CHAPTER 3: Marijuana

History of Marijuana Use

Marijuana was introduced into Micronesia during the late 1960s, most likely by Peace Corps volunteers. The early history of the drug in one of the states is outlined by a local author:

It is said that marijuana was first introduced to Chuuk by a foreigner who resided on Nama Island toward the end of the 1960s. The person is reported to have had in his possession some marijuana seeds which he sowed and which later grew into healthy plants. By the early 1970s there was a small amount of marijuana filtering into Chuuk. The substance was bought in by students from Palau, Yap and Saipan who were attending school in Chuuk. As early as 1973 marijuana seeds were brought in from Saipan by a sailor on one of the cargo ships. They were planted on one of the lagoon islands and grew to be extremely healthy plants. It was not until the late 1970s that marijuana invaded the islands in large quantity. With much improved means of communication and transportation, and the increased number of Chuukese leaving the islands for school, marijuana found new and effective means of entering the area. (Oneisom 1991:2)

Smoking marijuana caught on among Chuukese in the middle 1970s when large numbers of college students returned, bringing back the drug to share with their friends (Larson 1987:219). During the late 1970s the habit spread rapidly among young males. By the early 1980s marijuana was being widely grown in Chuuk, as in Yap and Pohnpei. Cultivation of the crop was often a family project, with even older women contributing to the business and demonstrating a surprising knowledge of cultivation techniques. According to a survey of marijuana dealers conducted by Oneisom in 1985, dealers admitted to making about $100 in an average week. Police files show that during the five years between 1979 and 1984 $105,000 worth of marijuana was confiscated in police raids. This presumably represented but a small percentage of the total value of the marijuana produced during these years (Oneisom 1991).

In the absence of any specific information about the other states, we may presume that the spread of marijuana use in Yap and Pohnpei followed similar lines. Wood (1991:46) relates that police in Pohnpei seized over 2,000 marijuana plants with a total street value of over $1 million in a single year (1988). This figure serves to indicate how widespread marijuana use there was at the time. Kosrae seems to have been slow in developing a local marijuana industry, thanks to strong church sanctions against the drug, but marijuana is reportedly now grown for local consumption in one part of the island.

Cultural Background

Marijuana, like other drugs, is used socially in Micronesia. What Larson reported witnessing in Chuuk during the early 1980s would seem to be equally applicable to other states:

Generally marijuana is smoked by groups of young men, about fifteen to twenty years of age, who gather in a secluded place. Though less common, groups of young women may also smoke regularly. A men's house is an ideal smoking place, but normal residences are also used if few people are around. After dark, smokers may sit circled in a yard or along the shore. Little ceremony surrounds the smoking event itself. Those who smoke together are usually relatives or close friends. Smoking may take place at any time of the day or night although most users prefer to smoke shortly after dark, about six o'clock, and finish later in the evening, about nine o'clock. Daytime smoking is usually of shorter duration and lasts no longer than an hour. Once a joint is lit, each smoker inhales deeply and holds the smoke in as long as possible while passing the joint on to the next person. No stigma is attached to anyone who refuses to smoke. Casual conversation may occur, but the passing of the joint commands the attention of those smoking....

The number of joints smoked during any one session varies considerably. One factor determining the number of joints smoked is the reliability of the source of marijuana. If smokers are accustomed to a daily supply of pot, they tend to smoke less in one sitting. If their supply is more sporadic, they tend to smoke whatever they acquire at once. Smokers' life experience is another factor determining the amount of pot smoked. Those who have never smoked outside Truk (Chuuk) tend to smoke more in one sitting and are less likely to save marijuana for the future. This style of smoking reflects Trukese attitudes toward consumption generally. Whether the activity is eating, drinking, smoking, making love, etc., the ideal is that one should continue until the effect is felt as fully as possible. The purpose of eating and drinking (nonintoxicants) is to feel full. The purpose of drinking intoxicants is to get drunk. With marijuana, the more one smokes, the higher one can get. Hence, the goal is to smoke as many joints as possible at one time. (Larson 1987:221-222)

Survey Data on Marijuana

General Prevalence Rate by Sex

The 12-month prevalence rate of marijuana use for the general population of the FSM (15+ years), as seen in Table 3.1, is 8.1%.

