Cannabis

Gap in treatment for adolescent cannabis users puts young adults at risk

Heather Carroll — Mon, 18 May 2026 14:38:11 +0000

Gap in treatment for adolescent cannabis users puts young adults at risk Heather Carroll Mon, 05/18/2026 - 10:38

Key Takeaways:

Research by Panagiota Kitsantas, professor in the College of Public Health Department of Health Administration and Policy, reveals that one in three adolescents with cannabis use disorder does not receive timely treatment.
Younger adolescents, males, White non-Hispanic youth, and those in residential rehabilitation and outpatient settings experienced more treatment delays.
Cannabis use can have negative impacts on brain development for adolescents and has been linked to poor academic performance.

In This Story

A study by 91��'s Panagiota Kitsantas and colleagues reveals patterns of treatment delays for youth with cannabis use disorder.

Panagiota Kitsantas

Teens may turn to marijuana use for many reasons: curiosity, stress relief, peer pressure, help with mental health, or for the positive feelings of being “high.” However, there is a difference between casual use and reliance on cannabis to function. Cannabis use disorder (CUD) is the persistent use and reliance on marijuana despite it causing physical or social harm.

Despite the well-documented health impacts, especially for youths, receiving treatment is not simple. Research by Panagiota Kitsantas found that nearly one in three adolescents with CUD experienced delays in accessing much-needed care.

“There are persistent and rising barriers to timely treatment. There are variations in access speed across referral processes, suggesting system-level improvements are needed,” said Kitsantas, professor and interim chair of the College of Public Health Department of Health Administration and Policy (HAP). Hong Xue, associate professor in the HAP department, was one of the study’s co-authors.

Kitsantas’ newly published research addresses key research gaps of patterns and predictors of treatment delays among U.S. adolescents with CUD. In particular, younger adolescents, males, White non-Hispanic youth, and those in residential rehabilitation and outpatient settings experienced more delays.

Why this matters

Despite treatment delays declining between 2012 and 2018, the rate of youth experiencing treatment delays has steadily risen since then.

For younger people, cannabis use can have negative impacts on brain development, impairing thinking, memory, problem-solving, learning, coordination, and attention. Cannabis use in adolescence has been linked to poor academic performance, including increased risk of school dropout and lower likelihood of seeking higher education.

Delving into the research

Kitsantas and the research team identified critical findings about CUD treatment and youth:

About 31% of adolescents experienced treatment delays for cannabis use disorder.
Despite treatment delays declining through 2018, they increased by 2022.
Younger adolescents (12–14), males, and White non-Hispanic youth were more likely to experience treatment delays.
Youth referred for treatment through health care systems were more likely to experience treatment delays compared to those who self-referred.
Adolescents in rehabilitation/residential and outpatient settings experienced more delays than those in detox services, suggesting system-level variation in access speed.

Admission Delays in Receiving Treatment for Cannabis Use Disorder among US Adolescents was published April 2026 in the American Journal of Preventive Medicine.

“I hope this research draws attention to the growing and preventable problem of delayed treatment for adolescents with cannabis use disorder. Ultimately, the goal is to promote timely access to treatment and improve long-term outcomes for adolescents while easing the broader public health burden of substance use,” said Kitsantas.

Thumbnail photo by Stephen Cobb via Unsplash.

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Child and Adolescent Health

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College of Public Health

New research describes the leisure motivations that underpin young U.S. adults' recreational cannabis use

Mary Cunningham — Mon, 10 Jun 2024 15:40:21 +0000

New research describes the leisure motivations that underpin young U.S. adults' recreational cannabis use Mary Cunningham Mon, 06/10/2024 - 11:40

In This Story

Iulia Fratila, PhD

As of 2024, 24 states including Virginia, Maryland, and Washington, D.C., have legalized the adult recreational use of cannabis. As laws change, citizens' perceptions of the drug and reasons for using the drug have also shifted. In 2020, 34.5% of adults aged 18–25 reported using cannabis in the previous 12 months, according to the Substance Abuse and Mental Health Services Administration. Health experts seek to better understand the broader implications of legalization and individuals’ motivations and attitudes related to cannabis use.

Iulia Fratila, assistant professor in 91��’s College of Public Health

New qualitative research by Iulia Fratila, assistant professor in 91��’s College of Public Health, and Liza Berdychevsky, associate professor at the University of Illinois Urbana–Champaign, describes in what ways young adults (aged 18–30) view cannabis as a recreational and leisure pursuit.

“Recreational cannabis legalization and liberalization is shifting across U.S. states. More holistic approaches to understanding perceptions of cannabis benefits and leisure motivations are scarce due to the longstanding criminalization of cannabis,” said Fratila, the principal investigator. “This research provides novel insights into cannabis users' leisure motivations of use and perceived benefits, which can be leveraged strategically in public health and drug education efforts in the societal transition from criminalization to normalization and commercialization trends concerning cannabis.”

Participants in Fratila and Berdychevsky’s study suggest cannabis can offer a leisure state of mind (e.g., experiencing flow, relaxation, and meditative state), as well as represent a leisure pursuit reserved for free time (e.g., using cannabis as a reward for free, post-obligations time outside of daily demands). Additionally, participants described how cannabis serves as a leisure activity itself (i.e., the act of getting high) and/or as an activity that accompanies other leisure pursuits and socialization (e.g., getting high and going to the movies), while providing pleasurable outcomes (e.g., feeling enjoyment, engaging in humor, enhancing senses).

