--- title: "When Green Means Stop (an update on marijuana use by adolescents) | Denver Psychiatry Blog" description: "According to the 2016 Monitoring the Future Survey, marijuana usage by American 8th and 10th graders has slightly declined over the last 5 years, while usage by 12th graders has been roughly the same...." lang: en json-ld: | [ { "@context": "https://schema.org", "@graph": [ { "@type": [ "MedicalBusiness", "MedicalOrganization", "LocalBusiness" ], "@id": "https://denverpsychiatry.com/#organization", "name": "Denver Psychiatry", "alternateName": "Denver Psychiatry - Dr. Steve Sarche", "description": "Denver Psychiatry is a private psychiatric practice founded by Dr. Steve Sarche in 2004, providing comprehensive mental health services for children, adolescents, and adults in the Denver metropolitan area.", "url": "https://denverpsychiatry.com", "logo": { "@type": "ImageObject", "url": "https://denverpsychiatry.com/logo.png" }, "image": "https://denverpsychiatry.com/og-image.png", "telephone": "+1-303-393-8808", "faxNumber": "+1-303-399-6069", "email": "drsteve@denverpsychiatry.com", "foundingDate": "2004", "founder": { "@id": "https://denverpsychiatry.com/#physician" }, "priceRange": "$$", "address": { "@type": "PostalAddress", "streetAddress": "720 S Colorado Blvd, Suite 910N", "addressLocality": "Denver", "addressRegion": "CO", "postalCode": "80246", "addressCountry": "US" }, "geo": { "@type": "GeoCoordinates", "latitude": 39.7086, "longitude": -104.9567 }, "areaServed": { "@type": "GeoCircle", "geoMidpoint": { "@type": "GeoCoordinates", "latitude": 39.7086, "longitude": -104.9567 }, "geoRadius": "50000" }, "medicalSpecialty": [ "Psychiatry", "Child and Adolescent Psychiatry", "Adult Psychiatry" ], "employee": [ { "@id": "https://denverpsychiatry.com/#physician" } ], "availableService": [ { "@type": "MedicalProcedure", "name": "Psychiatric Evaluation", "description": "Comprehensive initial evaluation for accurate diagnosis and treatment planning" }, { "@type": "MedicalProcedure", "name": "Medication Management", "description": "Expert prescription and monitoring of psychiatric medications" }, { "@type": "MedicalProcedure", "name": "Child & Adolescent Psychiatry", "description": "Age-appropriate psychiatric care for children and adolescents (ages 10+)" }, { "@type": "MedicalProcedure", "name": "Anxiety Treatment", "description": "Treatment for generalized anxiety, panic disorder, social anxiety, and PTSD" }, { "@type": "MedicalProcedure", "name": "Depression Treatment", "description": "Comprehensive treatment for major depression and mood disorders" }, { "@type": "MedicalProcedure", "name": "ADHD Treatment", "description": "Diagnosis and treatment of attention deficit disorders in all ages" }, { "@type": "MedicalProcedure", "name": "PTSD & Trauma Treatment", "description": "Compassionate, evidence-based care for post-traumatic stress and trauma-related conditions" } ], "openingHoursSpecification": { "@type": "OpeningHoursSpecification", "dayOfWeek": [ "Monday", "Tuesday", "Wednesday", "Thursday", "Friday" ], "opens": "09:00", "closes": "17:00" }, "aggregateRating": { "@type": "AggregateRating", "ratingValue": "5", "reviewCount": "50" }, "sameAs": [] }, { "@type": [ "Physician", "Person" ], "@id": "https://denverpsychiatry.com/#physician", "name": "Dr. Steve Sarche, D.O.", "alternateName": "Steve Sarche", "description": "Dr. Steve Sarche is a board-certified psychiatrist specializing in child, adolescent, and adult psychiatry. 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For children and adolescents, this includes integrated meetings with parents. By the end of 1-2 visits, you'll have a clear clinical formulation and personalized treatment plan." } }, { "@type": "Question", "name": "Does Denver Psychiatry treat both children and adults?", "acceptedAnswer": { "@type": "Answer", "text": "Yes, Dr. Steve Sarche is board certified in both general psychiatry and child & adolescent psychiatry. Denver Psychiatry provides comprehensive care for patients ages 10 and older, with age-appropriate treatment approaches." } }, { "@type": "Question", "name": "What mental health conditions does Denver Psychiatry treat?", "acceptedAnswer": { "@type": "Answer", "text": "Denver Psychiatry treats a wide range of mental health conditions including anxiety disorders, depression, bipolar disorder, ADHD, PTSD, situational stress, behavioral problems, and relational difficulties. Dr. Sarche takes a comprehensive, holistic approach to diagnosis and treatment." } }, { "@type": "Question", "name": "Does Denver Psychiatry offer non-medication treatments?", "acceptedAnswer": { "@type": "Answer", "text": "Absolutely. While medication can be an important part of treatment, Dr. Sarche also emphasizes non-medication modalities including sleep hygiene strategies, lifestyle modifications, stress reduction techniques, and therapeutic approaches. Treatment is tailored to each individual's needs and preferences." } }, { "@type": "Question", "name": "What is the difference between a D.O. and an M.D. psychiatrist?", "acceptedAnswer": { "@type": "Answer", "text": "Osteopathic physicians (D.O.s) receive the same training as M.D.s but with additional focus on the interconnection between the body's systems. 