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As Cannabis Availability and Potency Grows, Few Adolescents Receive Help for Addiction
Amid continued debate regarding the harms and potential medicinal benefits of cannabis use in adults, evidence is increasingly finding adolescence to be a critical period for the development of cannabis use disorder (CUD), according to a commentary article in the American Journal of Psychiatry.
“Similar to a number of other psychiatric conditions, CUD risk peaks in adolescence, with most CUD cases becoming evident between ages 18–30 years,” wrote corresponding author Yasmin L. Hurd, PhD, of the Icahn School of Medicine and the Addiction Institute at Mount Sinai, New York, New York, and coauthors. “Those who start using cannabis prior to age 16 years are at the highest risk of developing CUD.”
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Next to age, biological sex is another key factor consistently associated with CUD. Studies show higher rates of CUD risk in male individuals, who tend to show a higher frequency of use than female individuals. Nevertheless, CUD incidence does not appear to differ with biological sex after controlling for frequency of use. Additionally, faster CUD progression, increased withdrawal symptoms, and comorbid anxiety, mood disorders, and interpersonal difficulties may be associated with female sex.
The commentary also points out a sharp rise in the potency of Δ9-tetrahydrocannabinol (THC) in cannabis products. Commercialization has led to increased availability of high-THC products such as dab pens, wax, or shatter, as well as cannabinoid products such as the extremely potent tetrahydrocannabiphorol (THC-P). The mental health implications of the changing product landscape are unknown and require expert attention.
Unfortunately, the number of youths who receive evidence-based treatment for CUD is drastically lower than the estimated prevalence of CUD in the adolescent population.
“Treatment strategies are currently limited and consist mainly of motivational enhancement and cognitive behavioral therapies,” the authors wrote. “Given that the increased potency of cannabis and cannabinoid products is expected to increase CUD risk, it is disturbing that less than 10% of youths who meet the criteria for a substance use disorder, including CUD, receive treatment.”
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