Cannabis Use in Adolescents

Abstract

As cannabis legalization expands across the United States, its use among adolescents remains a pressing public health concern.This analytic essay analyzes the current prevalence, patterns, and consequences of cannabis use in adolescents.While legalization has not substantially increased adolescent use, it has contributed to normalization and greater access, ultimately lowering perceived risk and complicating prevention efforts.Increasing product potency and diversified consumption methods (e.g., vaping, dabbing, edibles) add to these challenges.Adolescent cannabis use is associated with adverse outcomes in brain development, mental health, and physical health including its effects on the gastrointestinal, cardiovascular, respiratory and endocrine systems of body.Cannabis Use Disorder (CUD) is underdiagnosed and undertreated in youth, with no FDA-approved pharmacological treatments.Psychosocial interventions such as contingency management and cognitive behavioral therapy (CBT) show modest efficacy, particularly when involving families.This paper highlights the urgent need for targeted education, policy measures, and accessible evidence-based interventions specifically tailored to adolescent populations to address the evolving challenges of cannabis use and its long-term consequences. Current State and PrevalenceCannabis ranks as the most frequently used illicit drug and the third most common psychoactive substance, following alcohol and nicotine among adolescents. 1As of 2024, cannabis use among middle and high school students in the United States remained at historically low levels compared to the previous three decades, with a significant decline during the period of the COVID-19 pandemic.According to the Monitoring the Future 2025 (MTF) report, despite the reduction, prevalence remains notable, with 26% of 12th graders, 16% of 10th graders, and 7% of 8th graders reporting marijuana use in the past year.Daily use (defined as use on 20 or more days in the past month) also remained low, particularly among younger students, with just 0.7% of 8th graders and 5.1% of 12th graders reporting such frequent use. 2 Notably, a higher prevalence of cannabis use has been observed among adolescents identifying as LGBTQ+ (30.9%), mixed race (27.1%), and Native Hawaiian or Pacific Islander (23.1%), and smoking cannabis was the most common method of consumption.Evidence indicates that coping-related motivations for cannabis use have become more prevalent among adolescents, with over half (53%) reporting its use to relax.Girls were more likely than boys to endorse coping reasons, and Black and Hispanic adolescents reported such motivations at higher rates than their White peers. 3milarly, cannabis vaping, which had been increasing in previous years, has stabilized, with approximately 17.6% of 12th graders reporting past-year use. 2 The MTF 2025 report also highlighted the emergence of Delta-8 Tetrahydrocannabinol (THC), also known as "marijuana light" due to its intoxicating effects.Unlike adolescents, cannabis use has continued to rise among young adults aged 19-30, reaching record-high levels for both smoking and vaping cannabis. 2According to a report from the Substance Abuse and Mental Health Services Doi: 10.32481/djph.2025.09.03Administration (SAMHSA), 10% of individuals who use marijuana develop a dependence, and this risk increases significantly for those who begin using marijuana before the age of 18, with approximately 16-17% becoming addicted. 4nnabis is derived from the dried parts of the Cannabis sativa or Cannabis indica plant, including its leaves, flowers, stems, and seeds.While "cannabis" refers to the plant material itself, "cannabinoids" include both naturally occurring and synthetic compounds that interact with the body's endocannabinoid system.In recent years, the growing legalization of cannabis for medical use and the commercialization of recreational use have expanded access and led to a wider variety of available products.5 These modern cannabis products, whether natural or synthetic, often contain much higher concentrations of THC than in the past, with average potency rising from about 1%-4% in the mid-20th century to over 19% today.This increase in potency has raised concerns about adverse health effects, especially among frequent or inexperienced users.New methods of consumption, such as vaping high-potency concentrates like wax and shatter or ingesting edibles, have further elevated these risks.5-7 However, cannabis and cannabinoids also offer important therapeutic benefits.The FDA has approved specific cannabinoids for medical use; including, dronabinol and nabilone for chemotherapy-induced nausea and vomiting in 1985, dronabinol for appetite stimulation in wasting conditions such as HIV in 1992, and cannabidiol for treating seizures associated with Dravet syndrome and Lennox-Gastaut syndrome in 2018, as well as other seizure disorders in 2020.

Topics & Concepts