As THC Levels in Marijuana Rise, Teen Addiction and Psychosis Follow

By: Tristan Sun

Ingesting extremely concentrated cannabis products is making teens mentally and physically ill.

Elysse was 14 when she vaped cannabis for the first time. She was hooked after just the second or third try. It lacked the distinct smell of weed, so it was also easy to hide from her parents. She told the New York Times that “It was insane. Insane euphoria … Everything was moving slowly. I got super hungry. Everything was hilarious.”

However, the euphoria eventually morphed into something more sinister. Elysse became more depressed and anxious. Once, she passed out in the shower and only woke up half an hour later.

Beginning in 2020, she started to have mysterious periods of severe illness. During one episode, she threw up over 20 times within a two-hour window. It wasn’t until a year later in 2021, that a gastroenterologist diagnosed her with cannabinoid hyperemesis syndrome (CHS), known for its periods of very painful vomiting. CHS is very rare and only occurs in daily long-term marijuana users, making it shocking that a teen developed the illness.

As it turned out, the marijuana products used by Elysse and many around her are not your usual cannabis. THC, or tetrahydrocannabinol, is the chemical responsible for most of marijuana's psychological effects. Today’s high-THC concentrated cannabis products – vastly different from the joints smoked just a few decades ago, which on average contained only 12 percent THC – typically contain about 90 percent THC.

The products used by Elysse and nearly everyone around her, oils and waxes, contain between 50 and 90 percent THC. Despite this, these products are housed in colorful, candy-like containers. Additionally, these products are derived from “natural” cannabis, leading Elysse to believe that they were relatively safe.

The average amount of CBD found in cannabis plants has been on the decline in recent years. CBD, a non-intoxicating compound found naturally in cannabis, has been tied to relief from seizures, pain, anxiety, and inflammation. Studies have shown that lower CBD levels may potentially make cannabis more addictive.

Michael McDonell, an addiction treatment expert at the Washington State University College of Medicine, said, “we definitely know that there’s a dose-dependent relationship between THC and psychosis.” One study conducted in Europe and Brazil found that the risk of having a psychotic disorder among daily high potency cannabis users was five-fold that of those who had never touched it.

When Dr. Sharon Levy, the director of the Adolescent Substance Use and Addiction Program at Boston Children’s Hospital opened her clinic in 2000, marijuana was illegal in Massachusetts. She said that far fewer children came in with psychotic symptoms, “and we almost never saw cannabis hyperemesis syndrome [CHS].”

Now, after Massachusetts legalized marijuana in 2016, Dr. Levy said that these numbers are shooting up. She added that if a teenager displays psychotic symptoms, getting them off cannabis “becomes an emergency … [because we could be] preventing someone from developing a lifelong psychiatric disorder.”

Even though cannabis is legal for recreational use in only 19 states and Washington D.C., and for medical use in 37 states and D.C., only two states have imposed limits on THC concentrations: Vermont and Connecticut. Both states forbid concentrates over 60 percent and cannabis plant material over 30 percent THC, but these limits are largely arbitrary with little evidence to suggest they are much safer.

It’s very difficult – possibly impossible – to impose “safe” limits on the amount of THC in marijuana products. For one, studies have shown that adolescents are more likely to become addicted and develop anxiety, paranoia, and psychosis when they start using marijuana before the age of 18.

Additionally, it’s not just the frequency of use and quantity of THC that affect dosage; the speed the chemicals are delivered to the brain also matters. In vaporizers, the rate of delivery depends on the base the THC is dissolved in and how hot the device can become. THC travels to the brain more slowly when eating or drinking cannabis since it must first travel to the stomach, then into the bloodstream and brain.

Dr. McDonell agreed that avoiding drug use entirely is always the safest option, but also advised having open discussions about drugs with teenagers. He recommended educating teens about the dangers of high-THC concentrates in contrast with those mainly made of CBD.

Notes:

• Hard lead

• Vaping was easy to hide from her parents bc odorless. And convenient, can do it anywhere

• At first insane euphoria

• Eventually morphed into something darker.

o Sad, anxious

o Passed out in the shower only to wake up 30 minutes later

• Starting in 2020, she started have mysterious periods of severe illness

o cannabinoid hyperemesis syndrome (CHS)

o known for its periods of violent very painful vomiting

o During one episode, she told The Times that she threw up over 20 times within a two-hour window

• This is not your usual cannabis

o THC, or tetrahydrocannabinol, is the chemical responsible for most of marijuana's psychological effects

o CBD is a compound found in cannabis.

 non-intoxicating compound

 tied to relief from seizures, pain, anxiety and inflammation

 meanwhile, has been on the decline in cannabis

 studies have shown lower cbd levels => potentially make cannabis more addictive

o Elysse and many other teens were doing oil and waxes (dabbing)

 Marijuana extracts, used in dabbing and edibles, can contain an 50% and up to 90% THC

 Marijuana concentrates sharply increase THC concentration

o Thought it was safe because derived from “natural” cannabis

• Cannabis causes psychotic conditions. Especially among teens

o One rigorous study found that the risk of having a psychotic disorder was five times higher among daily high potency cannabis users in Europe and Brazil than those who had never used it.

o What is CHS

• Dr. Sharon Levy, the director of the Adolescent Substance Use and Addiction Program at Boston Children’s Hospital

o Huge spike in kids coming in with psychiatric symptoms after marijuana became legal in MA

o “and we almost never saw cannabis hyperemesis syndrome.”

• There is no known limit for various factors

Marijuana can be taken in multiple ways:

• Smoked in joints (like a cigarette)

• Vaped in vapes

• Smoking oils concentrates, and extracts from the marijuana plant, known as “dabbing,” is on the rise

Quotes:

told The New York Times that when she first tried it, it was “insane euphoria,”

“Everything was moving slowly. I got super hungry. Everything was hilarious.”

“We got her in a program to help her with it. We tried tough love, we tried everything, to be honest with you,” Elysse’s father

“The younger you are, the more vulnerable your brain is to developing these problems,” Dr. Levy said.

In 2020, 35 percent of high school seniors, and as many as 44 percent of college students, reported using

marijuana in the past year. Michelle Groskopf for The New York Times