ER Visits for Self-Harming Doubles in 8 Years in Ontario - Why?

Some good theories listed below, but they are missing the most obvious

'New 18 now is 28': How screens delay teens' emotional maturity

Amina Zafar · CBC News 

Researchers said emergency department visits by those aged 13 to 17 in Ontario rose from 2009 to 2017, based on national data. Girls tend to show a greater willingness to seek mental health care than boys. (Shutterstock)

The number of teens who went to emergency departments in Ontario for injuring or poisoning themselves doubled from 2009 to 2017 — a surprisingly sharp rise, say Canadian health-care providers. They are calling for better ways to connect young people with mental health services.

Increasing rates of self-harm among teens in Canada, the U.S., Australia and Europe are a concern in part because those who deliberately harm themselves are at greater risk for repeated injury or for suicide.

In a study published this week in the Canadian Journal of Psychiatry, researchers looked at emergency department visits by those aged 13 to 17 in Ontario, based on national data from the Canadian Institute for Health Information.

"The number of kids who have at least one visit for self-harm in a given year basically doubled from 2009 to 2017 after it had been falling consistently from 2003 to 2009," said William Gardner, a senior scientist at the CHEO Research Institute who holds a senior research chair in child and adolescent psychiatry at the University of Ottawa.

Mental-health visits for anxiety and depression also rose starting in 2009.

Both the self-harm and anxiety trends pose a huge and worsening strain on the mental-health system for young people, Gardner said.

The big question is why. Gardner speculated on three potential reasons:

The launch of the iPhone in Canada in 2008 and rising smartphone use and engagement in social media.

The financial downturn in 2008 and its lingering damage through job losses and family instability.

A greater willingness to seek help after campaigns to reduce the stigma of mental illness.

Smartphones facilitated shifts in how people of all ages socialize.

We can do a better job of taking kids who show up in the

emergency department with mental health problems

and getting them into care in their community.

—  William Gardner

"For a certain group of vulnerable adolescents, kids who are at risk for various social and psychological problems already, a lot of them describe the experience of constant exposure to social anxiety [and] to bullying by peers as very stressful, and so that could be the cause of some of these problems."

For most people, Gardner believes, being online isn't terribly harmful. 

'The new 18 now is 28' because there is a delay in the emotional and social awareness and maturation of adult skills, says Dr. Chris Wilkes. (CBC)

In hospitals, decreasing stigma could also mean physicians who see a laceration on the arm now ask, "Did you cut yourself?" Previously, the question wasn't asked, and the cut would be classified as an injury, Gardner said.

But emergency departments aren't suited for teens needing continuing mental-health care.

"We can do a better job of taking kids who show up in the emergency department with mental health problems and getting them into care in their community."

Continuing a long-standing pattern, the increases in self-harm and emergency visits were higher among females than males.

In focus groups, girls often complain of incessant pressure to present a perfect image on Instagram, as well as a greater willingness to seek out care than boys, Gardner said.

Boys' aggression a 'mental health problem'

The problems boys face tend to manifest differently, such as trouble controlling their anger.

"They will get involved in various kinds of aggressive and deviant activities that could lead them to trouble with the criminal justice system, and we don't talk about those things as mental health problems but in many ways they are."

The study was excellent in its portrayal of a dramatic increase in self-harm happening across Canada, said Dr. Chris Wilkes. He heads the child and adolescent psychiatry division at the University of Calgary and wasn't involved in the research.

"What we say in the area of children's mental health and adolescent psychiatry is that the new 18 now is 28 because there is a delay in the emotional and social awareness and maturation of adult skills."

I have been expecting this for several years. Not because of social media - although I'm sure that is responsible for a lot of mental health issues, especially in young girls, but because of pot use. Check out this brief post from 2015 - 28% of 11-15 Year Olds Using Pot in Canada - Highest Rate in the World

Pot delays, or stops cold, the maturing process especially in children. Perhaps not all children but certainly enough to make it very obvious to anyone who bothers to look. There are numerous posts on this blog dealing with this concept and the well-known fact that pot triggers schizophrenia in as many as 1 in 6 teens.

Read eyes, not screens

More adolescents are living at home longer, often glued to screens. Wilkes called it a paradox that people have never been more connected yet alone. Online connections are no replacement for learning to read another person's eyes — in person.

"Emotional maturation takes time and it takes real experiences with relationships, and if you spend more and more time on screen time, you have less opportunities to practise these skills."