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The staff will help you find a convenient time and answer any questions about your first visit." } } ] }, { "@type": "Blog", "@id": "https://denverpsychiatry.com/#blog", "name": "Denver Psychiatry Mental Health Blog", "description": "Expert insights and articles on mental health topics from Dr. Steve Sarche, board-certified psychiatrist in Denver, Colorado.", "url": "https://denverpsychiatry.com/blog", "author": { "@id": "https://denverpsychiatry.com/#physician" }, "publisher": { "@id": "https://denverpsychiatry.com/#organization" } } ] }, { "@context": "https://schema.org", "@type": "Article", "headline": "When Green Means Stop (an update on marijuana use by adolescents)", "description": "According to the 2016 Monitoring the Future Survey, marijuana usage by American 8th and 10th graders has slightly declined over the last 5 years, while usage by 12th graders has been roughly the same....", "author": { "@type": "Person", "name": "Dr. Steve Sarche", "jobTitle": "Board Certified Psychiatrist" }, "publisher": { "@type": "Organization", "name": "Denver Psychiatry", "url": "https://denverpsychiatry.com" }, "datePublished": "2017-07-06T18:36:52+00:00", "mainEntityOfPage": { "@type": "WebPage", "@id": "https://denverpsychiatry.com/article/when-green-means-stop-an-update-on-marijuana-use-by-adolescents" } } ] --- [ Denver Psychiatry Dr. Steve Sarche, D.O. ](#home) [](tel:303-393-8808) [ Denver Psychiatry Dr. Steve Sarche, D.O. ](#home) [Home](#home) Services ### Conditions We Treat [ ADHD Treatment Child & adult ADHD specialist care ](/adhd)[ Anxiety Treatment Generalized anxiety, panic, social anxiety ](/anxiety-treatment)[ Depression Treatment Major depression, bipolar, mood disorders ](/depression-treatment)[ PTSD & Trauma Treatment Trauma recovery focused on full healing ](/ptsd-trauma-treatment) ### Specialty Care [ Child & Adolescent Psychiatry Fellowship-trained, ages 10 and up ](/child-adolescent-psychiatry)[ Performance Optimization Precision psychiatry for high performers ](/performance-optimization)[ Medication Management Expert prescription and monitoring ](#services) #### Talk to Dr. Sarche Call to schedule your initial evaluation [Call Now](tel:303-393-8808) About ### About Us [ Dr. Steve Sarche, D.O. 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Learn what to expect at your first visit [Learn More](#services) Contact ### Get In Touch [ Contact Form Send us a message ](#contact)[ Call Us (303) 393-8808 ](tel:303-393-8808)[ Our Location 720 S Colorado Blvd, Suite 910N ](#contact) [Call Dr. Sarche](tel:303-393-8808) [Back to Blog](/blog) Child & Adolescent # When Green Means Stop (an update on marijuana use by adolescents) Dr. Steve Sarche Board Certified Psychiatrist • Thursday, July 6, 2017 • 8 min read Share: [](https://www.facebook.com/sharer/sharer.php?u=https%3A%2F%2Fdrsteve.lovable.app%2Farticle%2Fwhen-green-means-stop-an-update-on-marijuana-use-by-adolescents)[](https://twitter.com/intent/tweet?url=https%3A%2F%2Fdrsteve.lovable.app%2Farticle%2Fwhen-green-means-stop-an-update-on-marijuana-use-by-adolescents&text=When%20Green%20Means%20Stop%20\(an%20update%20on%20marijuana%20use%20by%20adolescents\))[](https://www.linkedin.com/shareArticle?mini=true&url=https%3A%2F%2Fdrsteve.lovable.app%2Farticle%2Fwhen-green-means-stop-an-update-on-marijuana-use-by-adolescents&title=When%20Green%20Means%20Stop%20\(an%20update%20on%20marijuana%20use%20by%20adolescents\))[]() According to the 2016 Monitoring the Future Survey, marijuana usage by American 8th and 10th graders has slightly declined over the last 5 years, while usage by 12th graders has been roughly the same. States with legal medical marijuana have higher rates of adolescent usage than the other states. Marijuana is basically the name for the dried and shredded leaves and flowers of the cannabis plant. Delta-9-Tetrahydrocannabinol (THC) is the main active ingredient in cannabis, but the plant contains at least 489 chemical compounds, with an estimated 70 cannabinoids (substances that can affect how we feel or affect us cognitively). Shortly after smoking cannabis, heart rate increases, the bronchial system relaxes and becomes enlarged, and eyes become red as blood vessels expand.   