Marijuana: What You Need to Know to Help Protect Children, Teens and Young Adults

    Whether a child has not yet tried marijuana, has begun to use or uses it regularly, the guidance and information found here can help.

    Marijuana is a product of the cannabis plant and its main active chemical is THC. It poses substantial health and safety risks to young people, yet it is the most widely used drug among this population.

    The teen and early adult years are when our children are most vulnerable to marijuana’s harmful effects. It can affect how their brains develop, grades, relationships and physical health. Risk for addiction increases too.

    National trends have shown generally low rates of youth marijuana use.[1] Still, a recent spike in adolescent and young adult use, coupled with a decade-long decline in thinking about marijuana as risky or harmful[2], is concerning.

    Why do young people use marijuana?

    Regardless of whether a young person uses marijuana “to feel good” or “to feel better,” environment often shapes their beliefs and attitudes. These, in turn, influence choices around marijuana use and its potential consequences.

    A family history of substance use or addiction increases risk of use. Risk also increases with a parent or older sibling who uses marijuana, along with easy access to the drug in the home, neighborhood or at school.

    Friends and peers

    Research shows that having peers who use substances is one of the strongest predictors of a young person’s likelihood of trying and using a drug.[3] In our national survey of teens, we found that most who said they have a friend who uses drugs reported having more than one friend who does so.[4]

    Media & pop culture

    Movies, TV shows, music and social media are strong influences in young people’s lives which tend to glorify marijuana use and downplay its harms. We surveyed teens, and a third reported that their main source of information about drugs is social media, other teenagers or the internet[4] – sources that are often unreliable.

    Marijuana, more than other substances, receives a lot of attention due to nationwide legalization efforts. It’s often viewed as a harmless substance. Therefore, teens and young adults tend to discount its risk. About three-quarters of adolescents believe infrequent marijuana use does not harm the body.[5] The majority believes it is safer than alcohol even though we know each substance has its own set of risks.

    Mental health problems and stress

    Some young people use marijuana to try to relieve their feelings of depression or anxiety, sometimes the result of more responsibilities or school pressures. Marijuana use can worsen mental illness[6] and lead to addiction in some individuals.

    Why be concerned?

    The strength or potency of THC – the psychoactive ingredient responsible for the “high” associated with marijuana – has increased steadily since the 1960s. Between 1995 and 2018, the average THC concentration in leaf marijuana increased nearly fourfold, from 3.96% to 15.61%.[7] There has also been an increase in ER visits involving marijuana,[8] suggesting that the drug’s current strength is responsible for worse health consequences than decades past. Higher potency is also associated with more severe dependence and a greater likelihood among adolescents of developing psychosis and anxiety disorder.

     

    Short-term effects

    Marijuana use can affect people differently. The most common effects include:

    • Inaccurate perception of time and sounds
    • Slower reaction time, affecting driving and increasing injury risk
    • Problems with memory and learning
    • Poor judgment, increasing the likelihood of risky sexual behaviors and unlawful acts
    • Panic attacks
    • Suspicious or distrustful thoughts
    • Seeing things that aren’t there and other symptoms of psychosis

    Longer-term effects

    Adolescents and young adults are among the most vulnerable to the harms of marijuana. Substances like marijuana directly interfere with brain development,[9] especially the parts of the brain responsible for decision making, reward seeking and impulse control.

    Although there is conflicting information about the effects of marijuana on mental and physical health, research points to several conclusions:[9],[10]

    • Smoking marijuana may increase the risk of chronic cough, bronchitis and worsening symptoms of asthma
    • Marijuana use impairs learning, memory and attention, affecting school performance
    • Marijuana use can increase the risk of schizophrenia or other psychoses, with the highest risk among the most frequent and long-term users, especially in vulnerable individuals

    Driving under the influence of marijuana

    Much like alcohol, marijuana affects judgment and general motor skills, which is especially risky for new and inexperienced drivers. Driving while high is not safer than driving while drunk.

    Marijuana is the drug most frequently found in the blood of drivers involved in, and often responsible for, car crashes.

