Research roundup: Cannabis use among teens
Thousands of studies are conducted each year on this popular herb. I take a look at the latest scientific findings on cannabis use among adolescents.
The U.S. legal cannabis industry is estimated to reach over $31.8 billion in annual sales by the end of this year. While the variety of cannabis products available for medical and recreational use is impressive, new scientific research is still emerging about their safety and efficacy, particularly with regards to heavy use among teenagers and its impact on brain development. I provide a brief overview of some of the 1,536 new studies published on this topic from January to April 2023.
Cannabis use among adolescents
There are emerging concerns about the use of high-potency cannabis. In particular, the rise in the use of e-cigarettes and cannabis vapes is a growing public health concern among adolescents. Cannabis use disorder is defined by the CDC as people who are:
“unable to stop using marijuana [cannabis] even though it’s causing health and social problems in their lives.”
Starting marijuana use during youth or adolescence and using it more frequently increases the risk of developing cannabis use disorder.
Vaping of marijuana on the rise
A study using cross-sectional data from a national online survey found that demographic factors and other current substance use behaviors were associated with levels of blunt and liquid cannabis vape use, with cannabis blunt use being more frequent among participants not in school, non-Hispanic Blacks, multiracial respondents, and those whose incomes do not meet their expenses.
One study on 2,342 adolescents aged 12-17 found that flavored nicotine and cannabis vape products increase adolescents' willingness to try them. The study found that sweet or fruit flavors were preferred over tobacco or unflavored products, and a comprehensive ban on flavored vapes could likely reduce adolescent use.
A study in New Zealand surveyed students aged 14-15 years, finding that early-onset cannabis smoking and vaping are much higher among structurally disadvantaged groups and those who use tobacco and alcohol.
Cannabis use is linked to psychosis
One study warns that cannabis use increases the risk of psychotic symptoms in young people, including subthreshold and acute symptoms, and can exacerbate underlying psychosis risk and psychotic disorders. While there are suggestions for treating co-occurring psychosis and cannabis use, clinical trial research is lacking to support evidence-based treatment of these conditions.
A study evaluating patients in Sweden with a history of cannabis use (32) to those without (128) found that adolescent cannabis use is associated with an increased disease burden in individuals with schizophrenia, with earlier age of onset, more hospital admissions and longer hospital stays. However, there was no significant difference in the type of onset and clinical symptom profiles between individuals with and without a background of cannabis use.
Cannabis use affects brain development and brain function
One review concluded that frequent and active cannabis use in adolescents might lead to small cognitive deficits in memory, attention, executive functioning, and processing speed.
A study comparing MRI images of the brains of 73 cannabis users compared to 73 healthy controls (age range of 22-36 years) found several significant differences in local structural/functional network measures. Although both groups' global brain network organization remained intact, alterations in local topological properties of structural and functional networks were observed in cannabis users.
Treatment of Teens with Cannabis Use Disorder
According to a review of therapeutic interventions for teens with cannabis use disorder, psychotherapy, and behavioral interventions, particularly cognitive-behavioral therapy (CBT), have strong evidence for treating cannabis use disorder in adolescents. The FDA-approved drug N-acetylcysteine has also shown effectiveness in promoting abstinence during treatment while promising medication candidates for cannabis use disorder in adolescents require further research.
The Takeaway
The rise in teen consumption of high-potency cannabis products, such as in vapes, is an emerging public health concern. Teens who use cannabis beginning at an early age may be at a higher risk for development of psychosis and changes in brain development.
Cannabis use disorder is treatable. Parents concerned about their teen’s cannabis use should discuss treatment options with their doctor. There is strong evidence for individual and family-based psychotherapy and behavioral interventions, such as CBT, for treating cannabis use disorder in adolescents.
Yours in health, Dr. Quave
Cassandra L. Quave, Ph.D. is a scientist, author, speaker, podcast host, wife, mother, explorer, and professor at Emory University School of Medicine. She teaches college courses and leads a group of research scientists studying medicinal plants to find new life-saving drugs from nature. She hosts the Foodie Pharmacology podcast and writes the Nature’s Pharmacy newsletter to share the science behind natural medicines. To support her effort, consider a paid or founding subscription, with founding members receiving an autographed 1st edition hardcover copy of her book, The Plant Hunter.