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Mental Health Experts Worry About Increasing Marijuana Use Among Kids During COVID

Rate of Cook Children's Patients Reporting Marijuana Use Up 33% Compared to Pre-Pandemic

Written by: Jean Yaeger
Stock photo - marijuana

Anxiety and depression drive some teens to recreational marijuana as a way to self-medicate. But that coping strategy can backfire.

Health advocacy groups indicate a link between marijuana use and an increased chance for mental health problems. The National Institute on Drug Abuse and the American Academy of Child Adolescent Psychiatry, for instance, both list a correlation to schizophrenia, depression and anxiety. The Centers for Disease Control and Prevention cites those risks plus temporary psychosis – “not knowing what is real, hallucinations and paranoia” – on its list of mental health implications for dope users.

Lisa Elliott, Ph.D., psychologist/neuropsychologist and manager of the Behavioral Health Clinic at Cook Children’s in Denton, estimated that at least half of her adolescent patients report having tried or using marijuana. For those already struggling with their emotional well-being, is this something to avoid? “Yes. Put that in all capital letters: YES. We have too much evidence to show how harmful it is,” Dr. Elliott said. “There is a significant amount of research that supports the negative impact marijuana/THC use has, especially on the developing brain, so much so that it scares me for our kids’ future.”

Read more about the link between suicidality and young adults here.

Those harmful effects go beyond anxiety and depression to include impairment to intellectual functioning, memory, learning, attention, problem-solving skills and coordination, according to Dr. Elliott. Marijuana use also can cause coughing and wheezing, damage to the immune system and addiction for some people, she said. And when it comes to suicide, some studies show a relationship.    

“There’s been a significant increase in suicides as well as mental health disorders in states that have legalized marijuana,” Dr. Elliott said. “Can we say that marijuana causes suicides? We can’t really say that, but there’s a direct correlation. However, we also know that whenever you’re more depressed and also if you’re coming out of depression, you’re more likely to feel suicidal.”

Just breathe. Open up. You matter. That’s the truth behind the Joy Campaign, an ongoing rollout of articles, videos and other resources aimed to prevent youth suicide. Cook Children’s initiated the Joy Campaign in response to rising numbers of suicide attempts in our region and nationally. While raising awareness, the Joy Campaign delivers help and hope for children and teens who struggle with mental health. This article looks at the ways marijuana use complicates the picture.

How common is recreational marijuana among adolescents? The National Institute on Drug Abuse reports that 11.4% of eighth graders and 35.2% of 12th graders surveyed in 2020 said they had used marijuana in the past year. The Substance Abuse and Mental Health Services Administration calls marijuana the most common illegal drug in the United States, with particular risks for young users and pregnant women.

At Cook Children’s in 2019, there were 830 patients who acknowledged recent use of marijuana when they came to the Emergency Department (ED) for various complaints. That statistic increased to 986 patients in 2020 and 1,105 patients in 2021.  Patients as young as 10 years old were among that group who indicated “yes” to marijuana use on their ED intake paperwork.

In that three-year span at Cook Children’s, most of those who admitted using marijuana were discharged from the ED to home or self-care. Records show some of those patients left the ED against medical advice or were discharged to court or law enforcement. And there were 207 self-reporting marijuana users who were discharged from the Cook Children’s ED to psychiatric hospitals during 2019-2021.

 Dr. Elliott and others say marijuana products have become more potent in recent years. The cannabis plant’s main psychoactive ingredient, a molecule called tetrahydrocannabinol (THC), causes the “high” feeling. Marijuana can be smoked, vaped in an electronic cigarette, eaten in candy or baked edibles, or inhaled in dabs that contain especially high THC concentration.  

Recreational marijuana remains illegal in Texas. In states where it’s legal, consumers must be 21 or older to buy marijuana for non-medical use. Recreational use differs from approved medical use of cannabidiol oil (CBD). Doctors may prescribe CBD in children to help manage epileptic seizures and some other illnesses. But many young people mistakenly confuse THC with the medicinal value of CBD, Dr. Elliott said.  

