Cannabis Use in Teens and Young Adults
Marijuana, or cannabis, is the most commonly used illicit drug in the United States.1 15% of people aged 12+ used marijuana in the past month in 2023.2 11% of people aged 12 to 20 used marijuana in the past month in 2023.2 ⅔ of people aged 12 to 17 who used marijuana used it through vape.2 OPEN strives to teach young people today the associated risks of cannabis use and how they can stay safe.
What is Cannabis?
Cannabis
Cannabis is anything made from the plant Cannabis sativa. The cannabis plant has over 540 chemicals called cannabinoids. The main cannabinoids are tetrahydrocannabinol (THC) and cannabidiol (CBD).3
Marijuana
Marijuana refers to products that contain substantial amounts of tetrahydrocannabinol (THC).
Active Chemicals in Cannabis
THC is the chemical that makes people feel “high” when they use cannabis. It works by attaching to special receptors in the brain. It’s described as psychoactive because it changes how you think, feel, and experience things around you– and sometimes how you move. The impact THC has on your brain can make memory, coordination, and decision-making harder. You might feel really relaxed, happy, or even a little bit paranoid. It can also cause side effects like feeling dizzy, tired, or anxious. THC is often used for medical reasons, but it’s important to use it carefully because of how it affects the brain.
CBD is a part of cannabis that doesn’t make you feel “high.” It doesn’t affect your brain the same way THC does. CBD is the part of cannabis that can cause things like relaxation, decreased stress, and sometimes even pain relief. It can be used to help certain medical conditions like epilepsy. CBD is non-psychoactive, meaning it won’t change your thoughts or how you feel mentally—it helps your body feel calm and balanced. CBD can be used in oils, creams, or even in foods. Because it doesn’t make you feel high, it’s often seen as an alternative option for people who want the benefits of cannabis without the effects of THC.
Effects on the Brain and Body
What Does it Mean to be High?
Being “high” means the THC in cannabis is affecting your brain and body. It can change how you think, feel, and see things. Some people might feel relaxed, happy, or laugh a lot. Others might feel anxious, confused, or sleepy. THC can also make it harder to focus, remember things, or move and react quickly. Everyone’s experience can be different depending on the person, how much they use, and how strong the cannabis is.
What About Secondhand Exposure to Cannabis?
Secondhand smoke from cannabis can be just as powerful as firsthand ingestion. Exposure can lead to the feeling of effects of THC and CBD.5
Brain Development
The brain is still developing until age 25. Using cannabis can interfere with its growth and may cause lasting effects on thinking, memory, emotions, and movement. Specific parts of the brain that can be affected include:
Prefrontal Cortex:
This part of the brain helps with decision-making, problem-solving, and controlling impulses. When teens or young adults use cannabis, it can slow down the development of the prefrontal cortex. This can make it harder for them to control their actions, make smart decisions, and may lead to impulsive behavior.
Hippocampus:
The hippocampus is important for memory and learning. THC can affect how the hippocampus works, making it harder to form memories and learn new information. This is especially risky for teens or young adults, when the brain is still building its memory and learning abilities.6,7
Amygdala:
The amygdala controls emotions like fear and aggression. Cannabis can make the amygdala more sensitive, which can cause stronger or more intense emotional reactions. It can also mess with emotional regulation, making it harder for someone to stay calm or handle stress, especially if they’re already in an emotionally charged situation.
The Endocannabinoid System (ECS)
The endocannabinoid system (ECS) is a part of the body that helps keep control of things like mood, memory, pain, and how our bodies work. It helps to keep us balanced, a process called homeostasis.8
When THC from cannabis gets into a developing brain and connects with the ECS, it can mess with these connections and cause problems with:
- Short-term memory and learning
- Cognitive functions like motivation, attention and problem-solving
- Motor functioning, such as coordination and reaction time
Risks of Cannabis Use
Cannabis use can have both short- and long-term effects on young people’s health and relationships. Some things can make using cannabis even riskier, such as:
Age of First Use
The earlier a teen begins using cannabis, the greater the risk of negative mental health outcomes.
Frequency of Use
Teens who use cannabis on a daily or near-daily basis are at higher risk for cognitive decline, addiction, and mental health issues.
Genetic and Family Factors
Teens with a family history of mental health disorders are at higher risk of experiencing adverse mental health effects from cannabis use.
Environmental and Social Factors
Adolescents who experience stress or trauma may be more likely to turn to cannabis as a coping mechanism, which can increase the risk of developing mental health issues in the long term.
