New approach to curbing marijuana use among teens: ‘just say no’ gives way to ‘just smoke less’

By Naomi Martin

Zaire Richardson listed healthy alternatives to smoking marijuana at a Charlestown Coalition Youth Group gathering. Barry Chin/Globe Staff

CHARLESTOWN — In a church basement here one recent evening, two dozen teenagers sat in a circle, eating pizza and discussing how they view marijuana.

The teens, most of whom live in nearby public housing, agreed that cannabis could be addictive and expensive. But they also felt it helped them.

“I was using it to get myself up to go to school,” one girl said. Another added: “It helps me in social situations.”

A boy said pot eased his stress, but he didn’t like being dependent: “If you’re having a problem and you can’t get it, you’re all tight like, ‘Damn, I need my weed.’ ”

The adult leaders, from a local health nonprofit, nodded. Recognizing why teenagers use marijuana is the first step of their program to curb problematic pot use.

The program teaches students to try healthy stress relievers like exercise or meditation, before encouraging them to cut back on pot in a realistic way. But the approach stops short of one step: demanding they quit altogether.

A far cry from zero tolerance and “Just Say No,” the Charlestown program — funded by Massachusetts General Hospital’s center for community health improvement — is part of a growing effort around the state to help high schoolers make sound choices about cannabis in an era of marijuana legalization. The new initiatives tend to focus on treatment rather than on abstinence and punishment.

“Scare tactics don’t work — we’ve figured out a way to do something that works,” said Sarah Coughlin, director of the Charlestown Coalition, which runs the youth group in the church and a separate marijuana program for Charlestown High students caught stoned or with pot that lets them avoid suspension. Punishment misses the point, she said, that most teens she sees live in poverty, use marijuana to manage severe trauma and stress, and need healthy alternatives.

“No child is getting high every single day at 7 a.m. and going to school for no reason,” Coughlin added.

But how schools handle teenagers found with marijuana varies widely. At a time when educators largely agree that discipline alone doesn’t work, many schools lack the resources to deal with marijuana issues in any way besides suspensions, which are linked to higher dropout rates and the “school-to-prison pipeline.”

Sarah Coughlin, Director of the Charlestown Coalition Youth Group "Turn It Around", spoke at the group’s gathering. Barry Chin/Globe Staff

Boston Public Schools tries in-school suspensions first, but offers few treatment options unless a student receives an out-of-school suspension. At Brookline High School, students receive one-on-one counseling and are rarely suspended.

At Walpole High School, meanwhile, the principal suspends students for a few days and ensures their parents send them to therapy, though this year the school started a vaping-cessation course.

Massachusetts lawmakers, aiming to keep troubled students in class, enacted a discipline overhaul, effective in 2014. Since then, marijuana suspensions fell 20 percent, to 1,628 last year. Other states often arrest students and expel them.

More addictive products

High school students have long experimented with marijuana, but educators say they now contend with a dramatically different landscape.

Several schools have seen upticks in students with life-disrupting marijuana issues. Researchers say that change is likely linked to new high-potency pot products such as vapes and wax-like extracts called “dabs” that are odorless and popular in legal and illicit markets. 

Overall marijuana use among young people has held steady.

Medical specialists say the new products are more addictive and pose higher risks of harm to the developing brain, including on learning ability, cognitive functioning, and mental health. Vaping can also carry physical health risks; federal officials said a nationwide outbreak of deadly lung injuries this year was linked to an additive used mostly in illicit marijuana vapes.

 

“Even in the context of a flat level of overall use, the shift in the way that kids are using should make us all alarmed,” said Randi Schuster, a Harvard Medical School psychiatry professor. She found a 25-fold increase since 2015 in the portion of local pot-using high schoolers who primarily vaped. That mirrors nationwide trends.

Zaire Richardson listed healthy alternatives to smoking marijuana.Barry Chin/Globe Staff

For the first time, marijuana surpassed opiates in 2019 as the top drug among students struggling with addictions at William J. Ostiguy High School, a recovery school in Boston. Now, 38 percent have marijuana problems, compared to 18 percent three years ago.

