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Cannabis use among teens isn’t on the rise, but misuse of the substance has increased. Javi Julio Photography/Getty Images
  • Researchers report that misuse of cannabis among adolescents is now higher than alcohol misuse.
  • Experts say that edible cannabis products, in particular, are a problem.
  • They note that cannabis can have an effect on brain development in people under 25 years of age.

Cannabis misuse among children ages 6 to 18 rose from 2000 to 2020, while alcohol misuse has fallen, a new study reports.

All told, cannabis misuse cases have risen 245% since 2000 and more than 80% of those cases occurred among teenagers, researchers reported in their study.

All forms of marijuana use increased, but researchers said edible marijuana drove most cases of misuse. More male children were likely to misuse cannabis than females. About 58% of cases involved males while 42% were female.

Alcohol misuse cases overtook marijuana misuse cases from 2000 to 2013. However, in 2014, those positions reversed and cannabis misuse has remained the more dominant, the researchers said.

“Since 2014, marijuana exposure cases have exceeded ethanol cases every year and by a greater amount each year than the prior,” Dr. Adrienne Hughes, a study author and an assistant professor of Emergency Medicine at Oregon Health & Science University, said in a press release. “These findings highlight an ongoing concern about the impact of rapidly evolving cannabis legalization on this vulnerable population.”

“It’s not surprising to read, but peer-reviewed data, in particular, is always important,” said Aaron Weiner, Ph.D., a licensed clinical psychologist and the president of the Society of Addiction Psychology.

“I doubt what we’re seeing here is a shift of someone saying, ‘Oh, I was using alcohol and I’m going to use marijuana instead.’ My hunch is what’s happening is that normalization campaigns are surging in a lot of states,” Weiner told Healthline. “As normalization increases, today’s teenagers are soaking that in. And that’s why we’re seeing [cannabis misuse] rates increase.”

It’s important to note that this study covers “drug abuse or misuse” trends, a specific category based on cases reported to the National Poison Data System through 2020.

From that dataset, only 32% of cannabis misuse or abuse cases resulted in “worse than minor clinical outcomes,” the authors report.

“We know from the 2022 Monitoring the Future survey that teen use of cannabis decreased in 2021, after staying flat for over 10 years,” Daniele Piomelli, Ph.D., the director of the University of California Irvine Center for the Study of Cannabis, told Healthline.

Piomelli said the figures suggest less of a disturbing trend around cannabis use than the specifics of cannabis products that can lead to misuse or abuse.

“It is much easier to overdose with a cannabis edible than with a joint or a vape pen,” he said. “With smoking or vaping, the user can measure in real-time the drug’s effects and adjust intake accordingly. By contrast, once a candy containing a large amount of THC is ingested, the user loses all control over its effects. The ingested drug will be absorbed, whether or not the user likes the result.”

Dr. Joseph Tasosa, a psychiatrist and addiction medicine specialist at Kaiser Permanente in Falls Church, Virginia, agreed.

“Edibles are often packaged in attractive and flashy wrappers and come as gummies, cookies, and other sweets that attract the attention of kids and teens. It makes them look harmless,” he told Healthline. “In reality, edibles can contain very high levels of cannabis that are dangerous to consume, especially in excess.”

“Cannabis can also negatively impact young, developing brains [and] can cause a variety of serious psychiatric issues in children and teens, including drug-induced psychosis or drug-induced anxiety attacks,” he added.

As we enter a period of increased marijuana legalization nationwide — 21 states plus Washington D.C. and Guam have legalized recreational marijuana for adults outright — parents and policymakers might need to adjust to this “new normal.”

“We need to take a page out of alcohol education’s playbook and call marijuana for what it is: namely, a seriously dangerous substance in the developing brain,” said Joseph Garbely, DO, a psychiatrist specializing in addiction medicine as well as the medical director of Brookdale Premiere Recovery Center in Pennsylvania.

“We need to regulate the forms that edible marijuana takes and eliminate subliminal marketing to our young people. Parents using edible marijuana medicinally or recreationally need to take responsibility by locking up their supply and explaining the real perils that develop when their children and teens will experience if they ingest the edibles,” Garbely told Healthline.

Piomelli shared those concerns, although he noted that parents should take a pragmatic approach.

“A certain percentage of teens will experiment with drugs, no matter what adults say or do,” Piomelli said. “It is the adults’ responsibility to make that exploration safer. Taking a prohibitionist ‘just say no’ approach has not worked in the past. We should build on that simple fact to develop evidence-based policies aimed at reducing harm.”