Why are we seeing so many cannabis-related school suspensions and expulsions? Use isn't increasing but attitudes are changing and teens are doing 'stupid things'. What can parents do?

Over the past 12 months I have been contacted by an extraordinary number of schools struggling to deal with cannabis. Regardless of the system - Independent, Catholic or state - it would appear that a growing number of young people are making the foolish decision to take the drug to school. Once they have brought it onto the grounds, they are either choosing to smoke it, usually with a group of friends of their own age, or are selling it, either to others in their year group or younger students. Now many people may be thinking that this is nothing new - if there was an illicit drug that was likely to be used by secondary school students, it would be cannabis. I can certainly remember cannabis being sold or supplied to others when I was at high school and I was a teen in the mid-70s - to be honest some people went to school to buy drugs at that time! But times have certainly changed and if you speak to school principals across the country, they will tell you that having to deal with a student bringing an illegal drug to school is not the norm. The vast majority of schools have not had to deal with this sort of problem for some years ... but that certainly seems to be changing ...

What is interesting is that this is occurring at a time when we are continuing to see some of the lowest rates of cannabis use amongst our young people. The most recent Australian Secondary Students Alcohol and Drug (ASSAD) survey conducted in 2014 (released in 2016) found that although cannabis continues to be the most commonly used illicit substance by students, they are about half as likely to use the drug as they were in the late 90s. Cannabis use, whether it be lifetime or recent (used in the last 12 months), has actually decreased.

If you look at the graph provided, you can see across all year groups, lifetime cannabis use has decreased dramatically since the national survey began in 1996. Now it does need to be acknowledged that amongst the older students (those aged 15 or above), use has risen slightly since 2011 - but that small increase is not enough to explain the situation we are currently seeing ... So it would appear that what we have is continuing low rates of cannabis use but those young people who are using the drug are doing so in a much more risky way. So why is this happening? Why, after so many years, are we starting to see cannabis creeping back into the schoolyard?

I believe it has to do with how we're currently talking about cannabis. There is so much talk about legalizing the drug, as well as the whole medicinal cannabis issue, that young people are 'confused' about the legality of the drug. Now, this is not an article on whether or not the drug should be legalized, or issues around medicinal cannabis - the fact is that cannabis is an illegal drug (as I always say to young people who have strong feelings about the illegality of cannabis and believe the law should be changed - if that's how you feel, do something about it! Join a group that wants the law to change - don't just moan about it and say it's not fair, get up and take action!). It is vital that we ensure young people are aware of the law and what the consequences are should they choose to break it ...

I recently found a study from Norway that attempted to examine why young people take up opportunities to use cannabis - its findings were really interesting. According to the authors, Norway has experienced a decline in cannabis use amongst young people similar to the Australian experience, however, the study found that the proportion of adolescents exposed to 'concrete use opportunities' had increased significantly. At the same time, they found the perception of cannabis-related risks were significantly lower. The authors speculated that this could be "at least partially to the intense and growing international debate concerning cannabis deregulation, which may be interpreted as evidence of its minor harms, de-stigmatization, and use normalization among young." I think we're seeing the same thing here - young people just don't see cannabis as being a particularly risky drug. Ask any teacher and they will tell you when there is any discussion around cannabis, one of the first things that is brought up is "It's a medicine, it can't be bad for you!"

The reality is that, even the pro-cannabis lobby would say that it is best to delay use of the drug for as long as possible. The evidence is pretty clear that the younger you start using the drug, the greater problems you will experience. If you want to disregard the potential physical and psychological cannabis-related harms that teens may experience, the legal and resulting social ramifications of getting caught with the drug can affect a young person's life forever. No school wants to suspend or expel students but bringing illicit drugs to school cannot be ignored ...

Going back to the study, the researchers were also able to identify three 'protective factors' that were likely to prevent those 'opportunity-exposed' young people from taking up cannabis use opportunities and to remain non-users, i.e., when they found themselves in situations where the drug was available and offered to them, they were able to refuse. They were as follows:

• if they reported that their parents knew where they spend their Saturday nights
• if they were involved in sports regularly, and
• if they perceived even minimal or occasional cannabis use to be risky

Not surprisingly, parental monitoring plays a role here with this study supporting previous research that has found the general positive effects of proactive parenting strategies and close parent-child relationships when it comes to cannabis involvement. In addition, when teens believed that there were harms associated with even occasional use, this was a barrier to potential use. If we want to delay (or even prevent) early use of cannabis, or any substance, we must ensure the information we provide to young people is honest, accurate, credible and actually means something to them.

