New American Academy of Pediatrics report calls on doctors to help protect patients' developing brains and bodies from the health harms of marijuana amid increased legalization
With marijuana now legal for recreation or medical use in a majority of states—and access and attitudes toward it relaxing as a result—a new American Academy of Pediatrics (AAP) clinical report in the March 2017 Pediatrics equips doctors to advise patients and parents about harms the drug can cause, particularly for teens.
The report, "Counseling Parents and Teens About Marijuana Use in the Era of Legalization of Marijuana" (published online Feb. 27), highlights the dangers of a climate in which the drug increasingly is seen as acceptable, safe and therapeutic.
Currently, 29 states and the District of Columbia allow medical or recreational marijuana use. Although the laws are aimed at adults over age 21, the increased availability of marijuana in the community can create short- and long-term harm to youths, according to the AAP.
"Marijuana is not a benign drug, especially for teens. Their brains are still developing, and marijuana can cause abnormal and unhealthy changes," said Seth D. Ammerman, MD, FAAP, co-author of the AAP clinical report and former AAP Committee on Substance Use and Prevention Committee member.
Adolescents who use marijuana regularly can develop serious mental health disorders such as addiction, depression and psychosis. Marijuana causes dulled sensory awareness, motor control, coordination, judgment and reaction time, all of which can cause accidents involving teens who drive. Marijuana can impair lung function. It also causes decreased short-term memory and concentration, attention span and problem-solving skills, which can interfere with learning.
In the past few decades, the concentration of tetrahydrocannabinol (THC), the psychoactive substance in marijuana plants, has increased considerably. Research shows it rose from roughly 4% in 1995 to 12% 2014, and current strains contain concentrations as much as 20%—increasing the risk of overdose and addiction.
Overall, 9% of people experimenting with marijuana become addicted. That percentage increases to 17% among people who began using marijuana in adolescence, and to 50% among teens who smoke marijuana daily.
Despite this, the U.S. Department of Health and Human Services' National Survey on Drug Use and Health found the percentage of 12- to 17-year-olds who perceive "great risk" in smoking marijuana once or twice a week dropped from 55% in 2007 to 41% in 2015. The same survey linked decreases in perceived risk with increases in use.
Studies have found THC may be helpful for adults in reducing side effects of chemotherapy or pain from certain chronic conditions. But the AAP asks pediatricians to help counteract the perception that marijuana use is therefore "harmless" – especially for teens. The AAP recommends pediatricians offer guidance during office visits, and advise parents against using marijuana around their children.
"Parents who use marijuana themselves may not fully realize the effect this can have on their children," said Sheryl A. Ryan, MD, FAAP, lead author of the clinical report and chairperson of the AAP Committee on Substance Use and Prevention. "Seeing parents use marijuana makes kids more likely to use it themselves, whether or not their parents tell them not to, because actions speak louder than words," she said.
Parents who use marijuana at home also expose their children to secondhand smoke, Ryan said, or accidental pot poisoning from an increasing array of edible marijuana products such as pot-infused candies, baked goods and beverages that contain high amounts of THC yet are often indistinguishable from ordinary treats.
In addition, being "high" on marijuana interferes with a parent's ability provide a safe environment, especially for younger children, Dr. Ryan said.
The AAP urges pediatricians screen adolescents and preteens for substance use, offering interventions and treatment referrals and motivational reinforcement techniques to abstain and resist peer pressure.
