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The word “cannabis” refers to all products derived from the Cannabis sativa plant, which contains about 540 chemical substances. “Marijuana” refers to parts of or products from the plant containing substantial amounts of Δ9-tetrahydrocannabinol (THC). THC is the intoxicating substance primarily responsible for affecting a person’s mental state. More than 100 other cannabinoid substances have been identified, but the key cannabinoids are THC and cannabidiol, or CBD.
The FDA has not approved the cannabis plant for any medical use. However, the FDA has approved several drugs containing individual cannabinoids. For example, Epidiolex, containing a purified form of CBD derived from cannabis, is approved for treating seizures associated with Lennox-Gastaut syndrome and Dravet syndrome, two rare, severe forms of epilepsy. Cannabis products have diversified significantly, especially with the legalization and commercialization of cannabis in many areas.
Modern cannabis products often contain higher concentrations of THC (tetrahydrocannabinol) compared to traditional flowers (bud). Flower (Bud) is the conventional form of cannabis, consisting of dried and cured plant material. THC Concentration: 10–30%. Concentrates are highly potent extracts of cannabis that contain much higher THC levels. Wax is a concentrate, a soft, waxy substance extracted from cannabis with a THC concentration >60%. Shatter is a glass-like, brittle concentrate that shatters when broken and can have a THC concentration of 90%. THC Diamonds, Dabs, Moon Rocks, Crumble, Live Resin, and Rosin are ultrahigh THC preparations—edibles like gummies, chocolates, baked goods, and beverages typically are 5–10 mg, but 100 mg per package are sold too. Vapes (Cartridges) for vaporizing cannabis oil have a THC concentration of 50-95%. Lastly, THC Isolate is a pure THC crystal or powder, devoid of other cannabinoids and terpenes, which can have a THC Concentration of 99%+. Tinctures taken orally or sublingually are 10–50 mg THC per ml while infused beverages are 5–20 mg per serving.
More THC, More Often = More Risks
The potency of THC in cannabis products is increasing, with potential health implications. High-potency THC products (like concentrates and isolates) are more likely to cause dependency, cognitive impairments, and adverse effects, including anxiety, paranoia, and psychosis, especially in vulnerable populations or heavy users. Studies have explored the relationship between higher THC doses and health outcomes, including cannabis use disorder (CUD), cardiovascular issues, psychosis, depression, suicide, violence, and impaired driving. Regular use of high-potency cannabis is associated with an increased likelihood of dependence, craving, and withdrawal symptoms.
Individuals consuming high-THC cannabis daily are more prone to schizophrenia and early-onset psychosis, suggesting that there is a dose-response relationship between THC potency and adverse mental health outcomes. Additionally, the CDC notes that cannabis use can increase risks for psychosis or schizophrenia, especially in men and those starting use at an early age. Daily use of high-potency cannabis also contributes to an earlier onset of psychosis in users.
The cardiovascular effects of cannabis, particularly high-THC products, include increased heart rate and blood pressure, which may exacerbate underlying heart conditions and induce heart-related emergencies. Acute use may increase heart rate and blood pressure, triggering cardiovascular events in susceptible individuals.
THC impairs motor coordination, reaction time, and judgment, increasing risks for motor-vehicle and other accidents, and higher THC doses cause more impairment. Furthermore, individuals with THC in their system may be more likely to cause accidents.
Ultra-High-Dose THC
Cannabis products like concentrates (wax, shatter, oils), may reach very high THC levels of 60–90%. The adolescent brain is particularly vulnerable to high-dose THC due to ongoing brain development, especially in the prefrontal cortex, which governs decision-making, impulse control, and emotional regulation. Exposure to high levels of THC during this critical period can have significant, lasting effects on brain structure, function, and behavior. Ultra-high-potency products are linked to increased risks of addiction, psychosis, and other adverse effects. Research shows that prevalence of CUD is higher in states with recreational cannabis laws.
