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'Weed' is not the same: modern cannabis causes serious health problems and addiction in adolescents

Modern cannabis products contain up to 100% tetrahydrocannabinol (THC), which is very dangerous for the health of teenagers and makes them addicted. The edition told in more detail The New York Times.

Photo: Shutterstock

Alice was 14 when she first started smoking cannabis.

It is odorless, which made it easy to hide from parents. And it was convenient - just pressed the button and inhaled. After 2-3 times she got hooked.

"This is madness. Crazy euphoria,” said Alice, now 18. Everything moved slowly. It was fun".

But over time, the euphoria turned into something more disturbing. Sometimes marijuana made Alice feel more anxious or sad. Once in the shower she lost consciousness and woke up half an hour later.

It wasn't just weed. What she bought from dealers usually contained about 90% THC, the psychoactive component of marijuana. But since these products were derived from cannabis and almost everyone she knew used them, the teen assumed they were relatively safe. She started smoking several times a day. Her parents found out about it only a year later, in 2019.

“We enrolled her in the program to help her with that. To be honest, they tried everything," Alice's father said of her addiction.

Already in 2020, she began to have mysterious bouts of illness, the girl vomited again and again. At first, she, her parents, and even the doctors were confused. During one of the episodes, according to Alice, she vomited for an hour in the bathroom of the mall: "It seemed to me that my body was floating in the air."

On another occasion, she calculated that she vomited at least 20 times in two hours.

It wasn't until 2021, after half a dozen emergency room visits for a stomach ailment, including several hospitalizations, that a gastroenterologist diagnosed her with cannabinoid hyperemesis syndrome, a condition that causes occasional vomiting in avid marijuana users.

On the subject: Schizophrenia and vomiting: weird and dangerous side effects of cannabis use

While recreational marijuana is illegal in the United States for those under the age of 21, it has become more widely available as many states have legalized it. But experts say today's high-THC cannabis products are vastly different from weed smoked decades ago - poisoning some hardcore users, including teenagers.

Marijuana is not as dangerous as a drug like fentanyl, but it can have potentially harmful effects, especially for young people whose brains are still developing. In addition to uncontrolled vomiting and addiction, adolescents who frequently use high doses of cannabis may also suffer from psychosis, which can lead to lifelong mental distress, an increased likelihood of depression and suicidal thoughts, changes in brain anatomy and connections, and poor memory.

But despite these dangers, the effectiveness of the products currently on the market is largely unregulated.

"I felt trapped"

In 1995, the average concentration of THC in cannabis samples taken by the DEA was about 4%. By 2017, it was 17%.

Meanwhile, average levels of CBD — a non-intoxicating compound in the cannabis plant associated with relieving cramps, pain, anxiety, and inflammation — are dropping in cannabis. Research shows that lower levels of CBD can potentially lead to a stronger addiction to cannabis.

THC concentrates “are as close to the cannabis plant as strawberries are to frozen strawberry scones,” writes Beatrice Carlini, a research fellow at the University of Washington Institute for Addiction, Drugs, and Alcohol, in a report on the health risks of highly concentrated cannabis.

While cannabis is legal for recreational use in 19 states and Washington, DC, and for medical use in 37 states and the DC, only Vermont and Connecticut have imposed THC concentration limits. Both prohibit concentrates above 60% except for pre-filled cartridges. But there is little evidence that such specific levels are somehow safer.

“In general, we do not support arbitrary potency limits as long as products are properly tested and labeled,” said Bethany Moore, spokeswoman for the National Cannabis Growers Association. She added that the best way to keep marijuana out of teens is to enact laws to allow the cannabis industry to replace illegal markets that do not respect age limits.

The Food and Drug Administration (FDA) has issued warnings about various cannabis products, including edibles, but so far no action has been taken by federal regulators to limit THC levels as cannabis is illegal at the federal level, said Gillian Schauer, Executive Director of the Cannabis Regulators Association.

California lawmakers are currently considering adding a mental health warning label to cannabis products indicating that the drug may contribute to mental disorders.

National surveys show that marijuana use among 8th, 10th and 12th graders has declined in 2021, due in part to the COVID-19 pandemic. However, over the two-year period from 2017 to 2019, the number of children who reported smoking marijuana in the last 30 days increased across all grades and almost tripled among high school students. In 2020, 35% of adults and 44% of college students reported using marijuana in the past year.

Alice stopped using cannabis before going to college, but soon discovered that almost everyone in the dorm used weed.

“Not just cartridges,” she said, referring to the cannabis cartridges used in vape pens, “but absolutely everything.”

