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UK: The peer pressure to use cannabis Dr Thomas Stuttaford The Times Thursday 17 Jan 2002 For the last 25 years of my life in the NHS, most of my patients were aged between 16 and 30. Earlier in my career I was involved for a few years with the treatment of patients, mainly young patients, dependent on drugs. The media uproar over the antics of Prince Harry during his holidays seemed excessive - a reaction presumably distorted by his royal position and out of proportion to his problems. When compared with the behaviour exhibited by the truly disturbed adolescents whom I used to meet, his occasional reported excesses, foolish though they may have been, were similar to those experienced by many, if not most, families with teenage children. A generation or so ago, one of the catchphrases of popular psychology was 'viable minority'. It is a pity that the concept is no longer fashionable, for the term was used to describe an important phenomenon in adolescent behaviour. The rule of thumb was that potentially well-orientated young people will adapt their behaviour to that of the majority of their peer group, unless about 25 per cent share the same minority outlook. The young man or woman whose behaviour does not change to that of the majority is likely to be the oddball whose independence of thought, although possibly admirable, is unlikely to give them an easy ride with their peers. Although always wise to do so, and in some cases an essential medical precaution, it is nevertheless difficult for a 16-year-old to refuse cannabis if a room full of older people of university age, and above, are all smoking it. Likewise it is difficult for young people, when drinking with more sophisticated and alcohol-hardened adults, to stick to limits suitable for their age group. The more worldly-wise and experienced adolescent, whose lifestyle has meant that he or she has been nearly everywhere and done nearly everything, is naturally drawn to older people even though still emotionally immature. Parents are therefore left with the problem of arranging holiday activities that will capture the imagination of a precociously stimulated adolescent who is, by now, easily bored by his or her less sophisticated contemporaries. In some way or another, those adolescents who have had a different and more exciting background than the majority have to have a circle of friends, a 'viable minority', who are like-minded, but not jaded or delinquent, with whom they can share their leisure time. Although the furore in the press over Prince Harry may have been excessive, the carefully worded announcement from St James's Palace seemed to have struck the right note. The visit to the rehabilitation centre was a well-designed and presumably sobering experience, as it showed that cannabis could be the gateway to other drug abuse. It is a matter of debate whether, as Baroness Greenfield believes, the main hazard of cannabis in young people is the change in personality and intellectual ability that it produces, and which too often results in poor academic performance and a poor attendance record. Others fear that the major risk is to the appreciable minority in whom cannabis may induce psychotic changes. Before smoking cannabis, it is therefore important not only to consider one's psyche and decide whether one's particular quirks are likely to be symptoms of psychiatric disorders that could be exacerbated by cannabis, but also to look with some care at previous generations. A close study of a family tree, whether royal or plebeian, will, without going back to the time of Henry V, reveal antecedents whose psychological idiosyncrasies would be best left unexposed. Most doctors have also had experience of a slightly unusual adolescent whose behaviour after using cannabis became markedly strange, if not psychotic. A study from the National Drug and Alcohol Research Centre in New South Wales showed that early cannabis use appeared to be associated with the adoption of an anti-conventional lifestyle coupled with the precocious adoption of an adult way of life. The change in young people's personalities too often discouraged them from continuing with academic work, or from living in the parental home. Peer pressure from established cannabis users seemed to be a common cause of early cannabis use. Another recent report, from the Centre for Adolescent Health at the University of Melbourne, suggested that most young adolescents who had smoked cannabis at all did so only occasionally, but that in 12 per cent of the early users it escalated to a worrying daily use by the time they finished their schooldays. Those who smoked cigarettes early in life were more likely to be among the 12 per cent who became persistent cannabis smokers.
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