With the accessibility of marijuana in the community and the perception held by many that it is not harmful, we must hold in mind a population vulnerable to the negative effects of marijuana – children and adolescents. Compared to adults, youth are at a higher risk of the negative long-term impacts of marijuana use. As a health care provider, I am particularly concerned about the co-occurrence of marijuana use and mental health disorders among school-aged youth.

Over the past two years, health care providers and school educators have witnessed a steep rise in the mental health needs of adolescents. The isolation, stress and disconnectedness felt by youth during the COVID-19 pandemic have added to the underlying conditions that can affect the mental well-being of youth. For instance, a new federal Centers for Disease Control and Prevention report indicates that more than “37 percent of high school students reported they experienced poor mental health” during the pandemic, and “44 percent reported they persistently felt sad or hopeless during the past year.” Suicide rates have also risen for youth. Last year, the CDC reported that in May 2020, emergency department visits for suspected suicide attempts began to increase among adolescents aged 12 to 17 years, especially girls, among whom suicide attempts were up 51 percent from the same period in 2019.

Concurrently, health care providers are seeing youth struggling with marijuana use. Youth use marijuana for many reasons, most of which are closely related to their social and emotional health. Middle schoolers and teens describe the need to connect with friends, and some may use cannabis products to facilitate social connections. Other youth may use marijuana and other substances as coping mechanisms providing short-lived relief to stress. Youth also identify increased accessibility as a factor, including edibles that resemble candy, or vape, which is easy to hide and may be perceived as less harmful because of lack of smoke. Unfortunately, there is little understanding by youth about the strength of cannabis products or the long-term consequences, such as sleep difficulties and setbacks in learning and memory, as well as the risk of addiction with frequent use. Furthermore, youth are often unaware of how their social and emotional health influences marijuana use and of the association of frequent marijuana use with mental health disorders such as depression.

While marijuana use can affect youth differently, some of the most common signs include mood changes, decreased engagement in school, low energy, memory loss and worsening mental health. Other side effects include paranoia and anxiety, which may exacerbate a existing mental health disorder.

While youth are struggling because of marijuana use and mental health concerns, so are families. They are often unsure how to handle these co-occurring conditions because it is difficult, if not impossible, to identify which came first or which is most prevalent – and, truthfully, it doesn’t really matter because they need to be treated concurrently.

Unfortunately, with gaps in health care during the pandemic, medical providers may not see youth until they are already experiencing frequent marijuana use and/or showing signs of mental health disorders. However, we can all take many steps to help support both substance use prevention and the mental health of youth.

Start prevention messages early, beginning in elementary and middle school. Keep the lines of communication open with children and teens, explaining the facts and risks associated with marijuana and substance use. Talk with youth about ways to say “no” to peers and share ideas for healthy coping strategies when they face stress. Securely store cannabis products to limit access and prevent accidental poisonings. When you see youth struggling with mental health, connect them to NAMI Maine’s Teen Text Support Line at (207) 515-8398.

As a community we have the opportunity ­– and the responsibility – to help our youth overcome these challenges, and it starts with recognizing the symptoms and initiating judgment-free communication about substance use and mental health.