“Participants discussed the ways that their recreational cannabis consumption represents a controlled and calculated risk-benefit leisure choice that is successfully managed for their overall well-being. Their narratives highlight that this perceived leisure pursuit does not necessarily interfere with their otherwise productive lives,” said Fratila.

These insights can inform harm reduction approaches to cannabis education that may be more effective considering the cannabis legalization and liberalization landscape. Health educators and health promoters can discuss cannabis risks and potential negative health outcomes while acknowledging the desired benefits cannabis users anticipate.

Fratila warns about the impacts of widespread legalization and the emerging recreational cannabis markets, which highlights another meaningful implication connected to the study findings. “Under prohibitory regulations, recreational cannabis use has been explicitly framed as deviant, criminal, harmful, life-wrecking, and void of any potentially desirable leisure qualities (e.g., pleasure, socialization). This study showcases the cannabis users’ understanding of cannabis as normative recreation and the anticipated leisure benefits,” said Fratila.

She further explained, “However, this is a cautionary tale because these desirable qualities may be easily exploited. More specifically, society may be facing a new conundrum with the commercialization of recreational cannabis as the switch from criminalization to commercialization overly simplifies and glamorizes the leisure meanings of cannabis for profitable gain.”

Public health experts and scholars will need to be at the front lines, in collaboration with other fields, to monitor how cannabis is repositioned and accommodated in a cannabis-friendly society, according to Fratila. Specifically, it will be important to spearhead effective health promotion efforts that minimize any related harms and maximize well-being.

This was a qualitative research project utilizing hermeneutic phenomenology, a research method to study how experiences affect everyday practices, and in-depth interviewing with 16 individuals (ages 18–30) living in the U.S. states with legalized recreational cannabis.

“Phenomenological Exploration of Young Adults’ Recreational Cannabis Use Experiences and Associated Leisure Meanings” was published in the Journal of Leisure Research in June 2024. This research was not funded.

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Study: When Recreational Cannabis Is Legal, Codeine Demand Drops

Andrew J Schappert — Tue, 24 Jan 2023 13:49:46 +0000

Study: When Recreational Cannabis Is Legal, Codeine Demand Drops Andrew J Schappert Tue, 01/24/2023 - 08:49

In This Story

Catherine Maclean

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Catherine Maclean: ‘…[C]annabis use is arguably less harmful to health than the nonmedical use of prescription opioids.’

A new study published this month in Health Economics finds a significant reduction in pharmacy-based codeine distribution in states that have legalized recreational cannabis use. The finding is promising from a public health policy perspective because misuse of prescription opioids contributes to more than 10,000 overdose deaths a year in the U.S.

The study was coauthored by associate professor Johanna Catherine Maclean of the Schar School of Policy and Government at 91��. The research was supported by the National Institute on Drug Abuse of the National Institutes of Health.

So far, 21 U.S. states have passed recreational cannabis laws; legislatures in other states are considering similar measures.

“A reduction in the misuse of opioids will save lives,” said doctoral candidate Shyam Raman who is affiliated with the Cornell Jeb E. Brooks School of Public Policy and the lead author of the study. “Our research indicates that recreational cannabis laws substantially reduce distribution of codeine to pharmacies, an overlooked potential benefit to legalizing recreational cannabis use.”

Maclean, who specializes in the study of substance use disorder and public policy, said that while cannabis and opioids can be used to minimize chronic pain symptoms, they aren’t equivalent in their impact on overall health.

“Increasing legal access to cannabis may shift some consumers away from opioids and toward cannabis,” she said. “While all substances have some risks, cannabis use is arguably less harmful to health than the nonmedical use of prescription opioids.”

The study is believed to be among the first to separately examine the impact of recreational cannabis laws on shipments of opioids to hospitals, pharmacies, and other endpoint distributors. Previous studies have focused on medical cannabis laws or the use of opioids by subsets of consumers, such as Medicaid beneficiaries.

The researchers analyzed data from the Drug Enforcement Administration’s Automation of Reports and Consolidation Orders System which tracks the flow of controlled substances in the U.S.

Key findings from states that passed recreational cannabis laws:

A 26 percent reduction in pharmacy-based distribution of codeine and as much as a 37 percent reduction after recreational cannabis laws have been in effect for four years.
Minimal impact on distribution of other opioids such as oxycodone, hydrocodone, and morphine in any setting.
Minimal impact on codeine distribution by hospitals, which often have less permissive policies than pharmacies.

“This finding is particularly meaningful,” said senior author Coleman Drake of the University of Pittsburgh’s School of Public Health. “Where previous studies have focused on more potent opioids, codeine is a weaker drug with a higher potential for addiction. It indicates people may be obtaining codeine from pharmacies for misuse, and that recreational cannabis laws reduce this illicit demand.”

“Our study contributes new information to policy debates regarding legalization of recreational cannabis, which is a complex decision,” added Maclean. “Lawmakers could weigh the benefits we document alongside benefits and costs across a range of health, social, and economic domains potentially impacted by cannabis as they determine whether legalization is appropriate for their constituents.”

W. David Bradford of the University of Georgia also contributed to the study.

Additional reporting by Jim Hanchett, assistant dean for communications for the Cornell Jeb E. Brooks School of Public Policy. Cornell’s announcement is here.

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Schar School News January 2023

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