Short Term Effects
| Changes in mood | Can cause feelings of euphoria (feeling really happy), anxiety, or paranoia (feeling scared or nervous).
|
| Impaired coordination | Makes it harder to move smoothly, walk steadily, or react quickly. |
| Memory problems | Difficulty remembering things or forming new memories, especially while high. |
| Altered judgment | Makes it harder to think clearly and make good decisions. |
| Increased heart rate | Can cause the heart to beat faster, which may make you feel anxious or uncomfortable. |
| Dry mouth and red eyes | Can make the mouth feel dry, and eyes become bloodshot. |
| Altered time perception | Feeling like time is moving slower or faster than usual. |
| Increased appetite | Often leads to "the munchies," where you feel extra hungry and want to eat a lot. |
Long Term Effects
Teens that use cannabis repeatedly may have impacts on their long-term health and wellbeing, even into adulthood. Avoiding the hard stuff can slow down emotional growth, even if it feels easier in the moment. Using substances to escape tough feelings or avoid hard conversations can result in missing chances to learn important skills like handling anxiety, solving problems, and staying true to your values. Cannabis use can also affect these areas over time:
Brain Development
- Interferes with development of important brain area that control memory, learning, and decision-making.
- Problems with thinking clearly, focusing, and making smart choices, even into adulthood.
Mental Health
- Feelings of anxiety or paranoia, mood swings, and difficulty handling stress
- Feeling “flat” or numb: not feeling as excited or sad as they used to. This makes it harder to connect with others or enjoy things that once made them happy.
- Increases the risk of mental health problems like depression, psychosis, and schizophrenia.
Physical health9
- Increases risk of stroke, heart disease, and other vascular diseases.
- Smoking causes harm to lung tissue, similar to the risks of cigarettes.
Personal Goals
- Losing interest in working toward their personal goals.
- Distracting teens from thinking about their future and taking steps to achieve their dreams.
Interpersonal Relationships
- Social Isolation: pulling away from friends or not hanging out with them as much.
- Spending more time alone. If they feel like they have to hide their use, it can create distance and break down trust in relationships. Over time, this can leave them feeling disconnected from their relationships.
Peer Influence
- Using cannabis can put a teen in situations where they feel pressured to keep using it just to fit in with certain people. Can encourage risky behaviors.
Changes in Behavior
- Making someone act differently than usual. Might become more quiet, distant, or irritable, which can confuse or upset friends. This can create tension or make it harder to connect with others.
Legal Impacts
- Underage marijuana use can lead to a Minor-in-Possession (MIP) charge.
- Can include a fine, community service, or court-ordered drug treatment.
School and Work
- Trouble Focusing: Cannabis can make it harder to focus on homework or pay attention in class, leading to lower grades and falling behind in school.
- Memory Issues: Harder to remember things learned in class. A teen might forget what they studied or have trouble recalling important details during exams or discussions.
- Decreased Motivation: can affect academic performance and how much effort they put into their education.
- Extracurriculars: Breaking school rules around marijuana use can result in being removed from a sports team or other clubs.
- Suspension or Expulsion: Cannabis use at school can also lead to suspension or expulsion.
- Financial Aid: Underage marijuana-related charges can cause you to be ineligible for financial aid for college
- Many workplaces do not allow the use of cannabis. They may require drug tests upon hire, and a failed drug test can limit future opportunities.
Cannabis Use and Addiction
Cannabis use disorder is a significant psychiatric condition characterized by the continued use of cannabis despite notable impairment in psychological, physical, or social functioning. It is important to recognize that not all individuals who use cannabis develop an addiction or cannabis use disorder.
Not all individuals who use cannabis develop an addiction or cannabis use disorder.
Cannabis Use Disorder Criteria
Criteria used by a healthcare professional to determine if someone has a cannabis use disorder are:
- Using cannabis in larger amounts or over a longer period than intended.
- Craving, or strong desire to use.
- Wanting to or unsuccessful efforts to cut down or control use.
- Spending a lot of time getting cannabis, using cannabis, or recovering from its effects.
- Cannabis use causes failures to complete work, interpersonal problems, or important social, occupational, or recreational activities are given up or reduced.
- Using cannabis even when you know of having physical or psychological problems likely to have been caused or made worse by cannabis.
Cannabis Use Withdrawal
The severity of the symptoms will depend on how heavy the marijuana use is. Withdrawal symptoms can begin within 24 to 48 hours after stopping or reducing marijuana use after heavy, long-term use.
The most common marijuana withdrawal symptoms include:
- Anger, irritability and aggression
- Nervousness and anxiety
- Restlessness
- Decreased appetite, which may lead to weight loss
- Depressed mood
- Insomnia
- Disturbing dreams and nightmares
Less common physical symptoms include:
- Headaches
- Nausea and vomiting
- Excessive sweating
- Abdominal pain
- Shakiness (tremors)
Treatment for Cannabis Use
The primary treatment for cannabis use disorder is therapy. This includes cognitive and behavioral therapies, motivational interviewing and motivational enhancement therapy. The decision for which type of therapy to use depends on individual needs.12
Asking for Help
Every person that has a cannabis addiction or a cannabis use disorder may have different reasons that motivates them to get help.
