In recognition of Mental Health Awareness Month, we want to bring special attention to the mental health crisis affecting teens in our community.
Mirroring a national trend, 45% of California youth between the ages of 12 and 17 report having recently struggled with mental health issues, with nearly a third of them experiencing serious psychological distress that could interfere with their academic and social functioning, according to a UCLA policy brief released last year. The co-lead author of the study, D. Imelda Padilla-Frausto, points out, “With almost half of California’s adolescents experiencing moderate to serious psychological distress, there is an urgent need to protect their psychological and emotional well-being.”
Marin Residents for Public Health Cannabis Policies is particularly concerned about the introduction of high potency THC into the recreational cannabis marketplace, and the effect these ultra potent products have on the mental health of adolescents.
THC concentrates are a popular form of cannabis used today by young people. With names like “shatter”, “budder” and “crystalline”, they are distilled extracts and concentrated forms of cannabis which contain extraordinarily high levels of THC, from 40-95%, compared to 4-7% THC in the marijuana available in the 1990s. Even the familiar “flower” form of cannabis is averaging 20-30% THC in today’s marketplace.
The new, high potency products have been shown to impact the mental health of adolescents and young adults in particular. Nerves in the brain are not fully insulated with a protective sheath of fatty tissue (myelin) until the age of 26 which makes them particularly vulnerable. Studies now show that increased THC potency cannabis products, when used by youth, are associated with anxiety, panic disorders, suicidal ideation, self harm and even psychosis.
According to the International Review of Psychiatry (May 2020), complex relationships exist between cannabis use and mood and anxiety disorders. Many cannabis-using youth self-report using cannabis to ‘self-medicate’ depression and anxiety, and to reduce stress. But a comprehensive inspection of the research by this journal reports the majority of longitudinal studies show that, in reality, the opposite association exists. Statistically, adolescent-onset cannabis use is associated with increased likelihood and poorer course of mood and anxiety disorders during adolescence.
Lancet Psychiatry (April 2019) published the first longitudinal population-based birth cohort study to explore predictors of future suicide attempts among adolescents. Among the youth participants with suicidal thoughts, the second strongest predictor of transition to actual suicidal attempts was cannabis use. (The strongest predictor was previous non-suicidal self-harm.)
A recent NIH analysis of survey data from more than 280,000 American young adults ages 18-35 showed that cannabis use was associated with increased risks of thoughts of suicide (suicidal ideation), suicide plan, and suicide attempt (published in JAMA Network Open, June 2021).
Among all cannabis-related mental health outcomes, evidence is strongest for a relationship between adolescent-onset cannabis use and psychotic disorders. A meta-analysis of 18 studies (from a narrative review of 63 studies), reports that adolescent cannabis use was found to increase risk for psychosis and predict earlier onset of psychosis (Substance Abuse, February 2021). And according to DeForti et al (November 2014), early-onset daily use of high-potency cannabis starting before age 15 poses a five- to six-fold greater risk for the development of a psychotic disorder compared to non-use.
Distressing new trends among adolescents reveal use of high potency marijunana concentrates is dramatically on the rise. The 2019 Healthy Kids Survey in Colorado reported 52% of high school students who used marijuana in the last 30 days dabbed it - a 50% increase from their 2017 survey. (Dabbing is a delivery method using high potency marijuana concentrates.) Additionally, a study in Pediatrics (September 2019) entitled Cannabis Concentrate Use in Adolescents surveyed 47,142 adolescents in Arizona and found nearly three-quarters who used cannabis reported using a concentrate.
Although our latest Marin Healthy Kids Survey (2018) didn’t include a question about dabbing or concentrates, it would be naive to think the same trends are not occurring here as well. Marin youth have reported some of the highest levels of drug use in California. For example, data from Tam Union district revealed 18 percent of ninth-graders and 36 percent of 11th-graders reported marijuana use over the past 30 days. When compared with Colorado youth, where 11 percent of ninth-graders and 22.1 percent of eleventh- graders disclosed current use, Marin’s youth numbers dwarfed even Colorado’s teens.
A disproportionately higher rate of Marin’s teens and young adults have suicidal thoughts or mental health incidents than their population totals would suggest, according to a new county report released in 2021 by Marin Health and Human Services’ Behavioral Health and Recovery Services. “While youth between the ages of 15 and 24 represent 10% of the population, they represent 44% of emergency room visits, 36% of hospitalizations and 10% of the deaths,” the report said.
We need to pay attention to the mental health of Marin County teens. One way you can do this is to talk to your teen about cannabis and mood disorders. Explain to them that even though they may think cannabis will help emotional troubles, the research on youth shows otherwise. Point out that cannabis use, especially with high potency products, may contribute to emotional distress and feelings of hopelessness rather than alleviating them. Most importantly, listen to their concerns, be supportive, and get them professional help if they need it.
For more information on resources for suicide prevention:
Visit the Marin Outreach and Prevention Team, part of Marin Behavior Health and Recovery Services at https://prevention.marinbhrs.org/
Marin’s network has also created a new crisis text line. Teens can text MARIN to 741741 to connect with a friendly voice.
There is a 24 hour national telephone hotline at National Suicide Prevention Lifeline, 800-273-8255. Spanish speakers can call 888-628-9454.
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