Cannabis Toolkit for Parents and Mentors

Teens are getting mixed signals about the risks of cannabis use. More states across the United States are legalizing adult-use cannabis. As of August 2023, 44 states in the U.S. have legalized medical cannabis use and 23 states have legalized adult use. 

Conflicting information about cannabis makes it difficult for teens to know how much of a risk it truly is. They may also have heard that there is something called ‘medical cannabis’ that can be used to treat certain medical problems. In school, they may learn about the harmful effects that it can have on youth brain development and yet they may see their favorite celebrity or social media influencer talking about the benefits of cannabis. 

Where does all this conflicting information leave teens? What are they supposed to believe is true about cannabis? This inconsistency makes it hard for them to evaluate the risks and consequences of underage cannabis use.

You Can Help Guide Teens 

That’s where you come in. We may believe that teens don’t listen to us, but they take in more than we think. Although it can be challenging, it’s crucial that parents and other caring adults know how to discuss cannabis with teens because research shows that you can significantly influence a teen’s decision to use substances. 

This toolkit is designed to provide you with the facts, science, and approaches you need to have thoughtful, productive, and effective conversations with teens about cannabis. For those moments when a teenager tries to catch us off guard, it’s helpful to have a few tools in your back pocket to show them you did your homework.

The General Risks 

Substances like cannabis can have negative effects on teens. 

Research has shown that cannabis may: 

• Impair learning, short-term memory, attention, decision-making, problem-solving and motivation, which can affect school performance. 
• Increase the risk of chronic cough, bronchitis, and asthma severity.
• Increase the risk of schizophrenia or other serious mental health disorders that are similar to schizophrenia, with the highest risk among those who begin using at a young age, especially among individuals who may already be at risk because of genetics. 

Your Influence 

What you say and do matters. If you avoid talking with teens about cannabis, teens in your life might think the topic is off limits. It’s better to let them know they can openly discuss it with you. That way, they’ll receive the necessary information to make healthy decisions for themselves.  Regular conversations with teens about cannabis use in middle and high school is one of the best ways that you can help prevent early experimentation. 

What You Can Do

• Learn about risks of underage cannabis use. 
• Start the conversation early on and talk often about making safe and healthy choices. 
• Model healthy and safe behaviors. 
• Provide and discuss ways to say no to cannabis. 
• Ensure the teen in your life knows you disapprove of underage cannabis use.

Cannabis – also known as marijuana, pot, kush, and weed, among other names – is a plant that has been used for a variety of reasons for many years. Cannabis contains hundreds of different chemicals, including the well-known cannabinoid tetrahydrocannabinol (THC), that we’ll describe later. 

Consuming Cannabis Responsibly 

What are the different types of cannabis products available? 

Absorption

• Edibles: Cannabis is combined with different foods (gummies, baked goods, drinks) 
  and eaten. 
• Tinctures: Cannabis liquids that are placed under the tongue with a dropper or syringe. 
• Capsules/Tablets: Cannabis is swallowed in the form of a capsule or tablet, similar to a pill that does not contain cannabis. 
• Lozenges/Films: Cannabis concentrates are made into lozenges or films that dissolve in the 
  mouth or under the tongue.

Inhalables

• Pre-Rolls: Dried cannabis also known as “flower” is “rolled” into a cigarette-like or cigar-like shape using different kinds of smoking (rolling) paper.
• Concentrates: Cannabis concentrates, called dabs, shatter, and wax, are placed in and inhaled from a smoking device.
• Pipes & Bongs: Dried flower or cannabis concentrates are placed into a pipe and smoked.
• Vapes: Concentrated cannabis oil is smoked or “vaped” from a vaporizing device.

Cannabis Potency 

Today, cannabis is much stronger than in past decades. Modern cannabis plants contain higher amounts of tetrahydrocannabinol (THC), the main psychoactive compound in the plant that gives users the sensation of feeling “high.” The higher the THC content, the stronger the effects on your brain and behavior.

Health Risks for the Developing Brain 

THC and the Brain 

The brain continues to develop into your mid-20s and an important part of brain development involves the body’s endocannabinoid system (ECS). The ECS helps regulate the brain and other body systems, like the digestive system and the muscular system, to create a balance among them. The ECS is also involved in fine tuning the connections between brain cells, called neurons, in different areas of the brain. 

When THC from cannabis enters the developing brain and binds to receptors in the ECS, it can negatively affect the fine tuning and may cause the following: 

• Problems with short-term memory, attention, learning, motivation, and problem-solving. ^3,7
• Problems in these areas can impair school performance and poor school performance can affect professional and social achievements, and life satisfaction.³ 
• Problems with motor functioning, such as coordination and reaction time.³

THC and Mental Health

These days, teens are facing stress and anxiety like never before. As cannabis use has been growing in popularity following legalization, teens may see cannabis as a way to cope with their stress. 