Unfortunately, recent Canadian research has found that, for the most part, youth does not seem particularly concerned about potential cannabis risks. In a qualitative study of young people aged between 14-19 years of age, when asked about the consequences, legal ramifications were rarely mentioned. Very few "felt school presentations and learning about the health, social and legal consequences of use was enough to deter youth from trying ..". Physical risks, such as the potential smoking effects on eyes and throat were acknowledged but downplayed, however it was the psychological impacts on others that were regarded as most important. Changes in behaviour, such as lessening the ability to handle things, decreased motivation, mood swings, and the drug's capacity to make someone closed off and anti-social were raised as issues by those interviewed. Most importantly, young people reported personal experiences among their peers with worsening pre-existing mental health issues such as schizophrenia, psychosis or depression they believed were induced or aggravated by the use of the drug.

Is going down the 'mental health' road the way to go? It certainly is something that I cover when I speak about cannabis but you do have to do it carefully. Like any potential harm, you have to be careful you don't 'over-play' it. The reality is that most young people who use cannabis won't experience these problems - if you start making wild statements like 'everyone who uses cannabis will go crazy and develop a mental health problem', you're going to lose them. Many of them, however, will know someone who is experiencing problems, whether it be becoming social isolated, losing motivation, paranoia, or depression. Highlighting that if you see this in a friend you need to tell someone and get help could be a way of getting across that this is not a 'risk-free' drug.

In the past couple of months I have spoken to so many parents who are really having a tough time with their adolescent in relation to cannabis. The majority of these teens are young men, but there are certainly some young women who have also found themselves in trouble with this drug. Getting a call from the school and facing the nightmare of, at best, having a child suspended, or at worst, having them expelled or asking them to be withdrawn, must be earth-shattering, particularly if you didn't see it coming. For most parents, this is a 'one-off' thing - their child did something stupid with their mates, got caught and they won't do it again. Experimentation is a part of adolescence - that doesn't mean it can't be extremely damaging but it's what some teens will do! Unfortunately, for other parents, this will be the start of a long dark road and it's often really difficult to see the light at the end of the tunnel ... As I always say, if you find yourself in the latter situation, the cannabis use is not usually the problem, but a symptom of a much greater issue that needs to be identified and dealt with. Trying to 'fix' the cannabis issue (e.g., trying to put them into rehab or the like!) without digging deeper and finding out what that underlying problem is will often result in a lot of time-wasting and can destroy families ...

As community attitudes change and we see more countries move to decriminalise and even legalise cannabis, and medicinal use of the drug becomes more widely accepted, young people's perceptions of cannabis-related risks are also changing. Adolescents are at the greatest risk when it comes to cannabis-related harms - the earlier they use, the greater the risk - so it is important to delay potential use for as long as possible. Cannabis use amongst our school-based young people is certainly not 'spiralling out of control' but something appears to be happening, with those who are using, more likely to do silly things like take it to school ... We need to try to address this quickly by ensuring that schools have rules and protocols around bringing drugs to school and that these are clearly communicated to all students. At the same time, we must make sure that cannabis prevention programs are based on best practice and that the information we provide to young people is honest, accurate and credible. Trying to 'scare' teens is not going to work but if the current research is to be believed, it is most probably the mental health consequences that are going to have the most impact on our young people. At the same time, parents need to support these messages, making sure that they also provide balanced messages in this area.

Finally, it is important to acknowledge that for most young people cannabis use will not cause significant issues, they may experiment and use once or twice and then come out at the other end relatively unscathed. Where it does become a problem, however, it is usually life-changing, affecting both the user and all those around them. Take the time to talk to your teen about cannabis - tell them your views and get an understanding about how they regard the drug. Remember those protective factors - knowing where your teen is on a Saturday night; being involved in sport (but realistically involvement in any organised activity, whether it be music, drama or whatever is likely to have a similar effect); and seeing cannabis use as potentially risky. Highlighting realistic and credible cannabis-related risks in a conversation with your child is likely to be helpful ... remember, even though you may think your words may not have an effect, research shows you were their first teacher and will always be an important influence in their lives, even through those difficult teenage years ...

References:
Andreas, J.B. & Bretteville-Jensen, A.L. (2017). Ready, willing and able: the role of cannabis use opportunities in understanding adolescent cannabis use. Addiction 112, 1973-1982.

McKiernan, A. & Fleming, K. (2017). Canadian Youth Perceptions on Cannabis, Ottawa, Ontario: Canadian Centre on Substance Abuse. (PDF downloadable version)

White, V. & Williams, T. (2016). Australian secondary school students’ use of tobacco, alcohol, and over-the counter and illicit substances in 2014. Cancer Council Victoria.