Ask the Pediatrician: Does legal cannabis send a harmful message to kids?

​As states across the country vote to legalize cannabis for medical or recreational adult use (or both), some parents feel unsure about what this might mean for their children. Many are asking, if cannabis is legal, does that send kids the message it’s safe to use?

And 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 us to consider — and they’re part of a growing debate about cannabis use and the best ways to regulate it.

As a pediatrician and a parent, I am concerned about cannabis and the health of young people whose brains are still developing. As the conversation on cannabis continues, we are constantly reviewing the latest science so we can offer clear, helpful guidelines for families.

What should parents and caregivers know about cannabis?

Millions of young people use it, but most do not. In 2022, according to data from the Monitoring the Future survey of substance use behaviors, 8.3 percent of eighth graders, 19.5 percent of 10th graders and 30.7 percent of 12th graders reported using cannabis in the past 12 months.

It has powerful effects on young brains. Did you know your child’s brain will continue to grow and develop until about age 25? This is one of many reasons the American Academy of Pediatrics believes young people should not use cannabis. Research shows 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; and difficulty focusing and maintaining attention.

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 might also take more sexual risks, leading to long-term consequences.

It can harm your child’s lungs. Just like tobacco, cannabis smoke irritates the lining of the mouth, throat and lungs. In fact, cannabis smoke has many of the same toxins and cancer-causing chemicals as tobacco smoke. Cannabis use can trigger bronchitis and cause coughing and mucus production that interfere with healthy sleep.

It has been linked to mental health problems. Although 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, especially if cannabis use starts in the teen years. There’s a widespread belief that you can’t get hooked on cannabis, but research tells us differently. Fortunately, most people who use cannabis do not become addicted. But, according to the Centers for Disease Control and Prevention, 3 in 10 people who use cannabis show signs of a cannabis use disorder. Furthermore, for those who start in their teens, their risk of developing a cannabis use disorder is even higher than for those who start using as an adult.

Substance use disorder happens when your child can’t stop using, even when they experience negative consequences or want to quit. Cannabis is the most common substance used by teens seeking treatment.

New research is needed to help us learn more about how cannabis affects young people. A few cannabinoid-based medications have been approved by the U.S. Food and Drug Administration to treat some serious seizure disorders and chemotherapy-induced vomiting in children. Additional research is needed to develop and test other medications to determine what pharmaceutical products are safe and effective in children.

Our children rely on us to keep them safe and healthy. As attitudes and laws concerning cannabis change, I urge 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. For more information, go to HealthyChildren.org.

Dr. Maria H. Rahmandar is a pediatrician specialized in adolescent medicine.