Cannabis

Why is this important?

Did you know that approximately 44% of people will have tried marijuana by the time they are 18 years old and that now more youth are using marijuana than cigarettes (1)?

A lot of conflicting and confusing information exists today about cannabis or marijuana (2) which is also known by many other names (3). The public health and legal environments are rapidly changing and it is hard to keep up with the most current research, laws, and recommendations.

For an in-depth discussion about many aspects of cannabis use, please review the cannabis page from the NIH and/or read this podcast transcript with Dr. Wilson Compton.

Our goal is to give you science-based information and tips you can use to have important conversations with your college student.

What should I know?

Below are frequently asked questions about cannabis. Click on the button for a detailed explanation to each question.

Anchor 2

Anchor 1

How does the potency of today’s cannabis compare to that of the past?

Today’s typical cannabis is a lot more potent and most likely carries greater risk than what was used in past generations

Is cannabis addictive?

Cannabis is addictive and those who start early and/or use regularly have an increased risk of developing cannabis use disorder

Anchor 4

Anchor 3

What impact does cannabis have on academics?

Cannabis use can negatively impact academic performance and can have adverse consequences for personal and professional success in later adulthood

What impact does cannabis have on mental health?

Cannabis can worsen and/or raise the risk of mental health problems

As a parent, what should I do?

The guidance that might be most useful for you differs by your student's level of involvement with cannabis.

How would you describe your grown student's cannabis use?

Click on one of the buttons below for discussion points and examples of what to say.

I’m not sure if my student is using cannabis

Starting the conversation

Start from a place of care and concern.
Ask for permission to talk about it.
Ask about possible opportunities to use cannabis (friends, situations, etc...).
Set clear expectations around cannabis use and tell your student that your expectations and disapproval are the same for cannabis as they are for all other drugs.

Say 💬 something like this...

"I'm worried about what goes on out there and I care about you. It would mean a lot to me if we could talk about this. Is that okay with you?"

"I want to be clear that I disapprove of cannabis use. I don't want you to become distracted by something that will take you away from what you want to achieve - in school, in your life and in your personal relationships with other people."

Focus on the positives

Emphasize how important your student's health is to you, your family, and their friends.
Discuss your student's natural gifts, accomplishments and how cannabis use might halt their progress, and be a barrier to success during college.

Offer your student support

Offer a line of communication for when your student is feeling sad or distressed.
Discuss healthy behaviors that help to alleviate the stressors of young adulthood. Healthy behaviors might include exercise, using social supports, talking about their stressors, relaxation techniques, seeking professional help…

Say 💬 something like this...

"I am proud of what you have accomplished in life so far. You are important to us and I want you to make the most of your twenties. However, with added responsibilities, young adulthood can get extremely stressful. I would like to talk to you about how to deal with stress and your emotions in a healthy way. I want you to be able to handle whatever comes your way. Let's work together to find ways that work best for you."

Discuss potential risky situations and brainstorm effective strategies for how to respond.

Say 💬 something like this...

"I want to make sure you feel prepared in any situation. [Brainstorm risky situations that could come up.] Let's talk about what you can say or do if you find yourself in one of these situations."

Be a reliable source of information for your student and correct misinformation

Discuss any family history of mental illness and addiction. Even without a family history, cannabis can increase the risk of developing a mental illness or worsen mental health problems.

Say 💬 something like this...

"If you don't know, your relative struggled with alcohol use and it affected him, as well as the family, in this way. We might also be prone to an increased risk of…"

"Because we have family members who have had problems with addiction, we might have more risk than other people for developing an addiction/ it might be riskier for us than other people who don't have a family history of addiction./ I want you to have this information when you are making your decisions./so you can make informed choices-decisions"

"I don't know about all of our family members – some of them might have struggled with this stuff and we might never know."

Talk about how there is a lot of misinformation on the internet and social media about cannabis.
Emphasize the negative impacts of using cannabis that they might not have thought about (e.g., overdose vs. potentially serious impacts on academic success and personal achievement).

Say 💬 something like this...

"I know there is a lot of misinformation on the internet about marijuana being a stress reliever and you might meet people who use marijuana to relax. However, using cannabis is not a healthy way to relieve stress."