“It is impacting their lives where they can’t function on a daily basis,” said Principal Roger Oser.

Many local educators blame legalization for the changes, noting parents and students increasingly see pot as harmless. However, teen marijuana vaping is up nationwide. And other studies show that youth pot use did not increase after legalization in Colorado or Washington.

Fatima Fontes (left) and Zaire Richardson attended the Charlestown Coalition Youth Group gathering.Barry Chin/Globe Staff

The Charlestown High program, which partners with the Gavin Foundation and uses a motivational-enhancement treatment developed by the US Substance Abuse and Mental Health Services Administration, has seen success since 2014 in reducing students’ pot use and school suspensions. Medical specialists praised the program, saying teenagers would benefit from reducing their usage, though abstinence would be best.

Zaire Richardson, 19, said without the program she likely would’ve dropped out. She used to get suspended and spent those days getting high.

 

In the program, she examined why she smoked — marijuana helped her sleep, enjoy school, and cope with her best friend’s death. 

She also realized the downsides of her habit — spending money she needed for college and hurting her brain’s ability to be naturally happy. She learned to substitute aromatherapy, exercise, and music.

Now graduated and working, she still smokes cannabis, but less.

“I wouldn’t have had the tools to figure out how to break the habit” without the program, she said. “I would’ve just been an angry girl that was high all the time.”

‘A huge need’

Other city schools would love such a program but lack the money, staff, or know-how. A charity-run substance abuse program at Boston Public Schools shuttered in 2018 due to a lack of funding.

Since then, Coughlin and other educators said at least 10 public high schools have reached out to her — and many to the recovery high School, too — for help handling marijuana issues.

“Schools are frustrated because they don’t know what to do with students — they don’t want to suspend them,” Coughlin said. “There’s a huge need. The problem is there’s not a whole lot of resources.”

The district said it prioritizes treatment and sends suspended students — 98 last year — to substance abuse programs.

 

Youth advocates say Boston Mayor Martin J. Walsh’s office of recovery services issued a comprehensive plan in 2018 that acknowledged critical needs, but it lacked sufficient financial backing. The office said it is implementing the multi-year plan, has trained educators on marijuana, and is improving interventions.

In theory, there should be money for programs from taxes on the state’s booming cannabis industry, which brought in nearly $400 million of sales its first year. Under state law, part of the 10.75-percent excise tax on recreational pot should fund youth substance programs.

This year, the Legislature gave nearly $84 million of those taxes to the Department of Public Health’s substance services bureau, but the budget does not require that it fund youth programs statewide.

DPH said it will support more youth interventions. Schools can apply for grants, a spokeswoman said, though none are available now.

Changing times, new approaches

While educators and addiction specialists believe abstinence from cannabis is ideal until the brain fully develops, typically around age 25, they see value in teens reducing the frequency, potency, or amount of use.

“If a student walked in and I said, ‘You should never smoke pot again,’ they might walk out the door,” said Mary Minott, a longtime substance abuse counselor at Brookline High.

Minott counsels students who decide they want help or are referred by an adult. Last year, she said, referrals doubled, with most needing help with vaping marijuana, nicotine, or both. She talks to teens about why they use — often college anxiety, stress, and partying — and sets goals. Students are rarely suspended for pot, she said, unless they’re caught selling it.

At Walpole High, principal Stephen Imbusch was alarmed by a rise in vaping last year, so he sent his school nurse to learn how to run a cessation program. This year, he offered all students the chance to enroll, promising they wouldn’t get in trouble. A dozen signed up.

The school still suspends students for marijuana but sets a hearing within three days to craft a treatment plan, usually involving a private therapist, and now, the cessation course.

“Discipline on its own wasn’t really working,” Imbusch said. “I think more and more schools are going to be doing this kind of thing.”

At the church in Charlestown, the teenagers listed healthy alternatives to cannabis they pledged to try: sports, reading, sleeping, getting lost in nature.

“I’m trying to figure out how can I make myself happy again without using a drug,” Richardson said. “In the next five years, I don’t see myself smoking.”