It’s a minefield. Our youth face distractions, temptations, pressures, and dangers that boggle the mind. Some thrive in peril, but the majority of teens don’t – and may not even realize it. No more denial, adolescence and cannabis is a brain-blowing combination.
Synthetic cannabinoids are artificial compounds that have effects similar to those of THC but with significantly greater potency.
We began a two-part series a week ago on the damage cannabis can inflict on an adolescent brain.
In part one, we discussed the article that prompted the series as well as the potentially tragic impact of cannabis on the adolescent brain. The link between cannabis use and psychosis was also introduced.
Here in part two we’ll dig into more about cannabis and psychosis, inconsistencies and safety, and reduced perception of harm.
Quick note
The article that started it all, dated August 21, 2024, appeared on Psychiatric Times. “Not Your Average Hazard: Cannabis Use, Psychosis, and the Youthful Brain” was written by psychiatrists Nancy Shenoi, MD and Richa Vijayvargiya, MD.
Let’s get busy…
Cannabis and psychosis
Dr, Shenoi and Dr. Vijayvargiya point out that the link between cannabis use and the onset of psychosis has long been an area of interest and speculation.
Observational studies have consistently suggested an association between cannabis use and schizophrenia. Thing is, though, the nature and mechanisms of the relationship remain poorly understood.
A hypothesis
According to the good doctors, one hypothesis is that tetrahydrocannabinol (THC) may augment psychosis via alteration of the activity of the neurotransmitters dopamine and glutamate.
Shenoi and Vijayvargiya believe that genetic and epigenetic factors may impact one’s susceptibility to psychosis.
For backup they cite a genome-wide association study that found eight unique single nucleotide polymorphisms associated with lifetime cannabis use. The study also found genetic overlap in risk for cannabis use and schizophrenia.
Another study used a Mendelian genetic analysis to find a causal relationship of cannabis use with increased schizophrenia risk.
Cannabis inconsistencies and safety
Synthetic cannabinoids: Spice
Shenoi and Vijayvargiya emphasize that the risks of modern cannabis products are amped up by inconsistencies in product composition, such as cannabinoid concentrations. Lack of US Food and Drug Administration (FDA) oversight is also a contributing factor.
For reference, take a look at FDA Regulation of Cannabis and Cannabis-Derived Products, Including Cannabidiol (CBD).
Cultivation methods, processing techniques, and storage conditions can influence the THC content of cannabis products. And because of inconsistent regulation, cannabis products may contain incorrect labeling and be of varied potency, contributing to heterogeneous effects and safety problems.
Synthetic cannabinoids
But there’s more. The increased popularity of synthetic cannabinoids has generated dangerous consequences.
Synthetic cannabinoids are artificial compounds that have effects similar to those of THC but with significantly greater potency. Synthetic cannabinoids, sometimes known as Spice or K2, act as full agonists of cannabinoid receptors, whereas THC is a partial agonist.
Difficulty in detection due to structural diversity and rapid metabolism lead to an association with severe intoxications, even fatalities. And that means highly potent synthetic cannabis may promote development of psychotic symptoms.
Reduced perception of harm
So the medical benefits of cannabis got headlines. As a result, medical marijuana is now legal in 90% of US states and territories. In some states it’s been decriminalized or even legalized.
That’s great, except as Shenoi and Vijayvargiya point out, the public tends to focus on that instead of potential harms. And it’s likely to have led to increased use.
Medical cannabis variations
Medical cannabis products vary in their composition and include dronabinol (THC), nabilone (synthetic cannabinoid similar to THC), cannabidiol (CBD), and nabiximols (cannabis-derived extracts with equal parts THC and CBD).
These products collectively have been shown to have benefits in epilepsy, chronic pain, spasticity, appetite, Parkinson disease, sleep, substance use disorders, and Tourette syndrome. Just keep in mind, they can have adverse effects that may limit their use.
Department of Justice schedule transfer proposal
Shenoi and Vijayvargiya are concerned. On May 16, 2024, the US Department of Justice proposed transferring marijuana from Schedule I of the Controlled Substances Act (CSA) to Schedule III.
Okay, Schedule I drugs have no medical use and can’t be prescribed by a physician, Schedule III drugs have a medical use and low to moderate potential for physical and psychological dependence.
The change in scheduling wouldn’t legalize medical or recreational use of marijuana under federal law. However, the docs believe it would have a major impact on perception of harm.
The perceptual fallout
Studies suggest that perception of cannabis-related risk decreased among all adult age groups from 2002 to 2019. And, go figure, illicit cannabis use and the prevalence of cannabis use disorders increased significantly more in states that passed medical marijuana legalization laws
The docs believe this is relevant because adolescents are particularly vulnerable while their brains are undergoing maturation until young adulthood. They may be unaware of both the general harms posed by cannabis and the true composition of the substances they’re vaping and consuming.
Furthermore, chronic cannabis use is associated with increased schizophrenia risk, and schizophrenia has its onset in early adulthood.
Sadly, per the American Academy of Child and Adolescent Psychiatry, only half of children and adolescents with general diagnosable mental health problems, let alone those with substance use disorders, receive the care they need.
Dr. Shenoi and Dr. Vijayvargiya…
It is thus even more important that psychiatrists and primary care providers screen for cannabis use and cannabis use disorders and stay abreast of cannabis-related legislation that can impact patient health and safety. The cost is too great not to.
Wouldn’t you agree?
Ignorance ain’t bliss
The minefield of youth: distractions, temptations, pressures, and dangers that I can’t begin to wrap my head around. Whether they realize it or not, what a way to have to live.
Let’s step up and help them by spreading the word on the brain-blowing effects of adolescent cannabis use. Ignorance ain’t bliss.
Again, if you haven’t read part one, give it a go.
Spice image: Public domain
Be sure to read the full piece on Psychiatric Times: “Not Your Average Hazard: Cannabis Use, Psychosis, and the Youthful Brain”
As long as we’re talking about helping our youth, check-out these worthy articles…
Social media and youth mental health: An advisory
The truth about social media and suicide: The Molly Russell story
And those Chipur emotional and mental illness info and inspiration articles. The titles await.
After a decades-long battle with panic, generalized anxiety, fluctuating moods, and alcohol dependence; Bill finally found his life’s passion and work – lending a hand to those in the same boat. At age 49 he hit grad school and earned his counseling credentials. And he continues his service through Chipur and other projects.