Marijuana becomes more potent, and teens report addiction, vomiting and psychosis

Elysse was 14 years old when she started smoking marijuana in an electronic cigarette.

It didn’t smell, which was why it was easier to hide what she was doing from her parents. And it was convenient: just press a button and swallow. After the second or third try, she was hooked.

“It was crazy. An unbelievable euphoria,” said Elysse, who is now 18 years old and whose last name was not given to protect her privacy. “Everything started to slow down. I was starving. Everything was hilarious.”

But the euphoria eventually turned into something more disturbing. Sometimes marijuana made Elysse feel more anxious or sad. On another occasion she passed out in the shower and only woke up half an hour later.

It was no ordinary marijuana. The oils and waxes Elysse bought from dealers were usually around 90% THC, the psychoactive component of marijuana. But because these products were derived from cannabis, and because nearly everyone she knew was using them, Elysse figured they were more or less safe. She started smoking several times a day. Her parents only found out a year later, in 2019.

“We put her on a program to help her overcome the addiction. We took a hard line. We tried everything,” said Elysse’s father.

From 2020 onwards she started having mysterious seizures in which she repeatedly vomited. At first, she and her parents were baffled—her doctors, too. Elysse said that in one episode she spent an hour in a mall bathroom, vomiting nonstop. “It felt like my body was levitating.” In another incident, she estimates that she vomited at least 20 times in two hours.

It wasn’t until 2021, after half a dozen trips to the ER for gastrointestinal crises, including some that led to her being hospitalized, that a gastroenterologist diagnosed her condition as cannabinoid hyperemesis syndrome, a condition that causes recurrent vomiting in intensive drug users. marihuana.

While recreational marijuana is illegal in the United States for anyone under the age of 21, it has become more accessible after being legalized in many states. But experts say today’s high-THC cannabinoid products — very different from the joints smoked decades ago — are intoxicating some heavy users, including teenagers.

Marijuana is not as dangerous a drug as fentanyl, but it can still have harmful effects, especially for young people whose brains are still developing. In addition to uncontrollable vomiting and the risk of addiction, adolescents who frequently use high doses of cannabis may experience psychosis that can lead to lifelong psychiatric disorders, an increased tendency to develop depression and suicidal ideation, changes in brain anatomy and connectivity, and memory impairment. .

But despite these dangers, the potency of products on the market is almost unregulated.

‘I felt like I was in a dead end’

The average concentration of THC in cannabis samples seized by the Drug Enforcement Agency (DEA), the US federal police agency responsible for drug enforcement and control, in 1995 was 4% on average. In 2017, it had already risen to 17%. And now cannabis producers are extracting THC to make oils, edibles, wax, sugar cube-sized crystals and glassy-looking products known as “shatters” that are advertised as having high levels of THC — in some cases more than 95%.

Meanwhile, the average level of CBD — the non-psychoactive compound in the cannabis plant that is linked to relieving seizures, pain, anxiety and inflammation — has been dropping in cannabis plants. Studies suggest that lower levels of CBD can make cannabis more addictive.

Concentrated THC products “are as much like the cannabis plant as strawberries are like strawberry pop tarts with sprinkled sugar,” Beatriz Carlini, a research scientist at the University of Washington’s Institute for Chemical Dependencies, Drugs and Alcohol, wrote in an article. about the health risks of highly concentrated cannabis.

While marijuana is legally permitted for recreational purposes in 19 states and Washington and for medicinal purposes in 37 states and Washington, only the states of Vermont and Connecticut have set limits on THC concentration. Both prohibit concentrations greater than 60%, with the exception of pre-filled cartridges, and do not allow cannabis plant material to contain THC greater than 30%. But there is little evidence that these specific levels are safer.

National surveys suggest that marijuana use among 8th, 10th and 12th graders declined in 2021, a fact attributed in part to the pandemic. But in the two-year span between 2017 and 2019, the number of teens who reported having smoked pot in e-cigarettes in the previous 30 days rose across all grades, nearly tripling among high school seniors. In 2020, 35% of high school seniors and up to 44% of college students reported having used marijuana in the previous 12 months.

Elysse had given up marijuana before entering college, but soon discovered that virtually every other student in her college residence regularly smoked marijuana.

