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Cannabis and the Developing Adolescent Brain

  • Child and Adolescent Psychiatry (M Singh and M Goldsmith, Section Editors)
  • Published:
Current Treatment Options in Psychiatry Aims and scope Submit manuscript

Abstract

Purpose of review

This review summarizes (1) recent trends in delta-9-tetrahydrocannabionol [THC] and cannabidiol (CBD) content in cannabis products, (2) mechanism of action of THC and CBD and the neurobiological correlates of cannabis use on the developing adolescent brain, (3) effects of cannabis on psychiatric symptoms and daily functioning in youth (i.e., academic performance, cognition, sleep and driving), (4) cannabis products used to relieve or treat medical issues in youth, and (5) available treatments for cannabis use disorder in adolescence.

Recent findings

Despite marked increases in THC content and availability of cannabis, there has been a decline in perceived risk and an increase in use of cannabis extract products among youth in the USA. The primary psychiatric symptoms associated with cannabis use in youth are increased risk for addiction, depressive, and psychotic symptoms. Adolescent cannabis exposure also contributes to impaired cognition, sleep, and driving ability. Cannabis alters endocannabinoid system function which plays a central role in modulating the neurodevelopment of reward and stress systems. However, few studies have examined neurobiological mechanisms underlying the psychiatric and functional sequalae of cannabis exposure in youth. To-date, FDA-approved cannabinoid medications are very limited, none of them supporting their use for the treatment of psychiatric symptoms. Behavioral therapies are currently the mainstay of treating cannabis misuse, with no pharmacotherapies currently approved by the FDA for cannabis use disorder in youth.

Summary

Here, we summarize the neurobiological, psychiatric, and daily function effects of the most commonly used cannabinoids: delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD). Our current understanding of the effects of cannabis on the developing brain and treatments for cannabis misuse in youth remain limited. Future research aimed at examining the neurobiological effects of cannabis, with objective measures of exposure, over the course of pediatric development and in relation to psychiatric symptoms are needed.

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Funding

This work was supported by the Klingenstein Third Generation Foundation to ASF and the National Institute of Mental Health T32 MH019938 to ASF and R01MH106581 to MKS.

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA

    Adina S. Fischer MD, PhD, Dexter Lee Louie MD, Alan F. Schatzberg MD & Manpreet K. Singh MD, MS

  2. Department of Psychiatry, University of California San Diego, San Diego, CA, USA

    Susan F. Tapert PhD

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  3. Dexter Lee Louie MD
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  4. Alan F. Schatzberg MD
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  5. Manpreet K. Singh MD, MS
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Correspondence to Adina S. Fischer MD, PhD.

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Conflict of interest

Dr. Singh receives research support from Stanford’s Maternal Child Health Research Institute and Department of Psychiatry, National Institute of Mental Health, National Institute of Aging, Allergan, Johnson and Johnson, and the Brain and Behavior Research Foundation. She is on the advisory board for Sunovion and is a consultant for Google X and Limbix and receives royalties from the American Psychiatric Association Publishing.

Dr. Fischer received grants from the Klingenstein Third Generation Foundation.

Dr. Louie declares that he has no conflicts of interest.

Dr. Tapert declares that he has no conflicts of interest.

Dr. Schatzberg declares that he has no conflicts of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Child and Adolescent Psychiatry

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Fischer, A.S., Tapert, S.F., Louie, D.L. et al. Cannabis and the Developing Adolescent Brain. Curr Treat Options Psych 7, 144–161 (2020). https://doi.org/10.1007/s40501-020-00202-2

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