Editorial: Early Cannabis Exposure Definitions That Correspond With High Cumulative Lifetime Dose During Adolescence Are the Strongest Predictors of Adverse Health Outcomes

J Am Acad Child Adolesc Psychiatry. 2022 May;61(5):612-614. doi: 10.1016/j.jaac.2022.02.008. Epub 2022 Mar 2.


Although cannabis use during adolescence has been consistently linked to adverse health effects, the extent, nature, and cause of these effects remain widely debated in the public domain.1 Results from longitudinal studies conducted in North American, Europe, Australia, and New Zealand and meta-analytic reports suggest that exposure to cannabis during adolescence is associated with cognitive impairment, increased risk for psychiatric disorders, and academic and vocational failure.2,3 Recently, the rigor of some of these studies has been questioned, as a few of the studies have not found relationships between cannabis and adverse health outcomes or have shown nonsignificant effects after controlling for premorbid factors such as psychopathology or low IQ prior to cannabis exposure. Although adolescent cannabis users are at increased risk for developing a cannabis use disorder (CUD) compared to adults, not all adolescents who try cannabis develop problems related to its use. In fact, there is significant heterogeneity in how adolescents respond to cannabis exposure at the individual level.4 Some adolescents experiment with cannabis, use it sporadically and for a limited duration of time, and experience few negative consequences related to their cannabis use. Others, particularly those who use it frequently and for prolonged periods of time, go on to develop significant impairment related to their use. Cannabis use patterns among US adolescents and young adults are changing following 2 decades of legislative changes and expanding normalization of recreational and medical cannabis use.1 To improve prevention and early-intervention efforts during this time of societal change, it is critical that we identify which vulnerable populations are at greatest risk for experiencing negative outcomes related to cannabis use, and which features/aspects of adolescent cannabis use are most predictive of cannabis-associated adverse health outcomes.

Publication types

  • Editorial
  • Research Support, U.S. Gov't, P.H.S.
  • Research Support, N.I.H., Extramural
  • Comment

MeSH terms

  • Adolescent
  • Cannabis* / adverse effects
  • Cognitive Dysfunction
  • Humans
  • Longitudinal Studies
  • Outcome Assessment, Health Care*
  • Substance-Related Disorders
  • Young Adult