    According to the National Highway Traffic Safety Administration, the number of drivers found to have marijuana in their system is higher than drivers who test positive for alcohol. This is a reverse of findings from over 10 years ago.[11] In fact, our national survey of teens found that 83% said they would feel very unsafe to ride in a car with a driver who just drank alcohol. However, only 74% said the same about driving with someone who just used marijuana. Among teen drivers who said they have used marijuana in the past month, nearly half said they have driven after using marijuana.[4]

    Marijuana use disorder

    Marijuana, just like any other drug, can lead to addiction. It affects the brain’s reward system, and the likelihood of addiction increases considerably for those who start young. Symptoms of marijuana use disorder can include:

    • Physical tolerance to the drug, which means one feels the need to consume a greater quantity or concentration to achieve the same high
    • Withdrawal symptoms that include problems with sleep, nausea, irritability and restlessness, headaches and abdominal pain; symptoms can last for 2-3 weeks
    • A sense of craving for the drug
    • Problems with day-to-day functioning and responsibilities or giving up activities that were once enjoyed

    Individuals in late adolescence and early adulthood, especially males, are at the highest risk for developing this disorder.[12]

    Research has found that young people who use marijuana are as much as 4-7 times more likely than adults to become addicted.[13]

    Synthetic cannabinoids

    Synthetic “marijuana,” also known as spice or K2, is a man-made substance similar to THC. These drugs are not actually marijuana. They are more powerful, and their unpredictable and severe effects — including extreme anxiety, paranoia, vivid hallucinations, rapid heart rate, vomiting, violent behavior and suicidal thoughts — create increased risk and cause for concern.

    Synthetics are popular with teenagers because they are easily accessible in stores and online and often go undetected on drug tests.

    Learn more

    Ways marijuana is used

    Recognizing the different ways young people use marijuana is important to identify use and protect our young people from harm. While smoking remains the most common method of use, many teens believe there are safer or more discreet ways to use marijuana.

    Smoking

    Marijuana is smoked via a joint (marijuana rolled in paper), a blunt (marijuana in a hollowed out cigar), a bong (a glass or plastic bowl and stem used with water to create smoke), a bubbler (a mini bong), or a hookah pipe. Bongs and pipes are sometimes made out of common objects like soda bottles or cans, and even fruits or vegetables.

    Vaping

    Increasingly, young people are using smokeless devices to vape liquids or cartridges that contain THC. Vaping does not produce the same telltale smell as smoking, making use easier to conceal. Vaped marijuana also tends to be more potent with higher concentrations of THC.

    Dabbing

    Dabbing is similar to vaping. A waxy concentrate of marijuana, known as hash oil (or by other names like dabs, wax, butter), is placed on a glass pipe or bong heated with a blowtorch or other device. The heated wax, typically more potent than smoked marijuana, creates a vapor that users then inhale. Dabs can have as much as 90% THC concentration.

    Edibles, oils and beverages

    Dried cannabis or oil concentrates can be used on their own or baked into many types of food, including snacks and candy products. The added risk associated with edibles is that it is easy to consume more THC than intended. Some sugary seltzer drinks are also spiked with THC – yet another way for youth to consume THC discreetly and in high doses.

    Tinctures, capsules and sprays

    Often intended for medical use, tinctures are liquids extracted from the cannabis plant using alcohol. They are highly potent and used by placing drops under the tongue for fast absorption. THC can also be swallowed in capsules known as “cannabis caps” or weed pills. They are made by filling medication capsules with marijuana oil, wax or another extract. Liquids, infused with either THC or cannabidiol (CBD), can be discreetly sprayed under the tongue for fast absorption.

    Added risks of vaping marijuana

    Using a smokeless device carries its own risks. There are numerous toxic ingredients inhaled when vaping. In combination with vaping flavors and the respiratory effects associated with inhaling the aerosol, there was a wave of severe lung injuries and deaths associated primarily with marijuana vaping in 2020.

    Smokeless devices may also lead to more people using vaped marijuana instead of or in addition to smoked marijuana. It doesn’t produce the same telltale smell and can be used more discreetly, and in turn more frequently. Vaped marijuana also tends to be more potent with higher concentrations of THC.

