CANNABIS AND TEENS

A friend who discovered that her teenage son had been using marijuana was just sitting down to talk with him when he played the it’s-not-that-bad card: “But mommy you smoke, and daddy drinks. Aren’t those worse?” My friend fumbled for a response. And as she told the story, it gave me pause too. After all, her son had a point. If I were in her shoes, what would I say?

Given the rapidly changing social landscape of cannabis (marijuana) use in the United States, such conversations are going to become increasingly common, and parents need to be prepared.

Here are some points to consider should you find yourself in a similar position.

It’s Not Just Addiction

Emphasize to your teen that use, abuse, and addiction aren’t the same thing. Cannabis may indeed be less addictive than tobacco or alcohol, and certainly less so than other more dangerous drugs. Less than ten percent of regular cannabis users will go on to develop dependence on it.

But low risk isn’t no risk, and even in the absence of addiction, heavy cannabis use can lead to impairments in cognition and memory, hallucinations, poor academic performance, risky sexual behaviors, sleep problems, automobile accidents, and ER visits. And that’s not counting the legal dimensions. These risks are greatest during teen years, and for teenagers with existing mental health conditions, cannabis can worsen symptoms or interfere with prescription medications that they are taking.

‘Just say no.’ Isn’t Hypocritical

Parents shouldn’t feel guilty protecting their children against substances that they may use themselves. That’s not hypocrisy, that’s responsible parenting, and here’s why. Unlike other parts of our bodies, which are essentially fully functional at birth, the brain continues to develop through childhood and adolescence. While this flexibility is advantageous (for example, allowing us to learn how to walk and talk) it can also leave the brain vulnerable to insults.

Cannabis is one such example – the drug crosses into the brain and binds to cannabinoid receptors, altering brain circuits with long-lasting effects. The earlier use begins, research suggests, the more damaging the effects may be. Use in adulthood, once our brains are more permanently hardwired, is relatively less risky.

Study the Research

What if your teenager comes armed with literature claiming that cannabis is safe? Encourage a conversation about just what those studies may be saying. Is the research legitimate? Was it done in teens? When was it conducted? Where were findings published? Cannabis data are tricky to interpret. Using alcohol as a contrast, we can count the number of glasses of wine or beers to quantify how much alcohol the body has been exposed to. Doing so for cannabis is more problematic, given the variation in potency and purity, and different routes of administration (e.g., inhaled versus oral).

Moreover, the concentration of tetrahydrocannabinol (THC, the main psychoactive ingredient) has increased— in some cases more than 50-fold! — over the years. If a study conducted ten years ago suggested that cannabis was safe, how does one extrapolate those findings for today’s teen?

Look Behind the Weeds

Substance use rarely occurs in a vacuum. Certainly, some teenagers may use cannabis out of harmless curiosity or to be perceived as cool, the way cigarettes once were. But for others, it could be a marker of psychic distress: medicating their way out of depression, anxiety, stress, or loneliness, or coping with a traumatic event. In such cases, cannabis could be serving as a flag for a problem rather than being the problem.

Entering the conversation from an empathetic rather than “how dare you” perspective may be more fruitful in the long run, both for your teenager’s health and wellbeing, and for your relationship with them. For parents needing that conversational nudge, the National Institute for Drug Abuse offers dedicated informational websites with pages tailored to teen, parent, and teacher perspectives.

There is also reassuring news. Recent studies show that even as cannabis use in adults is increasing, teenage use has flattened or even declined. And, this is happening across the U.S., not just in states that have the most restrictive policies.

Plant That Seed

Circling back to the “It’s not that bad” argument, I’d turn it around and ask whether that’s really the comparison we want to be making in the first place. Cannabis may be less harmful than alcohol or tobacco, perhaps for teenagers too. But going 90 miles per hour is also safer than going 100, yet we don’t recommend that teens speed.

Maybe having this conversation with your teen will convince them to not use or to delay until a later age. But even if it does not, you will have planted a seed in their mind that they will remember, and eventually use, to make safer, more informed decisions over time.

This article is for informational purposes and is not a replacement for medical advice from your physician.

Dr. Talati is an Associate Professor of Clinical Neurobiology in Psychiatry at Columbia University Vagelos College of Physicians and Surgeons and a Research Scientist at New York State Psychiatric Institute.