Adolescents and cannabis in the 21st century: Current Problems in Pediatric and Adolescent Health Care

The past 30 years in the United States have seen a shift towards increasing decriminalization and legalization of cannabis products. Despite the evolving legal landscape, adolescent cannabis use appears to have remained relatively stable, while use among young adults has increased. Cannabis-related emergency department visits, hospitalizations, and unintentional ingestions, particularly among young children, have all increased, with the availability of higher potency products such as concentrates and edibles likely playing a role. Cannabis intoxication should be suspected in youth presenting with altered mental status, somnolence, anxiety or euphoria, tachycardia, and conjunctival injection. In adolescents presenting with cyclic vomiting, cannabinoid hyperemesis syndrome should be considered. Long-term effects of heavy and frequent cannabis use in adolescents such as cognitive impairment, increased risk of psychosis, and the development of cannabis use disorder remain of particular concern as the tetrahydrocannabinol (THC) content of cannabis products has continued to increase in recent years. Ongoing surveillance to monitor trends in adolescent cannabis use, public education on the health effects of cannabis use in adolescence, and expanding access to substance use and mental health treatment will be crucial in the coming years.