Reducing the Harms of Cannabis Use in Youth Post-Legalization: Insights from Youth, Parents & Service Providers

Background and Purpose: Cannabis is the most commonly used illicit drug worldwide. In 2018, Canada joined a growing number of countries moving to legalize recreational cannabis. A primary objective of this legislation was to safeguard young people by limiting their access to cannabis and increasing public awareness about the associated health risks. Cannabis use in Canada ranks among the highest globally, especially among youth and young adults. Among young adults aged 20-24, 51% reported use in the past year, while 37% of youth aged 16-19 reported use, compared to 21% of adults over 25. Cannabis use among youth is a serious public health concern associated with numerous adverse effects, including cognitive impairments, depression, anxiety, bipolar disorder, and psychosis. There has been limited qualitative research on youth cannabis use and sparse research on how to reduce harms and risks to youth. The aim of this qualitative study was to examine perceptions of cannabis use among youth from the perspectives of youth, parents, and service providers. We explored how participants describe the risks or harms associated with youth cannabis use and their harm reduction strategies.

Methods: This qualitative study utilized a community-based participatory research approach and worked in partnership with Families for Addiction Recovery (FAR)—a community agency founded by parents of youth with addiction-related concerns. Eligibility for participation was limited to (1) parents/caregivers of youth using cannabis, (2) youth using cannabis, and (3) mental health/addiction service providers working with youth. Recruitment was conducted through FAR’s network, mental health/addiction agencies, and social media. We conducted virtual semi-structured interviews and analyzed the data using thematic analysis.

Results: The study included 88 participants from three stakeholder groups (n=31 youth, n=26 parents, n=31 service providers). Two main themes emerged regarding perceived risks or harms associated with cannabis use: (1) concerns about cannabis risks and harms, including addiction, brain development, impact on family, and various adverse effects on areas such as motivation, concentration, finances, employment, education, physical and mental health; and (2) minimization of risks and harms featuring conflicting messages, normalization, and perceptions of cannabis being less harmful than other substances. Additionally, two themes related to harm reduction approaches were identified: (1) approaches to implementing harm reduction strategies, and (2) challenges in implementing a harm reduction approach. Specific challenges for each participant group were noted, along with structural barriers such as unavailable and inaccessible services, easy access to cannabis, inadequate public education, and insufficient information on lower-risk cannabis use guidelines and harm reduction strategies for youth.

Conclusion and Implications: Youth cannabis use is a significant public health concern that necessitates a comprehensive public health approach. Understanding how social and structural locations influence the extent to which cannabis use is stigmatized and addressed among different populations is crucial. Developing equitable, youth-centered harm reduction strategies that acknowledge the developmental needs and vulnerabilities of youth, along with the important role of families, is important. Additionally, there is a pressing need to enhance social work education and training to better equip students and practitioners to address youth cannabis use effectively.