#78 Strong Clinical Relevance
High-quality evidence with meaningful patient or clinical significance.
Parents and adolescent patients should understand that the psychiatric risks associated with cannabis use before age 18 are biologically distinct from adult-onset use, and delaying initiation until adulthood is one of the most evidence-supported harm reduction strategies available.
Research examining adolescent cannabis use has consistently identified a meaningful association between early initiation and elevated risk for psychotic spectrum disorders in adulthood, with the biological vulnerability of the developing adolescent brain playing a central role in this relationship. The endocannabinoid system undergoes significant maturation throughout adolescence, and exogenous cannabinoids introduced during this window appear to disrupt neurodevelopmental trajectories in ways that can have lasting psychiatric consequences. Potency of the cannabis product matters considerably here, as contemporary high-THC formulations represent a substantially different exposure profile than products studied in earlier decades.
“The science on adolescent cannabis and psychosis risk has been accumulating for two decades, and at this point dismissing the association requires more motivated reasoning than accepting it.”
🧠 This study adds to existing literature demonstrating that adolescent cannabis use carries meaningful psychiatric risks, particularly regarding psychotic spectrum disorders. The doubling of psychotic disorder risk is noteworthy and warrants honest conversations with teen patients and families about developmental vulnerability during critical brain maturation periods. ️ While cannabis may have legitimate therapeutic applications in adults, the evidence consistently shows adolescent brains respond differently, and clinicians should exercise particular caution in this population. Risk stratification based on personal and family psychiatric history becomes especially important when discussing cannabis use with younger patients.
Dr Caplan’s review of the JAMA Health Forum paper, including what the methods do and do not allow us to conclude: Adolescent Cannabis Use and Psychosis Risk – Study Review
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