As a pediatrician who has treated thousands of children in Colorado and New Mexico, I frequently discuss cannabis use during visits. My goal in these conversations is to provide the information that my patients need to make healthy life decisions. In recent years, I have noticed that more and more of the young people I see in my clinic have begun to vape or dab. Many of them report that their friends are vaping and dabbing, even in school. When talking with parents, medical providers, child psychologists and school officials, they are observing this trend as well. In the seven years since recreational dispensaries opened in Colorado, a new class of high-potency THC products has come into existence. While we are accustomed to thinking of cannabis as harmless, these new high-potency products bear almost no resemblance to cannabis and have been repeatedly shown to cause or exacerbate psychosis, dependency, and depression in young people. As leaders in the legalization of cannabis, Colorado has a responsibility to follow-up with the industry and address unintended consequences.
It is important to emphasize that cannabis use has greatly evolved from 2012. At that time, THC potency hovered at around 10-15% for most products, and flower and edible sales characterized the industry. However, the use of concentrates has escalated quickly during the first four years of legal recreational sales, rising from 11% of recreational users to 23.4% of recreational users. At the same time, the average potency of THC concentrates climbed dramatically, from 56% to 68.6%. Meanwhile, recent data from the Healthy Kids Colorado Survey shows that dabbing has become the second most-common method of use among high school students. In 2019, 52% of students who reported that they had recently used THC products stated that they had dabbed, skyrocketing from 20.3% in 2017. Given that this is self-reported data, we can assume that the prevalence of dabbing is even higher.
Substantial research has shown how these products can exacerbate mental health issues among our youth. A new study in JAMA Pediatrics, published less than a month ago, demonstrates that cannabis use disorder is a common comorbidity for youth with mood disorders. A 2016 paper by researchers at King’s College, London, which reviewed over a dozen studies conducted across the globe, found that people using high-potency THC products daily were five times more likely than non-users to suffer from a psychotic disorder. Their paper also found that concentrates have a far stronger link to increased risk for psychosis than hashish and low-potency products. Examining this data alongside the Healthy Kids survey results paints a troubling picture: as the use of concentrates rises, so will the mental health issues that Colorado’s youth experience.
Unfortunately, this is already playing out across our state. From Boulder to Pueblo, I have heard countless testimonies that follow a similar trend: a child, patient, or student begins to use concentrates, their use intensifies, and then they experience a number of mental health issues. I have received many emails from parents who have seen the lives and health of their children change drastically due to use of high potency products. Those who have recovered report that many of their friends are struggling with concentrate use as well. These products are not cannabis, and it’s nearly impossible for adults to fully comprehend how our youth are in a completely different situation than what previous generations experienced, even millennials who grew up during the dawn of legalization.
As with many bills I carry, my reasons for taking on issues around high-potency THC products in my upcoming legislation go back to the patients I see every day. In the last year alone, I have been involved in the care of a young man who has dealt with increasingly serious mental health issues as his THC use has increased, and I have also cared for a teenage girl who lost over 25 pounds due to frequent THC use that led to hyperemesis cannabinoid syndrome. Her care required hospitalization and frequent follow-up from our office to control abdominal pain and electrolyte abnormalities from her rapid weight loss. These cases are occurring across the state, and we can no longer ignore the issue.
Legal cannabis is here to stay, and Colorado has to exercise its responsibility to update regulations when markets shift and new products arise. Now is the time for industry advocates and concerned community members to come together and work on improving industry standards and implementing evidence-based reforms to protect public health.
Yadira Caraveo, a Thornton Democrat and practicing pediatrician, represents District 31 in the Colorado House.