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"I do feel a sense of freedom from not drinking anymore, because it took up so much brain space," said Laura Willoughby at London's Mindful Drinking Festival, an event founded to suggest that you don't need to be paralytic to have a good time. "It's been the best decision of my life."

Check every alcohol statistic from the last couple of years and you'll see I'm not alone: lots of people seem to believe that regularly poisoning yourself for fun isn't such a good idea. In a survey by Drink Monitor, almost a fifth of respondents said they were changing their drinking behaviours, while at least two-fifths have utilised planning methods to cut down, with older drinkers sticking to old-fashioned restraint and millennials being more likely to avoid alcohol altogether.

In fact, there's been a sharp rise in teetotallers generally. According to the Office of National Statistics, there are over 2 million teetotal adults in London – 30 percent of the adult population – while nationwide it's 20.9 percent. This trend only seems to be catching on, as you'll know from the endless reports of Gen-Z (16 to 24-year-olds) supposedly swapping Stella for sobriety

A decade ago, an event like the Mindful Drinking Festival (MDF) might have been derided as some kind of puritanical love-in. But today, in this climate, in makes perfect sense. Run by Club Soda – which describes itself as a "mindful drinking movement" – the festival at Spitalfields Market this past weekend was busy with people trying the various alcohol-free drinks on offer.

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JULY 18, 2018 BY COREY W. HUNTER, MD, FIPP

While opioid medications may be effective for treating pain in the short-term, they have an extremely high propensity for addiction and do nothing to address the underlying cause of the pain.

The good news is that there are many alternatives to opioids that can help alleviate your son or daughter’s pain. Below, we’ve helped to spell them out for you and have provided guidance on how to ask your doctor about these alternatives.

What if My Child Has Chronic Pain?

Chronic pain is defined by the CDC generally as pain that lasts more than three months. It’s a complex issue to manage successfully, but especially so in the case of someone you’re concerned about developing an addiction, or someone in recovery. The CDC actually recommends against opioids as the solution for chronic pain management, as they say the risks from opioids greatly outweigh the benefits for most people. Fortunately, there are several other methods to help manage these chronic issues that you and your child can discuss with a physician.

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All Young Cannabis Users Face Psychosis Risk  (Medscape and JAMA Psychiatry)  June 15, 2018

Cannabis use directly increases the risk for psychosis in teens, new research shows. A large prospective study of teens shows that "in adolescents, cannabis use is harmful" with respect to psychosis risk, study author Patricia J. Conrod, PhD, professor of psychiatry, University of Montreal, Canada, told Medscape Medical News.

The study included 3720 adolescents from the Co-Venture cohort, which represents 76% of all grade 7 students attending 31 secondary schools in the greater Montreal area.

Cannabis use, in any given year, predicted an increase in psychosis symptoms a year later, said Conrod. This type of analysis is more reliable than biological measures, such as blood tests, said Conrod. "Biological measures aren't sensitive enough to the infrequent and low level of use that we tend to see in young adolescents," she said.

The effect was observed for the entire cohort. This finding, said Conrod, means that all young cannabis users face psychosis risk, not just those with a family history of schizophrenia or a biological factor that increases their susceptibility to the effects of cannabis.

"The whole population is prone to have this risk," she said.

In light of these results, Conrod called for increased access by high school students to evidence-based cannabis prevention programs.

The study was published online June 6 in JAMA Psychiatry.

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BY THE PARTNERSHIP

First things first — how is marijuana vaped?

Vaping refers to the inhalation of an aerosol produced by heating a liquid/oil or substance in a compact electronic portable vaporizer. While many young “vapers” say they inhale flavored liquids like Gummy Bear, German Chocolate Cake and Cotton Candy, youth can vaporize marijuana – either the ground plant itself, waxes often referred to as dabs, or THC and CBD oils.

Selling equipment to vape marijuana in its leaf, dab or oil form is a booming business with many new entrants. Pax Labs, formerly Ploom, was founded over a decade ago and is a relatively well-known brand for vaping dry leaf marijuana. The company has introduced the Pax 3, which they describe as the “Apple I-Phone” of vaporizers as it allows you to vape both dry leaf and wax concentrates. It includes a free Android or iOS app to control temperature, play, free games, manage firmware and lock the device.

In California, a company called EAZE sells disposable all-in-one marijuana vape pens and cartridges. Flavors include Blueberry Kush, Lemon OG and Mango Passion Fruit. They market these as wellness products with advertising that reads, “Hello Marijuana, Goodbye Insomnia” or “Hello Marijuana, Goodbye Hangover.”