Check out the effects that cannabis may have on a teen’s mental health below: 

1. Adolescent cannabis use has been associated with an increased risk of developing schizophrenia or other serious mental health disorders that are similar to schizophrenia. ^1,3,7 
2. THC affects the part of the brain responsible for emotional regulation, making it harder for teens to manage stress and anxiety.³ 
3. Regular cannabis use over a long period of time may lead to tolerance, which means teens become less sensitive to the effects of THC over time and need more and more THC to feel the same effects.³
4. When someone is tolerant to the effects of cannabis, they may experience withdrawal symptoms such as irritability, trouble sleeping, loss of appetite and feelings of depression, a few days after they stop using.³ 
5. Cannabis use can become problematic when it starts affecting a teen’s life in ways such as being unable to stop using when they want to, giving up important activities with family or friends because they’d rather use cannabis, and using cannabis in risky situations like driving a car. These, along with tolerance and withdrawal, may be signs that a teen is developing an addiction to cannabis.³ 

Cannabis and the Lungs

How cannabis smoking affects the teenage lungs is still being studied, however, it may affect teens like it does adults. In adults, smoking cannabis on a regular basis can cause chronic bronchitis. Cannabis smoke has been shown to injure the cell linings of the large airways, which could explain why smoking marijuana leads to symptoms such as chronic cough, phlegm production, wheeze and acute bronchitis. ^{10, 11}  

22% OF ADOLESCENTS AGED 12 TO 17 WHO EXPERIENCED A MAJOR DEPRESSIVE EPISODE WERE MARIJUANA USERS. ¹

No matter their age, it’s important to have ongoing conversations with the teens in your life about using cannabis. If you can, it’s a good idea to have talks about use early, before they consider using cannabis. But talking with them at any age still makes a difference. Use the tips below so you’re ready to engage in productive, healthy, and supportive conversations about cannabis.

Knowing how and when to start conversations about cannabis (or any substance) with teens can be challenging. The most effective way to reach them is by having open, honest, two-way conversations about the risks. Take a deep breath and ASK.

Advise

You’re their role model. Talk about risks in a judgment-free way.

• Listen carefully to the teen in your life without judgment. 
• Ask open-ended questions that encourage them to elaborate. Having a genuine conversation lets them know they can come to you whenever they have questions or problems. 
• Correct any misconceptions teens may have, such as “everyone smokes weed” or “marijuana won’t hurt me.” 
• Address and acknowledge their comments so they know you’re paying attention and understand them. 
• Let them know they can always come to you if they’re in trouble and that their safety and well-being is your number one priority.

Support

Have open conversations. They’re listening to you. Be sure to listen to them. 

• Have casual conversations instead of lectures or formal meetings. 
• Choose informal times to talk, like while taking a walk, going to a practice or game or at meal sharing opportunities. 
• Look for natural opportunities to talk about cannabis with teens, like when you hear “weed” use mentioned in a song, in the movies or on television, or see people using it at events. 
• Be consistently clear on where you stand to help set an example. 

Know

They should know your expectations, and that you’ve got their backs. 

• Start the conversation early, if possible, even before the teens in your life start to think about experimenting, when they first start asking questions. 
• Stay involved, and keep the conversation going as they grow. Discussions about cannabis (or any other substance) use should not be a one-time thing. They should be ongoing because risk factors for substance use can change and multiply over time as teens deal with the different trials and pressures of adolescence. 

More Tips for Talking About Cannabis and Having the Cannabis Talk 

Keep it grounded and fact-based:

• Focus on the facts, and discuss how cannabis use might affect them. 
• Teens know when you are trying to exaggerate information or trying to scare them, so focus on real-life situations and believable consequences. 

If you think a teen in your life is using cannabis, don't panic: 

• Stay calm. Overreacting may lead the teen to rebel, feel angry, or take greater risks. 
• Seek to understand and empathize with their reason for using. Help them explore safer and healthier choices. 
• Talk about their concerns, and give positive reasons for wanting them to stop using cannabis. 
• Keep the conversation open so you can problem-solve, together. 

Let them know you care and are always there for them: 

• By maintaining a strong, open relationship with the teen in your life, they may be less likely to be influenced by outside sources. 
• Creating a supportive and nurturing environment can help them make better decisions. 

