Elysse was 14 when she first started vaping cannabis.
It didn’t smell, which made it easy to hide from her parents. And it was convenient; just press a button and inhale. After the second or third try, she was hooked.
“It was insane. Insane euphoria,” said Elysse, now 18, whose last name is being withheld to protect her privacy. “Everything went slowly. I got super hungry. Everything was hilarious.”
But the euphoria eventually turned into something more disturbing. Sometimes the marijuana made Elysse more anxious or sad. Another time she passed out in the shower, only to wake up half an hour later.
This was not your average weed. The oil and wax she bought from dealers usually contained about 90% THC, the psychoactive component in marijuana. But because these products were cannabis-derived and almost everyone she knew used them, she assumed they were relatively safe. She started vaping several times a day. Her parents only found out about a year later, in 2019.
“We put her in a program to help her with that. We’ve tried hard love. We’ve tried everything, to be honest,” Elysse’s father said of her addiction.
Beginning in 2020, she began to have mysterious bouts of illness, causing her to vomit again and again. At first, she and her parents—and even her doctors—were baffled. During one episode, Elysse said she was throwing up in the bathroom of a mall for an hour. “It felt like my body was floating.”
Another time, she estimated that she was vomiting at least 20 times in two hours.
It wasn’t until 2021, after half a dozen trips to the emergency room for stomach ailments, including several hospital stays, that a gastroenterologist diagnosed her with cannabinoid hyperemesis syndrome, a condition that causes repetitive vomiting in heavy marijuana users.
Although recreational cannabis is illegal in the United States for those under the age of 21, it has become more accessible as many states have legalized it. But experts say today’s high-THC cannabis products – very different from joints smoked decades ago – are poisoning some heavy users, including teenagers.
Marijuana isn’t as dangerous as a drug like fentanyl, but it can have potentially harmful effects, especially for young people whose brains are still developing. In addition to uncontrollable vomiting and addiction, adolescents who frequently use high doses of cannabis may experience psychosis that can lead to a lifelong psychiatric disorder, an increased risk of developing depression and suicidal thoughts, changes in brain anatomy and connectivity, and poor memory.
But despite these dangers, the potency of the products on the market is largely unregulated.
‘I felt so trapped’
In 1995, the average THC concentration in cannabis samples seized by the Drug Enforcement Administration was approximately 4%. In 2017 that was 17%. And now cannabis manufacturers are extracting THC to create oils, edibles, waxes, sugar crystals, and glass-like products called shatter that advertise high THC levels—more than 95% in some cases.
Meanwhile, average levels of CBD – the cannabis plant’s non-intoxicating compound that has been linked to relief from seizures, pain, anxiety and inflammation – has declined in cannabis plants. Studies suggest that lower CBD levels can make cannabis more addictive.
THC concentrates “are as close to the cannabis plant as strawberries are to Frosted Strawberry Pop-Tarts,” Beatriz Carlini, a research scientist at the Addictions, Drug and Alcohol Institute at the University of Washington, wrote in a report on the health risks of highly concentrated hemp.
While cannabis is legal for recreational use in 19 states and Washington, DC, and for medical use in 37 states and DC, only Vermont and Connecticut have imposed limits on THC concentration. Both prohibition concentrates contain more than 60%, with the exception of pre-filled cartridges, and do not allow cannabis plant material to exceed 30% THC. But there’s little evidence to suggest that these particular levels are somehow safer.
National surveys suggest marijuana use has declined among eighth, tenth and twelfth graders in 2021, a change attributed in part to the pandemic. Over the two-year period from 2017-19, the number of children who reported using marijuana in the past 30 days, across all grades, nearly tripled among high school students. In 2020, 35% of seniors and a whopping 44% of college students reported using marijuana in the past year.
Elysse got sober before going to college, but soon discovered that apparently everyone in her dorm was habitually using weed.