Generally a person will experience feelings of euphoria and relaxation with increased appetite, pain relief, followed by sleepiness.   Some people will experience anxiety and paranoia. The human nervous system has an endocannabinoid system with cannabinoid receptors (CB receptors). There is an increasing body of literature showing that the endocannabinoid system plays an important role in brain development and maturation (Compton, psychiatry news, 5/20/2016, 10). The role of the endocannabinoid system in neural development is likely why younger people, especially those under the age of 16, have a much higher risk of negative side effects of using cannabis. The effects of THC are more potent and last longer than the natural neurotransmitter, anandamide, that THC mimics. CB receptors are most abundant in areas of the brain responsible for pleasure, reward, cognition, memory, motor coordination and pain perception. Marie Banich, a well-known neuroscientist, describes how teens generally lack a mature ability to conceptualize the future, have a high reward and novelty seeking drive, have less self-control, are less organized in their decision making, and more vulnerable to peer pressure.   These are all aspects of executive functioning. Teens additionally are highly responsive to reward over punishment. This means their decisions are driven by now and not later.   As Banich says, they clearly see the carrot but they don’t see the stick as well. The part of the brain most responsible for executive functioning is the frontal lobe.   The frontal lobe mostly consists of white matter.   White matter is crucial in facilitating communication between different regions of the brain.   White matter tracks develop well into the 20’s. Earlier exposure to drugs or trauma may stunt development of white matter tracks. One study showed that adults exposed to cannabis earlier in life had less developed white matter than non-users (Coloradan, summer 2017, P 25). Frequent cannabis use has been linked to poorer educational and social outcomes in teens. This includes higher school dropout rates, and overall feelings of inferior life and interpersonal satisfaction. McLeod and colleagues additionally showed that cannabis use is consistently associated with lower grades (Lancet, 2004, 1579-88). Studies have also shown that frequent users tend to have increased absences and accidents at school or work and higher job turnover. The recent proliferation of genetically engineered strains of cannabis have resulted in an increased ratio of THC to other chemicals and that may be what causes even more harm. Adolescents are particularly prone to other negative effects of cannabis use as well. Acutely, it causes decreased attention, poor concentration, slow reaction times, short-term memory deficits, increased errors in task, and poor fine motor coordination. One study showed that these effects can last at least 28 days after last use (Hall and Degenhardt, Lancet 2009, 1383-1391). Heavy (daily) use places teens and young adults at the highest risk for these cognitive problems, and ongoing use can evolve to generally slower psychomotor speeds, poor sequencing ability, and difficulties in visual processing and verbal story memory. These findings are backed by functional imaging that has shown lower activity in brain regions involved in memory and attention in chronic cannabis users. Of considerable concern, there is a report that adults who used cannabis at younger ages had ongoing cognitive issues, even after cessation (Gonzalez, Swanson, Pro Natl Acad Sci, 2012, 15970-15971). On the other hand, Banich has shown that exercise and activities that engage many parts of the brain, such as reading, playing sports and playing music, improve cognitive abilities and overall brain development. She notes that the right or wrong stimulus at the right or wrong time may make or break how a teenager develops, depending on their individual susceptibility to various factors. Psychiatric side effects, especially for those who start using before age of 16 or for those using heavily at age 21, include depression and anxiety. Additionally, ­­­­­­­­those prone to schizophrenia have an enhanced risk of an episode of acute psychosis.   