My Viewpoint:
What the Data Actually Says About Adolescent Marijuana Use

A perspective from an addiction counselor with nearly two decades in the field

By Matt Hawk, B.Sc., ADC (IC&RC), CAC II (ADACBGA)

 

A study published earlier this year tracked the mental health outcomes of nearly 460,000 adolescents. It is believed to be the largest of its kind ever conducted. The findings were not subtle: teens who used cannabis faced more than double the risk of developing psychosis, double the risk of bipolar disorder, a 34 percent higher risk of depression, and a 25 percent higher risk of anxiety compared to those who did not use cannabis.

I have worked in the field of addiction since 2008 in various capacities and became a certified addiction counselor in 2018. It is not that I was unaware marijuana caused problems. As a young adult, I had firsthand experience failing my college classes because of it. In my work, I met people who could not get through the day without smoking some form of cannabis. But until now, the consequences of marijuana use seemed minor when compared with other substances. In close to 20 years, I have never seen a case of someone stealing to support their marijuana habit. I have never had to help someone who had only smoked cannabis come to terms with contracting an incurable disease from intravenous drug use. For adults, the consequences of marijuana use are not even comparable to those of alcohol.

I thought I had a clear picture of the risks. This study showed me that for teenagers and young adults, that picture was incomplete. For adolescents, marijuana use carries significant risks comparable to other drugs. A lifetime of mental health problems may not have the immediacy of overdose, but those problems can be catastrophic. And even when they are not, they significantly increase the likelihood that a young person will go on to self-medicate with other drugs and alcohol.

The question now is whether the people making policy decisions about marijuana will look at the same data and arrive at the same conclusion. I will be honest: the potential harm of adolescent marijuana use surprised me. But seeing those numbers laid out at this scale quickly changed my mind. More than double the risk of psychosis. Double the risk of bipolar disorder. And this tracked young people with no prior signs of mental health problems. We are not talking about kids who were already vulnerable in obvious ways. We are talking about ordinary adolescents whose risk profile changed significantly because of cannabis use. That is not what the public conversation around marijuana sounds like. Not even close.

“With legalization, we’ve had a tremendous wave of this perception of cannabis as a safe, natural product to treat your stress with. That is simply not true.”

— Dr. Lynn Silver, co-author of the study

What the Research Actually Shows

The study, titled “Adolescent Cannabis Use and Risk of Psychotic, Bipolar, Depressive, and Anxiety Disorders” and published in JAMA Network, https://jamanetwork.com/journals/jama-health-forum/fullarticle/2845356 followed youth with no prior signs of mental health problems until the age of 25. The results were stark. Teens who used cannabis faced more than double the risk of developing psychosis. They faced double the risk of bipolar disorder. Depression risk increased by 34 percent and anxiety by 25 percent. By every measure tracked, regular cannabis use during adolescence was associated with significantly worse long-term mental health outcomes.

The authors believe this is the largest study of its kind ever conducted. That matters. Skeptics can dismiss smaller studies as anomalies. They cannot as easily dismiss half a million data points. And this research does not stand alone. A Finnish study found that teenagers who used cannabis by age 15 or 16 had nearly four times the risk of self-harm compared to those who did not. A Swedish longitudinal study found that heavy use at age 18 increased the risk of later schizophrenia sixfold. The body of evidence, taken as a whole, is no longer ambiguous. The direction of the research is consistent, and the magnitude of the risk is serious.

The Gap Between Perception and Reality

Here is the problem I encounter in my work and in the broader culture almost every day: public perception has moved in exactly the wrong direction. Forty states have now legalized cannabis in some form, either medically, recreationally, or both. The messaging from the legal market is relentlessly positive. Dispensaries present themselves as wellness destinations. Products are marketed for stress, sleep, creativity, and pain. Nowhere in that messaging is there a frank acknowledgment that regular use during adolescence may increase a young person’s risk of spending the rest of their adult life managing a serious mental health condition.

