Cannabis interacts in a different way with the developing brain than it does with the adult brain. This is why medicinal cannabis use presents special challenges and risks when it comes to adolescents. Many young medical canna users are unlikely to suffer any major long-term adverse effects over a course of treatment at reasonable doses, however the use and effects need to be monitored and its doses controlled by a medical doctor.
The human being continues to develop through age 25. [1] It is necessary to control exposure to high doses of THC in cannabis products during the developmental phases, because there is some limited evidence that high-THC strains can negatively affect cognitive brain development. [2] Chronic, heavy use of THC-dominant products during this period of brain development brings an increased risk of dependency and the potential for long-term neurocognitive and social deficits. [3]
Convincing evidence exists that heavy use of cannabis among young people leads to increased rates of dependence. [4] There’s a correlation between the amount consumed and a higher rate of adult schizophrenia, but the connection remains controversial. [5] There is very little in the way of evidence that moderate medical cannabis use functions as a “gateway” to illicit drugs. A more clear-minded approach would be to understand that medical use by adolescents needs to be constrained within appropriate strains, ratios and dosing parameters as a well defined treatment course with very clear and continued dosage guidelines including follow up. In a more recent review, it was found that ongoing cannabis use is associated with harm to the brain by chronic exposure to tetrahydrocannabinol (THC), but that cannabidiol (CBD) can actually minimize such harm, and there can also be recovery with extended periods of abstinence. [6]
The Risks of Non-Medical Adolescent Use
High regular cannabis use in adolescence interferes with the endocannabinoid system’s role in brain development, based on recent preclinical research. [7] Chronic cannabis use by teen’s may result in memory and attention deficits, anxiety, and mood problems. [8] Therefore, special concern must be made when adolescents use the drug before age 13, as the neurological impact appears to be greater than when use is initiated in later adolescence. [9] The long-term use beginning in adolescence appears to have significant negative impacts on mental health and cognitive functioning in midlife. [10] For more information, read The Endocannabinoid System Explained.
The newly found ability of CBD to minimize neurological harms associated with the use of high-THC products must be examined further to see if this neuroprotection extends to younger users.
Authors of a meta-analysis published in 2008 reviewing the available literature concluded that, “Associations between cannabis use and cognitive functioning in cross-sectional studies of adolescents and young adults are small and may be of questionable clinical importance for most individuals. Furthermore, abstinence of longer than 72 hours diminishes cognitive deficits associated with use. Although other outcomes (eg, psychosis) were not examined in the included studies, results indicate that previous studies of cannabis in youth may have overstated the magnitude and persistence of cognitive deficits associated with use. Reported deficits may reflect residual effects from acute use or withdrawal. Future studies should examine individual differences in susceptibility to cognitive dysfunction.”
Another study published in 2019 assessed the available medical literature on whether cannabis use in adolescence increased risk for depression, suicide, and anxiety, concluding that, “Preadolescents and adolescents should avoid using cannabis as use is associated with a significant increased risk of developing depression or suicidality in young adulthood. Although individual-level risk remains moderate to low and results from this study should be confirmed in future adequately powered prospective studies, the high prevalence of adolescents consuming the drug generates a large number of young people who could develop depression and suicidality attributable to the compound. This is an important public health problem and concern, which should be properly addressed by health care policy.”
Many observational studies have suggested that adolescent cannabis use may be linked to long-term harms, including cognitive impairment and increased risk of schizophrenia. But in almost every area that researchers have examined, results have been inconclusive regarding the precise nature and strength of these associations. In particular, there’s little consensus as to whether cannabis directly causes long-term health harms in people, whether it’s one of a number of risk factors, or whether it simply correlates with other root causes. [11]
A 2019 study published in The Journal of Neuroscience involving forty-six 14-year old children found changes in grey matter volume in certain parts of the brain responsible for cognitive performance, reasoning, and with future generalized anxiety symptoms in the cannabis users. The authors also revealed startling statistics that, “Almost 35% of American 10th graders have reported using cannabis and existing research suggests that initiation of use in adolescence is associated with long-term neurocognitive effects.” [17]
A 2020 study found that, “Converging evidence indicates that adolescent-onset cannabis exposure is associated with short- and possibly long-term impairments in cognition, worse academic/vocational outcomes, and increased prevalence of psychotic, mood, and addictive disorders. Odds of negative developmental outcomes are increased in youth with early-onset, persistent, high frequency, and high-potency THC cannabis use, suggesting dose-dependent relationships.” [12]
Another 2020 study of the available evidence had researchers conclude that, “there are two important messages to adolescents and young adults: First, cannabis has potentially detrimental effects on cognition, brain and educational outcomes that persist beyond acute intoxication. Second, impaired cognitive function in cannabis users appears to improve with sustained abstinence.” [13]
A 2020 review of the research made points that, “the endocannabinoid system is under active development during childhood and adolescence, and little is known about the long-term effects of cannabis exposure on the developing brain. Furthermore, certain adverse effects such as depression, psychosis, suicidal behavior, and poor school performance may be particularly detrimental to young people, given their potential to impact important long-term outcomes.”
