YoIt’s a minefield. Our young people face mind-numbing distractions, temptations, pressures and dangers. Some thrive in dangerous situations, but most teens don’t, and they may not even realize it. Enough denial: adolescence and cannabis are a mind-boggling combination.
Synthetic cannabinoids are artificial compounds that have similar effects to THC but with significantly greater potency.
Last week we began a two-part series on the damage cannabis can do to a teenager’s brain.
In the first part, we analyzed the article that gave rise to the series, as well as details about cannabis-induced damage. In addition, the link between cannabis use and psychosis was presented.
In Part 2, we’ll take a deeper look at cannabis and psychosis, discussing inconsistencies and safety, diminished perception of harm, and the sad state of care.
Quick note
The article that started it all appeared in Psychiatric times“Not Your Average Hazard: Cannabis Use, Psychosis, and the Youthful Brain,” August 21, 2024, was written by psychiatrists Nancy Shenoi, MD, and Richa Vijayvargiya, MD.
Let’s get to work…
Cannabis and psychosis
According to Dr. Shenoi and Dr. Vijayvargiya, 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. However, the nature and mechanisms of this relationship remain poorly understood.
Hypothesis
According to good doctors, one hypothesis is that tetrahydrocannabinol (THC) may increase psychosis by altering neurotransmitter activity. dopamine and glutamate.
The authors also argue that genetic and epigenetic factors may influence a person’s susceptibility to psychosis. They cite a genome-wide association study that found eight single-nucleotide polymorphisms associated with lifetime cannabis use. The study also found a genetic overlap in the risk of cannabis use and schizophrenia.
Another study they mentioned used Mendelian genetic analysis to find a causal relationship between cannabis use and an increased risk of schizophrenia.
Inconsistencies and cannabis safety
Synthetic cannabinoids: Spice
Shenoi and Vijayvargiya point out that the risks of modern cannabis products are amplified by inconsistencies in product composition, such as cannabinoid concentrations. Lack of oversight by the U.S. Food and Drug Administration (FDA) 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 due to inconsistent regulation, cannabis products can be mislabeled and vary in potency, contributing to mixed effects and safety concerns.
Synthetic cannabinoids
But there is more. The growing popularity of synthetic cannabinoids It has had dangerous consequences.
Synthetic cannabinoids are man-made compounds that have similar effects to THC, but with significantly greater potency. Synthetic cannabinoids, sometimes known as Spice or K2, act as agonists of cannabinoid receptors, while THC is a partial agonist.
Difficulty in detection due to structural diversity and rapid metabolism lead to an association with severe, even fatal, poisoning. And that means highly potent synthetic cannabis can promote the development of psychotic symptoms.
Reducing the perception of harm
Thus, the medical benefits of cannabis made headlines. As a result, medical marijuana is now legal in 90% of U.S. states and territories. In some states, it has been decriminalized or even legalized.
That’s great, except, as Shenoi and Vijayvargiya point out, the public tends to focus on that rather than the potential harms, and this is likely what has led to increased consumption.
Variants of medicinal cannabis
Medical cannabis products vary in composition and include dronabinol (THC), nabilone (a synthetic cannabinoid similar to THC), cannabidiol (CBD), and nabiximols (cannabis-derived extracts with equal parts THC and CBD).
These products together have been shown to have benefits in treating epilepsy, chronic pain, spasticity, appetite, Parkinson’s disease, sleep, substance use disorders, and Tourette’s syndrome. Just be aware that they may have adverse effects that may limit their use.
Proposed transfer of Department of Justice hours
Dr. Shenoi and Dr. Vijayvargiya are concerned. On May 16, 2024, the U.S. Department of Justice proposed transferring marijuana from Schedule I of the Controlled Substances Act (CSA) to Annex III.
Well, Schedule I drugs have no medical use and cannot be prescribed by a doctor, Schedule III drugs have a medical use and a low to moderate potential for physical and psychological dependence.
The change in classification would not legalize medical or recreational use of marijuana under federal law. However, doctors believe it would have a significant impact on perceptions of harm.
The perceptual consequences
Studies suggest that cannabis-related risk perception declined among all adult age groups between 2002 and 2019. And, imagine, illicit cannabis use and the prevalence of cannabis use disorders increased significantly, more so in states that passed medical marijuana legalization laws.
Dr. Shenoi and Dr. Vijayvargiya believe this is relevant because adolescents are particularly vulnerable while their brains are maturing, into early adulthood.
They may be unaware of both the general harms posed by cannabis and the true composition of the substances they are vaping and consuming.
Furthermore, chronic cannabis use is associated with an increased risk of schizophrenia, with schizophrenia appearing in early adulthood.
The sad state of care
Doctors note that, according to the American Academy of Child and Adolescent Psychiatry, only half of children and adolescents with diagnosable general mental health problems, let alone those with substance use disorders, receive the care they need.
Continued…
It is therefore even more important for psychiatrists and primary care providers to screen for cannabis use and cannabis use disorders and stay abreast of cannabis-related legislation that may impact the health and safety of patients. The cost is too high not to do so.
Don’t you agree?
Ignorance is not bliss
The minefield of youth: distractions, temptations, pressures and dangers that I can’t even fathom. Whether they realize it or not, what a way to grow up.
Let’s step up and help them by spreading information about the devastating effects of cannabis use among teenagers. Ignorance is not bliss.
If you haven’t read the first part, give it a chance.
Spice image: public domain
Be sure to read the full article at Psychiatric times: ““A risk out of the ordinary: cannabis use, psychosis and the young brain”
While we’re on the subject of helping our youth, check out these valuable articles…
Social media and youth mental health: a guide
The truth about social media and suicide: Molly Russell’s story
And those informative and inspirational articles about mental and emotional illnesses by Chipur. The titles are waiting for you.
After a decades-long battle with panic, generalized anxiety, mood swings and alcohol dependency, Bill finally found the passion of his life and work: helping those in the same situation. At age 49, he began graduate school and earned his counseling credentials. And he continues his service through Chipur and other projects.
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