Cannabis and its effects on the health of children and adolescents

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Prakasit Wannapaschaiyong
Sitthiphon Bunman
Orarat Choukuljaratsiri


Cannabis is a herbal medicine that contains two essential cannabinoids: Cannabidiol (CBD) and Delta-9-Tetrahydrocannabinol (THC). CBD acts as an anti-inflammatory agent, helps improve sleep quality, and provides antiepileptic effects while THC has psychoactive effects and inhibits brain growth, especially in children and adolescents with developing brains. Currently, only pure CBD and CBD-enriched cannabis extracts are used in children and adolescents only for treating uncontrolled severe epilepsy. On the other hand, children and adolescents who use cannabis and cannabis products containing a large amount of THC can experience physical, mental health, and cognitive problems. Physical symptoms of cannabis use include restlessness or lethargy, abdominal pain, and severe nausea and vomiting while mental health issues are depression, anxiety, suicidal thoughts and behaviors, and severe aggressive behavior. Additionally, the use of cannabis also has negative impacts on cognitive functions and learning processes which include decreased cognitive levels, poor memory, and impaired executive functions, leading to failure in future academic and work performances. Therefore, all healthcare professionals should provide accurate information about cannabis to parents, children, and adolescents to prevent the adverse effects of cannabis use in children and adolescents after the implementation of “cannabis legalization.”


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Wannapaschaiyong P, Bunman S, Choukuljaratsiri O. Cannabis and its effects on the health of children and adolescents. Siriraj Med Bull [Internet]. 2023 Apr. 1 [cited 2023 Dec. 8];16(2):181-7. Available from:
Review Article


VanDolah HJ, Bauer BA, Mauck KF. Clinicians' Guide to Cannabidiol and Hemp Oils. Mayo Clin Proc. 2019;94(9):1840-51.

Schonhofen P, Bristot IJ, Crippa JA, Hallak JEC, Zuardi AW, Parsons RB, et al. Cannabinoid-Based Therapies and Brain Development: Potential Harmful Effect of Early Modulation of the Endocannabinoid System. CNS Drugs. 2018;32(8):697-712.

Legare CA, Raup-Konsavage WM, Vrana KE. Therapeutic Potential of Cannabis, Cannabidiol, and Cannabinoid-Based Pharmaceuticals. Pharmacology. 2022;107(3-4):131-49.

Nahtigal I, Blake A, Hand A, Friedberg J. The pharmacological properties of cannabis. J Pain Manage. 2016;9(4):481-91.

Russo EB. History of cannabis as medicine: nineteenth century irsih physicians and correlations of their observations to modern research. In: Chanda S, Lata H, ElSohly M, editors. Cannabis sativa L: Botany and Biotechnology. Switzerland: Springer International Publishing; 2017.

Maa E, Figi P. The case for medical marijuana in epilepsy. Epilepsia. 2014;55(6):783-6.

Talwar A, Estes E, Aparasu R, Reddy DS. Clinical efficacy and safety of cannabidiol for pediatric refractory epilepsy indications: A systematic review and meta-analysis. Experimental Neurology. 2023;359.

Ben-Zeev B. Medical Cannabis for Intractable Epilepsy in Childhood: A Review. Rambam Maimonides Med J. 2020;11(1).

Lattanzi S, Brigo F, Cagnetti C, Trinka E, Silvestrini M. Efficacy and Safety of Adjunctive Cannabidiol in Patients with Lennox-Gastaut Syndrome: A Systematic Review and Meta-Analysis. CNS Drugs. 2018;32(10):905-16.

Thompson MD, Martin RC, Grayson LP, Ampah SB, Cutter G, Szaflarski JP, et al. Cognitive function and adaptive skills after a one-year trial of cannabidiol (CBD) in a pediatric sample with treatment-resistant epilepsy. Epilepsy Behav. 2020;111:107299.

Gulbransen G, Xu W, Arroll B. Cannabidiol prescription in clinical practice: an audit on the first 400 patients in New Zealand. BJGP Open. 2020;4(1).

Uliel-Sibony S, Hausman-Kedem M, Fattal-Valevski A, Kramer U. Cannabidiol-enriched oil in children and adults with treatment-resistant epilepsy-does tolerance exist? Brain Dev. 2021;43(1):89-96.

Lusawat A, Suwannachote S, Sudachan P, Sri-udomkajorn S, Sattatporn C, Wechapinan T, et al. CBD-enriched Medical Cannabis Product for Pediatric Durg Resistant Epilepsy Treatment in Thailand: Experience from 2 Centers in Department of Medical Services, Ministry of Public Health. Journal of the Department of Medical Services. 2021;46(3):60-72.

Ngampoopun M, Nabangchang C, Suwanpakdee P. Survey of local cannabidiol use in parents of children with epilepsy in Thailand: the prevalence, perceptions, and knowledge. J Cannabis Res. 2022;4(1):43.

พระราชบัญญัติให้ใช้ประมวลกฎหมายยาเสพติด พ.ศ. 2565. ฉบับเล่มที่ 139 ตอนที่ 129ง. หน้า 21.

Claudet I, Le Breton M, Brehin C, Franchitto N. A 10-year review of cannabis exposure in children under 3-years of age: do we need a more global approach? Eur J Pediatr. 2017;176(4):553-6.

Grotenhermen F. Pharmacokinetics and pharmacodynamics of cannabinoids. Clin Pharmacokinet. 2003;42(4):327-60.