To set the record straight in therapy sessions, she provides her patients with facts about the documented negative impacts of marijuana, including exacerbated problems with mental health, impaired driving, difficulty in school, diminished IQ scores, aggression, anger and legal consequences. Adolescents who admit to marijuana use tell Dr. Elliott that the drug is easy to come by, even at home or school. She asks them why they started and how it impacts them.

“They’ll say that they will smoke marijuana because it helps them deal with the stress and the trauma and as well as the conflict and unrest in our world. Some of them report that it helps them feel happier, relaxed. Several report that they use it to help them sleep. And several of them report that they used it because they were bored (during the pandemic lockdown) and couldn’t go do things.”

Depending on the reason they’re using the drug, Dr. Elliott works with her patients to treat any contributing factors such as anxiety or depression, peer pressure and low self-esteem. “I try to encourage them and lead them toward healthy coping tools,” she said. “There have been times when I have discharged patients and referred them to therapists who specialize in drugs and addiction because they’re unwilling to stop smoking. Therapy is not productive if they’re high.”  

The Child Mind Institute, a nonprofit organization promoting mental health, sponsored a virtual symposium in October 2021 that featured new research and a panel of experts on the topic “Marijuana and the Teenage Brain.” Among the symposium’s highlights: 

THC exposure in animal models has shown repeated association with increased risk for developing anxiety, depression, substance abuse disorders and psychosis. Exposure to THC changes the cells in the brain and restructures how the gene networks talk to each other.

Adolescence is a critical period for brain development. The adolescent brain is primed to take risks, satisfy immediate wants and be easily swayed by social influences.

Parents should have frequent conversations with their children about the facts that marijuana can be addictive, there’s no such thing as a safe amount, and there’s no way to predict how it will impact a person. Factors such as age, genetics and amount/concentration of the drug play a role. 

 Dr. Elliott cited the statistic that about 1 in 10 people who use marijuana will become addicted. For those who start using before age 18, the addiction risk rises to 1 in 6. Warning signs of Cannabis Use Disorder include cravings, unsuccessful efforts to quit, and increased tolerance to the drug.

“One of the most frightening concerns with marijuana use is the increase in psychotic episodes, especially in those who have a family history of mental illness,” she said. “We also know the recent research really shows that for kids and teens who smoke that higher potency of marijuana, it will increase their chances of developing psychosis nearly five times more than those who have never used.”

Parents should stay alert to behavior changes -- such as secrecy, a sudden decline in grades, less motivation – that might point to a cause for concern in teens. Dr. Elliott recommended that parents speak to their children early and often about the dangers of marijuana. Her encouragement to parents? Keep an ongoing dialogue, stay calm, and set clear expectations and boundaries. And if their teens do start using marijuana, find out why.  

“If they’re feeling stressed, let’s get them into therapy. If they need help sleeping, let’s go talk to our pediatrician and get the sleep addressed,” Dr. Elliott said. She pointed to the good news of hope for families who stay vigilant regarding drug use, social media and mental health in general.

“Parents need to increase their awareness and be hyper alert to this as being an issue. And to create that dialogue and open communication and to be willing to seek help, because if you’re willing to seek help, it teaches your child healthy coping tools.”

About Cook Children's Behavioral Health Program 

Growing up in today's world is hard, and many children or teens may go through life experiences that cause them to feel anxious, depressed or even suicidal. It can be hard for parents and caregivers to know when to ask for help. The Behavioral Health Center at Cook Children’s brings all services together in an expanded space to provide a dedicated team of physicians and professionals with the facilities, resources, tools and programs that deliver the high-quality treatment these vulnerable children need and deserve.

Cook Children's Behavioral Health (

Joy Campaign Resource Sheet

About the Joy Campaign

Cook Children's Joy Campaign is a communication initiative that aims to encourage hope and resilience among children and teens.

Joy stands for: Just breathe. Open up. You matter.

The number of children and teens suffering from anxiety, stress and depression is skyrocketing. Sadly, Cook Children's has seen a record number of patients attempting suicide in the past year. The Joy Campaign is a suicide prevention communication initiative led by Cook Children's to bring hope and needed resources to children and families facing struggles and dark times in their lives.

Learn more about the Joy Campaign and available mental health resources here. 

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