What 2021 Taught Us About Youth Cannabis Use
How the research could shape federal laws going forward.
Cannabis' possible effects on young people will continue to be of the utmost concern as the legal marketplace takes shape. Throughout 2021, several studies helped further comprehension of an area that still suffers from a significant education gap.
While nothing became definitive in 2021, research helped advance understanding for several critical areas.
Legalization seemingly not increasing teen use
Minors don't appear to be using cannabis more as states legalize – or at all in some cases.
Medical and cannabis professionals wouldn't confirm that teen use was in the downturn. However, 2021 offered substantial studies and additional comments to suggest that may be the case.
A September 2021 study of high school use between 1993 and 2019 used the Youth Risk Behavior Survey (YRBS) to determine that adult-use laws did not increase teen use. After two years, states with adult-use laws saw decreases in usage.
Substance Abuse and Mental Health Services Administration (SAMHSA) released its annual health and drug use survey from the National Survey on Drug Use and Health (NSDUH).
The October 2021 report saw usage among minors aged 12-17 drop from 13% to 10% in 2020–however, the decline could be associated with research methodology changes due to the pandemic. 49.6 million Americans in the age group reported using cannabis during the analysis period.
Nicolas Schlienz, Ph.D., research director at cannabis education platform Realm of Caring, was encouraged by the results but urges additional analysis.
"A lot of the literature on cannabis legalization is difficult to compare due to differences in state policies, the states included in each paper's analysis, the time periods that researchers are examining, the way use is defined, and other issues," Schlienz said.
Still, optimism is high with more encouragement rolling in. Several sources also pointed towards August comments from National Institute on Drug Abuse (NIDA) Director Nora Volkow, who admitted to being wrong about the usage hypothesis.
Vaping concerns remain
Teen vaping is on the rise, regardless of the content being vaporized. A September 2021 survey from the Center for Disease Control (CDC) and Food and Drug Administration (FDA) reported that 2 million teens use e-cigarettes.
An October 2021 study of U.S. and Canadian vaping showed trends upward, with teens starting to prefer higher potency cannabis products over lower dosed products and nicotine options.
Codi Peterson is a pediatric pharmacist and educator with an M.S. in medical cannabis science from the University of Maryland. Peterson said the discretion of a vape pen allows it to be used in most places, increasing the risk of an unhealthy relationship consisting of overuse and possible addiction.
"As far as I can tell, little has been done to curb the problem of teen vape use," Peterson said.
Lo Friesen, CEO of cannabis extracts processor Heylo, agrees that teen use should be curtailed. She said that efforts need to come from more than the cannabis industry.
She added that the 2019 EVALI lung crisis heightened industry needs to combat the unregulated market by further restricting non-medical access to minors and highlighting concerns on glycol and glycerin additives.
"We still have a lot of work to do with respect to better regulations and education for consumers, but reducing teen cannabis vaping is not exclusively the responsibility of the cannabis industry," Friesen said, urging additional outside action.
Impact on developing brains remains
Concerns over the impact of cannabis on neuro-development continues, with adults up to 25 potentially impacted. A June investigation using neuroimaging and behavioral data found that cannabis was associated with cortical thinning in predominantly prefrontal regions in ages 14 to 19. The findings suggest that use could affect development in parts of the brain, particularly those rich in CB1 receptors.
In September, a study of alcohol and cannabis use on developing brains resulted in "small to moderate" disruptions in the brain's structure and function while also creating neurocognitive impairments.
Physicians noted concern, but Peterson eased those to some degree.
"At this time, the therapeutic use of medical cannabis has never been associated with adverse effects on brain development–only unmonitored recreational use has," he stated.
Additional education needed
Cannabis often has education gaps, and youth consumption may be the most concerning at this time.
Adryan Corcione, a journalist with a background in teen drug use for Teen Vogue, Filter Mag and Truthout, said comprehensive drug education is needed.
"Rather than a fear-mongering abstinence-only curriculum, youth need to understand the risks that come with teen cannabis consumption, including the very real punitive consequences for possessing and distributing cannabis," said Corcione who also called for an end of youth cannabis-based incarcerations.