"Cannabis is much stronger than it was when I was your age. Research shows that with this stronger cannabis people can become addicted and addicted faster and that it can be unhealthy for the brain, especially for people who might already feel anxious or sad."

"Eventually, this can cause people to lose interest in things that they really like to do. People may not even realize that they are spending a lot of time focused on their cannabis use."

My student uses cannabis, but I'm not sure how much or how often

Starting the conversation

Remain calm and resist temptation to blame.
Restate your expectations related to disapproval of cannabis use and all drugs.

Say 💬 something like this...

"I want you to know that I am aware that you are using cannabis and I want to be clear that I disapprove of cannabis use. I just don't want you to become distracted by something that will take you away from what you want to achieve - in school, in your life and in your personal relationships with other people."

Focus on the positives

Emphasize how important your student's health is to you, your family, and their friends.
Discuss your student's natural gifts, accomplishments and how cannabis use might halt their progress, and be a barrier to success during college.

Offer your student support

Offer a line of communication for when your student is feeling sad or distressed.
Discuss healthy behaviors that help to alleviate the stressors of young adulthood. Healthy behaviors might include exercise, using social supports, talking about their stressors, relaxation techniques, seeking professional help…

Say 💬 something like this...

"I am proud of what you have accomplished in life so far. You are important to us and I want you to make the most of your twenties. However, the responsibilities of young adulthood can get extremely stressful. I would like to talk to you about how to deal with stress and your emotions in a healthy way. I want you to be able to handle whatever comes your way. Let's work together to find ways that work best for you."

"Young adulthood can be a stressful time. I'm hearing you like to use cannabis because it helps you to calm down when you're stressed out. I want you to know that cannabis only provides short-term relief. It does not solve what might be actually causing your problems. However, we could discuss some healthier ways to cope with those stressful situations."

Discuss potential risky situations and brainstorm effective strategies for how to respond.

Say 💬 something like this...

"I want to make sure you feel prepared in any situation. [Brainstorm risky situations that have or could come up.] Let's talk about what you can say or do to avoid or remove yourself from these situations."

Be a reliable source of information for your student and correct misinformation

Discuss any family history of mental illness and addiction. Even without a family history, cannabis can increase the risk of developing a mental illness or worsen mental health problems.

Say 💬 something like this...

"If you don't know, your relative struggled with alcohol use and it affected him, as well as the family, in this way. We might also be prone to an increased risk of..."

"I don't know about all of our family members - some of them might have struggled with this stuff and we might never know."

Talk about how there is a lot of misinformation on the internet and social media about cannabis.
Emphasize the negative impacts of using cannabis that they might not have thought about (e.g., overdose vs. potentially serious impacts on academic success and personal achievement).
Emphasize that your student might never know the THC or CBD concentration or what else their cannabis products contain because the FDA does not regulate any sold products.
State that the potency of cannabis might differ from product to product.
Be sure to include how frequent use can increase the risk of developing a substance use disorder, worsen mental health outcomes, and impact their academic achievement.

Say 💬 something like this...

"Eventually, this can cause people to lose interest in things that they really like to do. People may not even realize that they are spending a lot of time focused on their cannabis use."

In a supportive, non-judgmental way gather information about their use patterns

Ask how frequently your student is using cannabis and under what circumstances.

Say 💬 something like this...

"Can you tell me how often and in what situations you use cannabis? How regularly?"

Acknowledge stressors and attempt to redirect student to use healthy stress management tools instead of cannabis use.

Offer a challenge (17)

Challenge your student to quit using cannabis for a brief period and see how it goes.
- If they are able to stop using: Ask if/how life differed from before and discuss the pros and cons of using cannabis based on this experience.
- If they are unable to stop using: Ask about what got in the way of stopping completely. Ask what types of situations/events trigger their desire to use. Discuss some solutions for how they could try again.
- If they are unwilling to try to stop using: Ask about motivations for continued use. Ask them to discuss the pros and cons of use...

Say 💬 something like this...

"I do not want your cannabis use to start impacting your health or other responsibilities in your life. I am here to help you. I want to challenge you to quit using cannabis for x number of days/weeks."

