Marijuana and Teens Published by American Academy of Child and Adolescent Psychiatry

Originally published at American Academy of Child & Adolescent Psychiatry
No. 106; Updated October 2019

Many teenagers try marijuana and some use it regularly. Teenage marijuana use is at its highest level in 30 years, and today’s teens are more likely to use marijuana than tobacco. Many states allow recreational use of marijuana in adults ages 21 and over. Recreational marijuana use by children and teenagers is not legal in anywhere in the United States. Today’s marijuana plants are grown differently than in the past and can contain two to three times more tetrahydrocannabinol (THC), the ingredient that makes people high. The ingredient of the marijuana plant thought to have most medical benefits, cannabidiol (CBD), has not increased and remains at about 1%.

There are many ways people can use marijuana. This can make it harder for parents to watch for use in their child. These include:

Smoking the dried plant (buds and flowers) in a rolled cigarette (joint), pipe, or bong
Smoking liquid or wax marijuana in an electronic cigarette, also known as vaping
Eating “edibles” which are baked goods and candies containing marijuana products
Drinking beverages containing marijuana products
Using oils and tinctures that can be applied to the skin

Other names used to describe marijuana include weed, pot, spliffs, or the name of the strain of the plant. There are also synthetic (man-made) marijuana-like drugs such as “K2” and “Spice.” These drugs are different from marijuana and are more dangerous. Additionally, the products being sold in dispensaries currently are not subject to Food and Drug Administration standards and are not purely isolated cannabinoids; they are therefore not reliable in their potency/concentration of CBD or THC, or the inclusion of other ingredients.

Parents and Prevention
Parents can help their children learn about the harmful effects of marijuana use. Talking to your children about marijuana at an early age can help them make better choices and may prevent them from developing a problem with marijuana use later. Begin talking with your child in an honest and open way when they are in late elementary and early middle school. Youth are less likely to try marijuana if they can ask parents for help and know exactly how their parents feel about drug use.
Tips on discussing marijuana with your child:

Ask what they have heard about using marijuana. Listen carefully, pay attention, and try not to interrupt. Avoid making negative or angry comments.
Offer your child facts about the risks and consequences of smoking marijuana.
Ask your child to give examples of the effects of marijuana. This will help you make sure that your child understands what you talked about.
If you choose to talk to your child about your own experiences with drugs, be honest about why you used and the pressures that contributed to your use. Be careful not to minimize the dangers of marijuana or other drugs, and be open about any negative experiences you may have had. Given how much stronger marijuana is today, its effect on your child would likely be much different than what you experienced.
Explain that research tells us that the brain continues to mature into the 20s. While it is developing, there is greater risk of harm from marijuana use.

Sometimes parents may suspect that their child is already using marijuana. The following are common signs of marijuana use:

Acting very silly and out of character for no reason
Using new words and phrases like “sparking up,” “420,” “dabbing,” and “shatter”
Having increased irritability
Losing interest in and motivation to do usual activities.
Spending time with peers that use marijuana
Having trouble remembering things that just happened
Carrying pipes, lighters, vape pens, or rolling papers
Coming home with red eyes and/or urges to eat outside of usual mealtimes
Stealing money or having money that cannot be accounted for

Effects of Marijuana
Many teenagers believe that marijuana is safer than alcohol or other drugs. When talking about marijuana with your child, it is helpful to know the myths and the facts. For example, teenagers may say, “it is harmless because it is natural,” “it is not addictive,” or “it does not affect my thinking or my grades.”

However, research shows that marijuana can cause serious problems with learning, feelings, and health. Short-term use of marijuana can lead to:

School difficulties
Problems with memory and concentration
Increased aggression
Car accidents
Use of other drugs or alcohol
Risky sexual behaviors
Worsening of underlying mental health conditions including mood changes and suicidal thinking
Increased risk of psychosis
Interference with prescribed medication

Regular use of marijuana can lead to significant problems including Cannabis Use Disorder. Signs that your child has developed Cannabis Use Disorder include using marijuana more often than intended, having cravings, or when using interferes with other activities. If someone with Cannabis Use Disorder stops using suddenly, they may suffer from withdrawal symptoms that, while not dangerous, can cause irritability, anxiety, and changes in mood, sleep, and appetite.

Long-term use of marijuana can lead to:

Cannabis Use Disorder
The same breathing problems as smoking cigarettes (coughing, wheezing, trouble with physical activity, and lung cancer)
Decreased motivation or interest which can lead to decline in academic or occupational performance
Lower intelligence
Mental health problems, such as schizophrenia, depression, anxiety, anger, irritability, moodiness, and risk of suicide

Medical Marijuana
Some teens justify use of marijuana because it is used for medical purposes. Marijuana use with a prescription for a medical reason is called “medical marijuana.” Laws for medical marijuana are rapidly changing and are different from state to state. In some states, children of any age can get medical marijuana if they have a “qualifying medical condition.” There is very limited research supporting use of medical marijuana in children or teens for most conditions. In most states that allow medical marijuana, the marijuana is not regulated and therefore is not checked for ingredients, purity, strength or safety. There is no evidence that medical marijuana is any safer than other marijuana.

Cannabidiol (CBD)
Many parents have questions about CBD and how it may be helpful for their child. There is ongoing research on the use of CBD-containing products for conditions such as epilepsy, , PTSD, Tourette’s disorder, pain, and other diagnoses. For now, the use of CBD is only FDA-approved in children for specific forms of epilepsy and in adults for chemotherapy induced nausea and vomiting. At this time, there is not enough evidence to recommend CBD for other uses, in children and adolescents including the treatment of autism and other developmental disorders. The approved CBD requires a prescription. Many stores sell CBD products. However, there are no safety and quality requirements for non-prescription CBD. They may have harmful additives or interfere with prescription medication. If you are considering using CBD for your child, please discuss this with their physician prior to starting to prevent harmful effects.

Conclusion
Marijuana use in teens can lead to long-term consequences. Teens rarely think they will end up with problems related to marijuana use, so it is important to begin talking about the risks with your child early and continue this discussion over time. Talking with your child about marijuana can help delay the age of first use and help protect their brain. If your child is already using marijuana, try asking questions in an open and curious way as your teen will talk more freely if not feeling judged. If you have concerns about your child’s drug use, talk with your child’s pediatrician or a qualified mental health professional.