Marijuana Use during Adolescence – The US Surgeon General’s Report

Judson Bemis | November 21, 2019

While I usually like to write about recent studies, this report speaks for itself.  I have edited this just for adolescents, the full report can be seen here.

Marijuana is also commonly used by adolescents, second only to alcohol. In 2017, approximately 9.2 million youth aged 12 to 25 reported marijuana use in the past month and 29% more young adults aged 18-25 started using marijuana. In addition, high school students’ perception of the harm from regular marijuana use has been steadily declining over the last decade. During this same period, a number of states have legalized adult use of marijuana for medicinal or recreational purposes, while it remains illegal under federal law. The legalization movement may be impacting youth perception of harm from marijuana. 

The human brain continues to develop from before birth into the mid-20s and is vulnerable to the effects of addictive substances25, 26. Frequent marijuana use during adolescence is associated with:

·         Changes in the areas of the brain involved in attention, memory, decision-making, and motivation. Deficits in attention and memory have been detected in marijuana-using teens even after a month of abstinence27.

·         Impaired learning in adolescents. Chronic use is linked to declines in IQ, school performance that jeopardizes professional and social achievements, and life satisfaction28.

·         Increased rates of school absence and drop-out, as well as suicide attempts29.

·         Risk for and early onset of psychotic disorders, such as schizophrenia. The risk for psychotic disorders increases with frequency of use, potency of the marijuana product, and as the age at first use decreases30. 

·         Other substance use31, 32. In 2017, teens 12-17 reporting frequent use of marijuana showed a 130% greater likelihood of misusing opioids23.

Marijuana’s increasingly widespread availability in multiple and highly potent forms, coupled with a false and dangerous perception of safety among youth, merits a nationwide call to action. 

You Can Take Action

No amount of marijuana use during pregnancy or adolescence is known to be safe. Until and unless more is known about the long-term impact, the safest choice for pregnant women and adolescents is not to use marijuana.  Pregnant women and youth--and those who love them--need the facts and resources to support healthy decisions. It is critical to educate women and youth, as well as family members, school officials, state and local leaders, and health professionals, about the risks of marijuana, particularly as more states contemplate legalization.

Science-based messaging campaigns and targeted prevention programming are urgently needed to ensure that risks are clearly communicated and amplified by local, state, and national organizations. Clinicians can help by asking about marijuana use, informing mothers-to-be, new mothers, young people, and those vulnerable to psychotic disorders, of the risks. Clinicians can also prescribe safe, effective, and FDA-approved treatments for nausea, depression, and pain during pregnancy. Further research is needed to understand all the impacts of THC on the developing brain, but we know enough now to warrant concern and action. Everyone has a role in protecting our young people from the risks of marijuana.

INFORMATION FOR PARENTS AND PARENTS-TO-BE

You have an important role to play for a healthy next generation.

·         Review the facts to understand the risks associated with marijuana use during pregnancy.

·         Check out these Frequently Asked Questions  about marijuana use and pregnancy.

·         Learn about marijuana safety for children and pregnant and breastfeeding women.

·         Start a conversation with your kids: Marijuana: Facts Parents Need to Know.

·         Keep your adolescent from using marijuana and other drugs: Keeping Youth Drug Free - PDF.

·         Watch the Message to Parents from NIH/NIDA 

INFORMATION FOR YOUTH:

You have an important role to play for a healthy next generation.

·         Want to know how marijuana affects brain development? Get the facts. 

·         Learn key techniques on how to resist peer pressure: Above the Influence .

·         Learn how to help friends stop using marijuana with Letter to Teens

·         Get around-the-clock free advice and referrals: Substance Abuse and Mental Health Administration (SAMHSA) National Helpline (1-800-662-HELP (4357).

Also , A guide filled with usable strategies for both preventing and stopping teen addiction.

Footnotes

·         4.↩ Elsohly, M. A., Mehmedic, Z., Foster, S. (2016). Changes in Cannabis Potency Over the Last 2 Decades (1995-2014): Analysis of Current Data in the United States. Biological Psychiatry, 79(7), 613-619. doi:10.1016/j.biopsych.2016.01.004.

·         23.↩ Substance Abuse and Mental Health Services Administration. (2018). Key Substance Use and Mental Health Indicators in the United States: Results from the 2017 National Survey on Drug Use and Health (HHS Publication No. SMA 18-5068, NSDUH Series H-53). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration

·         24.↩ Johnston, L. D., Miech, R. A., O'Malley, P. M., Bachman, J. G., Schulenberg, J. E., & Patrick, M. E. (2019). Monitoring the Future national survey results on drug use, 1975-2018: Overview, key findings on adolescent drug use. Ann Arbor: Institute for Social Research, The University of Michigan, 119 pp.

·         25.↩ Pujol, J., Vendrell, P., Junqué, C., Martí-Vilalta, J. L., & Capdevila, A. (1993). When does human brain development end? Evidence of corpus callosum growth up to adulthood. Annals of Neurology, 34(1), 71-75. doi:10.1002/ana.410340113.

·         26.↩ Levine, A., Clemenza, K., Rynn, M., & Lieberman, J. (2017). Evidence for the Risks and Consequences of Adolescent Cannabis Exposure. Journal of the American Academy of Child & Adolescent Psychiatry, 56(3), 214-225. doi:10.1016/j.jaac.2016.12.014.

·         27.↩ Meruelo AD, Castro N, Cota CI, Tapert SF. Cannabis and alcohol use, and the developing brain. Behav Brain Res. 2017;325(Pt A):44–50. doi:10.1016/j.bbr.2017.02.025.

·         28.↩ Meier M.H., Caspi A., Ambler A., et. al. Persistent cannabis users show neuropsychological decline from childhood to midlife. Proc Natl Acad Sci USA., 2012. Oct 2; 109(40) E2657-64 doi 10.1073/pnas. 1206820109. Epub 2012 Aug 27

·         29.↩ Silins, E., Horwood, L. J., & Patton, G. C. (2014). Young adult sequelae of adolescent cannabis use: An integrative analysis. The Lancet Psychiatry, 1(4), 286-293. doi:10.1016/s2215-0366(14)70307-4.

·         30.↩ Di Forti, M., Quattrone, D., & Freeman, T. (2019). The contribution of cannabis use to variation in the incidence of psychotic disorder across Europe (EU-GEI): A multicenter case-control study. The Lancet Psychiatry, 6(5), 427-436. doi:10.1016/S2215-0366(19)30048-3.

·         31.↩ Lopez-Quintero C., Perez de los Cabos J., Hasin D.S. (2011). Probability and predictors of transition from first use to dependence on nicotine, alcohol, cannabis, and cocaine: results of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Drug Alcohol Dependence. 115(1-2):120-130.

·         32.↩ Jones, C. M., & McCance-Katz, E.F. (2019). Relationship Between Recency and Frequency of Youth Cannabis Use on Other Substance Use. Journal of Adolescent Health, 64(3), 411-413. doi:10.1016/j.jadohealth.2018.09.017.