More broadly, Wilkes said, poorer teen relationships with parents, relatives and friends may have combined with cultural shifts to greater materialism and narcissism. Learning delayed gratification is at risk of being lost. 

Wilkes called Calgary ahead of the curve in providing walk-in mental health services in the community, in addition to national resources such as Sen. Stan Kutcher's teenmentalhealth.org.

On the front lines, school-based programs offer the best bang for the buck in prevention, he said.

"For every dollar you invest in early development you save $4 to $9 by reduced costs in education, justice, reduced mental health utilization and better employment prospects."

The future lies in integrating mental health and emergency department services, family and community resource hubs, acute care at home and peer support, Wilkes said.

Rates of self-harm visits in the study rose from 1.8 per 1,000 in 2009 to 4.2 per 1,000 by 2017. Over the same period, mental health visits increased from 13.5 per 1,000 to 24.1.

The teen research was funded by an unrestricted grant from the ScotiaBank Foundation.

Where to get help:

Canada Suicide Prevention Service: 1-833-456-4566 (phone) | 45645 (text) | crisisservicescanada.ca (chat).

In Quebec (French): Association québécoise de prévention du suicide: 1-866-APPELLE (1-866-277-3553).

Kids Help Phone: 1-800-668-6868 (phone), www.kidshelpphone.ca (live chat counselling).

Canadian Association for Suicide Prevention: Find a 24-hour crisis centre.

Medical Journal Calls for Tighter Rules on Legal Pot to Protect Young

Powerful pot strains put developing brains of young people at risk, CMAJ editorial says

CBC News 

A pot smoker has a joint at the annual 4/20 day, which promotes the use of marijuana, in Vancouver. Cannabis shouldn't be used by young people, a medical journal editorial says. (David Horemans/CBC)

Marijuana legalization will harm the health of youth unless major changes to the proposed law are made to protect their developing brains, a medical journal editorial says.

Dr. Diane Kelsall, interim editor in chief of the Canadian Medical Association Journal, says Bill C-45 fails to safeguard vulnerable youth.

"There are a number of things in the legislation that are truly worrisome," Kelsall said in an interview. "If the intent is truly a public health approach and to protect our youth this legislation is not doing it."

Canadian young people ranked first for cannabis use in North America and Europe, with one-third saying they tried it at least once by age 15, the Canadian Pediatric Society says. 

Before the federal election, physicians said the right legislation to legalize pot might curb teen toking by restricting access.

The editorial takes issue with several aspects of the bill, which:

Sets the minimum age to buy recreational marijuana at 18. Kelsall calls that too young given evidence suggesting that the human brain doesn't mature until about age 25.

Allows people to grow pot at home, which Kelsall said increases the likelihood of diversion to young people.

Lacks national standards for retail distribution.

Lacks limits on potency of strains despite increased risk of harmful effects with higher-strength cannabis.

"From my perspective, from my colleagues' perspective, this legislation is being pushed through," Kelsall said. "We're just very worried that we're conducting a national experiment and unfortunately the guinea pigs are kids."

Marijuana as a psychosis trigger

At the Centre for Addiction and Mental Health in Toronto, psychiatrist Romina Mizrah uses PET scanners to study how cannabis use changes brain function in young people with an average age of 20.

"There are physical and functional changes in the developing brains of regular users that are associated with damage".

Dr. Diane Kelsall

In young people who regularly use cannabis, preliminary evidence points to a reduction in an enzyme that regulates the endocannabinoid system that buffers key chemistry within the brain, said Mizrahi.

"There is some understanding at this point from epidemiological studies that certainly marijuana is a trigger," said Mizrahi, director of the Focus on Youth Psychosis Prevention program. "Marijuana use predates the psychosis. Whether it causes the psychosis, that's a different question and that we don't know."

Studies using MRI scanners also show physical and functional changes in the developing brains of regular users that are associated with damage, Kelsall said.

In fact, I believe that it stops all maturing processes in developing brains leaving adult people trying to function in society with the brain and maturity of a teenager. It doesn't work!

More potent pot

Mike Stroh, 35, of Toronto says he's part of a generation who grew up smoking current strains of marijuana, which have been genetically selected to produce a powerful high, with THC levels of about 20 per cent. That's up from around seven per cent in the 1960s and '70s.       

From age 13, Stroh got high almost daily until age 30.

"I was into sports," Stroh recalled. "I wanted to do stuff at school, but I wouldn't make it to the practice, I wouldn't make it to the tryouts, because I was either up all night selling drugs, trying to get them, fall asleep in a drug-induced coma, and then wake up in a mess."