A comparison of male and female prevalence rates reveals that marijuana use is even more gender-linked than alcohol use. The rate for FSM males is 15.1%, while the female rate is only 0.8%. The data indicate that marijuana use, which follows the pattern of other drug use in that it was sanctioned for males but not females, does not yet show even the slightly broader gender distribution that alcohol has gained.

The prevalence rates discovered in this study were lower than the rates reported from previous surveys. In her 1980 survey of Micronesian college students on Pohnpei, Palau and Saipan, Edman (1980) found that 34% of all students interviewed were using marijuana, at least on an occasional basis. Her survey offered no breakdown by sex and no information on quantity or frequency of use.

The survey of FSM school children undertaken by the FSM Substance Abuse and Mental Health Office in 1993 recorded a 30-day prevalence rate of 20% for boys and girls aged 12-18 with no breakdown by sex (Reed 1993). This is much higher than the 7.7% rate that we found for the 15-19 age group in FSM, the closest comparable cohort (see Table 3.2). Even the male 15-19 rate for Chuuk, the state in which the highest rates were found in this survey, is slightly below the figure reported by the 1993 survey.

Marshall's 1985 survey of the Chuuk population shows a current use rate of 26% among males and 0.6% for females over the age of 15 (Marshall 1991:339). The figures for the over-15 Chuuk population in this present survey are considerably lower than Marshall's: 17.2% for males and 0.2% for females.

General Characteristics

Age. Marijuana tends to be a younger man's drug, even more so than alcohol, as Table 3.2 shows in its breakdown of prevalence for different age groups. FSM rates by age form a pyramid with its apex in the 20-29 age group where the general rate rises to 12.1%. According to the survey data, a very small percentage of the 10-14 age group begin using marijuana, but the number of users grows greatly during the late teens and peaks during the 20s. The rate falls off for the 30-44 age group and drops even more sharply for the 45-64 age cohort. All the states show the same pattern except for Kosrae, where marijuana use peaks in the 30-44 age cohort and is generally greater among the older age groups than is the case in other states.

Marital Status. As Table 3.1 indicates, single persons (11%) show a significantly higher percentage of marijuana use than married persons (6%). This may be due to the fact that marijuana use, much more than alcohol use, tends to be concentrated among the young, many of whom are still unmarried. The higher rates among single persons are verified in Table 3.3, which corrects for any age bias by examining only those within the relatively young age range of 20-44. The use rate for the unmarried within this age range is 15%, well above the 8% recorded for married persons. The difference in rates between the single and the married is significant in every state but Kosrae, as Table 3.3 shows.

Employment. The current use rate among males with wage employment (31%) is nearly double the rate among the unemployed (17%), although for female users the gap is reversed. There is very little difference between the rates of employed and unemployed for both sexes, however.

Educational Status. The rate of marijuana use among students (15+ yrs), as shown in Table 3.1, is about 6%. This is lower than the 8% rate for the general population. Table 3.4, which focuses on comparative marijuana use rates among the school-age population, 10-19, offers a sharper look at the contrast between the drug use of in-school and out-of-school youth. Marijuana use, like alcohol use, is strongly correlated with educational status. The prevalence rate for out-of-school youth in that age group is 11.5%, nearly four times the rate of marijuana use among those who are still in school. Everywhere in FSM the rate of those not in school is three or four times higher than that of students.

Ethnicity. The survey sample showed very little marijuana use among non-Micronesian ethnic communities in FSM. Two Pacific islanders from outside FSM were the only other users found. In Pohnpei, the breakdown for marijuana use along ethnic lines paralleled what has been noted for alcohol use. Ngatikese (28%) and Kosraeans (12%) had much higher rates than ethnic Pohnpeians (8%), while Mokilese (6%) showed a lower rate. In Yap, however, where Yapese and Outer Islanders show very similar alcohol use rates, a far different picture emerges for marijuana use. While ethnic Yapese had a rate of over 3%, none of the Outer Islanders in the survey sample were current users of marijuana.

