REGULAR marihuana use is increasingly prevalent among young people.' Little systematic information, however, has been obtained from regular users concerning effects and patterns of use.' The purpose of this study was to evaluate psychiatrically a random sample of regular users selected from a non-patient population and to describe this new drug experience of white, young adults.

 

One hundred regular marihuana users from St. Louis were interviewed by a psychiatrist using a structured interview. Criteria for admission to the study were minimal: (1) subjects had to be at least 18 years old and white, (2) subjects had to be self-defined as "regular" marihuana users' and give a history of using marihuana on at least 50 occasions over at least a six-month period.

Subjects were obtained through word-of-mouth chains of referrals. Three source people known to have access to diverse groups of drug users in the metropolitan area were asked to encourage regular marihuana users to participate in the study. Each volunteer was assured of anonymity and was paid $10 for participation. After each interview, subjects were requested to tell their marihuana-using friends about the study and encourage their participation. Multiple referral chains of from one to nine generations were obtained by this arborization method. This chain referral method tapped most sectors of the white drug-using population in the metropolitan area. Participants ranged from high school drop-outs to PhDs and medical students, from transients to married professionals, from children of millionaires to children of blue-collar workers.

 

Interviews lasting two to four hours were administered to each subject. In addition, subjects filled out a checklist review of effects of marihuana intoxication occurring when marihuana was the only drug used. Acute intoxication effects as well as "hangover" or aftereffects were included. Aftereffects referred to those which occurred following the disappearance of all subjective feelings of intoxication or to next-morning effects. All effects were self-defined by each subject.

This communication deals with the results of the checklist review. The checklist included 105 items, many previously reported in the literature as marihuana effects. Areas covered included changes in mood, perception, consciousness, and personality, and various psychiatric and medical symptoms. Subjects were asked to note if these effects occurred "usually," "occasionally," or "once-or-never."

Results

 

Sample.—In general, the subjects were well educated and articulate, although of diverse backgrounds and interests. They ranged from 18 to 31 years of age, with a mean age of 22. Three fourths were between 18 and 23. There were 61 males and 39 females. Thirty had been raised in Catholic homes, 30 in Protestant, 30 in Jewish, and 10 in homes of no religion. Fifty-eight were full-time students, 24 had per- manent jobs or professions, 9 had part-time or transient jobs, and 9 were unemployed. Ninety were single. Four had not completed

high school, 5 were high school graduates, 62 had had some college, and 29 had had some graduate level education, including '9 medical students.

 

Usual Effects.—Tables 1 and 2 list the effects of marihuana surveyed. Nine effects were noted as "usual" occurrences during intoxication by a majority of the subjects: high feeling, keener sound sense, increased sensitivity to others' feelings, peaceful feeling, experience of slowed time, relaxation, increased hunger, increased thirst, and dry mouth and throat. No unpleasant effects were noted as usual occurrences by a majority of subjects. A clear mind, more restful sleep, and a calm feeling after intoxication effects had worn off were reported as usual by a majority. No adverse aftereffects were reported as usual occurrences by a majority.

 

Of the 105 symptoms, 37 occurred on a usual basis for 10% to 50% of these regular users. A wide variety of effects occurred at least occasionally to a majority of the group.

 

Adverse Effects.—A large number of adverse symptoms were reported as usual, but generally by a small minority in each case. These included reduced self-confidence, crying, indifference or apathy, aggressive feelings, poor memory, hearing voices, clumsiness, headache, restlessness, and jittery feelings.

 

Sixteen of the 100 subjects reported the usual occurrence of at least one of the following acute or postintoxication adverse effects: (1) acute—anxiety or fearfulness, brooding or morose feelings, sadness or despondency, aggressive feelings, amnesia, confusion and be-

wilderment, hearing voices, seeing visions; (2) postintoxication—depression, driving badly, unreasonable fears, hearing voices or seeing visions, and "anxiety flashes."

 

Comment

 

This study confirms previous descriptions of marihuana intoxication. Pleasurable effects are "usual" for most regular marihuana users. Of interest is the wide variety of adverse effects which occur usually to some individuals, and to many others on an "occasional" basis. These include hallucinations, anxiety symptoms, impaired mental processes, and symptoms of depression. Other effects, occurring only occasionally in a small minority of subjects, also are significant. Suicidal thoughts, for instance, occurred occasionally in 6% of subjects; amnesia was reported by 5% of subjects.

 

Volunteers in any study may be different from the population from which they are drawn. These findings are subject, therefore, to the limitations inherent in such studies. It is interesting, nevertheless, that one in every six subjects reported at least one unpleasant usual effect during marihuana intoxication. As Mendelson' has noted with regard to alcohol, and Lindesmith6 with regard to opiates, adverse effects from euphorogenic drugs do not always discourage their use.

 

This study was supported in part by Public Health Service grants MH-09247, MH-05804, MH-47325, and a Research Scientist Development Award MH-47325 from the National Institute of Mental Health (Dr. Goodwin).

 

References

 

1. Marihuana: First Report by the Select Committee on Crime ("The Pepper Report") House Report 91-978. Washington DC, US Government Printing Office, pp 1-114, 1970.

2. Pillard RC: Marihuana. New Eng J Med 283:6,924-303, 1970.

3. Manheimer DI, Mellinger GD, Bater MB: Marijuana use among urban adults. Science 166:1544-1545, 1969.

4. Kaplan J: Marijuana—The New Prohibition. Cleveland, World Publishing Co, pp 73-74, 1970.

5. Mendelson JH, La Don J, Solomon P: Experimentally induced chronic intoxication and withdrawal in alcoholics: Psychiatric findings Quart J Stud Alcohol 2: 40-52, 1964.

6. Lindesmith AR: Addiction and Opiates. Chicago, Aldine Publishing Co, 1968.