I’m Not Using “Hard” Drugs, So What’s the Big Deal?

For some drugs once is too much, but less potent drugs carry real risks as well

Posted Jan 19, 2013

In clinic yesterday, a 17 year old told me that he smoked marijuana but didn’t do any “hard” drugs, implying that therefore his drug use was really no big deal.  I don’t buy it.

This is not to say that all drugs are created equal. Some drugs are so powerful and carry with them such dramatic risks that even a single use is potentially too much.  I would put any of the opiates--which include prescription pain-killers like Oxycontin, Vicodin, and Percocet as well as heroin--in this category.  (I think methamphetamine belongs in this category as well.)  Drugs are now the number one cause of accidental death in the US, and opiates are responsible for the vast majority of these deaths.

Why are these drugs so risky that even a single use might be too much?  Because I have heard numerous times from folks addicted to these substances that the single best that they ever felt in their entire lives was the first time they used opiates.  And given that opiates made them feel so amazingly wonderful, it can prove impossible to avoid heading back there and using them again . . . and again.  (With repeated use, individuals never feel as good as they did the first time and quickly their lives can devolve into continuous use and a desperate effort to obtain more drugs in order to avoid going into withdrawal.) 

Not everyone who uses opiates feels this euphoria, but the problem is that you can’t know whether they might hold such appeal for you until you’ve tried them, and then it might be too late.

By contrast, a single use or infrequent use of drugs like marijuana rarely spells disaster.  But regular use of marijuana can cause major problems, and there are plenty of regular users out there. 

In 2012, for example, 3.5% of 10th graders and 6.5% of 12th graders used marijuana daily, and 17% and 22.9% smoked within the past month, respectively (   This kind of use exacts a toll.  Heavy marijuana use as an adolescent is associated with significantly lower IQ in adulthood as well as other measures of mental functioning.  Additionally, using marijuana as a teenager increases the odds of eventually becoming addicted to it from 1 in 11 to 1 in 6.  Not surprisingly, the odds go even higher for daily smokers.  (

Because of these realities, I have often told both the adolescents I see as well as their families that if I knew that my child had used opiates at all or that my child was smoking marijuana regularly, I would do anything and everything legally permissible to intervene and try to halt the use.  For those parents who dabbled with marijuana when they were young and brush it off as no big deal, they need to realize that today’s weed is nothing like the cannabis of old—it is 50 times more potent and using it can cause or exacerbate depression, anxiety, memory deficits, and even psychosis.  (See my previous PT post for more along these lines.)

Despite the prevalence of marijuana and other drugs, there are steps parents can take to intervene, and in my next post I will lay out strategies for parents who want to help their children make healthy choices regarding drugs.

Photo/image credit: Riude / / CC BY-NC-ND