    More on vaping illness

    Impact of legalization

    Many young people believe that legalizing marijuana means that it’s safe to use, no matter the age. Research tells us that when teens and young adults believe there is little risk in using marijuana, rates of use increase.[14]

    National data indicate that in all states that have legalized recreational marijuana as of 2018, reported rates of first use among adolescents are 12-63% higher than the national average.[15]

    The marijuana industry is eager to promote use to young people as they can become long-term, heavy and loyal users of the drug. The industry has already begun to use successful strategies borrowed from tobacco and alcohol promotions. It’s not surprising that edibles resembling candy and other snacks are popular with young people.

    Get vocal

    Parents and caregivers can join forces with local community organizations to help protect youth. Whether advocating around marijuana production, where stores are located, taxes or advertising, you can use your voice. Our advocacy toolkit is a helpful tool for people concerned about adolescent substance use.

    Download your advocacy toolkit

    Effective prevention and treatment, coupled with removing criminal penalties for personal possession and use (decriminalization), will address most of the concerns people rightly have regarding racial inequities and harsh drug laws without creating a money-making machine that ultimately harms young people’s health and safety.

    Steps to prevent use

    Despite what many parents believe and feel, you have tremendous influence over whether your children use substances, including marijuana. Kids themselves have shared that their parents have the greatest influence over their attitudes and behaviors around substances.

    Know the facts

    You are an essential buffer between your child and the many influences that encourage them to use marijuana. Try to do your homework and find up-to-date information on the how, where and why young people use marijuana. Be ready with honest answers, shared in an age-appropriate way, so that they see you as a good source of information.

    Start early

    By talking early, you are helping frame a healthy mindset when it comes to marijuana. Pre-middle school and high school conversations can lessen your child’s intention to try or use in the future, as well as influence how they approach friendships with peers who do use substances.  It’s important to keep talking as they get older, too. The time when parents pull away often coincides with a period of increased risk of teen substance use. Try to balance setting clear expectations and rules about drug use, while granting more choice, flexibility and independence for less risky behaviors.

    Have frequent and honest conversations

    Look for opportunities to discuss marijuana with your child calmly and casually. Conversation starters can be news stories, school lessons, advertisements, seeing someone use marijuana on TV or in a movie or smelling it in public. Second, be ready to listen, understand their perspective and try to avoid lecturing. It can help to start the conversation with open-ended questions about their perception of marijuana use, such as “Why do you think kids try marijuana?” and “What do you know about the risks of using it?”

    These conversations aim to acknowledge marijuana’s potential appeal and help them weigh the risks against the perceived benefits. Try not to use scare tactics or threaten. Instead, explain that you genuinely care about their health. Do your best to have these conversations frequently and, if you can, before they try marijuana for the first time.

    If there is a history of addiction in the family, your child’s risk of developing a problem with marijuana increases. As you would with any family disease, explain why they need to be more careful than their peers about substance use.

    download

    Marijuana Talk Kit for Parents and Caregivers

    For more information about how to talk with your child about marijuana, please see our Marijuana Talk Kit.

    Download now

    Convey your expectations

    Calmly explain why you don’t want your child to use marijuana but also be sure they understand that your main concern is their health and safety. Let them know that you will always be there to help them if they are in an unsafe situation, regardless of whether it involves marijuana use. If you choose to set consequences for their marijuana use, make sure your child knows what these consequences are in advance.

    Set a good example

    If you use marijuana – whether in front of your child or not – you should anticipate that they might call you out on it (“But you smoke weed too!”). Take the time to reflect on, and perhaps reevaluate, your own use – especially if your child is watching. Think about the effect your behavior has on them and the example you are setting. Using a substance to relieve stress or as a coping mechanism can send the wrong message. It is also important to keep any marijuana or drug paraphernalia out of your child’s reach.

    Spend time together

    You’re busy. They’re busy. Still, try to find opportunities to engage in open and unhurried conversation. Share thoughts and opinions and have heart-to-heart discussions. Your ability to check in on your child – face-to-face and regularly – can make a real difference. This can take place anytime and anywhere, as long as you have a routine to be together.

