Cannabis: Legal doesn’t mean safe

There is a growing perception that cannabis is not harmful as more states pass laws for its legalization and decriminalization.  As of July 1^st, possession and use of small amounts of cannabis is legal for adults 21 years and older in Maryland. But legal does not always mean safe, especially for children and adolescents.  

Lets start with some definitions:

• Cannabis is a general term that refers to the 3 species of hemp plants:  Cannabis sativa, Cannabis indica, Cannabis ruderalis.
• Cannabinoids are the chemicals found within cannabis that interact with cannabinoid receptors in your body to cause various effects. These receptors are widely distributed throughout the body including many parts of the brain. There are 100+ different cannabinoids in the cannabis plant, along with other compounds, which are known to have neurologic effects. The two main cannabinoids are:
• THC: delta-9-tetrahydrocannabinol, the psychoactive cannabinoid, which causes a “high’
• CBD: cannabidiol
• Marijuana is a term that describes the dried leaves, flowers, stems, and seeds from the hemp plant containing many different cannabinoids including the mood-altering THC. 
• Hashish (hash) is made from the resin found on cannabis flower buds

Marijuana is a drug. The THC in marijuana is a mind-altering chemical that affects the way your brain works. Research shows that cannabis use in adolescence and early adulthood (when the brain is still developing, which is until at least 25 years old) is harmful. Short-term use can impair memory, learning, attention, coordination, perception, and judgment, and can cause paranoia, anxiety, and irritability.

Consistent marijuana use at an earlier age poses greater risk of long-lasting impairment on cognition, brain structure and function, and is associated with a potentially irreversible decline in intelligence quotient (IQ). Long-term use of marijuana during adolescence is also associated with higher rates and more severe course of mood, anxiety, and substance use disorders. There is some evidence linking regular marijuana use to an increased risk of schizophrenia and psychosis, including delusions and hallucinations.

As with alcohol, being “high” puts teens (all people really) at risk for physical danger when driving, bike riding, or playing sports. It is still illegal in all states to drive while under the influence of cannabis. When smoked, marijuana can irritate the lining of the mouth, throat and lungs; and has the same toxins and carcinogens (cancer-causing chemicals) as tobacco cigarettes. Secondhand marijuana smoke also contains the same toxins and carcinogens as directly inhaled smoke.

Cannabis is addictive. The concentration of THC in marijuana has significantly increased in recent years. Approximately 17% of adolescents who use cannabis develop a substance use disorder with this. More than 50% of all youths (12-17 years old) who seek treatment for substance use disorders are addicted to cannabis.

CBD (cannabidiol) is the chemical found in marijuana that doesn't contain THC and does not produce a high and is found in a wide range of over-the-counter health and beauty products and is also infused into food, drinks, and supplements. Although these products may claim to provide benefits, there is no significant research to back up the advertising. Though it's often well-tolerated, CBD can cause side effects, such as dry mouth, nausea, and fatigue. These products are also unregulated so the dosage is unreliable and there can be contamination with other potentially harmful ingredients. A study of 84 CBD products bought online showed that more than a quarter of the products contained less CBD than labeled, and THC was found in 18 of them. There are a lot of unknown factors with CBD products- unknown quantity of CBD in a product, unknown contamination, unknown dose for use, unknown interactions with other medication, unknown long term effects.

Only one marijuana-derived medication containing CBD has been approved by the FDA, Epidiolex, which is used to control seizures caused by severe forms of epilepsy, Lennox-Gastaut syndrome and Dravet syndrome. Epidiolex is not medical marijuana, it is FDA-approved and regulated like other medications with this approval.

Given all the negative health and brain development effects of marijuana in children and adolescents, the American Academy of Pediatrics (AAP) is opposed to marijuana use in this population and is opposed to “medical marijuana” outside the regulatory process of the FDA. The AAP also discourages the use of marijuana by adults in the presence of minors because of the important influence of role modeling by adults on child and adolescent behavior.

Millions of young people use cannabis, but most do not. Statistics from 2021 show the percentage of youths using cannabis or hashish in the past 12 months as the following: 8^th graders: 7%, 10^th graders: 17%, and 12^th graders: 30%

Talk with your children about the risks of marijuana. As with other risk-taking behaviors, it’s important that parents start the conversation when children are young and keep the dialogue going throughout development into tween, teen and young adult years. Look for opportunities when the topic can arise naturally, such as when it comes up in the media or when driving past a cannabis dispensary.