Marijuana use 2013 BC Adolescent Health Survey Presentation: Overview of marijuana use among students in Grade 7-12 in Vancouver. Focus on some of the differences seen among youth who start using at a younger age, compared to those who wait until they are older, stop using or have never tried marijuana.

Fewer youth tried marijuana 17% had ever tried marijuana Among those: Youth waited longer to try marijuana 4% used last Saturday 3% mixed alcohol and marijuana Most commonly got marijuana from a youth outside their family (88%) Most recent BC Adolescent Health Survey in 2013: In Vancouver 17% of 12-19 year olds (19% males and 15% females) had ever tried marijuana – decrease from 24% in 2003 and lower than the provincial rate of 26%. (CLICK) Among Vancouver youth who had tried marijuana: (CLICK) More youth were waiting until they were 15 years old to try it -49% in 2013 compared to a 34% in 2003 .Vancouver youth were also less likely than their peers across BC to have first used marijuana before the age of 15 (51% vs. 59%). Among youth who had tried marijuana, 54% had used in the past month and 23% males and 10% of females used it on at least 6 days in the month before the survey. (CLICK) Overall, 4% used marijuana last Saturday (CLICK) AND 3% mixed alcohol and marijuana that day. (CLICK) The BC AHS asked for the first time about the source of marijuana, and students most commonly got it from a youth outside their family – rate in Vancouver was higher than that found provincially (82%).

Friends with pro-social attitudes Students whose friends would be upset with them if they...   2003 2013 Change since 2003 Dropped out of school 79% 86% Were involved in gang activity NA Were involved in a pregnancy 70% 81% Got arrested 62% 80% Beat someone up 56% 78% Used marijuana 57% 64% Got drunk 39% 52% Lots of reasons why marijuana usage might be lower in Vancouver and the role of friends is one: Students were asked if their friends would be upset with them if they were involved in certain risk behaviours. Locally, (CLICK) students were more likely than a decade ago to report having friends with these pro-social attitudes. Vancouver students were more likely than those throughout BC to have friends who would be upset with them if they beat someone up (78% vs. 71%), got drunk (52% vs. 44%), or used marijuana (64% vs. 58%). Note: NA means that the question was not asked.

Areas of Concern Fewer youth had ever driven after drinking or using marijuana than in prior years. However: Vancouver youth were twice as likely to have driven after using marijuana as after drinking alcohol. 23% of those who were driving while impaired did not have a drivers licence Driving under the influence of marijuana use has been shown to increase the risk of a crash . Also , 17% of Vancouver youth had ever been a passenger with a driver who was impaired

Views of marijuana “Studies show that people drive more carefully when high on weed. You are ignorant if you think anything otherwise.” — 15 year old male Common view of marijuana seen on the survey. Highlights the confusing messages and misinformation that youth receive.

Common reasons for using marijuana and other substances the last time Males Females I wanted to have fun 60% 69% My friends were doing it 29% 37% I wanted to experiment 27% Because of stress 16% 25% I felt down or sad 11% 21% I felt there was nothing else to do 9% 10% To manage physical pain 5% 7% I was pressured into doing it 3% 4% I thought it would help me focus Because of an addiction 2% I didn’t mean to do it 1% To change the effects of other drug(s) For the first time, we asked Vancouver youth about their reasons for using marijuana and other substances. The most common reasons were that they wanted to have fun (65%), their friends were doing it (33%) or they wanted to experiment (28%). Females were more likely than males to have used because of stress (23% vs. 14%) or because they felt down or sad (22% vs. 14%), as were youth who were not getting mental health services that they felt they needed and those who had self-harmed or attempted suicide in the past year, Students may have been using marijuana and other substances to manage a variety of symptoms. Examples: Youth with a chronic health condition or physical disability were 3x more likely to use substances to manage physical pain than youth without a physical disability. Youth with ADHD were four times as likely to have used to help them focus. Youth with almost any type of health condition or disability were more likely to report having used substances recently to change the effects of other drugs. Note: Among youth who used marijuana and other substances.

Marijuana use & mental health Survey results such as provided through the BC Adolescent Health Survey provide correlations not causations, so it can be hard to determine which way the relationship goes. For example, youth with a mental health or emotional condition were more likely to be heavy users and to have tried marijuana at an early age but is unclear whether usage came first or mental health issues came first. (Although we know from the last slide that youth are using marijuana and other substances to manage their symptoms). Note: Among youth who ever used marijuana.