“Not just cartridges [usados em cigarros eletrônicos]but also bongs, pipes, bowls, everything.” Every morning she would find students washing their bongs in the community bathroom at 8 am to prepare their “morning smoke”.

Elysse said that after a few weeks she started smoking concentrated THC with electronic cigarettes again and also started having negative and dark thoughts. Sometimes she would sit alone in her room, crying for hours on end.

“I felt like I was at a dead end,” she said. “It wasn’t fun anymore, not at all.” Today, she has been smoke-free for two months.

Teenagers are especially affected by cannabis

Michael McDonnell of Washington State University’s medical school specializes in treating addicts. He said more research is needed to come to a greater understanding of the prevalence of psychosis and cannabinoid hyperemesis syndrome among teenagers and others who use high-potency products.

Even so, he said, “we definitely know that there is a relationship between THC and psychosis that depends on the dose of THC.”

A rigorous study found that the risk of experiencing a psychotic disorder is five times higher among daily users of high-potency cannabis in Europe and Brazil than among people who have never used the product.

Another study, this one published in 2021 in JAMA Psychiatry, reported that in 1995 2% of schizophrenia diagnoses in Denmark were associated with marijuana use, but that by 2010 that percentage had risen to between 6% and 8%, something researchers have linked increased consumption and potency of marijuana.

Cannabinoid hyperemesis syndrome, which can often be relieved by hot baths, is also linked to long-term use of high doses of cannabis. As with psychosis, it is unclear why some people develop it and others do not.

Sharon Levy, director of the Adolescent Substance Use and Addiction Program at Children’s Hospital Boston, said, “There is no doubt that higher-concentration products are increasing the number of people who have negative experiences with cannabis.”

‘What is the problem? It’s just marijuana

Laura Stack, who lives in Highlands Ranch, Colorado, said that when her son Johnny confessed to using marijuana at age 14, she thought, “Okay, it’s just marijuana. Thank God it’s not cocaine.”

She herself had smoked weed a few times in high school and warned her son that marijuana “can devour your brain cells.” But she wasn’t particularly worried: “I used it and I’m fine. What’s the problem?”

“But I had no idea,” he continued, alluding to how marijuana has changed in recent years. “Many dads and moms are totally ignorant about it, like me.”

At first, her son did not have any mental health problems. His school performance was excellent. But after a while, he started using high-potency marijuana products several times a day, and this, Stack said, “made him delusional.”

By the time Johnny arrived at college, he had already been through several drug treatment programs. He had become so paranoid, Stack said, that he thought the mob was after him and that his college was an FBI base. At one point he threatened to kill the family dog ​​if his parents didn’t give him money. His mother later found out that when he turned 18, Johnny got a card that authorized him to buy marijuana for medical purposes and began selling it to younger teenagers.

After several stints in psychiatric clinics, doctors determined that Johnny was suffering from a serious case of THC abuse. An antipsychotic drug was prescribed to him and it helped him, but then he stopped taking it. Johnny died in 2019 after jumping from the sixth floor of a building. He was 19 years old. A few days before he died, Stack said, Johnny apologized to him, saying that marijuana had ruined his head and his life and saying “sorry, I love you”.

​There is no ‘known safe limit’

It can be difficult to determine exactly how much THC enters a person’s brain when they use cannabis. This is not just because the frequency of use and the concentration of THC affect dosage — it also depends on how quickly the substances reach the brain. With vaporizers, the speed of the process can change depending on the base in which the THC is dissolved, the power of the device’s battery and the temperature the product reaches when it is heated.

Higher doses of THC are more likely to generate anxiety, agitation, paranoia and psychosis.

“The younger a person is, the more vulnerable their brain is to developing these problems,” Levy said.

According to the Substance Abuse and Mental Health Services Administration, young people are more likely to develop dependence when they start using marijuana before age 18.

In addition, there is growing evidence that cannabis can alter the brain during adolescence, a period when the brain is already undergoing structural changes. Until more is known about this, researchers and doctors recommend that cannabis use be postponed until later in life.

“I’m always approached by teenagers who ask me, ‘What if I only smoke once a month, is that okay?'” Levy said. “I can only tell you that there is no known safe limit.”