Seek treatment

If you are worried about your student's safety, seek treatment from professional resources.

My student uses cannabis regularly

Starting the conversation

Ask about possible opportunities to use cannabis (friends, situations, etc...).
Set clear expectations around cannabis use and tell your student that your expectations and disapproval are the same for cannabis as they are for all other drugs.

Say 💬 something like this...

"I want to be clear that I disapprove of cannabis use. I just don't want you to become distracted by something that will take you away from what you want to achieve - in school, in your life and in your personal relationships with other people."

Focus on the positives

Don't blame yourself. You are not alone in your situation and it's important for you to seek support for yourself as well.
Emphasize how important your student's health is to you, your family, and their friends.
Discuss your student's natural gifts, accomplishments and how cannabis use might halt their progress, and be a barrier to success during college.

Offer your student support

Offer a line of communication for when your student is feeling sad or distressed.
Discuss healthy behaviors that help to alleviate the stressors of young adulthood. Healthy behaviors might include exercise, using social supports, talking about their stressors, relaxation techniques, seeking professional help…

Say 💬 something like this...

"I want to take this opportunity to discuss how I am worried about you. Your cannabis use has become a problem. I am concerned that it is negatively impacting your mental health, your academic achievement, and how you go about your daily life. I have also noticed that you do not seem as happy as you once were. I have also noticed that you are continuing to use cannabis regardless of the negative consequences it is causing. I don't want you to feel isolated or helpless."

Discuss potential risky situations and brainstorm effective strategies for how to respond.

Say 💬 something like this...

Be a reliable source of information for your student and correct misinformation

Discuss any family history of mental illness and addiction. Even without a family history, cannabis can increase the risk of developing a mental illness or worsen mental health problems.

Say 💬 something like this...

"If you don't know, your relative struggled with alcohol use and it affected him, as well as the family, in this way. We might also be prone to an increased risk of…"

"I don't know about all of our family members – some of them might have struggled with this stuff and we might never know."

Talk about how there is a lot of misinformation on the internet and social media about cannabis.
Emphasize that there are several factors that influence the risk of developing a substance use disorder. These factors include early initiation of use, the strength of the drug, the frequency of use, and certain genetic predispositions.
Emphasize the negative impacts of using cannabis that they might not have thought about (e.g., overdose vs. potentially serious impacts on academic success and personal achievement).

Say 💬 something like this...

"Eventually, this can cause people to lose interest in things that they really like to do. People may not even realize that they are spending a lot of time focused on their cannabis use."

In a supportive, non-judgmental way gather information about their use patterns

Ask how frequently your student is using cannabis and under what circumstances.

Say 💬 something like this...

"Can you tell me how often and in what situations you use cannabis? How regularly?"

Acknowledge stressors and attempt to redirect student to use healthy stress management tools instead of cannabis use.

Offer a challenge (17)

Challenge your student to quit using cannabis for a brief period and see how it goes.
- If they are able to stop using: Ask if/how life differed from before and discuss the pros and cons of using cannabis based on this experience.
- If they are unable to stop using: Ask about what got in the way of stopping completely. Ask what types of situations/events trigger their desire to use. Discuss some solutions for how they could try again. Most of all, consider seeking outside help (e.g. treatment, counseling) as not being able to quit can be a symptom of cannabis use disorder.
- If they are unwilling to try to stop using: Ask about motivations for continued use. Ask them to discuss the pros and cons of use. Consider seeking outside help (e.g. treatment, counseling).

Say 💬 something like this...

Encouraging and facilitating treatment seeking

Know that treatment for cannabis use disorder can be a long process and that change usually is not immediate.
Discuss how the apathy associated with cannabis use can influence the desire to seek treatment..

Say 💬 something like this...

"You might feel like treatment for your cannabis use is unnecessary. It might be possible for some people to stop using cannabis on their own. However, there are people that can help you. I would like you to talk to these people to find out what help you need so that you can stop using cannabis. I will help and support you in any way I can through the process."

Want to know more?

General Resources

Cannabis Use Disorder

Criteria for Cannabis Use Disorder

Diagnostic criteria for Cannabis Use Disorder (CUD), as well as Cannabis Withdrawal, are defined by the American Psychiatric Association (18).

