Jan. 24, 2022 — Marijuana. Jane Mary Weed. Skunk. Pot. Pre-rolls, shatter and shake. Whatever you want to call it, a growing number of teenagers are using the drug, with perhaps harmful and often unanticipated effects, as a result of cannabis’ increased medical and recreational availability in the United States. Parents and professionals are also being taken off guard.
A parent in Boston named Deborah (whose name has been changed to protect her family) is aware of the dangers firsthand. After using marijuana with his buddies last year, her 19-year-old son ended up in the emergency room and then a behavioral health facility. She had dropped him off for his sophomore year of college just a few days earlier.
“Since the 10th grade, he has smoked cigarettes on a regular basis and occasionally smoked marijuana and drank alcohol. But he had some terrible luck, “Medscape Medical News was informed by Deborah.
He experienced a psychotic reaction from cannabis, which is known as cannabis-induced psychosis. Three days later, he was still experiencing delusions that his friends were talking about him in his apartment and on social media.
Prior red flags—social anxiety, depression, and a family history of bipolar disorder—became obvious when he was admitted to the hospital and started taking the antipsychotic medication olanzapine (Zyprexa). With one exception: “The physicians advise us that we now have to treat pot like a life-threatening allergy,” she said. A year later, he is still receiving therapy, is enrolled in community college, and is doing well.
A Convergence of Risks
Deborah’s experience is by no means exceptional.
As of November, 18 states, four territories, and Washington, DC had passed laws allowing for recreational use, and 36 US states and four territories had authorized medical cannabis. Despite the fact that national data do not show a dramatic increase in youth cannabis use since legalization, researchers and clinicians have expressed concern about the confluence of risks that include adolescents using the drug as young as 12 or 13, a market dominated by extremely potent cannabis products, and short- and long-term effects of exposure, particularly on the developing brain.
According to Krista Lindahl, Ph.D., director of the Brain Imaging and Neuropsychology Laboratory at the University of Wisconsin-Milwaukee and principal investigator in the ongoing Adolescent Brain Cognitive Development Study of the National Institutes of Health, younger children do experience more negative effects from more frequent cannabis exposure. What we typically observe are modest to moderate impairments in verbal memory, complex attention, problem-solving, and psychomotor states.
If use is stopped, Lisdahl discovered that cognitive function begins to improve within a few weeks. Additional evidence for her study comes from three prospective longitudinal studies of 3,762 identical and fraternal twins that were published in PNAS this April: Cannabis usage is linked to a higher incidence of mental health issues in young people, such as significant depression, anxiety, and antisocial personality disorder, however, these effects are largely transient.
If early use affects adults negatively, researchers are trying to find out. They also wonder if different state regulations may be facilitating easier access to and increased cannabis usage among teenagers who might not grasp the need to use the substance responsibly and in moderation.
According to Sharon Levy, MD, head of the Adolescent Substance Use and Addiction Program at Boston Children’s Hospital, “We’ve created this patchwork of goods with variable regulation from state to state, but what we don’t have is federal regulation.”
From Initiation to Abuse
According to the National Institute on Drug Abuse, in 2021, 7.1% of eighth-graders, 17.3% of tenth-graders, and 30.5 % of twelve-year-olds smoked cannabis in the previous year. These figures should not come as a surprise, as a study this week highlighted in the Journal of Studies on Alcohol and Drugs revealed that recreational producers are creating content — promotions, discounts, health benefits, even swag like T-shirts or hats — that appeals to teenagers despite state laws prohibiting cannabis product advertising to children. In addition, many of these marketing tactics, claim the study’s authors, are intended to break social media platform policies without the approval of the businesses who originally established the policies.
The study showed that, in addition to raising driving awareness, cannabis marketing messages also encourage driving habits that, in this situation, maybe rather hazardous, according to the researchers. THC, the primary psychoactive component in cannabis, causes rapid brain surges that, when combined with adolescent impulsivity and an inclination to seek rewards, can quickly result in hazardous use. In fact, according to recent projections from the 2020 National Survey on Drug Use and Health, 4.1 percent of US youths are thought to have a cannabis use disorder (CUD).
Despite the fact that 80 percent of US teenagers surveyed between spring 2019 and fall 2020 admitted to using drugs in the past as a coping mechanism, the data also show that many teenagers have resorted to cannabis to deal with the isolation brought on by the pandemic.
According to Levy, there is a period throughout adolescence when children show a greater interest in using psychoactive substances. This attraction is neurologically based. They are in a stage where they are more impulsive, and they have more dopamine receptors in their brains.
Risky behaviors in adolescents appear to be influenced by social and cultural factors, mental health conditions like melancholy, anxiety, attention deficit hyperactivity disorder, a history of trauma, genetics, and mental health difficulties, especially when it comes to the decision to use cannabis.
The tendency toward risk-taking and reward has, however, muddled the distinction between drug use for therapeutic and recreational purposes, which is crucial for clinicians to take into account.
During the week, teens may use marijuana “to support other areas of health, things like mental health, or struggles with sleep,” according to Lauren Kelly, Ph.D., assistant professor of pediatrics and child health at the University of Manitoba, Winnipeg, Canada, and scientific director of the Canadian Childhood Cannabinoid Clinical Trials. Teens may use marijuana on the weekends “to enjoy the company of friends and to remove some social anxieties,” she added. “Starting these dialogues may be able to minimize cannabis usage and recommend alternatives with stronger support from the scientific community.”
Kelly also emphasized the significance of comprehending the many product varieties that are currently offered. “Someone may claim to use cannabis, but it may actually be cannabidiol [CBD] oil, cannabinol [CBN], or something else entirely distinct [from] a high-potency THC product,” she added. “These products are quite different in terms of effects and risk.”
On the clinical side, screening during routine checkups is crucial to identifying users and learning their motivations for using certain substances. Clinicians can rapidly and effectively identify adolescents with moderate to severe substance use disorders using the online screening tool Levy and her colleagues have developed.
Major organizations like the National Institutes of Health are investing in research to learn more about how cannabis impacts adolescent development and long-term health outcomes. Parents and professionals should not remain apathetic in the interim, according to Lindahl: “It’s vital to be talking freely about these things without stigma so we can actually build the greatest solutions and best circumstances for teenagers to flourish.”