by David Sheff
BINGE DRINKING
The potential for injuring yourself or others is even more dramatic—much more dramatic—when you binge drink, which is defined as having four alcoholic drinks for women and five alcoholic drinks for men within two hours. Binge drinking is prevalent—and often deadly—among teenagers. About 90 percent of the alcohol consumed by those under the age of twenty-one comes in the form of binge drinks.
In some places, bingeing has become a perverse rite of passage. Kids have died at parties at which they drink twenty-one shots to celebrate their twenty-first birthdays. Many teenagers drink to get drunk. Some boys told us they were looking forward to the weekend when they were “going for blackout.” It’s probably not a surprise to hear that that kind of drinking is particularly dangerous and can be deadly.
Bingeing, sometimes combined with other drugs, is also related to what’s been described as an epidemic of sexual assault. Being drunk is never an excuse for sexual assault; any sex without consent is rape. And consent from someone who’s drunk or high isn’t consent.
Lisa’s Story
I lived in a small town. All through high school I worked hard to keep up my GPA. I didn’t drink or do drugs. I was getting ready for college. But in my senior year, I went to a party. I still don’t know what happened exactly. I do know I had a beer. Then something must’ve been slipped into it. I’m not sure what happened, but it wasn’t good. When I came to, I was outside in the backyard. I’d been molested. I don’t know who did it.
I went home. At first I didn’t tell my parents—I was pretending that it wasn’t a big deal. Then when I did tell them, they said that the best thing to do was forget it happened. I tried, but I couldn’t help thinking about it, especially at night. I couldn’t sleep. So, I began drinking a lot. Beer, shots. And partying more and more. It was my way of dealing with what happened. Or not dealing with it. I started taking pills someone gave me. I was that kid. The one I never wanted to be and couldn’t imagine being.
I began thinking about killing myself—I looked up suicide on the Internet. I got more and more depressed, wasn’t keeping up in school, was sick a lot. A teacher finally called my parents, who brought me to see a therapist. The doctor said I was suffering trauma from the assault. I’m still in therapy. Sometimes it’s the last thing I want to do, but I’m doing better. I have a boyfriend. My grades are up again and I got into college. I’m not drinking or taking drugs at all. You hear about things like that happening to other people, and we never think it could happen to us, but now I know it can. I just want girls to know. To be careful.
Alcohol also plays a role in more than a third of teenage deaths involving accidents, homicide, or suicide. “The problem,” says the psychiatrist Dr. James D. Flack, associate medical director of the Menninger Clinic, “is that a beer or two can appear to relieve depression for a little while, but by the time you have your eighth beer you feel suicidal, angry, or out of control and more depressed.”
In fact, alcohol is used disproportionately by people who are already depressed. Teens who’ve had an episode of major depression are twice as likely as those who aren’t depressed to start drinking alcohol.
There’s also ample evidence that heavy drinking has a negative impact on many other aspects of kids’ lives. One study showed teenagers who began binge drinking performed more poorly on intellectual tests as they got older. Researchers looked at brain scans of some of the teens and found that heavy drinkers had damaged an area of the brain vital for learning, which continues to develop into middle age. This means the damage done during teenage years could limit a drinker’s intellectual growth well into adulthood.
BREAKING IT DOWN
When a person has a drink, ethanol—a form of alcohol—reaches the brain and all the organs of the body within ninety seconds. Ten percent of the ethanol is eliminated (through sweat, breathing, etc.), and the liver begins working to metabolize the rest; alcohol is toxic, and the body tries to get rid of it as quickly as possible. On average, the liver metabolizes half an ounce of ethanol in an hour. When there’s more alcohol in the body than the liver can break down, the concentration of alcohol in the bloodstream increases, which makes people feel buzzed/high.
Alcohol decreases the normal functioning of the brain, particularly in areas of the brain involved in memory formation, decision-making, and impulse control. By preventing a chemical called glutamate from doing its work, ethanol slows reaction times, impairs memory, dampens motor skills, and can cause slurred speech, nausea, emotional volatility, loss of coordination, and visual distortions.
The effects of alcohol vary according to the individual’s gender, body size, amount of body fat, amount of alcohol consumed, family history, and other factors. That is, all people aren’t created equal when it comes to the process by which our bodies metabolize alcohol. Women absorb and metabolize alcohol differently from men; they’re more vulnerable to smaller amounts.
Kids often think that compared to other drugs—especially some hard drugs—alcohol is safer. But alcohol damages more neurotransmitter systems than many drugs. If you become addicted, withdrawal can be lethal, triggering seizures and even heart attacks. And the earlier someone begins drinking, the more likely he or she will abuse alcohol and become addicted.
Some people think it takes decades for alcohol to damage the brain, but at the University of California, San Diego, researchers looked at twelve- to fourteen-year-olds’ brains before they used any alcohol or drugs and then followed them as they began drinking. The researchers scanned the brains of those who became binge drinkers and compared them to the brains of kids who drank moderately. They also tested their thinking and memory. The results were dramatically different, with a much greater damage done to the brains of the heavy drinkers.
