The legalization of cannabis across the U.S. has led many people to think consuming it is safe. However, that is not automatically the case. One of the primary public policy goals with legalizing cannabis products is to decriminalize a substance that has disproportionately put people of color in prison. Elected leaders and medical experts increasingly agree the use of substances like marijuana is a public health concern – for which criminalization isn’t an appropriate intervention.
A by-product of legalizing cannabis for the above reason is cannabis products are now more widely available and easily accessed by adolescents and young adults. And, there are serious health concerns with young people using cannabis products.
In the Talking Pediatrics episode, “In the Weeds: What You Need to Know About Teens and Cannabis,” host Dr. Angela Kade Goepferd talks with Dr. Sarah Polley, medical director of the Hazelden Betty Ford Foundation’s national substance use and mental health treatment center for adolescents and young adults. This important conversation explores the cannabis products teens are using, how they impact developing brains and how to intervene as a parent or caregiver.
The types of cannabis products
All marijuana and cannabis plant products fall under the term “cannabinoids,” which includes both psychoactive and non-psychoactive products. Typically, when people talk about marijuana, they’re referring to the dried leaves and flowers that are put in a bowl or blunt and smoked. However, there are many other cannabinoids available in different forms.
The main psychoactive ingredient in cannabinoids is THC, which stimulates the part the brain that responds to pleasure. THC triggers the brain to release the chemical dopamine, causing a relaxed and euphoric feeling. Some popular forms of THC include delta-8 and delta-9. Products with THC include gummies, chocolates, cookies, candies, etc., and they can be purchased at convenience stores, gas stations, health food stores and online. Products with concentrated THC like waxes or oils may be illicitly prepared into pods that are vaped with an electronic cigarette device.
CBD is another type of cannabinoid, but it doesn’t contain the same psychoactive properties as THC and it doesn’t produce a high. The usual CBD formulation is oil, but it also comes in an extract, capsules and is added to hundreds of foods, drinks and beauty products. CBD is being studied as a treatment for a wide range of conditions including Parkinson’s disease, schizophrenia, diabetes, multiple sclerosis and anxiety.
Impact on teen brains and behaviors
As cannabis products have become more widely available, use has increased among teens and young adults. National studies report nearly 40% of adolescents used cannabis within the past 12 months; the rate of teens using cannabis daily is around 5%. Teens are using marijuana and cannabis products at lower rates than alcohol or nicotine, but they can still cause addiction and negative health impacts.
“A myth I hear is that marijuana or cannabis are not addictive,” said Dr. Polley. “The thing that makes a substance addictive is dopamine in the brain, which is released when we do things or consume things that are pleasurable. Marijuana and cannabis do that.”
The prefrontal cortex is the last part of the human brain to develop, which doesn’t happen until the mid-20s. While the prefrontal cortex is developing, it is very vulnerable to chemicals, stress and trauma. Consuming cannabis products as a teen disrupts the normal development of this part of the brain. If cannabis use is high enough during the teen years, there will be changes in the brain development that mimics attention deficit hyperactivity disorder (ADHD), including difficulty with impulse control and emotional regulation, as well as increased prevalence and treatment resistance of their underlying mental health conditions.
A young person with mental health concerns is automatically at a higher risk of substance use, and young people under the age of 18 who use any substances have a much greater risk of developing addiction later in adulthood. “I try to educate families and let them know that’s a really sensitive period for the brains of young people,” said Dr. Polley. “You want to limit the exposure to substances in that period because you don’t want to accidentally end up with problems you didn’t have before that time.”
More to learn about cannabis safety
Health care providers often hear from their teen patients that they’re using something like a THC gummy to treat their anxiety or insomnia because they perceive the cannabinoid is “natural” and therefore safer than an anti-anxiety prescription medication from their doctor.
Dr. Polley says it’s important to validate the teen (and sometimes also their parents) because “the approach of having it just be off limits or saying this is bad isn’t going to work and isn’t fair because it could be really effective for the treatment of certain things in certain people.” However, current research hasn’t confirmed the benefits of using THC or other cannabinoids outweigh the risks for young people.
“I’m hopeful that we’ll be able to study marijuana and THC and ratios of THC to CBD to be able to figure out how medical professionals can use it therapeutically,” said Dr. Polley. “But we just don’t have that information right now.”
Here are some additional resources for addiction and mental health treatment offered during this podcast episode: National Institute on Drug Abuse (NIDA), Substance Abuse and Mental Health Services Administration (SAMHSA) and Hazelden Betty Ford Foundation.
Listen to the full podcast or read the transcript: “In the Weeds: What You Need to Know About Teens and Cannabis.”
Alexandra Rothstein