Mike Stroh started smoking pot almost daily from age 13 until he was 30. He says it's an 'illusion' that pot is a relatively harmless drug. (CBC)

Stroh also lived with depression and anxiety and said he was never able to like himself. "That's the torment that brought me to my knees."

He felt robbed of being himself and the opportunity for emotional maturity, cognitive development and professional opportunities.  

"Because marijuana doesn't bring you to your knees as quickly as other drugs may … there's this illusion that because you can be high and do things, it's not bad, so to speak."

Stroh is now a mental health advocate who draws on his personal and family experiences to educate.

"We need to teach kids how to take care of themselves so when they do feel anxious and do feel depressed, scared or … frustrated with life, because yes, that's a part of being a teenager, then they learn that there's so many things they can do to help themselves as opposed to use drugs."

Pot Heads Have Abnormally Low Blood-Flow in Their Brains

Marijuana users 'have abnormally low blood flow in every part of the brain - including Alzheimer's danger zones'

Researchers studied brain scans of 1,000 US marijuana users
They found cannabis users all had low blood flow in the hippocampus
The users also had significant restricted blood flow all over the brain
Hippocampus is key for memories, and is a ground zero for Alzheimer's

By Mia De Graaf For Dailymail.com

Marijuana users have abnormally low blood flow in virtually every part of the brain, new scans reveal.

Sophisticated imaging of 1,000 cannabis users' brains found all of them had widespread restrictions or build-ups of blood flow.

Many had abnormal blood levels in areas affected by Alzheimer's disease, such as the hippocampus.

The findings, published in the latest Journal of Alzheimer's Disease, are an ominous warning as the United States rapidly embraces recreational and medical marijuana legalization.

It comes just weeks after the White House's surgeon general, Dr Vivek Gupta, warned legalization is moving faster than research.

    Health dangers? Sophisticated imaging of 1,000 cannabis users' brains found 1,000 marijuana
    users had widespread restrictions or build-ups of blood flow (file image)

The researchers at Amen Clinics analyzed data from a broad database including 26,268 patients across the US between 1995 and 2015.

The patients - from California, Washington, Virginia, Georgia and New York - all had complex treatment-resistant issues, and all underwent single photon emission computed tomography (SPECT) - a sophisticated imaging study that evaluates blood flow and activity patterns while undergoing concentration tests.

One thousand of the patients were marijuana users. 

Comparing those patients' brain scans with 100 healthy controls, the researchers saw a stark difference in blood flow levels. 

Every marijuana user had significantly lower blood flow in the right hippocampus compared to the controls. 

Marijuana use is thought to interfere with memory formation by inhibiting activity in this part of the brain.

Shocked by findings

Co-author Dr Elisabeth Jorandby said even she was shocked by the findings, despite dealing with marijuana patients on a routine basis. 

'As a physician who routinely sees marijuana users, what struck me was not only the global reduction in blood flow in the marijuana users brains , but that the hippocampus was the most affected region due to its role in memory and Alzheimer's disease,' she said.

'Our research has proven that marijuana users have lower cerebral blood flow than non-users. 

In other words, they're stupider, but is that because they are marijuana users, or are they marijuana users because they are stupider?

'Second, the most predictive region separating these two groups is low blood flow in the hippocampus on concentration brain SPECT imaging. 

'This work suggests that marijuana use has damaging influences in the brain – particularly regions important in memory and learning and known to be affected by Alzheimer's.'

Dr George Perry, editor in chief of the Journal of Alzheimer's Disease said: 'Open use of marijuana, through legalization, will reveal the wide range of marijuana's benefits and threats to human health.

'This study indicates troubling effects on the hippocampus that may be the harbingers of brain damage.'

Dr Daniel Amen, founder of Amen Clinics, said: 'Our research demonstrates that marijuana can have significant negative effects on brain function. 

'The media has given the general impression that marijuana is a safe recreational drug, this research directly challenges that notion. 

'In another new study just released, researchers showed that marijuana use tripled the risk of psychosis. Caution is clearly in order.'

And, as mentioned before, my own observations are that pot virtually stops the maturing process in regular users, such that if you start smoking pot regularly when you are 15, when you are 35 or 45 or 55, you will still act, talk, dress, think and behave like a 15 year old. I believe it is the reason why Michael Jackson never grew beyond being a little boy.

