THE PEER PRESSURE TO USE CANNABIS

Medical Briefing

For the last 25 years of my life in the NHS, most of my patients were aged
between 16 and 30. Earlier in my career I was involved for a few years with
the treatment of patients, mainly young patients, dependent on drugs. The
media uproar over the antics of Prince Harry during his holidays seemed
excessive -- a reaction presumably distorted by his royal position and out
of proportion to his problems. When compared with the behaviour exhibited
by the truly disturbed adolescents whom I used to meet, his occasional
reported excesses, foolish though they may have been, were similar to those
experienced by many, if not most, families with teenage children.

A generation or so ago, one of the catchphrases of popular psychology was
"viable minority". It is a pity that the concept is no longer fashionable,
for the term was used to describe an important phenomenon in adolescent
behaviour. The rule of thumb was that potentially well-orientated young
people will adapt their behaviour to that of the majority of their peer
group, unless about 25 per cent share the same minority outlook. The young
man or woman whose behaviour does not change to that of the majority is
likely to be the oddball whose independence of thought, although possibly
admirable, is unlikely to give them an easy ride with their peers.

Although always wise to do so, and in some cases an essential medical
precaution, it is nevertheless difficult for a 16-year-old to refuse
cannabis if a room full of older people of university age, and above, are
all smoking it. Likewise it is difficult for young people, when drinking
with more sophisticated and alcohol-hardened adults, to stick to limits
suitable for their age group. The more worldly-wise and experienced
adolescent, whose lifestyle has meant that he or she has been nearly
everywhere and done nearly everything, is naturally drawn to older people
even though still emotionally immature. Parents are therefore left with the
problem of arranging holiday activities that will capture the imagination
of a precociously stimulated adolescent who is, by now, easily bored by his
or her less sophisticated contemporaries. In some way or another, those
adolescents who have had a different and more exciting background than the
majority have to have a circle of friends, a "viable minority", who are
like-minded, but not jaded or delinquent, with whom they can share their
leisure time. Although the furore in the press over Prince Harry may have
been excessive, the carefully worded announcement from St James's Palace
seemed to have struck the right note. The visit to the rehabilitation
centre was a well-designed and presumably sobering experience, as it showed
that cannabis could be the gateway to other drug abuse.

It is a matter of debate whether, as Baroness Greenfield believes, the main
hazard of cannabis in young people is the change in personality and
intellectual ability that it produces, and which too often results in poor
academic performance and a poor attendance record. Others fear that the
major risk is to the appreciable minority in whom cannabis may induce
psychotic changes. Before smoking cannabis, it is therefore important not
only to consider one's psyche and decide whether one's particular quirks
are likely to be symptoms of psychiatric disorders that could be
exacerbated by cannabis, but also to look with some care at previous
generations. A close study of a family tree, whether royal or plebeian,
will, without going back to the time of Henry V, reveal antecedents whose
psychological idiosyncrasies would be best left unexposed. Most doctors
have also had experience of a slightly unusual adolescent whose behaviour
after using cannabis became markedly strange, if not psychotic. A study
from the National Drug and Alcohol Research Centre in New South Wales
showed that early cannabis use appeared to be associated with the adoption
of an anti-conventional lifestyle coupled with the precocious adoption of
an adult way of life. The change in young people's personalities too often
discouraged them from continuing with academic work, or from living in the
parental home.

Peer pressure from established cannabis users seemed to be a common cause
of early cannabis use. Another recent report, from the Centre for
Adolescent Health at the University of Melbourne, suggested that most young
adolescents who had smoked cannabis at all did so only occasionally, but
that in 12 per cent of the early users it escalated to a worrying daily use
by the time they finished their schooldays. Those who smoked cigarettes
early in life were more likely to be among the 12 per cent who became
persistent cannabis smokers.