Talking to a trusted adult like a school counselor, coach, or another trusted teacher or mentor can be an important first step.
There are also anonymous resources available to find support and treatment options.
Social Influence and Peer Pressure
Popularity of Cannabis
Cannabis has become more popular and socially accepted, especially among young people. In many states, it is now legal to use for adults, which can make it seem safer or more “normal” to teens. For some, it’s also seen as a more modern or culturally acceptable version of smoking than it was in the past.
In places where nonmedical use is legal, you may find cannabis advertisements such as billboards. Cannabis is also marketed online and through social media. Many state laws do not allow cannabis marketing toward youth. However, some companies and dispensaries will use gifs, cartoons, or sales to directly target teens and youth adults.
It is important to be aware of how the advertisement of cannabis can make it seem like everyone is using it. However, most young people are not using marijuana.
Handling Peer Pressure
Peer influence is when friends or people your age affect how you act because you want to feel accepted, included, or valued. Peer influence can be positive or negative, depending on your values.
Plus: Can encourage you to try new activities, join groups that fit your interests, or feel more confident.
Minus: Happens when you feel pushed to do things you don’t want to do; like bullying, using substances, or taking risks that don’t feel right.
Responses to Peer Pressure
Simple refusal script:
- “Nah, I’m good.”
- “Not today, I’m trying to stay clear.”
- “Respect, but that’s not my thing.”
Nonverbal refusal skills:
- Standing tall
- Avoiding lingering in the situation
- Maintaining eye contact
Using “I” Statements
- “I” statements are a way of expressing your feelings, needs, and boundaries clearly without blaming or attacking the other person.
- They let you express yourself honestly and respectfully, which is essential for healthy communication and for building and maintaining strong, positive relationships.
Tips:
- Keep it honest
- Keep it calm
- Focus on your feelings, not their flaws
- Say it once clearly, then repeat if needed
How to Talk About Cannabis with Friends
Youth often expect a negative reaction, but friends can respond in many ways. Here are examples and simple replies:
Assertive Communication Matters
It Helps You Set Healthy Boundaries
Assertiveness lets you communicate what you are okay with and what you are not. Clear boundaries protect your physical and emotional safety.
It Helps You Communicate Your Needs
Being honest about what you feel or need, without apologizing, helps build confidence and self-respect.
It Strengthens Relationships
When you communicate clearly and respectfully, friendships become more trusting and supportive. People know where you stand.
It Prevents Misunderstandings or Pressure
Being assertive makes it easier to say “no” firmly, avoid situations you don’t want, and stop peer pressure before it grows.
When it comes to handling peer pressure, it is important to stand your ground and be firm in your decision. It is important to know that friends that do not respect your boundaries are not ones that are worth having, so if they really do care about you, then you won’t lose the friendship over one decision you two disagree over.
Healthy Alternatives to Cannabis
Healthy coping skills give you practical, real-life tools to manage stress, emotions, and difficult situations without turning to substances. Whether you need to release tension, express how you feel, calm down when you’re overwhelmed, stay connected to supportive people, or quickly navigate moments of pressure, there are many simple strategies that can help.
Quick In-the-moment Strategies
- Excusing yourself from the situation
- Taking 5 slow breaths
- Texting someone you trust
- Repeating a grounding phrase (“I can handle this” “I know my values.”)
- Reminding yourself of your “why” for staying cannabis-free
Physical coping strategies
Help release tension and regulate emotions through movement.
- Go for a walk, run, or bike ride
- Stretching or yoga
- Dancing to music
- Playing sports or doing a quick workout
- Deep breathing or grounding exercises
Emotional Coping Strategies
Help name, feel, and work through emotions.
- Talking to a trusted friend, mentor, or adult
- Journaling what you feel
- Using “I” statements to express feelings
- Practicing mindfulness or meditation
- Remember, we’re not trying to get rid of emotions, but recognize what they’re telling us.
- Listening to music that matches or lifts your mood
Feeling “Stuck” Strategies
These help calm your nervous system when you feel overwhelmed.
- Taking a warm shower
- Drinking water or herbal tea
- Using aromatherapy
- Spending time in nature
- Cuddling with a pet
- Watching funny reels or videos
Social Coping Strategies
Healthy connection reduces the need to use substances to cope.
- Hanging out with supportive friends who respect your boundaries
- Joining clubs, sports teams, or interest groups
- Planning substance-free activities (movies, art nights, games, cooking)
Creative Coping Strategies
Creative outlets help release emotions in safe ways.