Approximately one in ten young people is using cannabis monthly. That translates to roughly four million adolescents and young adults exposed to this elevated risk every month, in a market designed to grow, not to caution. The legal market did not create this problem. But it has absolutely made it harder to talk honestly about it.

In February 2026, the editorial board of The New York Times published a piece titled “It’s Time for America to Admit That It Has a Marijuana Problem.” https://www.nytimes.com/2026/02/09/opinion/regulate-legalized-marijuana.html That is a remarkable statement from an institution that a decade ago compared the federal marijuana ban to alcohol prohibition and characterized marijuana addiction as a relatively minor concern. The board now acknowledges that many of those predictions were wrong. Daily use has surged. Addiction rates have climbed, and the broader consequences of heavy, habitual use have materialized in ways that legalization advocates did not foresee.

Seeking a Real Solution

Criminalizing marijuana possession and use has not worked. Despite decades of enforcement, cannabis use rates in the United States remain among the highest in the world, demonstrating that prohibition has failed as a deterrent. What it has accomplished is the disproportionate arrest and prosecution of Black and Latino communities, who face enforcement at rates far exceeding those of white Americans despite similar patterns of use. The consequences include criminal records, lost employment, disrupted families, and restricted access to housing and education, all of which have caused lasting harm to communities already navigating systemic disadvantage. Criminalization may even contribute to the use of harder substances by creating a group of citizens who simply cannot get ahead of the consequences.

What has worked for other substances that pose this level of harm is what the late drug policy scholar Mark Kleiman called “grudging toleration.” The concept is that governments can keep a substance legal while aggressively working to minimize its harms through tight market controls, honest public messaging, and cultural norm-shifting. Applied here, that framework would look something like this: decriminalize use and possession, heavily regulate who can sell cannabis and under what conditions, prohibit unsubstantiated health claims, require meaningful warning labels on high-THC products, and invest seriously in drug education that actually works.

The decline in tobacco use shows what can happen when policy and education shift how the public views a harmful product. Anti-smoking campaigns reduced youth smoking rates dramatically over decades. We did not prohibit cigarettes. We changed the culture around them by being honest about what they do to people. There is no reason that same approach cannot work with cannabis. But right now, the market is structured to maximize profit, not to minimize harm, and the regulatory framework in most states is nowhere near strong enough to change that.

What Education Can Actually Do

Not long ago I attended a Narconon drug education presentation given to a mixed group of kids, some middle school age, some older. The room had that familiar energy where half of them looked like they would rather be anywhere else and the other half were watching the presenter carefully to see if they were going to say anything real. When the presentation started to cover marijuana, I watched the posture in the room shift.

A hand went up from a kid toward the back, maybe thirteen or fourteen years old. He was not being a smart aleck. He genuinely wanted to know. “But isn’t it natural?” he asked. “Like, it comes from a plant. How bad can it actually be?”

It was a good question. Rather than simply saying marijuana is bad, the presenter walked him through what the research actually shows about the developing brain. Keeping the information specific to the person asking allowed him to receive it. Instead of a blanket warning that marijuana is harmful to everyone, the focus stayed on why it is particularly harmful to kids.

At the end of the session, that same kid approached the presenter. He said, quietly, that he had not known it was actually risky. He had heard adults say marijuana was dangerous his whole life, but at the same time, half of his family smoked it. He had honestly been confused.

That is the whole point. Scare tactics bounce off kids. Honest information sticks. The Narconon approach works because it treats young people as capable of handling the truth, and in my experience, they are. They just need someone to give it to them straight.

The Responsibility Is Ours

Legalization is now a reality in most of this country. That is not going to change. What can change is how seriously we take our responsibility to pair that legalization with honest, evidence-based public health infrastructure. Warning labels. Age restrictions with real enforcement. Restrictions on marketing. Prohibition of unsubstantiated medical claims. Robust treatment and prevention funding. These are not radical demands. They are the minimum standard of responsibility we owe to young people who are making decisions in an environment that is actively misleading them.