Help them say "no":

• Helping the teen in your life deal with peer pressure can prevent them from using drugs. 
• Let them know they can say “no” if they’re put in a situation that makes them uncomfortable. 
• Work with the teen to think of a way to handle this situation, whether it’s simply saying, “no, I don’t smoke,” or “I have a game tomorrow,” or “I have to go to work tomorrow.”

How to Respond

Once you’ve opened the conversation about cannabis with the teen in your life, they may have questions or comments that are hard to address. Here are some frequent teen comments and responses that you can implement so you’re prepared to answer them in the moment.

If a teen says, “But it’s natural,” you can say: 

• "Just because it’s natural, it still doesn’t mean it’s safe at your age. Your brain won’t stop developing until you’re in your mid-20s. Using marijuana now can impact your memory, and your ability to cope with stress, and anxiety.” 
• More info: THC in cannabis can affect teen brains by impacting their memory, and their ability to manage stress, and anxiety.³ 

If a teen says, “But it’s not as bad as tobacco or other drugs,” you can say: 

• “As your brain develops, it’s fine-tuning its connections, and many substances—including cannabis—can disrupt that important process.” 
• More info: The science on THC and teens shows that THC can disrupt the brain’s developmental process and may cause problems with short-term memory, attention, and more.³ 

If a teen says, “But vaping isn’t harmful,” you can say: 

• “Vaping marijuana can still expose you to toxins that can affect your health.” 
• More info: When vaping, teens can still inhale toxic metals and chemicals from the heating chamber, which can affect their overall health.⁹ 

If a teen says, “But so many successful people use it,” you can say: 

• “Just because someone is successful now and uses cannabis, doesn’t mean they started when they were young. The best way to let your brain grow to its full potential is to avoid underage cannabis use.” 
• More info: The teen brain does not stop developing until their mid-20s.³ 

If a teen says, “But you used when you were young,” you can say: 

• “Cannabis today is stronger now than it used to be, which can affect your brain and may become addictive.” 
• More info: Cannabis today is stronger than in the past as it contains higher levels of THC, which may be more harmful to the teen brain and make cannabis more addictive.³ 

If a teen says, “But I saw you use,” you can say: 

• “Using cannabis underage puts your brain development at risk. That means your memory, attention, coordination, and mental health could all be affected.” 
• More info: Human brains do not fully develop until our mid-20s, and large amounts of THC in the brain can impact normal functions like learning, memory, attention, coordination, and mental health.³

1. Key Substance Use and Mental Health Indicators in the United States: Results from the 2020 National Survey on Drug Use and Health, SAMHSA, 2020. 
2. Centers for Disease Control and Prevention. 2021 Youth Risk Behavior Survey Data. Available at: www.cdc. gov/yrbs. 
3. Office of the Surgeon General. “U.S. Surgeon General’s Advisory: Marijuana Use and the Developing Brain.” U.S. Dept. of Health and Human Services. (2019). 
4. Effects of Marijuana Smoking on Pulmonary Function and Respiratory Complications Tetrault - Archives of Internal Medicine - 2007 
5. Why You Should Talk With Your Child About Alcohol and Other Drugs, SAMHSA, 2022. 
6. NIDA. 2022, March 29. Starting the Conversation. Retrieved from https://nida.nih.gov/publications/marijuanafacts-parents-need-to-know/starting-conversation on 2022, December 21 
7. Bloomfield, M. A., Ashok, A. H., Volkow, N. D., & Howes, O. D. (2016). The effects of Δ9-tetrahydrocannabinol on the dopamine system. Nature, 539(7629), 369–377. https://doi.org/10.1038/nature20153 
8. Colizzi, M., Bhattacharyya, S. (2018). Cannabis use and the development of tolerance: a systematic review of human evidence. https://www.sciencedirect.com/science/article/abs/pii/S0149763418302665 
9. Bonner, E., Chang, Y., Christie, E., Colvin, V., Cunningham, B., Elson, D., Ghetu, C., Huizenga, J., Hutton, S. J., Kolluri, S. K., Maggio, S., Moran, I., Parker, B., Rericha, Y., Rivera, B. N., Samon, S., Schwichtenberg, T., Shankar, P., Simonich, M. T., Wilson, L. B., Tanguay, R. L. (2021). The chemistry and toxicology of vaping. Pharmacology & therapeutics, 225, 107837. https://doi.org/10.1016/j.pharmthera.2021.107837 
10. Tashkin DP. Effects of marijuana smoking on the lung. Ann Am Thorac Soc. 2013;10(3):239-47. 11. Howden ML, Naughton MT. Pulmonary effects of marijuana inhalation. Expert Rev Respir Med. 2011;5(1):87-92.