Heavy cannabis use can also cause earlier onset of psychotic illness. Depending on age of first use and genetic make-up, it is thought that cannabis use can cause a psychotic illness in and of itself. Regular use may also lead to generally poorer outcomes with any psychiatric treatment. Cannabis can be addictive. There is approximately a 1 in 7 chance that a teenager who uses cannabis will develop an addiction to it. Regular use of cannabis can cause tolerance, psychosocial problems, interpersonal problems, loss of self-control, and diminished productivity. People will continue use despite problems. Cannabis withdrawal has also been identified manifested by irritability, anxiety, insomnia, dysphoria, craving, and appetite changes. These are all characteristics of drug dependency or addiction. There is also an associated gateway effect. It was shown that regular users of cannabis have a 124 times higher risk for initiating other illicit drug use (Mayet, Legleye et al, Addict Behav, 2012, 160-6). Health risks include cough, bronchitis, and lung infections. Due to elevated heart rate and toxins in smoke, there is a higher risk for cardiovascular problems.   There is evidence that smoked cannabis can contribute to various kinds of cancers. Cannabis smoke does contain toxins found in tobacco smoke such as carbon monoxide and cyanide. While it has been reported that casual use can increase air flow due to bronchial expansion, there may be more lung damage with regular use due to the fact cannabis users tend to inhale more deeply and hold the smoke in longer than tobacco users. Synthetic cannabinoids, “Spice” or “K2”, are a combination of herbs and chemical compounds similar to THC, but more potent. They gained popularity because they may not be detected in typical urine drug screens. The effects are similar to cannabis, but they are also considered more dangerous as the mixture of substances varies greatly.   Synthetics have the same physical and mental health risks that natural cannabinoids have, but also seizures, increased risk for cardiovascular damage, kidney damage, and a greater risk for psychosis. It is estimated that 1 in 10 high school aged kids in the US have tried this, and the adverse effects can happen after one use. How do we help teenagers make better decisions about using cannabis (hopefully helping them decide not to)? That is not the scope of this article, but in a nutshell, family support work is important with motivational interviewing, incentive based interventions, and cognitive behavioral therapy (CBT) with focus on building life skills. CBT helps anticipate triggers for use and helps build coping strategies for those.   There is a program at Denver Health for this called the “STEP Program” at 303-602-1893. They do thorough consultations and offer interventions. If cannabis is being used by your teenager, urge him to keep an eye out not only for the benefits but for any side effects it is causing. Watch for trends in use, especially any increases and the usage of any other substances. Get as many details as possible about what is being used, as well as the volume and frequency of use. Sometimes consequences in the form of punishments are needed, but incentives work better in helping with long-term abstinence. Keep the discussions open, listen, and make it a conversation, not an argument or lecture.   Work to understand the motivations for his use and help him decide he wants to cut back for himself. Find what incentives would lead to that. As teenagers have less sight of the stick, more of the carrot, they ultimately have to figure out for themselves why it is worth not using. Although the research shows association, not causation of the problems of cannabis use, I advise teenagers under age 16 across the board that they should not take any chances with using marijuana under any circumstances.    _-Thanks to Douaihy, Cannabis Revisited, UPMC Synergies, Fall 2013._ Share: [](https://www.facebook.com/sharer/sharer.php?u=https%3A%2F%2Fdrsteve.lovable.app%2Farticle%2Fwhen-green-means-stop-an-update-on-marijuana-use-by-adolescents)[](https://twitter.com/intent/tweet?url=https%3A%2F%2Fdrsteve.lovable.app%2Farticle%2Fwhen-green-means-stop-an-update-on-marijuana-use-by-adolescents&text=When%20Green%20Means%20Stop%20\(an%20update%20on%20marijuana%20use%20by%20adolescents\))[](https://www.linkedin.com/shareArticle?mini=true&url=https%3A%2F%2Fdrsteve.lovable.app%2Farticle%2Fwhen-green-means-stop-an-update-on-marijuana-use-by-adolescents&title=When%20Green%20Means%20Stop%20\(an%20update%20on%20marijuana%20use%20by%20adolescents\))[]() ### Need Help With Your Mental Health? 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