Diagnostic Criteria: Cannabis Use Disorder

A) A problematic pattern of cannabis use leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12-month period:

1) Often taken in larger amounts or over a longer period than was intended.

2) A persistent desire or unsuccessful efforts to cut down or control use.

3) A great deal of time is spent in activities necessary to obtain, use, or recover from its effects.

4) Craving, or a strong desire or urge to use.
5) Recurrent use resulting in a failure to fulfill major role obligations at work, school, or home.

6) Continued use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects.
7) Important social, occupational, or recreational activities are given up or reduced because of use.
8) Recurrent use in situations in which it is physically hazardous.
9) Continued use despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by use.
10) Tolerance, as defined by either of the following:

a) A need for markedly increased amounts of cannabis to achieve intoxication or desired effect.
b) Markedly diminished effect with continued use of the same amount of cannabis.

11) Withdrawal, as manifested by either of the following:

a) The characteristic withdrawal syndrome for cannabis (refer below to Criteria A and B of the criteria set for cannabis withdrawal.)
b) Cannabis (or a closely related substance) is taken to relieve or avoid withdrawal symptoms.

Severity
2 - 3 symptoms ► Mild
4 - 5 symptoms ► Moderate
7+ symptoms ► Severe

Diagnostic Criteria: Cannabis Use Withdrawal

A) Cessation of use that has been heavy and prolonged (i.e., usually daily or almost daily use over a period of at least a few months).
B) Three (or more) of the following signs and symptoms develop within approximately 1 week after Criterion A (cessation of heavy and prolonged use):

1) Irritability, anger, or aggression.
2) Nervousness or anxiety.
3) Sleep difficulty (e.g., insomnia, disturbing dreams).
4) Decreased appetite or weight loss.
5) Restlessness.
6) Depressed mood.
7) At least one of the following physical symptoms causing significant discomfort: abdominal pain, shakiness/tremors, sweating, fever, chills, or headache.

C) Signs or symptoms of Criterion B cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
D) Signs or symptoms are not attributable to another medical condition and are not better explained by another mental disorder, including intoxication or withdrawal from another substance.

Trends in Cannabis Use Disorder

For more information on cannabis use disorder trends, please refer to the following research articles.

Marijuana Use, Recent Marijuana Initiation, and Progression to Marijuana Use Disorder Among Young Male and Female Adolescents Aged 12-14 Living in US Households

🔑 Key finding: Approximately 17% of past year marijuana users ages 12-14 developed marijuana use disorder (MUD) within a year of their first use.

Higher Average Potency Across the United States is Associated with Progression to First Cannabis Use Disorder Symptom

🔑 Key finding: There is evidence that use of higher potency cannabis places users at increased risk of developing cannabis use disorder (CUD).

DSM-5 Cannabis Use Disorder in the National Epidemiologic Survey on Alcohol and Related Conditions-III: Gender-Specific Profiles

🔑 Key finding: Women might have faster progression to cannabis use disorder(CUD) after use compared with men.

