Cannabis and the Developing Adolescent Brain

Purpose of review This review summarizes (1) recent trends in delta-9-tetrahydrocannabionol [THC] and cannabidiol (CBD) content in cannabis products, (2) mechanism of action of THC and CBD and the neurobiological correlates of cannabis use on the developing adolescent brain, (3) effects of cannabis on psychiatric symptoms and daily functioning in youth (i.e., academic performance, cognition, sleep and driving), (4) cannabis products used to relieve or treat medical issues in youth, and (5) available treatments for cannabis use disorder in adolescence. Recent findings Despite marked increases in THC content and availability of cannabis, there has been a decline in perceived risk and an increase in use of cannabis extract products among youth in the USA. The primary psychiatric symptoms associated with cannabis use in youth are increased risk for addiction, depressive, and psychotic symptoms. Adolescent cannabis exposure also contributes to impaired cognition, sleep, and driving ability. Cannabis alters endocannabinoid system function which plays a central role in modulating the neurodevelopment of reward and stress systems. However, few studies have examined neurobiological mechanisms underlying the psychiatric and functional sequalae of cannabis exposure in youth. To-date, FDA-approved cannabinoid medications are very limited, none of them supporting their use for the treatment of psychiatric symptoms. Behavioral therapies are currently the mainstay of treating cannabis misuse, with no pharmacotherapies currently approved by the FDA for cannabis use disorder in youth. Summary Here, we summarize the neurobiological, psychiatric, and daily function effects of the most commonly used cannabinoids: delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD). Our current understanding of the effects of cannabis on the developing brain and treatments for cannabis misuse in youth remain limited. Future research aimed at examining the neurobiological effects of cannabis, with objective measures of exposure, over the course of pediatric development and in relation to psychiatric symptoms are needed.