Although not a vape per se, another company, Aeroinhaler, has developed a product that looks exactly like an inhaler one would use to treat asthma. It’s marketed as a healthy alternative to vaping or smoking combustible marijuana, delivering a metered dose with each puff. The company says that their product uses concentrates of 80 percent THC potency.

Juul can also be used to vape marijuana; however, it should be noted that as of now, Juul does not offer marijuana products. The device has to be hacked in order to use it with THC oils and, as with most things, there are YouTube videos demonstrating how. There are also companies making pods that fit a Juul, so a THC oil pod may be in the future.

Marijuana is used recreationally and medicinally, so what’s the big deal for adolescents and young adults?

It turns out that the brain of an adolescent or young adult is still growing, and therefore on a mission to increase efficiency and to develop critical skills related to problem-solving, impulse control, anticipating consequences and more. Marijuana can get in the way of this development, causing brain circuits to wire in a less optimal way.

One way to think about this is comparing the developing brain and its neural connections to your home electrical wiring grid. You want the best possible wiring for your house, so that when you need to use your appliances, everything works as it should with no shorts or blown fuses. The house can still function if everything isn’t up to code, but it won’t be ideal. Marijuana use can impact the wiring of the brain in a similar way, with the impact being subtle in some cases and more severe in others.

According to the CDC, marijuana use may have long-lasting or permanent effects on the developing adolescent brain. Negative effects include:

• Difficulty with critical thinking skills like attention, problem solving and memory
• Impaired reaction time and coordination, especially as it relates to driving
• Decline in school performance
• Increased risk of mental health issues including depression or anxiety and in some cases, psychosis where there is a family history of it
• Research also shows that about one in six teens who repeatedly use marijuana can become addicted, as compared to one in nine adults

It’s really important for parents and caregivers to note that these impacts of marijuana differ from the impacts on a fully mature adult brain. Delaying substance use of any kind, including marijuana, gives your child the best opportunity to have optimal brain functioning.

How can I recognize use, especially if there is no smoke and telltale smell?

Vaping can be difficult to detect as there is no smoke, minimal odor (although you may catch a whiff) and the vapor produced dissipates rapidly. However, just like smoking, vaping marijuana can result in bloodshot eyes, dry mouth and thirst, increased appetite and shifts in behavior and mood. Sometimes, there is a noticeable change in friends and a decrease in activities that were once enjoyed.

You may also find vaping paraphernalia such as devices that look like flash drives, gel jars that contain dabs, and pods or cartridges that contain THC oil. There’s a lot of high-tech-looking equipment that can accompany vaping, so if you’re not sure, it might be time to talk to your child about what you found.

What can I do if I suspect my child is at risk for vaping or is already vaping marijuana?

Given the growth of marijuana use and vaping among American youth, it’s a good idea to explore your son’s or daughter’s views on vaping and perceptions of the risks.

1. Have conversations often. Before any talk, it helps to be able to share
facts, but don’t assume that an information download to your child will translate into healthy behaviors.

2. Look for good opportunities to have a discussion. You can do this when passing a vape shop, smelling marijuana on the street, seeing someone vaping on TV or in person or seeing one of the ads for vapes.

3. Try to listen, rather than give a lecture. Open-ended questions can be a great way to get your child’s perspective, i.e. “I understand that some kids are vaping marijuana. What are your thoughts about it?” If you know they are already vaping marijuana, you might ask “What does vaping marijuana or THC oil do for you?” Perhaps it’s a way to fit in, handle social anxiety or address boredom. Get to the root of “why.”

4. Set clear expectations. Express your understanding of the risks, but also why a person may want to vape. Share why you don’t want him/her vaping, and remember, it’s important to avoid scare tactics. Be honest.

5. Teach refusal skills. It’s likely that your teen or young adult will be introduced to vaping marijuana by a friend or older sibling. It helps to rehearse what he/she will say if that happens.

6. Have your loved one talk to other trusted adults who can reinforce your message. Sometimes, messages coming from your pediatrician, school counselor, favorite aunt or uncle, etc. can be more impactful.

7. Model healthy behaviours. If you come home from work and discuss what a tough day it’s been while popping open a beer, pouring a glass of wine or smoking a joint, you are conveying this is how you handle stress. It’s healthier for your child — and you — if you take a walk with the dog or a bath or go for a run rather than turn to substances as stress busters.

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