Teen and Young Adult Marijuana Use & Psychosis
Teen and Young Adult Marijuana Use & Psychosis
While Boomers, Millennials, and GenZers may struggle to find common ground on everything from fashion to finance, many echo similar sentiments when it comes to their perspective on marijuana: “It’s only weed.” But weed is sending more young people to ERs, according to a recently published study from the U.S. Centers for Disease Control and Prevention. Emergency departments across the country are seeing a rise in teen and young adult visits for cannabis-related complications – and the reasons for the increase are complex. Symptoms of cannabis poisoning and signs of marijuana dependency are prompting a growing concern among mental health experts, the medical community, and parents.
Developing Teen Brains
Developing brains like those in children, teens, and young adults are especially susceptible to the harmful effects of marijuana. During adolescence and young adulthood, the brain undergoes significant changes, particularly in areas associated with decision-making, impulse control, and emotional regulation. As if adolescence isn’t difficult already, introducing marijuana into this delicate developmental stage can disrupt the intricate brain anatomy and have deleterious outcomes. Studies show a link between increases in THC potency and troubling effects, such as anxiety, agitation, paranoia, increased risk of psychosis and decreased age of onset psychosis, impairment of creative thinking, depression, and suicidal ideation.
Rise in Marijuana Use and Low Perception of Risk
According to the Monitoring the Future adolescent survey, marijuana use reached the highest levels ever recorded since 1988. The proportion of young adults who reported past-year marijuana use reached 43% in 2021, a significant increase from 34% in 2016. Additionally, studies suggest people’s risk perception of marijuana use has declined, especially among young people. Many teens and young adults already perceive weed as a “safer” substance – one that is relatively harmless when compared to other substances like cocaine, meth, opioids, and even alcohol. Only 32 percent of 12th graders recognize the risk of harm from regular marijuana use, the lowest level ever, and use among college students has reached an all-time high. Decriminalization of marijuana across the nation, along with access to trendy products such as a variety of edibles and vape options, has contributed to more teens and young adults choosing to use marijuana.
Additionally, research is emerging to suggest that more young people may be using marijuana as a coping mechanism for pandemic-related stressors – the number of teens and young adults experiencing anxiety and depression has risen significantly when compared to pre-pandemic levels.
Increase in Potency and Risk of Poisoning
As noted in last month’s blog, today’s marijuana is different from the marijuana of the past, with THC levels reaching nearly 100% in some products. Plus, the potency of some forms of marijuana, like the THC oils inhaled while “dabbing,” is often underestimated by teens and young adults. Dabbing is when highly concentrated forms of THC oils and other extracts from the cannabis plant are inhaled. A recent study at the University of Southern California suggests that dabbing cannabis concentrate is the method most likely to lead to continued and increasingly frequent use. The high dose of THC delivered to the body through dabbing makes the practice particularly risky in both the short- and long-term.
A recent study published in Clinical Toxicology noted that the number of calls to poison control centers, between 2000 and 2020, involving marijuana rose 245% among children and youth, with over 80% of exposures among youth 13- to 18-year-olds. Likewise, hospitals throughout the country are seeing a rise in young patients with symptoms of marijuana poisoning: vomiting, confusion, seizures, difficulty breathing, and even psychotic episodes. Cannabinoid hyperemesis syndrome, a condition known to healthcare workers as “scromiting,” is repeated severe vomiting accompanied by intense pain that is caused by cannabis poisoning, which has seen an uptick in the last few years. According to the Centers for Disease Control (CDC), cannabis-involved ED visits among young persons under age 25 increased during the COVID-19 pandemic and remain above pre-pandemic levels.
The Link to Psychosis
Recent evidence suggests that teens and young adults who frequently use potent doses of marijuana experience higher rates of psychotic episodes – a disconnection from reality, often leading to hallucinations, delusions, and impaired thinking – and increase their risk of developing schizophrenia, a brain disorder that not only causes psychosis but also problems concentrating. The stories of teens and young adults who have suffered psychotic episodes – sometimes violent – sound similar: frequent use of high-potency marijuana over time that leads to progressively more concerning behaviors such as an inability to engage in everyday tasks, withdrawal from family and friends, hallucinations, erratic behavior, and extreme mood swings. Sadly, for some teens and young adults, cannabis-induced psychosis has led to despair and suicide, devastating the loved ones left behind.
The Next Steps
Navigating the complexities of teenage life is challenging, and the allure of experimentation is powerful. People who begin using marijuana before age 18 are 4 to 7 times more likely than adults to develop problems, with a 1 in 6 chance of experiencing addiction. Creating a welcoming and honest space for teens to share their perspectives and ask questions is important – lecturing is rarely effective. John Stogner, Ph.D., assistant professor, Department of Criminal Justice and Criminology, the University of North Carolina at Charlotte, stresses being direct and honest with teens and urging them to use caution and refrain from experimenting with new, and potentially more dangerous, methods. While abstinence may be the goal of parents and caregivers, discussing safer habits such as less frequent use and lower potency products can be effective.
Additionally, addressing underlying causes that lead to mental health difficulties with anxiety or depression is critical, as we know many young people, especially girls, are struggling nationwide. If there is a family history of psychotic disorders or substance abuse, including these topics in discussion will create more of an open, honest dialogue that can lead to healthier outcomes.
By raising awareness, providing education, and supporting evidence-based prevention programs, we can empower teenagers to make informed decisions, safeguarding their futures and well-being.
For more tips on talking with your teen or the young adults in your life about marijuana use, check out Harvard's Teens and drugs: 5 tips for talking with your kids or SAMHSA’s Talking With Your Child About Marijuana. If you or someone you know is struggling with substance use, know there are resources and supports available! Visit us at Safer Sacramento for help.
References
Barrington-Trimis, PhD, J. L., Cho, PhD, J., Ewusi-Boisvert, BA, E., Hasin, PhD, D., Unger, PhD, J. B., Miech, PhD, R. A., & Leventhal, PhD, A. M. (2020, January 24). Risk of Persistence and Progression of Use of 5 Cannabis Products After Experimentation Among Adolescents. JAMA Netw Open, 3(1). doi:10.1001/jamanetworkopen.2019.19792
National Institutes of Health. (2022, August 20). Marijuana and hallucinogen use among young adults reached all-time high in 2021. https://www.nih.gov/news-events/news-releases/marijuana-hallucinogen-use-among-young-adults-reached-all-time-high-2021#:~:text=The%20proportion%20of%20young%20adults,2016%20and%2017%25%20in%202011.
Nierengarten, M. (2016, February). Dabbling in 'dabbing': a potent new delivery system for cannabis poses heightened risks for adolescents who use marijuana. Contemporary Pediatrics, 33(2). https://go.gale.com/ps/i.do?id=GALE%7CA446292442&sid=googleScholar&v=2.1&it=r&linkaccess=abs&issn=87500507&p=AONE&sw=w&userGroupName=oregon_oweb&isGeoAuthType=true&aty=geo
U.S. Department of Justice & Drug Enforcement Administration. Preventing Marijuana Use Among Youth and Young Adults. https://www.dea.gov/sites/default/files/2018-07/DEA-Marijuana-Prevention-2017-ONLINE.PDF