Cerebral Cortex: This is the main area involved in thinking, decision-making, emotions, and the five senses. Alcohol’s effects on this area can impair your ability to think clearly and lower your inhibitions. Alcohol may make you act impulsively or make you angry or sad for no reason. Your senses may be affected, such as blurring your vision. Long-term alcohol abuse can permanently damage this region.
Cerebellum: This part of this brain is important for coordinating your daily movements, such as walking and grabbing objects. Alcohol can slow your reflexes, cause you to lose your balance or make your hands shake.
Hippocampus: Your memory is controlled by the hippocampus. Drinking a lot of alcohol at one time can cause you to black out, or forget a period of time. Long-term alcohol abuse can permanently damage the hippocampus, making it difficult for a person to learn.
Hypothalamus: Many body processes, such as heart rate and the feeling of hunger or thirst, are controlled here. Alcohol can slow your heart rate and may make you hungrier and thirstier.
Central Nervous System: Alcohol slows down this system, which is made up of the brain, spinal cord, and nerves, making you think, speak, and move more slowly.
Medulla: Involuntary processes, such as breathing and maintaining body temperature, are controlled here. Drinking a lot of alcohol at one time can shut down the medulla, leading to a coma.
Elsewhere in the body, alcohol is especially toxic in the liver, kidney, and nervous system, though it affects every organ. Alcohol slows breathing and heart rate, sometimes to the point of coma—even death. Alcohol is potentially dangerous for anyone, but’s it’s extremely dangerous for a person who’s pregnant; it can damage a developing fetus.
As with all drugs, it’s important to remember that some people are more likely to become addicted than others. If alcoholism runs in the family, if you experience high stress, traumatic events, learning disabilities, or psychological problems like depression, your chances of developing the disease of alcoholism are higher. However, anyone can become addicted.
Ten to fifteen percent of people who try alcohol will become addicted. And as with every drug or dangerous endeavor, no one really believes the risk is to them. But it will always start with that first
step—that first drink.
CHAPTER SEVEN
Marijuana: Hits and Myths
They told me I couldn’t get addicted to pot. Well, look at me. I smoked every day all day, and I’m twenty-two but feel like I’m twelve. —PAUL (NEW YORK CITY)
HIGH TIMES
In talking with kids around the country about drugs, we’ve found that most don’t have to be convinced that drugs like cocaine and heroin are dangerous. And while sometimes they’re uninformed about alcohol—they usually don’t know it has a different impact on their brain than on an adult’s—they understand that binge drinking is dangerous.
Many, however, roll their eyes when anyone says that marijuana is dangerous too. “It’s natural,” they say. “It’s an herb.” They say, “No one’s ever died because of pot,” and “Weed isn’t addictive.” It’s legal in some states, and more states are considering legalizing it.
Pot smoking has become an accepted part of mainstream culture. It’s everywhere. There’s even an unofficial but widely celebrated National Pot Smoking Day, 4/20, when people post lists of the best movies to watch stoned and comedians joke about it on late-night TV.
Of course, even in states where marijuana is legal for adults, those under twenty-one are prohibited from using it. We’re not going to argue the issue of legalization in this book. You may have strong views on the subject—many in America do.
It doesn’t really matter whether pot is legal in the United States when it comes to its impact on health and safety. Prescription medications are legal, but they kill more people than any other drug except, of course, cigarettes, and alcohol, which is also legal for those over twenty-one. For that matter, driving is legal and accessible to teens as young as sixteen, but fatalities abound. So something’s legality has little bearing on its safety.
One difference a drug’s legality makes to a potential user, other than removing the risk of incarceration, has to do with its “perception of risk.” In other words, because a drug is legal, or because the penalties for possessing it feel comparatively minimal, some people consider it less risky to use.
Some teenagers have told us that almost everyone they know smokes. Some get high on “edibles,” which these days include marijuana brownies, ice cream, gummy bears, barbecue sauce, and food made from any of many popular pot cookbook recipes, such as Ganja Granny’s Smoked Mac ’N’ Cheese.
Some teens use synthetic marijuana, which despite its name isn’t marijuana and has completely different effects and risks. (We’ll get back to Spice and other drugs billed as synthetic pot.) Some use hash and similar drugs derived from the cannabis plant.
Clearly many people smoke (or consume) pot without any obvious negative impact on their lives. Again, though, “obvious” is the operative term here. Negative effects may be subtle or may not become apparent for years. And while those who preach that marijuana will kill you, make you crazy, or make you shoot heroin are wrong, usually so are people who claim it’s harmless.
Here are the facts.
Though marijuana use doesn’t appear to harm lives like alcohol or opioids, research has shown that many long-term pot smokers have reported poor outcomes on a variety of life satisfaction and achievement measures. Fewer smokers than nonsmokers complete college, and here’s a fact that may surprise some kids: smokers are far more likely than nonsmokers to earn yearly incomes of less than thirty thousand dollars.
Says Dr. Richard N. Rosenthal, chair of psychiatry at St. Luke’s-Roosevelt Hospital in Manhattan and professor of clinical psychiatry at Columbia University: “The people who become chronic users don’t have the same lives and the same achievements as people who don’t use chronically.”
