Thirty-two clinicians across multiple specialties described post-legalization increases in adolescent cannabis use, uptake of high-potency products, cannabinoid hyperemesis syndrome, and cannabis-related psychosis, alongside decreased perceived harms and more permissive parenting.
Pediatricians and adolescent health specialists; cannabis policy makers.
Clinicians from all 4 specialties reported increased adolescent cannabis use and high-potency product adoption
What the researchers found
Clinicians reported post-RCL increases in adolescent cannabis use, non-combustible modes and high-potency products, younger first use ages, and self-medication. They described shifts in social norms, appealing marketing, easier access, fewer perceived harms, greater parental permissiveness, more cannabinoid hyperemesis syndrome, increased psychosis, and decreased court-mandated treatment.
Why it matters
Clinicians across specialties are observing a consistent pattern of adolescent cannabis-related changes post-legalization that quantitative studies have been slow to capture. Their perspectives on high-potency products, psychosis, and parental permissiveness provide early clinical signals that deserve population-level investigation.
The numbers in context
32 clinicians interviewed (56.3% female, mean age 45.9 years, 65.3% non-Hispanic White). Four specialties represented: Addiction Medicine (n=13), Psychiatry (n=7), Pediatrics (n=5), Emergency (n=7). Interviews conducted September 6 to December 21, 2022.
How the study worked
Semi-structured qualitative interviews with 32 clinicians from Addiction Medicine (n=13), Psychiatry/Mental Health (n=7), Pediatrics (n=5), and Emergency Department (n=7) in Kaiser Permanente from September-December 2022. Thematic analysis of transcribed interviews.
What this study cannot tell us
Clinician perspectives are subjective and may reflect selection bias (clinicians who see the most severe cases). The sample is from one healthcare organization in California. Without quantitative data, it is impossible to determine the actual magnitude of the changes described.
How to read the evidence
Preliminary: systematic qualitative study across multiple clinical specialties, but relies on clinician perceptions without quantitative confirmation.
When this study was published
2024 study using 2022 interview data.
The bigger picture
The combination of decreased court-mandated treatment and increased permissive parenting suggests that the formal and informal systems that previously motivated adolescent cannabis treatment are weakening post-legalization. This creates a gap where problematic use may go unaddressed longer.
Questions still open
- Do quantitative data confirm the increases in CHS and psychosis that clinicians report? Has the elimination of court-mandated treatment measurably decreased adolescent treatment engagement?
Common questions
What specific changes did clinicians see in teens?
How did legalization affect parents?
Read the original research
Clinician perspectives on adolescent cannabis-related beliefs and behaviors following recreational cannabis legalization.
Addictive behaviors, 156, 108046
Citation
Young-Wolff, Kelly C; Does, Monique B; Mian, Maha N; Sterling, Stacy A; Satre, Derek D; Campbell, Cynthia I; Silver, Lynn D; Alexeeff, Stacey E; Cunningham, Sarah F; Asyyed, Asma; Altschuler, Andrea. (2024). Clinician perspectives on adolescent cannabis-related beliefs and behaviors following recreational cannabis legalization.. Addictive behaviors, 156, 108046. https://doi.org/10.1016/j.addbeh.2024.108046
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