- Drawing, painting, doodling
- Writing stories, poems, or lyrics
- Playing or creating music
- Photography or digital art
- Crafts, building, or DIY projects
Resources
Truth or NahA campaign that works on providing young people with straightforward, science-backed information about cannabis.
SUD Treatment AccessA guide to help connect you to the care that best fits your needs. In addition to clinical treatment options, there are state and county resources available to help you navigate treatment options within your area.
FindTreatment.govA confidential and anonymous resource for persons seeking treatment for mental and substance use disorders in the United States and its territories.
988 Suicide & Crisis LifelineProvides support to people struggling or in crisis with their mental health or substance use. Text, call or chat 988 for judgment-free support 24/7.
Marijuana AnonymousProvides marijuana addiction resources such as workshops and meetings near you or online.
Michigan 211A free, confidential service that connects you to local resources. Text, call or chat 211 for help 24/7 to get connected.
References
- Surgeon General’s Advisory: Marijuana Use & the Developing Brain | HHS.gov. August 29, 2019. Accessed November 26, 2025. https://www.hhs.gov/surgeongeneral/reports-and-publications/addiction-and-substance-misuse/advisory-on-marijuana-use-and-developing-brain/index.html
- 2023 NSDUH Annual National Report | CBHSQ Data. Accessed November 26, 2025. https://www.samhsa.gov/data/report/2023-nsduh-annual-national-report
- Cannabis (Marijuana) and Cannabinoids: What You Need To Know. NCCIH. Accessed November 26, 2025. https://www.nccih.nih.gov/health/cannabis-marijuana-and-cannabinoids-what-you-need-to-know
- Chayasirisobhon S. Mechanisms of Action and Pharmacokinetics of Cannabis. Perm J. 2020;25:19.200. doi:10.7812/TPP/19.200
- CDC. Cannabis and Secondhand Smoke. Cannabis and Public Health. May 20, 2024. Accessed November 26, 2025. https://www.cdc.gov/cannabis/health-effects/secondhand-smoke.htm
- Lubman DI, Cheetham A, Yücel M. Cannabis and adolescent brain development. Pharmacol Ther. 2015;148:1-16. doi:10.1016/j.pharmthera.2014.11.009
- Arain M, Haque M, Johal L, et al. Maturation of the adolescent brain. Neuropsychiatr Dis Treat. 2013;9:449-461. doi:10.2147/NDT.S39776
- Atakan Z. Cannabis, a complex plant: different compounds and different effects on individuals. Ther Adv Psychopharmacol. 2012;2(6):241-254. doi:10.1177/2045125312457586
- CDC. Cannabis Health Effects. Cannabis and Public Health. May 21, 2024. Accessed November 26, 2025. https://www.cdc.gov/cannabis/health-effects/index.html
- Marijuana in Michigan: What You Need to Know. Michigan Marijuana Regulatory Agency; 2021. https://www.michigan.gov/-/media/Project/Websites/cra/consumer-connection/2021-lara-child-marijuana-brochure-APPROVED.pdf?rev=8a7de5aa78394b5d932b0bed20b4e20a
- Marijuana Withdrawal. Cleveland Clinic. Accessed November 26, 2025. https://my.clevelandclinic.org/health/diseases/marijuana-weed-withdrawal
- Cannabis Use Disorder. Cleveland Clinic. Accessed November 26, 2025. https://my.clevelandclinic.org/health/diseases/cannabis-use-disorder
- LoParco CR, Cui Y, McCready DM, et al. Cannabis Marketing Strategies in the United States: A Descriptive Analysis of Four Prominent Companies. Subst Use Addict J. 2025;46(3):601-611. doi:10.1177/29767342251313860
- Experts KBH. Assertiveness (for Teens). Accessed November 26, 2025. https://kidshealth.org/en/teens/assertive.html
Social Influence and Peer Pressure
Popularity of Cannabis
Cannabis has become more popular and socially accepted, especially among young people. In many states, it is now legal to use for adults, which can make it seem safer or more “normal” to teens. For some, it’s also seen as a more modern or culturally acceptable version of smoking than it was in the past.
In places where nonmedical use is legal, you may find cannabis advertisements such as billboards. Cannabis is also marketed online and through social media. Many state laws do not allow cannabis marketing toward youth. However, some companies and dispensaries will use gifs, cartoons, or sales to directly target teens and youth adults.
It is important to be aware of how the advertisement of cannabis can make it seem like everyone is using it. However, most young people are not using marijuana.
Handling Peer Pressure
Peer influence is when friends or people your age affect how you act because you want to feel accepted, included, or valued. Peer influence can be positive or negative, depending on your values.
Plus: Can encourage you to try new activities, join groups that fit your interests, or feel more confident.
Minus: Happens when you feel pushed to do things you don’t want to do; like bullying, using substances, or taking risks that don’t feel right.