“Not just carts,” she said, referring to the cannabis cartridges used in vape pens, “but bongs, pipes, bowls — absolutely everything.” Every morning at 8 a.m., she found students using their bongs in the communal bathroom to prepare for their “morning smoke.”
After a few weeks, she started vaping concentrated THC again, she said, and also started having dark thoughts, occasionally alone in her room and sobbing for hours.
“I felt so trapped,” said Elysse, who has been clean for nearly two months now. “There’s no way this is fun anymore.”
Teenagers in particular suffer from cannabis
Michael McDonell, an addiction treatment expert at Washington State University School of Medicine, said more research is needed to better understand how much more common psychosis and cannabinoid hyperemesis syndrome have become among teens and others who use potent products.
Still, he added, “we know for sure that there is a dose-dependent relationship between THC and psychosis.”
An in-depth study found that the risk of developing a psychotic disorder was five times higher among daily heavy cannabis users in Europe and Brazil than those who had never used it.
Another study, published in 2021 in JAMA Psychiatry, reported that in 1995, 2% of schizophrenia diagnoses in Denmark were associated with marijuana use, but by 2010, that figure had risen to 6% to 8%, which researchers associated with an increase. of cannabis use and potency.
Cannabinoid hyperemesis syndrome, which can often be relieved by hot baths and showers, is also linked to long-term, high-dose cannabis use. As with psychosis, it’s unclear why some people develop it and others don’t.
dr. Sharon Levy, director of the Adolescent Substance Use and Addiction Program at Boston Children’s Hospital, said there is “no doubt that products with a higher concentration increase the number of people who have had bad experiences with cannabis.”
“Oh, well, it’s just weed”
Laura Stack, who lives in Highlands Ranch, Colorado, said that when her son Johnny first confessed to using marijuana at age 14, she told herself, “Well, it’s just weed. Thank God it wasn’t cocaine.”
She had used marijuana a few times in high school and warned him that marijuana would “eat up your brain cells.” But at the time, she wasn’t too worried: “I was using it. I’m fine. What’s the problem?
“But I had no idea,” she added, referring to how marijuana has changed in recent years. “So many parents like me are completely ignorant.”
Initially, her son had no psychological problems and excelled in school. But eventually he started using potent marijuana products several times a day, and this, Stack said, “made him completely delusional.”
By the time he entered college, he had gone through several addiction treatment programs. He had become so paranoid that he thought the mafia was after him and that his university was a base for the FBI, Stack said. At one point, after he moved out of his childhood home, he threatened to kill the family dog unless his parents gave him money. His mother later learned that Johnny had received his own medical marijuana card when he turned 18 and started trading with younger children.
After several stays in mental hospitals, doctors determined that Johnny had a serious case of THC abuse, Stack said. He was prescribed an antipsychotic drug, which helped – but then he stopped. In 2019, Johnny died after jumping from a six-story building. He was 19. A few days before his death, Stack said, Johnny had apologized to her, saying that weed had destroyed his mind and his life, adding, “I’m sorry and I love you.”
There is ‘no known safe limit’
It can be difficult to determine exactly how much THC enters a person’s brain when they use cannabis. That’s because it’s not just frequency of use and THC concentration that affect dosage; it’s also how quickly the chemicals are delivered to the brain. In vaporizers, the rate of delivery can change depending on the base the THC is dissolved in, the strength of the device’s battery, and how hot the product gets when heated.
Higher doses of THC are more likely to cause anxiety, excitement, paranoia and psychosis.
“The younger you are, the more vulnerable your brain is to developing these problems,” Levy said.
According to the Substance Abuse and Mental Health Services Administration, young people are more likely to become addicted if they start using marijuana before the age of 18.
In addition, there is mounting evidence that cannabis can alter the brain during adolescence, a time when it is already undergoing structural changes. Until more is known, researchers and clinicians recommend postponing cannabis use until later in life.
“I have kids who ask me all the time, ‘What if I only do this once a month; is that okay?’” Levy said. “All I can tell them is that there is no known safe limit. “