Residence. The highest marijuana use rate was found in rural villages, where the general prevalence rate was over 10% and the male rate was 19%. By comparison, the towns had an overall rate of 7% and a male rate of 13%. The lowest rates were recorded in the outer islands, which registered a general rate of 3% and a male rate of 6%. That the outer islands, where marijuana can not be grown nor easily imported, should have a low use rate is not surprising. One might expect that the towns would show a higher rate than they do in this survey, however. Yet, rural villages seem to be where most of the locally grown marijuana is cultivated just as they offer the seclusion that many young smokers seek.

Other drugs. Marijuana use is closely correlated with alcohol use everywhere in the FSM. Marshall (1991:252-253) cites Oneisom (1991) and Larson (1987) in support of his own findings that drug use in Micronesia is additive rather than substitutive. This assertion is confirmed by our survey, which found that 94% of all current marijuana users (339 of 362 identified in the survey) also drank alcohol.

Breakdown by states

Pohnpei. The overall rate of marijuana use is comparable with the rates for the other states in FSM. The female rate on Pohnpei is higher than anywhere else in FSM; Pohnpei is the only state with a female rate of higher than 1%. Although Pohnpei generally follows the FSM pattern for use rates by age groupings, the base of the curve is much broader than in other places. The male rate for the 30-44 age group actually exceeds the rate for the 20-29 group on Pohnpei, and the use rate among the 45-64 group is higher than anywhere else in FSM.

Kosrae. The very young in Kosrae apparently do not use marijuana, just as they do not drink alcohol. Marijuana use begins later, with the 20-29 age group, and reaches a high of 32.6% for the 30-44 group. Kosrae is the only state in which marijuana use is recorded for the 65+ age group. No female users were found in the survey, in keeping with the reputation of the state for exercising strong controls over the behavior of its women.

Chuuk. This state shows the highest use rate in the nation. Marijuana use, like alcohol use, is more tightly clustered by age group in Chuuk than it is in other states. Use rates ascend sharply during the late teens, rise to a high in the 20-29 age group, and then fall off quickly for the 30-44 group. Chuukese society seems to sanction pecadillos like drinking and smoking marijuana during younger years, but this behavior seems to be less acceptable during the years of supposed maturity.

Yap. At 3.6% the overall marijuana use rate inYap is significantly lower than that of the other states and less than half the national use rate of 8.1%. The low rate for Yap is especially surprising in view of the high alcohol rate there, especially among women and older persons. The survey data show that marijuana use appears to be confined to the young adult age groups (15-44) and then disappears entirely. Perhaps the widespread use of betelnut, a stimulant, makes marijuana less desirable. In contrast with relatively high female alcohol use rates, Yap shows a very low rate of female marijuana use (0.4%) that is half the national rate for women.

Consumption Patterns

Table 3.5, which shows the frequency of marijuana consumption by current users, indicates that half of the males (who comprise 95% of all users) smoke daily. Chuuk has the largest percentage of daily male smokers (56%), followed by Pohnpei (48%). The percentage of daily smokers in Kosrae and Yap is only half as great (26%), with most of the male users in these two states smoking a few times a week. Chuuk, the state with the highest frequency of use, shows that almost three-quarters (73%) of all marijuana smokers there use the drug every day or every other day.

Females were more occasional users than men. As Table 3.5 indicates, only slightly more than one-third of all women using the drug smoked several times a week, while most smoked much less frequently.

This survey indicates that Chuuk reports high consumption levels to match its high frequency levels, for nearly two-thirds of Chuukese marijuana users (63%) smoke four or more cigarettes a day (see Table 3.6). The average number of joints smoked a day in Chuuk over the past 12 months was 4.2, compared with the FSM-wide average of 3.5 daily. This differs markedly from the consumption pattern recorded for Pohnpei and Yap, where 75% of all users smoked 1-3 marijuana cigarettes on any day that they used marijuana. The average daily number of marijuana cigarettes smoked in Pohnpei and Yap were 2.8 and 2.3 respectively. Kosrae showed a higher level of consumption than Pohnpei and Yap, but lower than Chuuk; 74% of its users smoked 2-4 cigarettes a day with an average of 3.1 daily.

