Here’s the sitch. Weed is everywhere. It’s legal, easy to get, marketed as “wellness” and all over my house. (I get a LOT sent to me to write about).
Teens think it’s safer than booze. Chills their anxiety. That it’s no big deal. I was guilty of buying into this too.
But then ER doctors are the ones watching 16-year-olds roll in mid-panic attack, chest pounding, parents freaking out. Ok this freaked me out. I have been beyond chill, when it came to my teen smoking in high school. I chatted with Dr. Leigh Vinocur, emergency physician, one of the first grads from the University of Maryland’s cannabis science program.
She laid out for me…us…them.
Teen brains aren’t done cooking. The prefrontal cortex (decision-making, impulse control) doesn’t fully mature until your mid-20s. Mess with it early and you risk long-term damage. This is knew but still shrugged it off.
The studies are messy. Some were biased, some overstated the harms. But what’s clear: heavy weed use in adolescence is linked to cognitive issues, lower grades, higher risks of depression, even suicidality later on. Great.
Psychosis is complicated. Weed doesn’t cause it for everyone, but if you’ve got certain genetic risk factors, it can be the trigger. And sometimes the psychosis was already brewing, and weed was just the self-medication.
The anxiety paradox. Low THC can calm you down. High-potency THC (which is most of what’s out there now) can crank anxiety way up. Dose matters. But how on earth do we know potency??
Medical use ≠ recreational use. Under a doctor’s care, cannabis can help kids with conditions like autism or drug-resistant epilepsy. Parents report big improvements. But that’s not the same thing as teens vaping high-THC carts to relax. Obvi.
Bottom line from Dr. Vinocur: no responsible cannabis physician is telling teens to use weed recreationally. Potency is up, research is still a mess, and the risks are real.Cannabis might be medicine. But for the adolescent brain, it’s usually just trouble.
Side note, Dr. Vinocur sits on Maryland’s Cannabis Public Health Advisory Council. In other words: she actually knows what she’s talking about. (She also just wrote a book called Never Let Them See You Sweat.)
Bullet points with links to data for days:
Everything you wanted to know about cannabis effects on adolescent brains:
The adolescent brain is still developing and maturing until the mid-to-late 20s, with the prefrontal cortex which is the area responsible for planning, decision-making, and impulse control, being the last to fully form
During this critical phase, any substances use can interfere with development and create long-lasting, and in some cases permanent, damage
It’s important to remember that many studies on cannabis examined illicit use by adolescents whose primarily goal was getting high as a recreational drug
It is also important to keep in mind much of this older data was sometimes biased and skewed towards showing cannabis harm via the grants from organizations like NIDA that were calling for it
Some of these studies did show that regular/heavy use starting in youth is linked to persistent cognitive deficits and worse educational outcomes, but even this study states that perhaps previous studies of cannabis in youth may have overstated the magnitude and persistence of cognitive deficits associated with use
Another study looked at youth use is associated with higher risks of later depression and suicidality; causality is complex and not definite, but the association signal is consistent even when accounting for prior mental health issues.
As far as psychosis with cannabis use in adolescents, studies have discussed, the relationship between cannabis use in adolescents and psychosis is an association, not a definite causality, and genetic predispositions play a key role as most cannabis users do not develop psychosis
Both environmental factors (like adolescent cannabis use) and genetics are involved in triggering psychosis, research has identified specific variations in the AKT1 and COMT genes that increase a young person's vulnerability to cannabis-induced psychosis and problematic use of cannabis called cannabis use disorder
Additionally, since psychosis often does develops during late adolescence and early young adulthood years and there is the possibility that their cannabis uses maybe an attempt to self-medicate and may be a chicken and egg scenario.
Therefore, it is important for both youth (and adults alike) to not self-medicate if they have these feeling of anxiety or mental health issues they are worried about, they need to seek out a knowledgeable medical profession to help them.
Remember it’s the dose that makes it poison, and we do know that THC levels and cannabis potencyhave been increasing in recent years and that while lower levels may help with anxiety in general higher levels of THC may in fact increase anxiety.
However, all of this does not apply to children or adolescents under medical supervision using cannabis products for medical conditions such as autism or drug-resistant seizure disorder, who probably have clinical endocannabinoid deficiency, CECD which is a hypothesis that low endocannabinoid “tone” underlies these and other condition.
Studies under the care of a physician found these children and adolescents with conditions like autism and drug-resistant epilepsy actually make good developmental strides without any neurocognitive harms, according to parents on both full spectrum medical cannabis which has low doses of THC and just CBD products.
Parents reported improvements in challenging behaviors like hyperactivity, self-injury, and aggression, as well as anxiety and sleep problems, and some also noted increases in social interaction and expressive language, and a few studies indicated improvements in adaptive behaviors such as independent dressing and showering.
However, it's important to note that while promising, these findings come from observational studies and surveys, and large-scale, rigorous clinical trials are needed to confirm the efficacy and long-term safety of these treatments.
Additionally, at the present due to the federal illegality these studies are hard to create and reproduce because of the patchwork of state regulations we have today, where there is no standardization of products or their dosing which is critical to eventually creating clinical guidelines.