Medicinal cannabis for young people is an oxymoron. Teens and young adults using cannabis have markedly increased risks of addiction, depression, anxiety, and psychotic disorders.
Youth often use cannabis to self-medicate, only worsening paranoia and underlying psychiatric vulnerabilities. For teens and young adults, medicinal cannabis has no proven benefits but its use engenders major risks.
risks vs benefits. But, in a risk/benefit analysis for cannabis most people don’t realize that adolescents and young adults obtainand substance use outcomes among adolescents and young adults using cannabis. Hill and colleagues emphasized that cannabis use—particularly early, frequent, or high-potency use—is linked with worsening. The authors also associated high-potency cannabis with subsequent psychotic symptoms and noted that nearly a third using cannabis for medical purposes met the criteria for cannabis use disorder.of randomized trials of cannabinoids for mental disorders and substance use disorders. In this largest-ever review of the safety and efficacy of medicinal cannabis across a range of mental health conditions, published inthat there were substantial adverse effects with cannabis. They concluded that THC-predominant cannabis does not improve PTSD symptoms and that there is insufficient evidence of beneficial effects on anxiety, depression, andand function in bipolar disorder and increased psychotic symptoms in psychotic-spectrum disorders. They warned that it’s important for clinicians to understand the lack of clear benefits of cannabis for mental health conditions and thetracked nearly a half-million adolescent Kaiser Permanente Northern California members. They were screened for substance use in routine care and followed into young adulthood. Past-year adolescent cannabis use was associated with increased risks for psychiatric diagnoses, including psychotic disorders, bipolar disorder, depression, and anxiety. The strongest associations were for psychotic and bipolar disorders. Higher-frequency cannabis use was also associated with greater risk compared with any use, suggesting a dose-response relationship. Cannabis use was documented approximately 1.7-2.3 years prior to the first recorded psychiatric diagnoses. This important data remind me of an analysis of nationally representative survey data from 280,000-plus U.S. young adults age 18-34 inby Nora Volkow and colleagues which found that cannabis use correlated with a higher prevalence for suicidal ideation, suicide planning, and suicide attempts. These associations were observed across levels of use, including nondaily use, daily use, and cannabis use disorder, and presented in individuals with and without major depressive episodes. The associations were particularly strong in women.showing that risks of developing cannabis use disorder included an increased risk of developing depression and bipolar disorder. In addition, risks increased for psychotic and nonpsychotic unipolar depression and bipolar disorder. CUD itself was associated with nearly double the risk for depression and a 2-3 times higher risk of developing bipolar disorder in men and women.with cannabis use is strongly age-dependent, with a peak between ages 15-30. Males tend to present earlier , while females often show a slightly later peak. Some psychosis findings may be a result of attempts to self-medicate psychosis-spectrum symptoms. Importantly, psychosis exists along a spectrum. Subclinical psychotic-like experiences are relatively common in adolescence, with prevalence estimates of 5-10%, although most do not progress to clinical disorder. However, the persistence and severity of such symptoms are predictive of later psychotic illness.review summarized youth literature by stating regular use of high-THC products by adolescents and young adults is linked with a 2-fold to 11-fold increased risk of psychosis. In addition, a higher risk of cannabis use disorder andCannabis potency has increased substantially over the past two decades, with typical THC concentrations rising from 3-5% in the 1990s to 15-20% or higher today. Concentrates like dabs and oils often reach 60-90% THC. This increase in potency represents a larger shift in exposure than changes in the overall prevalence of use or cannabis use disorder.The expansion of legal cannabis markets, combined with persistent illicit supply, has increased drug availability. Also, the rise of high-THC formulations and frequent use patterns suggest that population-level exposure to risk factors has increased. Medicinal claims and legal markets increase availability, further normalize use, and facilitate the commercialization of high-THC products. Young users are more likely to use high-potency products, including concentrates and vapes. These products deliver higher doses of THC per exposure and may facilitate repeated dosing within brief time intervals. Adolescence is characterized by ongoing brain maturation, which means high THC exposure during this period may disrupt these processes, potentially leading to persistent alterations inEvidence for the medicinal benefits of cannabis do not appear to exist, while serious psychiatric risks continue to be proven, especially in teens and young adults. Although questions of individual-level causality remain, the key message isWilson J, Dobson O, Langcake A, Mishra P, Bryant Z, Leung J, Dawson D, Graham M, Teesson M, Freeman TP, Hall W, Chan GCK, Stockings E. The efficacy and safety of cannabinoids for the treatment of mental disorders and substance use disorders: a systematic review and meta-analysis. Lancet Psychiatry. 