When the frequency data from the survey are computed against the average daily usage reported, we can easily derive the total amount of marijuana consumed in a year and the amount consumed by the average marijuana user in the same period of time. This latter figure may be a better index of the relative usage in each state. Using frequency and consumption data from the survey, then, we calculated the average number of marijuana cigarettes that a user smokes in a year as follows:

Pohnpei 505
Chuuk 860
Kosrae 460
Yap 355

Chuuk, which has a slightly higher prevalence rate than the FSM average, has a much higher yearly consumption rate per user than the other states. At the other end of the scale is Yap, which also shows a prevalence rate considerably lower than the other states.

If the consumption figures reported in the survey are taken at face value, the 353 current marijuana users in FSM smoked approximately 250,000 marijuana cigarettes during the past year. By using the figures on total current marijuana users in the FSM general population (Table 3.7), we can estimate the amount of marijuana smoked last year throughout the nation-860,000 cigarettes in Pohnpei, 175,000 in Kosrae, 2,200,000 in Chuuk, and 120,000 in Yap. Of the total estimated 3,350,000 marijuana cigarettes smoked during the year in FSM, two-thirds were smoked in Chuuk.

Total Estimated Marijuana Use

When the survey sample is adjusted for age to yield a representative sample, the number of current marijuana smokers can be estimated. For the entire nation the number of marijuana users can be estimated at just below 5,000, as Table 3.7 shows; only about 200 of these are female, all the rest are males. More than half of them are from Chuuk State; the smaller states of Yap and Kosrae have only about 330 each.

Lifetime Prevalence

Lifetime prevalence data, which was sought for all types of drugs, was found to be much more robust for marijuana than for alcohol use. A comparison of lifetime use of marijuana with current use is presented in Table 3.8, which shows a significant difference between the two in some of the states. This is not remarkable of itself, for users of marijuana often outgrow the habit, as we have seen in our discussion of the prevalence rates for the various age groups. Hence, the difference between lifetime and current rates for older age groups might simply indicate that a certain number of individuals who had been regular marijuana smokers in their 20s dropped the habit in their later years.

Of greater interest, however, is the difference between lifetime and current use recorded for the lower age groups in some states, a difference that is especially large in Pohnpei and Yap. This difference implies that some of those who had been smokers just a few years earlier gave up marijuana. One user out of 15 from the FSM 15-19 age group, representing 7% of the total, dropped marijuana, and ten percent of the lifetime users from the next age group (20-29) quit smoking. The decline of 28% in the 30-44 age group, although much greater than the younger groups, could be attributed to the fact that people who used marijuana when they were younger simply gave it up as they matured.

Survey data on the younger age groups, particularly from Pohnpei, suggest that a number of young marijuana users are choosing to give up the habit while they are still well within the ordinary age range for smoking. The figures from Pohnpei show that one-third (33%) of the lifetime users in the 15-19 male cohort (30) were not smoking marijuana over the past year. The drop in use is also significant in the two next older age cohorts. Only 53 of 70 of the lifetime users in the 20-29 cohort have smoked in the last year; thus, 25% appear to have stopped smoking. Of the 77 lifetime users in the 30-44 cohort, 29 have dropped the drug. This age cohort shows a 38% fall off in the use of marijuana.

The conclusion may be drawn that dropping the drug does not simply occur as a function of age, with young people outgrowing the use of marijuana, for a significant number of males drop marijuana at an age when they still might be expected to smoke the drug. This is a finding that has a great bearing on treatment strategies, since it would seem that an appreciable number of young people give up the drug without recourse to formal treatment. Reasons for this are not clear from the survey, but other informal interviews and reports suggest that some of the young smokers do not like the effects that the drug has on them, especially the paranoia and social withdrawal that many young people speak of. If so, those who have voluntarily given up marijuana might be prompted to share their experiences with at-risk youth or actual users in an educational campaign to decrease the use of the drug.