As states across the country vote to legalize cannabis for medical or recreational use (or both), some parents feel unsure what this might mean for their children. Many are asking:
If cannabis is legal, does that send kids the message that it's safe to use?
If some people use it to try to relieve pain, sleep better or cope with the symptoms of a serious illness, will young people assume it's just another kind of medicine?
These are valid questions for all of us to consider—and in fact, they're part of a growing debate about cannabis use and the best ways to regulate it.
At the American Academy of Pediatrics (AAP), we are concerned about cannabis and the health of young people whose bodies and brains are still growing. As the conversation on cannabis continues, we are constantly reviewing the latest science so we can offer clear, helpful guidelines for pediatricians and families.
Cannabis, marijuana, weed, pot: are they all the same thing?
Many parents and caregivers feel overwhelmed by the different
names and terms for cannabis. Here's a quick review of what you need to know.
For centuries, cannabis went by street names such as pot, weed or grass. While you'll still hear these in casual conversation or even in news coverage,
cannabis is the term most often used for substances coming from the
cannabis sativa plant. (Other strains of the plant, such as
cannabis indica, are also used in cannabis products.)
Marijuana is often used interchangeably with cannabis, but there can be a difference. Marijuana is technically any part of the plant (or any product) with substantial levels of tetrahydrocannabinol, or THC. This is the mood-altering chemical that creates the "high" we associate with cannabis use. Some people avoid the term marijuana due to concerns about anti-Mexican sentiments associated with the term.
THC isn't the only active ingredient found in cannabis. In fact, there are more than 100 cannabinoids, including one you've probably heard of—cannabidiol, or CBD.
Hashish—also called hash—is made from the resin found mainly on cannabis flower buds.
Different forms of cannabis can be smoked, inhaled through water pipes, or "vaped" through pens and other aerosolizing devices. It can be added to foods, drinks or candies to make "edibles." Cannabis concentrates or oils can also be inhaled—this is called "dabbing."
What's happening with cannabis laws across the country?
37 states and the District of Columbia have passed laws allowing the sale and use of cannabis for medical purposes. Another
21 states (and D.C.) have legalized it for adult recreational use.
At the federal level, cannabis is still classified as a Schedule I drug, placing it in the same category as other drugs such as heroin and LSD. Many lawmakers and advocates feel cannabis should be reclassified so more research can be done to determine how cannabis affects our bodies, brains and behavior.
What should parents and caregivers know about cannabis?
Millions of young people use it, but most do not. In 2021, roughly 7% of 8th graders, 17% of 10th graders and 30% of 12th graders reported using cannabis or hashish in the past 12 months.
It has powerful effects on young brains. Did you know that your child's brain will continue to grow and develop until about age 25? This is one of many reasons the AAP believes that young people should not use cannabis. Research shows that cannabis use in adolescence and early adulthood can cause:
Difficulty thinking and problem-solving
Problems with memory and learning
Poor physical coordination and reaction time
Difficulty focusing and maintaining attention
It can hurt school performance. Academic struggles—and lower prospects for college and career success—can result when young people use cannabis often. In fact, the results of 48 studies show that kids who regularly use cannabis are much likelier to leave school before graduating or earning degrees.
It can make life more dangerous.
Driving, skateboarding, riding a bike or playing sports while high can lead to serious accidents. Teens under the influence may also take more sexual risks, leading to long-term consequences.
It can harm your child's lungs. Just like tobacco, marijuana smoke irritates the lining of the mouth, throat and lungs. In fact, pot smoke has many of the same toxins and cancer-causing chemicals as tobacco smoke. Marijuana use can trigger bronchitis and cause coughing and mucus production that interfere with healthy sleep. And in case you're wondering if vaping is safer, here are
facts about the dangers of vaping for kids.
It has been linked to mental health problems. Though we need more research to understand exactly why, cannabis use has been associated with depression and anxiety in teens. Cannabis has also been identified as a possible trigger for the
psychosis—or sudden break from reality—that can be an early sign of schizophrenia or bipolar disorder. There is evidence that young people who use cannabis face higher risks for suicidal thinking and actions.
It can be addictive. There's a widespread belief that you can't get hooked on cannabis, but research tells us differently. About 9% of all people who use cannabis develop substance use disorder with cannabis – but for those who start in their teens, the rate jumps to 17%.
Substance use disorder happens when your child can't stop using, even when they experience negative consequences or even want to quit. More than 55% of kids between 12 to 17 who seek treatment for substance use disorder are addicted to cannabis.
Where does the AAP stand on cannabis?
To protect the health and well-being of young people now and in the future, the AAP has made its position clear in
guidelines for pediatricians and families. We strongly believe that:
People under 21 should not use any form of cannabis.
Parents, relatives and other caregivers should set a good example and put children's safety first. This means avoid using cannabis in front of kids and keeping all cannabis products locked and out of reach.
Cannabis advertising and promotions that target young people should be banned.
Cannabis products should be sold in child-proof packaging.
Public health campaigns should help people of all ages understand why cannabis use is harmful to young bodies, brains and the future health and success of kids who start using it early.
What about cannabis-based medicines for kids with serious health problems?
The AAP supports the science-driven methods used by the Food and Drug Administration (FDA) to evaluate the safety and effectiveness of new drugs. Epidiolex, a drug that contains a purified form of cannabidiol (CBD), has been shown to be effective in controlling seizures caused by Lennox-Gastaut syndrome and Dravet syndrome. After extensive tests, the FDA has approved the use of Epidolex for kids as young as 2. Dronabinol and nabilone are THC-based medications FDA-approved for treatment of chemotherapy-induced nausea/vomiting.
Our hope is that, with continued research, more cannabis-based pharmaceuticals will be developed, and tested and reviewed by the FDA.
Should young people be arrested or jailed for using cannabis?
The AAP believes that legal penalties for using marijuana shouldn't ruin a child's future. Already, hundreds of thousands of young people have been arrested, jailed and imprisoned for cannabis use. Having a criminal record can make it hard—if not impossible—to get college loans, financial aid, housing and many kinds of jobs.
Even though we strongly believe cannabis use is dangerous for young people, we realize that some kids will experiment with it—and some will continue to use or develop addiction.
We believe treatment and prevention, not jail time, is the healthier approach. Decriminalizing cannabis use among minors will help ensure that young people get the help and support they need to quit.
What more can be done to protect our kids?
New research is urgently needed to help us learn more about how cannabis affects young people. Already, we have evidence that cannabis-based treatments may help adults living with serious health conditions. But without studies that specifically focus on kids, we can't be sure if these treatments are safe or effective for them.
We need to find ways to fund this research and make it easier to do so that we can understand everything about how cannabis really affects kids—and whether or not, in carefully tested forms, it might actually benefit some of them.
Our children rely on us to keep them safe and healthy. As attitudes and laws concerning cannabis change, the AAP urges parents and caregivers to act as advocates for young people. Know the facts, foster
an open dialogue with your children, and if you're worried about cannabis use, ask your pediatrician for guidance and support.