desire to quit her cannabis use, she wanted a full
physical exam and tests to determine whether she suffered any deleterious
health effects.

During her first visit last October, she stated she was experiencing mild,
manageable mood swings. She could concentrate and functioned well at work.
She had normal sleep patterns and appetite.

She stated she was a high achiever with many goals and dreams. She
expressed frustration that she could not sing as she once could or motivate
herself to achieve her goals.

She smoked outside of the house and never in front of the children.
However, they knew what was going on. Her guilt about the message she was
sending to her children was unbearable.

Her physical exam and blood tests were normal. A lung function test
indicated the smaller airways were becoming blocked. The chest X-ray was
normal.

The question "why does she continue to smoke?" does not necessarily have a
straightforward answer. We know she started at age 15, the middle or tribal
stage of adolescent development. In this stage, there is a consolidation of
body image and sexual identity. The school environment is comfortable. Peer
groups become their new family and safe haven and are a form of tribalism
with all its rituals, markings and lingo. Peer pressure becomes the
dominant behavioural influence. In the quest for independence they test
their limits and compare themselves to their friends. Paradoxically, they
conform to their peer group in order to feel more independent.

Drug abuse during adolescence will arrest or hinder progression through the
developmental stages that lead to independence and self-awareness. Indeed,
Deborah readily admits she has difficulty defining who she is. At 37, she
remains stuck in her adolescent middle stage. Although she appears to be
coping with many of her responsibilities on an adult level, her sense of
self remains undefined.

I usually give my adolescent patients some "homework" after the preliminary
evaluation to better understand their concept of friendship, relationships
and their self-image. These questions are part of the Adolescent Toolkit
http://members.rogers.com/barrydworkin/help_teens_tune_in.html ) and are
germane to Deborah's situation:

- - What do you like and dislike about yourself?

- - What are your good and bad qualities?

- - What are your definitions of a friendship and relationship?

The goal for Deborah is to understand why she smokes, gain control over her
behaviour and achieve true independence.

Next week's column will review Deborah's progress.