2026 Apr;13:304-315. doi: 10.1016/S2215-036600015-5. Epub 2026 Mar 16. PMID: 41856154. Kansagara D, Terry GE, Ayers CK, D'Souza DC. Cannabis and Mental Health: A Review. JAMA Intern Med. 2026 Mar 9. doi: 10.1001/jamainternmed.2025.8215. Epub ahead of print. PMID: 41801216. Young-Wolff KC, Cortez CA, Alexeeff SE, Silver LD, Pacula RL, Slama NE, Padon AA, Satre DD, Campbell CI, Koshy MT, Does MB, Sterling SA. Adolescent Cannabis Use and Risk of Psychotic, Bipolar, Depressive, and Anxiety Disorders. JAMA Health Forum. 2026 Feb 6;7:e256839. doi: 10.1001/jamahealthforum.2025.6839. PMID: 41719031; PMCID: PMC12924094. Arseneault L, Cannon M, Poulton R, Murray R, Caspi A, Moffitt TE. Cannabis use in adolescence and risk for adult psychosis: longitudinal prospective study. BMJ. 2002 Han B, Compton WM, Einstein EB, Volkow ND. Associations of Suicidality Trends With Cannabis Use as a Function of Sex and Depression Status. JAMA Netw Open. 2021 Jun 1;4:e2113025. doi: 10.1001/jamanetworkopen.2021.13025. PMID: 34156452; PMCID: PMC8220498. Di Forti M, Marconi A, Carra E, et al. Proportion of patients in South London with first-episode psychosis attributable to use of high-potency cannabis. Br J Psychiatry. 2015. Di Forti M, Quattrone D, Freeman TP, et al. The contribution of cannabis use to variation in the incidence of psychotic disorder across Europe . Lancet Psychiatry. 2019. Di Forti M, Sallis H, Allegri F, et al. Daily use, especially of high-potency cannabis, drives the earlier onset of psychosis in cannabis users. Schizophrenia Bulletin. 2014. Jefsen OH, Erlangsen A, Nordentoft M, Hjorthøj C. Cannabis Use Disorder and Subsequent Risk of Psychotic and Nonpsychotic Unipolar Depression and Bipolar Disorder. JAMA Psychiatry. 2023;80:803–810. doi:10.1001/jamapsychiatry.2023.1256 Petrilli K, Ofori S, Hines L, Taylor G, Adams S, Freeman TP. Association of cannabis potency with mental ill health and addiction: a systematic review. Lancet Psychiatry. 2022. Robinson T, Ali MU, Easterbrook B, Hall W, Jutras-Aswad D, Fischer B. Risk-thresholds for the association between frequency of cannabis use and the development of psychosis: a systematic review and meta-analysis. Psychological Medicine. 2023. Myran DT, Pugliese M, Harrison LD, et al. Changes in Incident Schizophrenia Diagnoses Associated With Cannabis Use Disorder After Cannabis Legalization. JAMA Network Open. 2025. Osborne KJ, Barch DM, Jackson JJ, Karcher NR. Psychosis Spectrum Symptoms Before and After Adolescent Cannabis Use Initiation. JAMA Psychiatry. 2025. West ML, Sharif S. Cannabis and Psychosis. Child and Adolescent Psychiatric Clinics of North America. 2023. Purushothaman D, Tayfur SN, Song Z, Li F, Corbera S, Sykes LY, Riley S, Terashima JP, D'Souza DC, Tek C, Srihari VH. Changes in cannabis use following legalization: Effects in first-episode psychosis. Schizophr Res. 2026 Apr;290:86-87. doi: 10.1016/j.schres.2026.02.001. Epub 2026 Feb 10. PMID: 41671766. Lake S, Murray CH, Henry B, Strong L, White K, Kilmer B, Cooper ZD. High-Potency Cannabis Use and Health: A Systematic Review of Observational and Experimental Studies. Am J Psychiatry. 2025 Jul 1;182:616-638. doi: 10.1176/appi.ajp.20240269. Epub 2025 Mar 26. PMID: 40134269; PMCID: PMC12549548. Kansagara D, Terry GE, Ayers CK, D'Souza DC. Cannabis and Mental Health: A Review. JAMA Intern Med. 2026 Mar 9. doi: 10.1001/jamainternmed.2025.8215. Epub ahead of print. PMID: 41801216. Hsu M, Shah A, Jordan A, Gold MS, Hill KP. Therapeutic Use of Cannabis and Cannabinoids: A Review. JAMA. 2026 Jan 27;335:345-359. doi: 10.1001/jama.2025.19433. PMID: 41296368. Jefsen OH, Erlangsen A, Nordentoft M, Hjorthøj C. Cannabis use disorder and subsequent risk of psychotic and nonpsychotic unipolar depression and bipolar disorder. JAMA Psychiatry. 2023. Wilson J, Dobson O, Langcake A et al. The efficacy and safety of cannabinoids for the treatment of mental disorders and substance use disorders: a systematic review and meta-analysis The Lancet Psychiatry, 2026; 0 D’Souza DC, Perry E, MacDougall L, et al. The psychotomimetic effects of intravenous delta-9-tetrahydrocannabinol in healthy individuals: implications for psychosis. Neuropsychopharmacology. 2004.is a pioneering researcher, professor, and chairman of psychiatry at Yale, the University of Florida, and Washington University in St Louis.Self Tests are all about you. Are you outgoing or introverted? Are you a narcissist? Does perfectionism hold you back? Find out the answers to these questions and more with Psychology Today.
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