Chu F, Cascella M. Cannabinoid Hyperemesis Syndrome. StatPearls. Treasure Island (FL)2022.

Patel J, Marwaha R. Cannabis Use Disorder. StatPearls. Treasure Island (FL)2022.

Schier JG, Meiman JG, Layden J, Mikosz CA, VanFrank B, King BA, et al. Severe Pulmonary Disease Associated with Electronic-Cigarette-Product Use - Interim Guidance. MMWR Morb Mortal Wkly Rep. 2019;68(36):787-90.

Hage R, Schuurmans MM. Suggested management of e-cigarette or vaping product use associated lung injury (EVALI). J Thorac Dis. 2020;12(7):3460-8.

Gobbi G, Atkin T, Zytynski T, Wang S, Askari S, Boruff J, et al. Association of Cannabis Use in Adolescence and Risk of Depression, Anxiety, and Suicidality in Young Adulthood: A Systematic Review and Meta-analysis. JAMA Psychiatry. 2019;76(4):426-34.

Stiles-Shields C, Archer J, Zhang J, Burnside A, Draxler J, Potthoff LM, et al. A Scoping Review of Associations Between Cannabis Use and Anxiety in Adolescents and Young Adults. Child Psychiatry Hum Dev. 2021.

Patton GC, Coffey C, Carlin JB, Degenhardt L, Lynskey M, Hall W. Cannabis use and mental health in young people: cohort study. BMJ. 2002;325(7374):1195-8.

Moreno-Mansilla S, Ricarte JJ, Hallford DJ. Cannabis use among early adolescents and transdiagnostic mental health risk factors. Clin Child Psychol Psychiatry. 2021;26(2):531-43.

Monshouwer K, S VAND, Verdurmen J, Bogt TT, R DEG, Vollebergh W. Cannabis use and mental health in secondary school children. Findings from a Dutch survey. Br J Psychiatry. 2006;188:148-53.

McGee R, Williams S, Poulton R, Moffitt T. A longitudinal study of cannabis use and mental health from adolescence to early adulthood. Addiction. 2000;95(4):491-503.

Hall WD, Lynskey M. Is cannabis a gateway drug? Testing hypotheses about the relationship between cannabis use and the use of other illicit drugs. Drug Alcohol Rev. 2005;24(1):39-48.

Lorenzetti V, Hoch E, Hall W. Adolescent cannabis use, cognition, brain health and educational outcomes: A review of the evidence. Eur Neuropsychopharmacol. 2020;36:169-80.

Pope HG, Jr., Gruber AJ, Hudson JI, Cohane G, Huestis MA, Yurgelun-Todd D. Early-onset cannabis use and cognitive deficits: what is the nature of the association? Drug Alcohol Depend. 2003;69(3):303-10.

Tamm L, Epstein JN, Lisdahl KM, Molina B, Tapert S, Hinshaw SP, et al. Impact of ADHD and cannabis use on executive functioning in young adults. Drug Alcohol Depend. 2013;133(2):607-14.

Fergusson DM, Poulton R, Smith PF, Boden JM. Cannabis and psychosis. BMJ. 2006;332(7534):172-5.

Semple DM, McIntosh AM, Lawrie SM. Cannabis as a risk factor for psychosis: systematic review. J Psychopharmacol. 2005;19(2):187-94.

Di Forti M, Morgan C, Dazzan P, Pariante C, Mondelli V, Marques TR, et al. High-potency cannabis and the risk of psychosis. Br J Psychiatry. 2009;195(6):488-91.

Arseneault L, Cannon M, Witton J, Murray RM. Causal association between cannabis and psychosis: examination of the evidence. Br J Psychiatry. 2004;184:110-7.

Guttamannova K, Kosterman R, White HR, Bailey JA, Lee JO, Epstein M, Jones TM, Hawkins JD. The association between regular marijuana use and adult mental health outcomes. Drug and Alcohol Dependence. 2017;179:109-16.

Cass D, Flores-Barrera E, Thomases D, et al. CB1 cannabinoid receptor stimulation during adolescence impairs the maturation of GABA function in the adult rat prefrontal cortex. Mol Psychiatry. 2014;19:536-43.

Whitehill JM, Dilley JA, Brooks-Russell A, Terpak L, Graves JM. Edible Cannabis Exposures Among Children: 2017-2019. Pediatrics. 2021;147(4).

Wang GS, Le Lait MC, Deakyne SJ, Bronstein AC, Bajaj L, Roosevelt G. Unintentional Pediatric Exposures to Marijuana in Colorado, 2009-2015. JAMA Pediatr. 2016;170(9):e160971.

Terry-McElrath YM, Patrick ME, O'Malley PM, Johnston LD. Self-reported perceived negative consequences of marijuana use among U.S. young adult users, 2008-2019. Addict Behav. 2022;124:107098.

Wang GS, Davies SD, Halmo LS, Sass A, Mistry RD. Impact of Marijuana Legalization in Colorado on Adolescent Emergency and Urgent Care Visits. J Adolesc Health. 2018;63(2):239-41.

ฐานข้อมูลกระทรวงสาธารณสุข. อัตราป่วยรายใหม่และจำนวนสะสมของผู้ป่วยที่มีความผิดปกติทางจิตและพฤติกรรมที่เกิดจากการเสพกัญชา (F12.XX) ปีพ.ศ.2565 [updated 2022 November 16; cited 2022 November 16]. Available from:

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