Cannabis References

Notes and References

Schulenberg JE, Johnston LD, O'Malley PM, Bachman JG, Miech RA, Patrick ME. Monitoring the Future national survey results on drug use, 1975-2019: Volume II, college students and adults ages 19-60. Ann Arbor: Institute for Social Research, University of Michigan; 2020.
We recognize that "cannabis" is the scientific name for the plant and that many people still use the term "marijuana" in surveys to understand patterns of use, scientific publications and resources including those that are provided by the National Institute on Drug Abuse. On this page we have chosen to use the term cannabis, but when study findings are reported, we will use the term used in that particular study. No matter what term(s) are used, it is important for parents to be informed and to have conversations with their grown children. We welcome your thoughts and feedback about this page and how to improve it.
Examples of other names include weed, pot, hash, blunt, grass, joint, reefer, and skunk.
Chandra S, Radwan MM, Majumdar CG, Church JC, Freeman TP, ElSohly MA. New trends in cannabis potency in USA and Europe during the last decade (2008-2017). Eur Arch Psychiatry Clin Neurosci. 2019;269(1):5-15.
ElSohly MA, Mehmedic Z, Foster S, Gon C, Chandra S, Church JC. Changes in cannabis potency over the last 2 decades (1995-2014): analysis of current data in the United States. Biological Psychiatry. 2016;79(7):613-619.
See FDA Regulation of Cannabis and Cannabis-Derived Products, Including Cannabidiol (CBD).
Hasin DS, Saha TD, Kerridge BT, Goldstein RB, Chou SP, Zhang H, Jung J, Pickering RP, Ruan WJ, Smith SM, Huang B, Grant BF. Prevalence of marijuana use disorders in the United States between 2001-2002 and 2012-2013. JAMA Psychiatry. 2015;72(12):1235-1242.
Ramesh D, Schlosburg JE, Wiebelhaus JM, Lichtman AH. Marijuana dependence: not just smoke and mirrors. ILAR J. 2011;52(3):295-308.
Volkow ND, Wise RA, Baler R. The dopamine motive system: implications for drug and food addiction. Nat Rev Neurosci. 2017;18(12):741-752.
Bonnet U, Preuss UW. The cannabis withdrawal syndrome: current insights. Subst Abuse Rehabil. 2017;8:9-37.
DuPont RL. Chemical slavery: Understanding addiction and stopping the drug epidemic. Rockville, MD: Institute for Behavior and Health; 2018.
Arria AM, Barrall AL, Allen HK, Bugbee BA, Vincent KB. The academic opportunity costs of substance use and untreated mental health concerns among college students. In: Cimini MD, Rivero EM, eds. Promoting Behavioral Health and Reducing Risk Among College Students: A Comprehensive Approach. New York: Routledge; 2018:3-22.
Arria AM, Caldeira KM, Bugbee BA, Vincent KB, O'Grady KE. The academic consequences of marijuana use during college. Psychol Addict Behav. 2015;29(3):564-575.
Suerken CK, Reboussin BA, Egan KL, Sutfin EL, Wagoner KG, Spangler J, Wolfson M. Marijuana use trajectories and academic outcomes among college students. Drug Alcohol Depend. 2016;162:137-145.
Hall W, Degenhardt L. Cannabis use and the risk of developing a psychotic disorder. World Psychiatry. 2008;7(2):68-71.
Bonn-Miller MO, Moos RH. Marijuana discontinuation, anxiety symptoms, and relapse to marijuana. Addict Behav. 2009;34(9):782-785.
Adapted from Ryan SA, Ammerman SD, Gonzalez PK, Patrick SW, Quigley J, Walker LR, AAP Committee on Substance Use, Prevention. Counseling parents and teens about marijuana use in the era of legalization of marijuana. Pediatrics. 2017;139(3):e20164069.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. Arlington, VA: American Psychiatric Publishing; 2013.

Disclaimer: Unfortunately, even with the "best" parenting practices, there is no guarantee that students will refrain from starting to use drugs or alcohol, developing a drug problem, or even worse, experiencing serious drug-related consequences. Conversely, the worst of circumstances does not necessarily predispose one to a life of addiction.

Cannabis

What should I know?

How does the potency of today’s cannabis compare to that of the past?

Is cannabis addictive?

What impact does cannabis have on academics?

What impact does cannabis have on mental health?

As a parent, what should I do?

How would you describe your grown student's cannabis use?

I’m not sure if my student is using cannabis

My student uses cannabis, but I'm not sure how much or how often

My student uses cannabis regularly

Want to know more?

General Resources

Adolescent Brain Development and Drugs

Counseling Parents and Teens About Marijuana Use in the Era of Legalization of Marijuana

FDA Regulation of Cannabis and Cannabis-Derived Products, Including Cannabidiol (CBD)

Partnership to End Addiction

U.S. Surgeon General's Advisory: Marijuana Use and the Developing Brain

Considerations when Attending College in a State with Legal Adult Use Cannabis: Maryland as an Example

Cannabis Use Disorder

Criteria for Cannabis Use Disorder

Diagnostic Criteria: Cannabis Use Disorder

Diagnostic Criteria: Cannabis Use Withdrawal

Trends in Cannabis Use Disorder

Notes and References