    How to address use

    During the teen and young adult years, any use poses health and safety risks and increases the likelihood of addiction. In case your child’s health, relationships, grades or everyday life is suffering due to marijuana use, you may need to seek professional help. Even if they don’t use marijuana frequently, it should still be addressed.

    Signs of use

    It can be challenging to know the difference between normal teen behaviors and those that may be related to substance use. The following details telltale signs that you child may be using marijuana.

    Change in friends, behavior, mood & personality

    • Uncharacteristically relaxed or reserved

    • Unfazed by conflicts or stress

    • Slurred, slow, repetitive speech

    • Inappropriate laughter

    • Paranoia over small inconveniences

    • Confusion, disorientation or delusions

    At home or in car


    • Uses heavily-scented perfumes, candles, air freshener or dryer softener sheets to hide the smell

    • Spends more time than usual in the shower or outdoors to prevent smoke odor inside house

    • Lighters, roller papers or other small drug paraphernalia

    • Disappearance of money or valuables

    • Hidden stashes of marijuana or paraphernalia

    • Smell of marijuana in the car, trunk, glove compartment

    Health issues


    • Excessive sleeping

    • Lethargic movement

    • New symptoms of asthma or breathing issues

    • Excessive eating and snacking

    • “Cotton mouth” – dry mouth and lips

    Hygiene & appearance


    • Skunk-like odor on clothes or belongings

    • Dry, bloodshot eyes; uses eye drops to decrease dryness and redness

    School & work


    • Diminished ability to focus and engage with assignments

    • Decreased attendance

    • Changes in academic or work performance

    • Disregard for rules at school or work

    More on spotting substance use

    If you have reason to suspect use, don’t be afraid to err on the side of caution.

    Keep reading

    Take a health, not a punitive, approach

    Emotions can run high but rely on the facts. It is important to keep lines of communication open and show your concern, but avoid threats and punishment.

    If you know your child is using marijuana, try to understand why

    Ask your child why they use marijuana, and try to understand what’s driving their decision. Is it social pressure? Curiosity? Or, is it a way to cope with stress, anxiety or depression? Their answers can help you address the underlying motivations and manage them in a safer or healthier way. Some examples of questions can include: What do you enjoy about using marijuana? How does it make you feel? What other ways can you think of that make you feel the same way?

    It is also important to challenge young people on their perceptions of what is ‘normal’ when it comes to youth marijuana use. Many young people (and parents) overestimate the number of teens and young adults who use marijuana. This can increase the risk that young people will use it to fit in with their peers.

    Get help and support

    Depending on your child’s level of marijuana use, we provide different ways to get help and support.

    Our text messaging program, Help & Hope by Text, can help you guide your child away from marijuana use and toward healthier behavior. You can learn skills to manage parenting challenges with our e-learning courses, and our weekly online support community provides parents and caregivers with practical solutions in a safe and caring environment. The Partnership’s parent coaching program extends our peer-to-peer support, pairing parents with a volunteer coach to address a child’s substance use. You may find that your child is unable to stop using marijuana or significantly cut down. Our helpline specialists can provide personalized guidance and help you navigate the treatment system if needed.

    Don’t panic and go easy on yourself

    Parents are up against many contrary forces when trying to prevent youth marijuana use. Among these are peer pressure, media influences, legalization efforts and young people’s natural tendency to take risks. With patience, love and the right interventions, you can help your child understand marijuana’s dangers, prevent them from developing a problem and encourage them to make healthier choices.

    Are you an educator or health care professional?

    There’s an important and unique role for you to play in preventing and addressing youth marijuana use as well.

    Marijuana: What School Professionals Should Know and Do

    Schools that implement comprehensive, age-appropriate and research-based prevention programming can have a real impact on reducing youth marijuana use and its adverse effects.

    Learn more
    Marijuana: What Health Care Professionals Should Know and Do

    You can play a critical role in preventing and mitigating marijuana use, which is a significant risk to the health and safety of your adolescent and young adult patients.

    Learn more

    Published

    February 2021