Potent marijuana is linked to impaired brain development

It is becoming clear that the adolescent brain is particularly vulnerable to cannabis, especially today's high-potency products, which puts teens at risk for impaired brain development. Mental health issues, including psychosis. and cannabis use disorder (CUD).

That was the message Dr. Yasmin Hurd, director of the Institute on Addiction Studies at Mount Sinai in New York, gave at a May 6 press conference. American Psychiatric Association (APA) 2024 Annual Meeting.

“We're actually in a historic time in that we now have highly concentrated, potent cannabis products that are administered through a variety of routes,” Hurd told reporters.

Heard noted that tetrahydrocannabinol (THC) levels in cannabis products have increased over the years, from about 2% to 4% to now 15% to 24%.

The impact of high-potency products and the increased risk of CUD and mental health problems, especially in adolescents, “needs to be taken seriously, especially in light of the current mental health crisis,” Dr. Hurd et al. I wrote this in the explanation about the trajectory. CUD is American Journal of Psychiatry.

Dramatic increase in teen cannabis use

recent research Researchers at Oregon Health and Science University showed that marijuana abuse among adolescents in the United States has increased dramatically by about 245% since 2000.

“Substance abuse is often driven by what's in front of you,” Dr. Nora Borkow, director of the National Institute on Drug Abuse, said in an interview. Medscape Medical News.

“Right now, cannabis is widely available. So what's going to happen? Cannabis becomes a drug that people consume. Nicotine is much more difficult to obtain, because nicotine is much more heavily regulated than cannabis. , the number of teens ingesting nicotine is lower than the number of teens consuming marijuana,'' Volkow said.

Cannabis exposure during neurodevelopment can alter the endocannabinoid system, which in turn may affect the development of neural pathways that mediate reward. Emotional regulation. Hurd told the press conference that there are multiple cognitive domains, including executive function and decision-making, learning, abstraction and attention, and that all of these processes are at the core of substance use disorders and other mental disorders.

Borkow said marijuana use during adolescence and young adulthood is “a very concerning age, because this is also the age when there is a high risk for psychosis, especially schizophrenia, and one study found that “It has been shown that high doses of cannabis use can cause psychotic episodes among young men.”

Hurd noted that while not all young people who use cannabis will develop CUD, “a significant number will develop CUD,” and large studies have consistently found two main factors associated with CUD risk. He said that it has been reported.

The first is age, with both onset and frequency of use occurring at a younger age. People who start using cannabis before the age of 16 are at the highest risk for CUD. The risk of CUD is also significantly increased among youth who use cannabis at least weekly, with prevalence being highest among youth who use cannabis daily. One large study has associated increased frequency of use with up to a 17-fold increase in his risk of CUD.

A second factor consistently associated with risk of CUD is biological sex, with men typically having higher rates of CUD.

Therapeutic challenges

For young people who develop CUD, accessing and accepting treatment can be difficult.

“It is concerning that less than 10% of youth who meet criteria for substance use disorders, including CUD, are receiving treatment, given the expected increase in CUD risk due to the increased potency of cannabis and cannabinoid products. That's what we should do,” Dr. Hurd and colleagues point out. in their commentary.

Another challenge is that treatment strategies for CUD are currently limited and consist primarily of motivational enhancement and cognitive behavioral therapy.

“New treatment strategies are clearly needed to address the growing challenge of CUD risk in teens and young adults,” Hurd et al. write.

“We know that most mental disorders have a developmental origin and that adolescence is a critical period of risk for cannabis use disorder,” Hurd told reporters.

But on a positive note, “the plasticity of the developing brain that makes it vulnerable to comorbidity in cannabis use disorder and mental illness also provides opportunities for prevention and early intervention to change that trajectory,” Hurd said. said.

The changing legal status of cannabis (the U.S. Drug Enforcement Administration is moving ahead with plans to move marijuana from a Schedule I to a Schedule III controlled substance under the Controlled Substances Act) will make addressing these risks more timely. It has become.

“As states compete to take advantage of tax dollars from the growing cannabis industry, the majority of those funds must go toward early intervention and prevention strategies to reduce the effects of cannabis on the developing brain.” Hurd et al. write.

This research was supported in part by the National Institute on Drug Abuse and the National Institutes of Health. Mr. Heard and Mr. Volkow have no relevant disclosures.