Cannabis continues to be the most common ‘main problem drug’ for new cases accessing treatment in Ireland. In 2018, it was reported as the main problem drug for 38% of new cases, followed by cocaine (31.1%) and opioids (18.1%).1 A new Irish study explores the experiences of a sample of teenagers (n=8) attending treatment for their cannabis use, entitled ‘Debt on me head’: a qualitative study of the experience of teenage cannabis users in treatment.2 

Sample profile and method

The paper reports on a qualitative study based on interviews with eight young people in Dublin who were in treatment for their cannabis use. They were aged between 15 and 18 years, with a mean age of 16.75 years. Age at initiation of cannabis use ranged from 11 to 15 years, with the mean age for first use at 13 years. On average, 3.5 years had passed since their first use. Interviews were recorded and transcribed verbatim. They were analysed thematically and six core themes were identified. Key findings under each theme are outlined below. 

The findings of this study should be considered within the context of two main limitations. First, interviews were carried out by a member of staff from one of the treatment centres. This may have impacted on young people’s willingness to disclose certain types of information, in particular when discussing their views and experiences of treatment. Second, the sample was drawn from two Dublin-based centres and these young people’s experiences may therefore not reflect those of teenagers living in other parts of the city or the country. 

Early initiation and heavy use

Initial cannabis use began with friends in relaxed social situations. However, usage became more regular and seven of the eight respondents progressed to daily use. This more regular use became less associated with feeling ‘giggly and high’ and more linked with ‘feeling normal’. They described feeling psychologically addicted and some experienced cravings and withdrawals when they did not use cannabis. Effects included sleep problems, appetite disturbance, and agitation. 

Cannabis ambivalence

Respondents were found to be largely ambivalent about their cannabis use. On the one hand, they valued the high experienced and the opportunities to meet new people that it presented. However, on the other hand, they described in negative terms the costs and other effects such as anxiety and low mood, which they associated with heavy use. Overall, the negative effects were not associated with cannabis as such, rather with the frequency with which it was used. This ambivalence led to a situation whereby respondents continued to want to use cannabis albeit at a reduced level. ‘All but one were still using cannabis and had no strong desire for abstinence’ (p. 214). 

Stealing and dealing

Selling cannabis, stealing money and mobile phones, and armed robbery were all identified as ways in which these young people had raised money to buy cannabis. There were also reports of young people getting into debt with dealers and threats being made to them and their families over payment of these debts. 

Treatment

Overall, respondents were reported to have spoken favourably about treatment. They valued the opportunity to talk with well-informed, non-judgemental professionals about their situation. However, as noted above, these findings may have been impacted by the interviews having been carried out by a member of staff from one of the treatment centres. 

Damage to relationships

In some cases, cannabis use was perceived to have caused problems for users in their personal relationships with friends and family members. There were tensions within families over drug debts and the associated threats, as well as some parents’ concerns about their young person’s drug use progressing to ‘more harmful’ or ‘harder’ drugs. 

Parental cannabis use

The final recurring theme discussed in the paper is that of parental cannabis use – that of either the respondent's own parents or those of their friends. While the study found that some of the young people knew adults who smoked cannabis, it was not found that parents either provided or condoned its use. 

Conclusion

Despite the limitations of this study, Debt on me head provides insights into the experiences of this cohort of service users in an Irish context. The early onset of use and subsequent problems experienced, alongside their ambivalence to cannabis and resistance to aim for abstinence as a result of treatment, are shown by the authors to reflect findings elsewhere in the literature. Among the authors’ conclusions is that despite this ambivalence to the effects of cannabis ‘the financial cost of cannabis use and the ensuing debts appear to act as a catalyst to change’ (p. 217). They argue that the study emphasises ‘the reality that young people attending treatment for their cannabis use have experienced significant problems because of their cannabis use and cannabis dependency appears common’ (p. 217). They highlight the need for other professionals working with young people to understand the negative effects that cannabis use may be having on these young people. 

Health Research Board (2019) National Drug Treatment Reporting System 2012–2018 drug data. Dublin: Health Research Board. https://www.drugsandalcohol.ie/30969/

2James PD, Comiskey C and Smyth BP (2019) ‘Debt on me head’: a qualitative study of the experience of teenage cannabis users in treatment, J Addict Nurs, 30(3): 211–218. https://www.drugsandalcohol.ie/31042/