CBD and Adolescence
More recent data on how cannabidiol (CBD) affects the developing brain was found in one study published in 2018 showing that CBD helped prevent early stages of schizophrenia developing [14[, with another study published in the same year showed that CBD treatment of adolescent patients with epilepsy resulted in a significant reduction in seizures, showing neuroprotection. [15]
In a 2018 study CBD was found to significantly decrease social anxiety in teens after just four weeks of treatment. [16]
A 2021 pilot study to assess the effects of CBD in children with severe behavioral problems and intellectual disability discovered that among the eight, 8-16 year olds, the medicine was very well tolerated with parents in support recommending more of this work should be completed. Adherence to the study protocols was reported as excellent. [18]
A 2020 report has highlighted the new ABCD study which began in 2018 after completing enrollment in 2018, recruiting nearly 12,000 children aged 9 or 10, and will follow the children through roughly age 20. Researchers at 21 institutions around the United States have already collected the baseline brain images, genetic information, and neuropsychological, behavioral, and many other health measures. Over time, the project aims to characterize normal adolescent brain and cognitive development and tease apart multiple factors that can influence those processes, such as screen time, sports injuries, and importantly, substance use. [19]
When doing a quick search online there are several questions from parents related to CBD, such as about how it affects children on the autism spectrum, what are the benefits vs the side effects, and whether kids should be going near CBD products at all.
When it comes to the many wide spectrum of conditions and disorder that effect the western world, it is no wonder parents are searching for ways to bring more relief to their children. Many questions about hemp and CBD oil remain unanswered, but what we do know, is that CBD is an effective drug, and although it comes with a strong safety profile, quality research in the form of clinical trials on long-term use in adolescence is needed before anyone can say whether it is a good solution to be placed alongside other home remedies.
In saying that, there are CBD medications that are approved for use in children with epilepsy such as Sativex and Epidiolex by GW Pharmaceuticals, both of which are derived from the whole plant, which you can read more about in our article on epilepsy.
Commonly Asked Questions
Can a 14 year old use CBD oil?
In the US, CBD derived from the marijuana variety of cannabis is illegal at the federal level, but in states with legal medical marijuana laws, it's legal. Some hemp-derived CBD products on the US market still contain THC, after independent research discovered mislabeling by several manufacturers. Giving THC to children is illegal, therefore, the legality of giving CBD oil to kids remains a gray area.
Can my 13 year old take CBD?
The only CBD drug that is approved for any age group is made by GW Pharmaceuticals and is available by prescription from a doctor only. It is designed for rare forms of epilepsy in children. The research is still out on whether CBD is safe for kids with other conditions such as anxiety and pain.
Can you use CBD if you're under 18?
In the US, you are required by law to be 18 years or older, however, in some states you have to be 21. If you're purchasing through a brick-and-mortar retail store, you'll be asked to verify that you're 18 by presenting your drivers licence, passport, or other form of identification. Online retailers also have basic measures in place to check.
What age group uses CBD?
According to research completed by SingleCare, people aged 18-29 are most likely to use CBD regularly, with its popularity of use decreasing with age (Gallup, 2019): Compared to 20% of people aged 18-29 using CBD, just 16% agred 30-49 use the drug.
CBD has varying legal status depending on the country in which you reside. Check your country, federal, and state laws prior to purchasing cannabidiol.
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The information contained in this article is for informational purposes only and does not constitute medical advice. Prior to making changes to your lifestyle or treatment plan, consult with your doctor.
1. https://pubmed.ncbi.nlm.nih.gov/18383544/
2. https://www.ncbi.nlm.nih.gov/books/NBK423845/
3. https://pubmed.ncbi.nlm.nih.gov/25921032/
4. https://www.bmj.com/content/325/7374/1195.1
5. https://pubmed.ncbi.nlm.nih.gov/12446534/
6. https://pubmed.ncbi.nlm.nih.gov/27549374/
7. https://pubmed.ncbi.nlm.nih.gov/26344755/
8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5406224/
9. https://pubmed.ncbi.nlm.nih.gov/21628706/
10. https://pubmed.ncbi.nlm.nih.gov/28008372/
11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6955325/
12. https://pubmed.ncbi.nlm.nih.gov/32026735/
13. https://pubmed.ncbi.nlm.nih.gov/32268974/
14. https://pubmed.ncbi.nlm.nih.gov/30186164/
15. https://pubmed.ncbi.nlm.nih.gov/29674131/
16. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6856203/
17. https://pubmed.ncbi.nlm.nih.gov/30643026/
18. https://pubmed.ncbi.nlm.nih.gov/32478863/
19. https://www.pnas.org/content/117/1/7