In some users, marijuana has been shown to cause something called amotivational syndrome, a pattern of behavior characterized by, yes, a lack of motivation. Even though it’s tough to quantify motivation, many long-term pot smokers describe a lack of drive that affects and in some cases defines their lives.
In the movie Jackie Brown, Samuel L. Jackson’s character tells his girlfriend, “That sh— gonna rob you of your own ambition, girl.” She answers, “Not if your ambition is to get stoned and watch TV.”
An adult we met told us that he began smoking when he was a teenager, which either caused or contributed to what he described as a “life of disappointments.” “I’ve never been able to hold down a job and never had a relationship that lasted,” he said. “I’ve lived in a cloud of smoke and television since I was thirteen, so maybe it’s not surprising that things haven’t turned out better for me.”
A 2014 study showed that teenagers who smoked pot daily were both 60 percent less likely to finish high school and 60 percent less likely to finish college than teens who didn’t smoke. Also, they were seven times more likely to attempt suicide.
Plenty of research exists that shows that pot may even affect brain structure, cognitive functioning, and memory in adolescents. Dr. Susan Tapert, professor of psychiatry at the University of California, San Diego, scanned the brains of kids who had smoked weed throughout their childhoods and those who had never smoked. She found startling differences.
Group Reckoning
It’s a clear spring morning in Plymouth, Michigan, and David is visiting a rehab center called Hazelden Betty Ford. It’s a program for kids—well, it’s called an adolescent treatment center, and it’s for fourteen- to twenty-five-year-olds, but the kids in this group are on the younger side of that range—mostly between fourteen and seventeen. Most are in treatment because of addiction exclusively to pot. Anyone who says marijuana isn’t addictive should talk to these kids. Indeed, they have all suffered devastating consequences from their pot smoking, and most have tried to stop but can’t.
The boys tell about experimentation turning to consistent use turning to addiction. Some were arrested for using or selling. One was arrested because he struck his mother. (“It just happened. I lost it. I felt real bad.”)
Some haven’t experienced the same kinds of calamities as the others. One kid says, “I just couldn’t stop. No sh—. You think, I’m not an addict. I can quit. I just like it. I’ll stop when I feel like it. But you don’t quit. Then you’re smoking every day.”
A boy says, “For me, there was one thing that happened that bothers me. I have no short-term memory. It’s really a drag.” It’s a classic symptom of pot smoking—the impact of marijuana on memory retrieval.
“I know what you mean,” another boy says.
Another boy says, “Yeah, then there’s the breathing thing—I had bronchitis all the time. I know it was related because it’s gone now that I’m not smoking.”
A boy with long auburn hair parted in the middle says that another effect of smoking was burning through money. “I thought, Aw, it’s cheap, but when you’re smoking every day it’s not cheap unless you’re getting schwag [low-grade pot]. So you run out of money and you have to figure out how to get more, and there was always more in my mom’s purse. She never suspected. She doesn’t even now.”
“I never had a problem with money,” says a boy in torn jeans and a white T-shirt. “My main thing was just that I stopped caring.”
The counselor asks how that made him feel, and he says, “Pretty bad. I mean . . .”
Another boy says, “Depressed.”
“Yeah.”
“Weed’s a depressant,” says a boy on the opposite side of the circle. “I’m on like forty antidepressants and I’m smoking a depressant.”
That brings the conversation around to another kid, who admits he’s there because he tried to kill himself.
One of the other kids says, “Who hasn’t tried to kill themselves? I mean, we’re here, aren’t we? Welcome to the club.”
Another says, “I was trying to kill myself too. Just the slow way. By using.”
In brain scans, Dr. Tapert found alterations of marijuana users’ white matter—the network of fibers that link brain regions and allow signals to be sent between them. In heavy marijuana smoke
rs’ brains, the white matter had “poorer integrity,” she says. That means that brain regions may not be able to communicate as efficiently and as quickly as in nonsmokers’ brains. The faulty memory and slow reaction time of teens when they’re high may become permanent problems in adulthood.
OPENING THE GATE
Many say that marijuana isn’t a gateway drug—that it’s a myth that people who smoke weed go on to shoot heroin or meth. Of course, plenty of people begin and end their drug use with weed. But many people who smoke pot in high school do go on to try other drugs.
A study of more than three hundred fraternal and identical twins found that a subject who had used marijuana before the age of seventeen had a higher rate of other drug use and drug problems later on than their twin who hadn’t used before that age.
Another consideration is that drugs really are more potent today than they were in the “old days.” Tests of marijuana have found four times as much THC (tetrahydrocannabinol)—the plant’s chief intoxicating substance—in the average weed smoked today than in the marijuana of two decades ago. This means that some of the assumptions adults make about marijuana, based on their experiences or outdated research, just don’t apply today.
Those who claim that no one has died from marijuana use are correct if they’re only considering overdose. But they’re ignoring pot’s frequent link to fatal car accidents. Researchers have found that drivers who used marijuana within three hours of getting into a car nearly doubled the risk of causing a collision, especially a fatal one.