THC and the Adolescent Brain
Researchers have identified key risks from high-THC exposure for adolescent brains. For example, THC disrupts the hippocampus, a region critical for memory formation; disruption may lead to difficulties in learning and retaining information. Long-term cannabis use initiated during adolescence is associated with a decline in IQ scores and cognitive performance. In addition, high-THC exposure can reduce gray matter volume in the prefrontal cortex, impairing executive functions like planning and impulse control.
THC also affects the brain’s white matter, reducing connectivity between brain regions crucial for coordinated cognitive processes. Adolescents using high-THC products are at higher risk for developing cannabis-induced psychosis and long-term psychiatric disorders like schizophrenia, especially in those with a genetic predisposition. Chronic cannabis use has been linked to heightened anxiety and depression, suicidal thoughts, and suicides in adolescents.
THC interferes with development of brain circuits responsible for regulating behavior, leading to increased risk-taking and poor decision-making. THC use during adolescence can accelerate cortical thinning in the prefrontal cortex, increasing risks of cognitive deficits and heightened vulnerability to anxiety, depression, and psychosis.
Adolescents are more likely than adults to develop cannabis use disorder due to heightened neuroplasticity during this developmental stage, making the brain more susceptible to addiction. The resulting impaired cognitive and emotional regulation may lead to academic underperformance and difficulties in interpersonal relationships. Some neurobiological effects of adolescent cannabis use, such as reduced gray matter volume and altered connectivity, may persist into adulthood, even after use of the substance is stopped.
Asking Experts about Risks and Current Issues
According to Johns Hopkins University researcher Chris Hammond, M.D,, Ph.D., rapid shifts in state and federal cannabis policies across the United States and also the commercialization and societal normalization of cannabis use carry unknown health implications for American youth. “Cannabis use is associated with suicide-related outcomes in both adolescents and adults,” Hammond observes. He notes that cannabis use and cannabis use disorders are common among youth in the U.S. and globally.
Neuroscientist Yasmin Hurd, Ph.D., of the Icahn School of Medicine emphasizes that the adolescent brain is highly vulnerable to THC due to ongoing development, especially the prefrontal cortex. Her studies demonstrate that early exposure to THC disrupts neural connections, leading to long-lasting issues with memory, learning, and emotional control. Animal research from her lab shows that THC exposure during adolescence can lead to increased sensitivity to other drugs and compulsive behaviors. The effects may persist into adulthood—or even across generations.
Hurd worries about exposure to potent cannabis and cannabinoid extracts heightening health risks for vulnerable groups associated with sensitive windows of brain development—the fetuses of pregnant women, children, adolescents, and emerging adults.
Nora Volkow, M.D., director of the National Institute on Drug Abuse (NIDA), emphasizes non-use of cannabis and prevention. She also warns about the potential harm cannabis poses to adolescent brain development.
Challenges and Future Directions
Based on research evidence, every package of cigarettes sold in America carries strong standardized health warnings. Alcoholic beverage containers bear labels warning about risks to pregnancy. In contrast, state health warnings for cannabis use are not evidence-based. In Oregon, a label warns, “For use only by adults 21 and older. Keep out of reach of children.” New York State’s Cannabis Control Board’s warnings are less specific: “Smoking or vaping is hazardous to health” and “Keep out of reach of children and pets.” Deploying educational campaigns, labels, and restrictions on sales and marketing of cannabis could mitigate risks.
Conclusion
Neuroscience research has advanced knowledge of cannabis pharmacology and the endocannabinoid system in the brain on which cannabis acts. Rsing THC potency in cannabis correlates with increased risks of cannabis use disorder, cardiovascular issues, psychosis, accidents, depression, and impaired driving.
Experts warn that cannabis should not be used by pregnant women, children, teens, and young adults. Cannabis use by teens and young adults is causing increasing rates of schizophrenia, psychosis, depression, and suicide.
At the same time, cannabis research has identified therapeutic ideas for pain or sleep medicines and may lead to treatments that prevent cannabis toxicity and ameliorate cannabis use disorder. Continuing research suggests that it is time to consider employing federal measures to reduce the harms associated with ultra-high-THC cannabis.
“}]] High-dose cannabis can interfere with normal brain development, increasing medical and psychiatric risks for teens and young adults. Read More
