Most of us know at least one person who embodies the "stoner" stereotype: the unkempt hippie-type with a closet full of ragged Bob Marley T-shirts and a DVD library featuring movies like "Half Baked" and "Dazed and Confused," or the underachiever who loses their train of thought mid-sentence and chuckles clumsily. As with many stereotypes, there may be a grain of truth to the public's perception of chronic marijuana users. But also like most stereotypes, the reality is more complex than it initially appears.
The Lazy Loafer
We have long suspected that some regular pot smokers have "amotivational syndrome,"as demonstrated by their indifference and lack of motivation to excel at work or school or to pursue personal interests. New research reveals that there are biological roots to this stereotype. Some chronic marijuana users produce less dopamine, a "feel good" chemical in the brain that drives motivation.
Although this aspect of the stoner stereotype is backed by science, the research is limited. In the study, all participants began using marijuana during adolescence and had experienced symptoms of psychosis while high on the drug. In addition, evidence suggests the changes in the brain that hinder motivation are likely reversible.
The Distracted Dreamer
Absent-minded, forgetful and inattentive, the stereotypical stoner struggles with thinking clearly and making decisions. Indeed, research shows chronic marijuana use takes a toll on the user's ability to form and recall memories for days or weeks after stopping use of the drug. In animal studies, the active ingredient in marijuana, THC, alters the way information is processed in the part of the brain responsible for forming memories and learning new information. In essence, the brain ages prematurely.
Again, science backs the stereotype but it only goes so far. Not all regular marijuana users will develop problems with memory and learning, and there is evidence to suggest that cognitive abilities can return to normal after about four weeks off of the drug, even among long-term heavy marijuana users. However, age, mental illness and other factors may hamper the recovery of certain skills.
The Paranoid Psychotic
Heavy marijuana users may become distrustful or anxious over time. This is because one type of learning is actually increased by marijuana use: learned fear, or what is more commonly described among marijuana users as paranoia.
In animal studies, rats given a marijuana-like drug were fear-stricken when presented with stimuli that wouldn't ordinarily trigger fear. Their response was out of proportion to the actual threat, which helps explain why chronic marijuana users may become convinced that others are judging them or conspiring against them and feel constantly on guard.
Not everyone who smokes pot will become paranoid. However, a number of studies have shown that regular marijuana use can prompt psychotic symptoms, such as paranoia or delusions, in healthy people, and in vulnerable individuals can increase the risk of schizophrenia and other psychotic disorders.
The Clumsy Clod
Clumsy thinking and behavior is characteristic of the stereotypical stoner. THC disrupts coordination, balance and reaction time and also impairs judgment and decision-making, making it dangerous to drive under the influence of marijuana. A driver high on marijuana has double the risk of being in an accident. The risk is higher if both marijuana and alcohol are used.
The Sloppy Slacker
According to the stereotype, stoners are apathetic and lacking the ambition to set and achieve goals. This may be true for some, particularly those who start young or use every day. Marijuana use is tied to academic problems, lower achievement and incomes, and overall reduced satisfaction with life. A 10-year study of college freshman tied marijuana use to skipping classes, lower grades, dropping out of college and being unemployed after college. An estimated 9 percent of users become addicted to marijuana. Among daily users, that rate increases to 25 to 50 percent. Of course, there are also many pot smokers who lead corporations, have families and live productive lives.
So, does the image of a "dazed and confused" stoner hold up in real life? Yes and no. Clearly, the stereotype isn't an accurate depiction of everyone who uses marijuana. But it does emphasize an important point: Marijuana is not a harmless drug. It has measurable and predictable effects that, at least in some users, interfere with their ability to learn, remember, pursue goals and make the most of life.
David Sack, M.D., is board-certified in psychiatry, addiction psychiatry and addiction medicine. He is CEO of Elements Behavioral Health, a network of mental health and addiction treatment centers that includes Promises, The Ranch, Right Step, The Recovery Place, The Sexual Recovery Institute, Malibu Vista, and Spirit Lodge.
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