Age of first marijuana use (among 16-18 year old students) 15 or older 23% 13 or 14 years old 13% 11 or 12 years old 3% 9 or 10 years old 1% Less than 9 years old <1% Have not used 60% Having got an overall picture of marijuana use, we wanted to look at the effect of earlier use so we took the sample of students aged 16-18 across BC and looked at youth who first used at 12 or younger, those that first used at 13/14 and then those who waited until later (15 plus) – and those who never used. The following slides also use results from the 2013 BC Adolescent Health Survey but include all 16-18 year olds across BC, not just Vancoouver (approx 10,000 students)

Youth at higher risk for early marijuana use Some youth were at greater risk for early use: Youth who face challenges in their lives are particularly vulnerable to early marijuana use. Examples: Youth who had a health condition or disability (physical disability, long-term illness, mental or emotional condition, etc.) were more likely to have first used marijuana (14% vs. 8%) at 12 years of age or younger. Youth who had ever been in government care Youth who identified as lesbian, gay or bisexual Youth who reported a history of physical or sexual abuse Youth who were bullied

Early use and recent use Studies have shown early use is linked to problematic use and heavy use in adulthood. BC AHS results showed: 60% of students who first used marijuana at the age of 12 or younger smoked marijuana last Saturday, (compared to 21% of students who waited until 15) Early marijuana was linked with using marijuana on 6 or more days in the past month, as well as every day There was a link between early marijuana use and a variety of health risks or concerns eg the earlier youth used marijuana the more likely they were to be sexually active and to report pregnancy involvement, to drive under the influence and to have done so recently, to have tried substances other than alcohol and marijuana. Early users were also more likely than later users and those who hadn’t used to think that their use had some direct negative consequences such as affecting their school work, getting injured, getting into fights with family.

Youth aged 16-18 who did not access needed medical help in the past year The earlier youth were when they started using marijuana, the more likely they were to report not accessing medical services or mental health help when they felt they needed them.   Maybe this is because youth who started using marijuana at an earlier age were generally more likely to have asked a variety of professionals for help with their problems (e.g., youth worker, social worker) but they were less likely to find these professionals helpful. During adolescence in particular if young people do not have a good experience when they ask for help, they often will not ask again, and we lose an opportunity. Note: Among youth who ever used marijuana.

Health among youth aged 16-18 who had started using marijuana at age 12 or younger Youth who used marijuana at an earlier age were more likely to experience a range of negative health outcomes than their peers who did not use them until they were older. However, it was encouraging to note that youth who had used marijuana at an earlier age but had not done so recently (in the past month), reported lower rates of some health risk behaviours than their peers who continued to use this substance. Examples: Youth who used marijuana before age 13 but had not used it recently were less likely to have recently ridden in a vehicle with a driver who was impaired, than those who continued to use marijuana. They were also less likely to have used alcohol recently or to have binge drunk recently. Youth who used marijuana at an earlier age were less likely than their peers to have post-secondary plans. However, early users who had not done so recently reported similar rates of planning to go to college or university to those who waited until they were older to use marijuana. For most analyses, youth who had never used marijuana (72 % of 16-18 year olds in Vancouver) were the least likely to have engaged in risk behaviours such as skipping school, getting drunk, fighting, and pregnancy involvement, and they reported the highest rates of good/excellent mental health as well as lowest rates of suicide attempts and self harm.

Protective factors associated with delayed marijuana use (among youth aged 16-18) Positive relationships with family Meaningful youth engagement School connectedness Self-confidence & sense of competence Protective factors (What was present in the lives of 16 to 18 year olds who delayed their use of marijuana) Youth who had the most positive relationship with their families were more likely to delay marijuana use. For example, youth who started using marijuana at age 15 or older were more likely than those who started at age 12 or younger to report having their family understands them and that they have fun with their family. Youth who delayed their marijuana use until they were at least 15 years old were more likely to feel highly connected to their school, including feeling that they were a part of their school and that their teachers cared about them. Students whose friends would disapprove of them using marijuana were more likely to wait until they were 15 or older to use marijuana than to start when they were 12 or younger Students who felt valued and listened to in their extracurricular activities and felt that their activities were meaningful to them were more likely to wait until they were older to use marijuana Students who reported higher self esteem and could name things they were good at were more likely to wait until they were older to use marijuana We also looked at cultural connectedness – and saw that for males it wasn’t associated with delayed use but for females it was. These protective factors were also present in the lives of youth who had not used marijuana. Friends with pro-social attitudes

Fewer Vancouver youth used marijuana Youth who did not use marijuana or who waited until they were older to use reported better health than those who used at an early age Promoting protective factors play a key role in improving outcomes for Vancouver youth Summary: Less Vancouver youth are using marijuana and those that are are waiting longer to do so If youth are going to use, they report better health if they delay use than if they start at an early age There are some clear protective factors that we can foster to support youth to delay use

Vancouver Results of the 2013 BC Adolescent Health Survey The full 2013 Vancouver BC Adolescent Health Survey results are available at www.mcs.bc.ca The 2013 marijuana use data has not yet been published but the report ‘What a difference a year makes’ using the 2008 data is available a www.mcs.bc.ca For any questions, please contact annie@mcs.bc.ca annie@mcs.bc.ca