After a few weeks, she started smoking concentrated THC again, she said, and she had dark thoughts. Sometimes she sat alone in her room and wept for hours.

Teenagers are particularly affected by cannabis

Michael McDonell, an addiction treatment expert at the Washington State University College of Medicine, said more research is needed to better understand how more common psychosis and cannabinoid hyperemesis syndrome have become among teens and other users of potent products.

However, he noted, "we definitely know that there is a dose-dependent relationship between THC and psychosis."

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One rigorous study found that the risk of a psychotic disorder was five times higher among daily users of high concentrations of cannabis in Europe and Brazil than among those who never used it.

Another study, published in 2021 in JAMA Psychiatry, reported that in 1995 only 2 percent of schizophrenia diagnoses in Denmark were related to marijuana use, but by 2010 that figure had risen to 6-8 percent, which the researchers attributed to an increase cannabis use.

Cannabinoid hyperemesis syndrome, which can often be relieved with hot baths and showers, is associated with long-term high-dose cannabis use. As with psychosis, it is not clear why some people develop it and others do not.

Dr. Sharon Levy, director of the Adolescent Addiction and Substance Use Program at Boston Children's Hospital, said "there is no doubt that higher concentration foods increase the number of people who have bad experiences with cannabis."

When her clinic opened in 2000, marijuana was illegal in Massachusetts. At the time, according to Dr. Levy, far fewer children were being treated with psychotic symptoms, "and we almost never saw cannabis hyperemesis syndrome."

Now, she says, those numbers are rising. Psychotic symptoms in this state, she said, could include hallucinations, trouble distinguishing between fantasy and reality, odd behavior (one young man spent days tying plastic bags in knots), or voices talking to them in their head.

"It's just weed"

Laura Stack, who lives in Highlands Ranch, Colorado, said that when her son Johnny first admitted to using marijuana at the age of 14, she said to herself, “Well, it's just weed. Thank God it's not cocaine."

She used marijuana a couple of times in high school and warned him that marijuana would "eat brain cells." But at the time, Laura wasn't too worried.

“But I had no idea,” she said, referring to how marijuana has changed in recent years. “So many parents, like me, are completely ignorant.”

Initially, her son had no mental health problems and did well in school. But he soon began using potent marijuana products several times a day, which, according to Stack, "drove him crazy."

By the time Johnny entered college, he had gone through various addiction treatment programs. According to Stack, the son became paranoid: he thought that the mafia was after him, and his college was the base for the FBI. At some point, when the guy left home, he threatened to kill the dog if his parents did not give him money. His mother later discovered that Johnny got his own marijuana card when he turned 18 and began selling it to younger children.

According to Stack, after several stints in psychiatric hospitals, doctors determined that Johnny had a severe case of THC abuse. He was prescribed an antipsychotic medication, which helped, but then he stopped taking it. In 2019, Johnny died after jumping from a six-story building. He was 19 years old. According to Stack, a few days before his death, Johnny apologized to her. He admitted that the weed had ruined his mind and life, after which he said, "I'm sorry and I love you."

On the subject: How different ways of using cannabis affect the body: benefits and harms

A recent study found that people who used marijuana were more likely to have suicidal thoughts, plans, and attempts than those who didn't use marijuana at all. Stack now runs Johnny's Ambassadors, a non-profit organization that educates communities about high-THC cannabis and its effects on the teen brain.

No "known safe limit"

It can be difficult to pinpoint exactly how much THC enters someone's brain when they use cannabis. This is because the dosage is affected not only by the frequency of use and the concentration of THC, but also by the rate of delivery of chemicals to the brain. In vaporizers, the delivery rate can vary depending on the base in which the THC is dissolved, the battery capacity of the device, and how warm the product becomes when heated.

Higher doses of THC are more likely to cause anxiety, agitation, paranoia, and psychosis.

“The younger you are, the more vulnerable your brain is to developing these problems,” Dr. Levy said.

According to the Substance Abuse and Mental Health Administration, youth are more likely to become addicted when they start using marijuana before age 18.

In addition, there is growing evidence that cannabis can change the brain during adolescence, when it is already undergoing structural changes. Until more is known, researchers and clinicians recommend postponing cannabis use until later in life.

“Kids ask me all the time, ‘What if I do this at least once a month, is that okay?’” says Dr. Levy. “All I can tell them is that there is no known safe limit.”

Dr. McDonell agreed that a complete abstinence from drug use is always the safest option, but noted that some children may need a more detailed conversation. He advised having open discussions about drugs with schoolchildren and teenagers, as well as educating them about the dangers of products in THC compared to those that mainly consist of CBD.

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