I am writing a list. It is a list of slang and street terms related to marijuana. Many of the words are straightforward:
I’ve known these words and heard them for years. My patients, and even their parents, use them all the time. They know what they mean. You probably know and understand them also, even if you’ve never used marijuana.
Some words are less common, but some of my patients use them all the time. I use them too, but they do not come out of my mouth quite as easily or quite as fast. That restless feeling I have when I have to use them is anxiety.
The youth who use these words usually have Cannabis Use Disorder, a diagnostic term from the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM V) of the American Psychiatric Association. The youth who use these words just know too much of the language not to have spent some time hearing them, saying them. Many parents do not know these terms, but I do. Sometimes the person using poppers or spliffs does not actually know what they’re using, but I know. I find it difficult at times to hide my concern.
“It’s just another weed product, Dr. Beck. It’s like a different flavor – chocolate versus vanilla.”
When I hear statements like this, I want to keep my face neutral. I want to know how much of the language of marijuana this youth knows, how many “flavors” they’ve tried. These statements are signs that a youth may have a clinical condition and a clinician must determine how serious the condition is. The clinician investigates this, no matter how worried it makes them and especially if it worries them. That panicky feeling that a health condition may require specialized clinical skills is one that most doctors learn in medical school. They usually learn on the first day of their clinical rotations.
Then there are the words that a youth uses that indicate more than a passing knowledge of the language of marijuana. These are the expressions of someone familiar with the territory. This territory terrifies me – these words terrify me:
Atom bomb or A bomb
When I hear one of these words, I know that I will likely fail to keep my voice neutral or my face calm. My heart rate will increase and my whole spirit will ache. Even as I write this, even as I write these words, with no one in front of me reporting them, no one right here and now telling me that they’re using these mixes, I have this horrible feeling. The images of the youth – people under twenty – I have known who know this language so intimately likely have or know someone with a very serious medical condition. It breaks my heart.
It took me 3 hours to write the glossary and another 3 hours to recover. It is not because the list is long. It is because the language reminds me of the pain of youth and families I have worked with. It is because the language is difficult to learn emotionally. It is because addiction to marijuana can be heart-breaking and writing out these individual words reminds me of that.