It’s a minefield. I can’t even begin to wrap my head around the distractions, temptations, pressures, and dangers our youth face. Curiously, one of them often gets a pass, but maybe that’ll change once the brain-blowing news circulates.
Substance use, including cannabis, may lead to loss of gray matter in areas such as the medial prefrontal cortex. When that happens, decision-making skills and impulse control become compromised.
A number of years ago, I was called to the E.R. to do a psychiatric admission assessment. All I knew going in was the patient had been transported by ambulance from his high school.
I arrived at the E.R. and made my way back to one of the awful rooms in which “high-risk” patients are held. As I got closer, I could hear this odd, unremitting laughter. And when I looked through the door glass, I saw a guffawing 17-year-old boy in a gown, alone, holding a soulless stare.
The boy was psychiatrically admitted with a diagnosis of cannabis-induced psychotic disorder.
Quick note
As you can imagine, there’s so much to discuss when it comes to adolescence and cannabis. So we’re going to handle the goods in two parts.
Here, we’ll review the article that started it all, “Not Your Average Hazard: Cannabis Use, Psychosis, and the Youthful Brain,” as well as the potentially tragic impact of cannabis on the adolescent brain.
We’ll come back in part two with cannabis and psychosis, inconsistencies and safety, and reduced perception of harm.
Let’s roll…
“Not Your Average Hazard: Cannabis Use, Psychosis, and the Youthful Brain”
Was doing my usual browsing on Psychiatric Times and an alarming article grabbed my attention. “Not Your Average Hazard: Cannabis Use, Psychosis, and the Youthful Brain was written by psychiatrists Nancy Shenoi, MD and Richa Vijayvargiya, MD, and posted on August 21, 2024.
Case study
The doctors begin their piece with a case study about 17-year-old “Valerie.” Of note, she had a difficult home life, her parents often verbally and physically abusing each other.
Two years prior to coming to the psychiatry clinic, a friend introduced her to synthetic cannabis vaping, which Valerie believed was cooler than nicotine. And she could justify its use by calling it a stress reliever. After all, medical cannabis was listed on her state’s compassionate use registry as a treatment for PTSD.
One day after school, Valerie was stunned when her friend shoved a vape pen in her hand as she ran by. And when she was asked by the principal to show the contents of her backpack, another vape pen appeared.
Valerie was suspended, transferred to an alternative school, and became a loner.
Spiraling downward
She went on solitary late night cannabis-vaping walks while her parents fought. Over the course of the school year, Valerie withdrew further – staying in her room and ceasing to consistently shower or brush her teeth.
Her mother brought her to the psychiatry clinic after the school notified child protective services about Valerie’s truancy.
Reality
Dr. Shenoi and Dr. Vijavargiya point out that Valerie’s experience with cannabis is not unusual. And, tragically, most teenagers don’t even know the contents of the vape products they consume.
Prevalence is high in Valerie’s age group. The Monitoring the Future survey of 2023 found the following percentages of youth using marijuana in the last year…
- 29% in 12th grade
- 18% in 10th grade
- 8% in 8th grade
Incidentally, vaping marijuana is often the choice of young people because it serves as a way to avoid detection. It can also be a way to supplement the marijuana they smoke (combustible).
The impact of cannabis on the adolescent brain
Brain MRI showing the medial prefrontal cortex area, which is often damaged as a result of adolescent cannabis use
Shenoi and Vijavargiya leave no doubt that cannabis use during adolescence can profoundly impact brain development.
As you may know, the brain develops until age 25, with an evolving of gray and white matter. Take a look at just a few of the things that are happening in the adolescent brain…
- Gray matter diminishes while white matter increases, impacting cognitive development
- Synaptic pruning takes place, promoting learning and brain efficiency
- The prefrontal cortex develops, which is responsible for the development of impulse control and appropriate social behavior
By the way, do you find this stuff interesting? Man, I do.
The brain-blowing
Now that we know some of the normal goings-on in the adolescent brain, let’s see what happens when substances make the scene.
Substance use, including cannabis, may lead to loss of gray matter in areas such as the medial prefrontal cortex. When that happens, decision-making skills and impulse control become compromised.
And if that isn’t bad enough, cannabis use may also negatively affect other cognitive domains – particularly learning, memory, attention, and working memory.
Mental health fallout
Have you ever heard of amotivational syndrome? It’s defined by apathy and decreased goal-directed behavior. Yes, it’s associated with cannabis use. And that’s a tough handicap for an adolescent who would like to be pursuing academic or vocational achievement. Think about what Valerie is facing.
The psychosis link
There is a two-way link of cannabis use with psychosis, as well as an increased risk of comorbid substance use disorders. In patients with preexisting psychosis, cannabis is associated with worse health outcomes and greater disease severity.
In adolescents, cannabis is also believed to affect synaptic plasticity and N-methyl-d-aspartate (NMDA) receptor–mediated memory formation. The impact on NMDA is a huge problem, as its receptors are involved in numerous important brain processes and illnesses.
Finally, from Dr. Shenoi and Dr. Vijavargia…
“Since adolescence to early adulthood is the time frame associated with the onset of schizophrenia, this can be a particularly fraught period.”
There’s a lot at stake.
Come on back for part two
Distractions, temptations, pressures, and dangers – it’s absolutely a minefield out there for our youth. And cannabis is one of the brain-blowing explosives.
No more passes, it’s time to do something about it. Information is a great start and circulation brings power.
Come on back for part two and we’ll talk about cannabis and psychosis, inconsistencies and safety, and reduced perception of harm. It’ll be here shortly..
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.
