83. Mental Health and Marijuana in Adolescents83. Mental Health and Marijuana in Adolescents
Addiction Medicine Journal Club
Two addiction physicians review a major study linking adolescent cannabis use with later mental health diagnoses and discuss how SAMHSA’s new guidance can shape front-line counselling. Their chat blends research, clinic anecdotes, and wider concerns about youth addiction, from marijuana to social media.
37:04•21 Sept 2026
Teen Cannabis, Mental Health Risks, and What Clinicians Should Say
Episode Overview
- Large cohort data suggest adolescent cannabis use is associated with increased risk of anxiety, depression, bipolar and psychotic disorders.
- Self-report screening in routine teen check-ups can reveal clinically relevant patterns of cannabis and other substance use.
- Current SAMHSA guidance focuses on counselling and brief interventions, emphasising that no FDA-approved medications exist for cannabis use disorder.
- Clinicians often prioritise managing withdrawal and underlying symptoms such as insomnia, anxiety, or pain rather than chasing a single "fix-it" pill.
- The hosts argue that doctors should be cautious about endorsing medical marijuana for mental health, especially in young people whose brains are still developing.
“I tell people I just can't recommend it's a healthy habit in that age group.”
What can we learn from those who have battled addiction? This instalment of Addiction Medicine Journal Club turns its attention to teenagers, cannabis, and mental health, offering busy clinicians a brisk but detailed look at emerging evidence. Across the conversation, Dr. John Kian and Dr. Sonia Deltretti break down a large JAMA Health Forum cohort study on adolescent cannabis use and later psychotic, bipolar, depressive, and anxiety disorders.
With over 460,000 young people followed for several years, the data suggest that teen cannabis use is linked with higher rates of anxiety and depression, and roughly doubles the risk of bipolar and psychotic disorders.
As one line that sums up their clinical stance puts it: "I tell people I just can't recommend it's a healthy habit in that age group." You’ll hear how they grapple with the classic "chicken or egg" problem: does cannabis trigger mental illness, or are struggling teens drawn to cannabis? They’re careful to stress that this study shows association, not definite causation, but they still see it as strong ammunition for frank risk–benefit conversations with families.
The tone stays relaxed and occasionally funny – including a running joke about "the avengers of weak medications" like gabapentin and naltrexone – yet the content is squarely aimed at clinicians. They highlight SAMHSA’s new primary-care guide for cannabis use disorder, note its focus on counselling over medication, and share practical ideas like turning the brief-intervention section into a ready-made clinic note.
The episode also touches on a lawsuit against Meta over alleged social media addiction in young people, drawing parallels between fast-moving public health risks (cannabis, social media, e-bikes) and slow-moving legislation. If you’re supporting adolescents or young adults around substance use and mental health – or just trying to sharpen your counselling on cannabis – this conversation might prompt you to rethink how you talk about "medical marijuana" and where you draw the line on teen use.
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