Parenting and Providing Care to Adolescents and Young Adults Who Use Cannabis

Introduction

Adolescence and young adulthood are critical periods when people undergo major physiological and behavioral changes. Unlike childhood, when parents and other family members play an instrumental role in shaping the child's understanding of the social world, it is during adolescence and young adulthood that people are introduced to a myriad of social influences that they must learn to navigate. Teachers, friends, and peers become powerful agents of socialization, often shaping the child's sense of self in some small way. School provides the opportunity to learn, make friends, and build the skills necessary to contribute to society as an adult. However, it is also in arenas like this—namely, environments where young people socialize and find a sense of belonging—that young people learn habits and begin to take risks that are not conducive to a sense of well-being.

For most of our lives, we have been taught that cannabis use is a dangerous behavior, one that is not conducive to a long-term sense of well-being. Prohibitionist rhetoric from as early as the 1930s drew an association between cannabis use (and drug use broadly), mental health issues, and criminality—a sentiment that has since been echoed (in more moderate terms) by national leaders like US Presidents Richard Nixon, Ronald Reagan, and Bill Clinton. Their discourse closely mirrors the public view of cannabis users in the United States until recently.

The grips of prohibition have been loosening in the United States since the late 20^th-century and paving the way to regulated markets for medical and adult-use recreational cannabis in many, although not all, of the United States. In states where the adult use (typically 21 and older) of cannabis is legal, there are clear guidelines distinguishing acceptable from unacceptable consumption. Alternatively, when medical but not recreational cannabis is legal, or both medical and recreational cannabis are illegal. Still, when the possession of cannabis is decriminalized, the guidelines are difficult to follow and enforce. Social and political uncertainty presents many challenges and opportunities for people occupying guardian and clinical roles to consider. On the one hand, it is comforting to learn that cannabis policy liberalization is not causing increased juvenile delinquency or delinquent use of cannabis (Banys, 2016; Kan et al., 2020; Lu et al., 2021), nor is the increase in legal retail cannabis establishments associated with increased use of cannabis in adolescence (Kerr et al., 2023). On the other hand, there is reason to believe that cannabis legalization and the normalization of cannabis use are associated with lower perceived harms of cannabis use, the availability of diverse cannabis products, and the use of marketing ploys by cannabis businesses that appeal to young consumers (e.g., see “A Primer on Cannabis” below).

Figure 1.

Prevalence of past-year substance use

The use of cannabis, by many measures, no longer represents an act of social deviance; instead, the rates of experimental use reported by high school-aged adolescents suggest the use of cannabis in the United States has been a regular part of the life course for some time. The Monitoring the Future (MTF) survey collects data on substance use for a nationally representative sample of high school students. Specifically, 8^th, 10^th, and 12^th graders are surveyed using a longitudinal design to track trends in young people's use of drugs and alcohol. The recent trends in past-year use are telling. From the early 2000s to 2010s, the prevalence of 8^th-grade students reporting past-year cannabis use fluctuated between 10 and 15 percent before dropping below 10 percent during the COVID pandemic (see Figure 1). A similar trend can be seen for 12^th-graders, though in the 30 to 40 percent prevalence range. Tenth graders witnessed sharper declines in past-year use in the early 2000s and during the COVID-19 pandemic. Unlike the use of cannabis, which stabilized or lowered slightly, the use of alcohol has declined sharply since the early 2000s (NIDA, 2021).