More Scary Research into the Effects of Marijuana on Teenagers
28% of 11-15 Year Olds Using Pot in Canada - Highest Rate in the World

28% of 11-15 Year Olds Using Pot in Canada - Highest Rate in the World

A whole generation of Canada's youth going up in smoke

A 2013 UNICEF report found that the prevalence of self-reported cannabis use among youth aged 11, 13 and 15 in the preceding year was highest in Canada at 28 per cent. Findings in other countries included:

Norway — 4%.
Spain — 24%.
The Netherlands — 17%.
United Kingdom — 18%.
U.S. — 22%.

At 28%, more Canadian kids are lighting up than those in countries where pot is legal!

In the CMAJ (Canadian Medical Journal) paper, the authors also compare the experiences with marijuana policies in the Netherlands, Spain, Uruguay and three U.S. states, where cannabis is legal for recreational use.

For example, Spithoff said Uruguay has a model that could be adapted for use in Canada, because it puts public health first. In contrast, the Dutch model hasn't solved the "back door" illegal supply problem.

Uruguay has licensed producers and a government commission that purchases cannabis from growers. The government sells it to individuals through pharmacies. The commission has control over production, quality and prices and has the ability to undercut the illegal market. Uruguay has also set a cutoff for cannabis-impaired driving.  

Education, Suicide, Sanity, Maturity

Frequent pot use by teens is linked to a greater likelihood of incomplete education, suicide attempts and other harmful effects, say researchers in Australia and New Zealand, who suggest their findings should be considered as countries move to decriminalize or legalize cannabis.

Marijuana is the most widely used illicit drug worldwide, and statistics suggest that adolescents in some countries are starting to use it at a younger age and more heavily.

In 2013, about 23 per cent of students surveyed in Ontario said they’d used cannabis at least once in the previous year, according to an annual report from the Centre for Addiction and Mental Health.

The prevalence of past-year cannabis use among Canadians aged 15 years and older was 10 per cent in 2012, the Canadian Alcohol and Drug Use Monitoring Survey suggested.

Cannabis use is more common among those with low educational attainment, but there’s a debate about whether marijuana use is a marker or a cause. In other words - does it make you stupid or were you stupid in the first place for using it? A study published in the journal The Lancet Psychiatry helps to answer some questions.

Long-running studies

Researchers analyzed data on up to 3,765 participants who used marijuana from three long-running studies in Australia and New Zealand. The studies compared those who had never used pot with those who had and their developmental outcomes, which were assessed for the participants up to 30 years of age.

"Study findings suggest that adolescent cannabis use is linked to difficulties in successfully completing the tasks that mark the transition to adulthood," study author Richard Mattick, a professor of drug and alcohol studies at the University of New South Wales and his co-authors concluded.

This is more confirmation of what I have been saying since the late 1970s - pot retards, or stops cold the maturing process of regular users. In my observations this effect is not restricted to any age group. 

"Prevention or delay of cannabis use in adolescence is likely to have broad health and social benefits."

Not even mentioned in this article is the frightening research on use of pot by young teens and a dramatic increase in the likelihood of developing full-blown, permanent schizophrenia.

The findings are relevant given the move in some countries to decriminalize or legalize cannabis, which raises the possibility that the drug might become more accessible to young people, the researchers said.

In the study, those who used marijuana daily before age 17 were less likely to complete high school or earn a degree compared with those who’d never used it.

Cannabis use was associated with increased risk of suicide attempts and later cannabis dependence and use of other illicit drugs, said Merete Nordentoft, a professor of psychiatry at the University of Copenhagen, in a journal commentary published with the study.

Harms of frequent cannabis use

Nordentoft said the "convincing results" are valuable and appropriate given several U.S. states and countries in Latin America and Europe have decriminalized or legalized cannabis and allow unrestricted marketing of the drug.

Increasing evidence shows that brain development during adolescence can be harmed by frequent cannabis use and cognitive functions can be permanently reduced, she said.

Young people need to develop and mature and prepare themselves to meet demands in adult life.

"Cannabis use, especially frequent use, impairs this development and reduces the likelihood that a young person will be able to establish a satisfactory adult life," Nordentoft concluded.

The researchers acknowledged that the measurements were based on self-reported data, which could lead to over-reporting or under-reporting of cannabis use. They said rates of cannabis use by young people in their study are similar to those in Canada, the U.S. and the U.K., but the social and legislative context of cannabis varies between regions.

The study was funded by the Australian Government National Health and Medical Research Council.