Cannabis Q&A with an Expert on Substance Abuse


Gage Thompson

Gage Thompson: What are professional expectations for the prevalence of abuse following legalization?

Dave Bernstrom: I would say about 80 – 90% of my clients currently use cannabis. It’s hard to think for me and my clients that we would see much increase in that. Cannabis is ubiquitous enough in our community right now for me to state that legalization will not really change access a whole lot.

GT: Would you say there is currently an issue with people self-medicating instead of seeking treatment?

DB: I would say, in my population, yes. I have an awful lot of kids who tell me outright, ‘ya know I used to take something for my ADHD but I didn’t like the way that made me feel so now I just get high every day before I go to school.’ And they honestly believe that’s managing their ADHD better than the psychotropic medication. Now whether that’s true or not obviously we can’t say.

GT: How does one recognize that harmless use has become abuse?

DB: That is the $1,000 question right now. It’s one that we constantly wrestle with. Those things changed with the last incarnation of the DSM (Diagnostic and Statistical Manual), which is our diagnostic criteria. One of the things we talk about for all disorders, not just substance abuse disorders, is an impairment in functioning. That is, does it impact your ability to socialize? Does it impact your vocational or educational abilities? Does it impact your physical health? Basically, does it create a barrier between yourself and successful and healthy living?

GT: So that’s the first criteria we use but more specifically for substance abuse we talk about different levels of it. Intoxication, use, abuse, and dependence are the different levels we talk about.

DB: Abuse is simply what I said before, that your use of a substance is significantly impacting your daily function. Dependence is when it goes over the line and you’re now addicted to that substance. There may be physical or emotional withdrawal from it. One of the questions is, have you ever tried to stop using the substance before? It’s much harder to move into the dependence area for cannabis than it is for other drugs like cocaine or opiates. There aren’t the actual physical withdrawals like if you’re coming down off of heroin you feel like you’re gonna die, that kind of thing.

GT: What are some general misconceptions regarding cannabis?

DB: The numbers will say that even within the baby boomer generation more than 50% of people who live in the U.S. have at least tried cannabis. I think the perception is changing pretty drastically these days. A lot of people are coming around to the idea that as far as drugs go it’s fairly benign. It’s probably less dangerous physically than alcohol. On the other had there are tons of social implications for its use. It is criminogenic. It’s such a complex question and I don’t think the average American has thought it through all that much. You tend to have people on one side say, oh this is no big deal we should legalize it, make money off of taxing it. It’ll become a cash crop for us, the practical view of it. Then theres folks who just believe that intoxicants are bad. Theres the potential for abuse. There are so many people in this country that are challenged with a predisposition to substance use and abuse that the more we can keep these substances out of their hands or make it more difficult to obtain, really the better it is for public health. So it’s a really hard question. As to what the average American thinks, I really couldn’t say.

GT: What effects might legalization have on the counter culture aspects of cannabis?

DB: Personally, in the short term especially, I don’t see any change at all. I don’t think that the legalization will change much. Most of my kids are going to continue to obtain it through the black market the way they always have because it won’t be legal for them anyway. What I can tell you is that in their world it’s much easier to obtain cannabis than it is to get beer. It’s a completely ubiquitous substance that, in their lives, everyone uses. Everyone they know, their parents, their grandparents. For so many of these kids it’s just part of their culture.


Dave Bernstrom has been a licensed independent social worker since 1995. His work has been predominately with kids in the Quad City area struggling with behavioral and substance abuse disorders. Bernstrom has worked for Family Resources in Davenport for 16 years. He earned a bachelors degree in psychology and a masters of social work from St. Ambrose.