What Are Drugs Really Doing to Teens?

Adolescence is a time when people are exploring the world and finding themselves. Teens and young adults seek diverse personal and social experiences, interpersonal relationships, and cultural perspectives. For that reason, this is also when many people try alcohol, marijuana, and psychedelic drugs (like LSD and psilocybin mushrooms) for the first time. 

Is this drug experimentation a harmless phase? Does early exposure to certain substances lead to adult addiction and psychological disorders? Can drugs really “fry your brain”?

The dirt on weed

“My perspective on early marijuana use is that it all depends on what you mean by ‘early’,” says Philip D. Harvey, Ph.D., a professor of psychiatry and director at the University of Miami Health System and the University of Miami Miller School of Medicine. “If you’re smoking cannabis regularly before you’re 13 years old, the data are really clear,” he says in reference to a study conducted in Canada that examined the marijuana use, academic achievement, and mental acuity of children and young teenagers in a four-year study.

The researchers found that ongoing marijuana use during this early adolescent developmental period is tied to the following:

• weakened working memory
• reduced inhibitory control
• delayed memory recall and perceptual reasoning

Working memory helps us process small amounts of information for a short time to complete mental tasks, like remembering a phone number long enough to dial.

Inhibitory control enables us to act with self-control to reach our goals and avoid distractions. 

Memory recall is the ability to retrieve the information you’ve learned or events that happened in the past — without a cue to help trigger the memory.

Perceptual reasoning helps us solve problems in our heads by visualizing the solution.

Pre-teens and teenagers with impaired memory, mental control, and visualization abilities are at risk for poor academic performance. “In that study in Canada, early-onset alcohol use did not lead to the academic challenges that were experienced by young people who had early onset cannabis abuse,” Dr. Harvey says. “There are risks associated with cannabis use during adolescence when your brain is not fully developed (until you’re in your early 20s). We don’t know what dosing yourself with cannabis does to brain development.”

Very early-onset cannabis use also increases the risk of triggering psychotic disorders. 

“People who have a genetic polymorphism (called the Val/Val COMT polymorphism) breakdown dopamine to the cortex quite rapidly,” says Dr. Harvey. “They seem to be the ones who are at highest risk for cannabis-related psychotic onset, regardless of their age.”

In these cases, early marijuana use activates an existing predisposition for psychosis that might not get triggered without the introduction of cannabis. 

“The psychosis maybe didn’t originate from cannabis use, but relapse and exacerbation are definitely associated with cannabis use. If you’ve ever had a psychotic episode and you smoke cannabis, you’re more likely to relapse,” Dr. Harvey says. “I don’t believe that every single person who smokes cannabis when they are 11 years old is going to develop psychosis. It’s a complex interaction with the dopamine system. But, any cases of psychosis that wouldn’t have happened otherwise are good to avoid.”

Is medical marijuana safer than pot sold on the streets?

Medicinal marijuana is currently legal in 37 states within the United States, as well as in Washington D.C. and most U.S. territories. Qualifying patients with a government-issued medical marijuana license and a doctor’s recommendation can purchase products containing the psychoactive (THC) and therapeutic but non-psychoactive (CBD) ingredients found in cannabis.

The dried cannabis plant, oils, and distillates derived from it, and infused gummies and chocolates are prescribed to reduce the symptoms of medical conditions, including cancer, epilepsy, glaucoma, chronic pain, PTSD, inflammatory gastrointestinal disorders, and migraines.

“I don’t know how common it is that minors are prescribed and taking medical cannabis for legitimate medical reasons,” Dr. Harvey says. “But, in most of the U.S. and Canada, you no longer need a prescription for cannabis. So, the whole issue of medicinal versus recreational marijuana is off the table (other than for issues of purity and potential contaminants). The question is, ‘Is cannabis exposure something bad for adolescents in general?’”

Marijuana use is on the rise.

Self-reported surveys and the state-reported legal sales of medical and recreational marijuana (to adults) suggest that cannabis use is increasing in the U.S. for users of all ages. 

“I don’t know if drug use is dramatically increasing among adolescents. It may be to some extent. What is clearly happening is accessibility is increasing,” Dr. Harvey says. 

“I think we need to be concerned about it, whether or not the increase in use has happened yet, because it certainly can. In North America, there are about 300 million people who live in places where cannabis has become decriminalized. When it’s decriminalized, it’s easier for people, including minors, to get their hands on it. So, the likelihood of adolescents being exposed to cannabis is greater these days than at any time in the past.”

The future of psychedelic drugs

Researchers and healthcare providers are exploring using psychedelic drugs as psychotherapeutic interventions. 

These drugs include:

• LSD (aka acid)
• psilocybin (aka shrooms, magic mushrooms)
• MDMA (aka molly, ecstasy)
• ketamine

Providers see success in using these controlled substances to reduce the symptoms of treatment-resistant depression, severe anxiety, and PTSD. Because these conditions don’t affect adolescents as commonly as adults, psychedelics are not commonly prescribed to young patients. But, the reported use of hallucinogens among older teens reached a historic high in 2021.

“There’s little likelihood of adolescents being prescribed these drugs legitimately psychotherapeutically. Treatment-resistant depression, for example, means the patient has been treated for years before their depression is designated as ‘treatment-resistant.’ And PTSD more commonly develops after adolescence,” Dr. Harvey says. 

“Meanwhile, there’s no reason to believe that ketamine does not reverse treatment-resistant depression for the right patients. Whether it is suitable as a maintenance (long-term) therapy is unproven and currently being tested.

“The bigger question is, ‘Are micro- or full doses of LSD, psilocybin, MDMA, or ketamine good or bad? And if these drugs do, in fact, improve symptomatology, is it enough of an improvement to justify their risks, whatever they are?’”

The public interest in psilocybin (aka magic mushrooms) is growing. 

Once considered a trippy and risky experience for hippies, taking mushrooms is now advertised on social media as a therapeutic tool to regulate mood and ease depression and anxiety.

But, Dr. Harvey warns there’s a dangerous difference between therapeutically administered psilocybin, LSD, ketamine, or MDMA and the same drugs being self-administered without professional guidance and supervision.

“This is similar to the difference between using methadone in a medical setting to treat opiate addiction versus buying methadone on the street and drinking it. There are lots of controlled substances that are, in fact, very good when used for legitimate therapeutic purposes under a doctor’s supervision. But, it’s not the same treatment when administered by sellers or practitioners who don’t provide follow-up or pay attention to dosing or other drugs that patients are taking.”

The bottom line from Dr. Harvey: “The unsupervised and early onset use of any drug — including alcohol, cannabis, and psychoactive compounds — before the brain is fully developed is always riskier than later in life. We need to keep in mind that any kind of use of substances during developmental periods can be bad.”

Dana Kantrowitz is a contributor to UHealth’s news service.

Tags: cannabis use disorder, Dr. Philip Harvey, parts of the brain, people who use marijuana, smoke marijuana, substance abuse