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Epidemiology, Health Implications, and Resilience Factors in Adolescent Marijuana Use: A Comprehensive Review

Background: Marijuana is a very common illicit drug used across the United States and around the world. It has many adverse effects on adolescents and societal health. Among adolescents, it can cause chronic brain damage and psychoactive effects. This literature review aims to discuss topics concerning the epidemiology of marijuana use, adverse health consequences, and risk and protective factors. In addition, the concept of resilience was explored in-depth. Review: Most marijuana users start in their adolescence. As the legal and social perspective of marijuana is beginning to change, many adolescents are beginning to view marijuana as harmless. However, marijuana use has negative effects on adolescents, such as on their brain development and neurocognitive functions. To prevent adolescents from engaging in marijuana use, researchers have identified risk and protective factors. In our review, we identified more risk factors for marijuana use than protective factors. Understanding these factors can help in developing intervention approaches and nurturing positive adaptation skills. Finally, regarding resilience and marijuana use, two levels could be identified, namely asset and contextual resource levels. Conclusion: The prevalence of marijuana use was found to be increasing among adolescents. In addition, the adverse consequences of marijuana use on adolescents were found to be pronounced, with both long- and short-term effects. Lastly, extensive insights were gained on the risk and protective factors related to marijuana use. Further research in relation to marijuana use and adolescents should look into ethnicity differences, social and economic costs, as well as analyzing resilience-associated protective factors that can aid in developing preventive interventions regarding marijuana use.

Adolescents, Cannabis, Marijuana, Health Consequences, Risk Factors, Protective Factors, Resilience

APA Style

Yajuan Gao. (2023). Epidemiology, Health Implications, and Resilience Factors in Adolescent Marijuana Use: A Comprehensive Review. European Journal of Preventive Medicine, 11(5), 75-81.

ACS Style

Yajuan Gao. Epidemiology, Health Implications, and Resilience Factors in Adolescent Marijuana Use: A Comprehensive Review. Eur. J. Prev. Med. 2023, 11(5), 75-81. doi: 10.11648/j.ejpm.20231105.13

AMA Style

Yajuan Gao. Epidemiology, Health Implications, and Resilience Factors in Adolescent Marijuana Use: A Comprehensive Review. Eur J Prev Med. 2023;11(5):75-81. doi: 10.11648/j.ejpm.20231105.13

Copyright © 2023 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License ( which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

1. Agerwala, S. M., & McCance-Katz, E. F. (2012). Integrating screening, brief intervention, and referral to treatment (SBIRT) into clinical practice settings: a brief review. J Psychoactive Drugs, 44 (4), 307-317. doi: 10.1080/02791072.2012.720169.
2. Blohm, E., Sell, P., & Neavyn, M. (2019). Cannabinoid toxicity in pediatrics. Curr Opin Pediatr, 31 (2), 256-261. doi: 10.1097/MOP.0000000000000739.
3. Bolton, K. W., Hall, J. C., Blundo, R., & Lehmann, P. (2017). THE ROLE OF RESILIENCE AND RESILIENCE THEORY IN SOLUTION-FOCUSED PRACTICE. Journal of Systemic Therapies, 36 (3), 1-15.
4. Burdzovic Andreas, J., Pape, H., & Bretteville-Jensen, A. L. (2016). Who are the adolescents saying "No" to cannabis offers. Drug Alcohol Depend, 163, 64-70. doi: 10.1016/j.drugalcdep.2016.03.025.
5. Campos, A. C., Fogaca, M. V., Sonego, A. B., & Guimaraes, F. S. (2016). Cannabidiol, neuroprotection and neuropsychiatric disorders. Pharmacol Res, 112, 119-127. doi: 10.1016/j.phrs.2016.01.033.
6. CentennialInstitute. (2018). Economic and Social Costs of Legalized Marijuana
7. Johnson, R. M., Fleming, C. B., Cambron, C., Dean, L. T., Brighthaupt, S. C., & Guttmannova, K. (2019). Race/Ethnicity Differences in Trends of Marijuana, Cigarette, and Alcohol Use Among 8th, 10th, and 12th Graders in Washington State, 2004-2016. Prev Sci, 20 (2), 194-204. doi: 10.1007/s11121-018-0899-0.
8. Keyes, K. M., Rutherford, C., & Miech, R. (2019). Historical trends in the grade of onset and sequence of cigarette, alcohol, and marijuana use among adolescents from 1976-2016: Implications for "Gateway" patterns in adolescence. Drug Alcohol Depend, 194, 51-58. doi: 10.1016/j.drugalcdep.2018.09.015.
9. Kliewer, W., & Parham, B. (2019). Resilience against marijuana use initiation in low-income African American youth. Addict Behav, 89, 236-239. doi: 10.1016/j.addbeh.2018.08.038.
10. Kramer, J. L. (2015). Medical marijuana for cancer. CA Cancer J Clin, 65 (2), 109-122. doi: 10.3322/caac.21260.
11. Levy, S. J., Williams, J. F., Committee On Substance, U. S. E., & Prevention. (2016). Substance Use Screening, Brief Intervention, and Referral to Treatment. Pediatrics, 138 (1). doi: 10.1542/peds.2016-1211.
12. Luthar, S. S., Cicchetti, D., & Becker, B. (2000). The construct of resilience: a critical evaluation and guidelines for future work. Child Dev, 71 (3), 543-562. doi: 10.1111/1467-8624.00164.
13. McDonald, E. A., Popova, L., & Ling, P. M. (2016). Traversing the triangulum: the intersection of tobacco, legalised marijuana and electronic vaporisers in Denver, Colorado. Tob Control, 25 (Suppl 1), i96-i102. doi: 10.1136/tobaccocontrol-2016-053091.
14. Mead, A. (2017). The legal status of cannabis (marijuana) and cannabidiol (CBD) under U. S. law. Epilepsy Behav, 70 (Pt B), 288-291. doi: 10.1016/j.yebeh.2016.11.021.
15. Merudelo, A. D., Castro, N., Cota, C., & Tapert, S. F. (2017). Cannabis and Alcohol Use, and the Developing Brain. Behav Brain Res (325 (Pt A)), 44-50.
16. Mokrysz, C., Freeman, T. P., Korkki, S., Griffiths, K., & Curran, H. V. (2016). Are adolescents more vulnerable to the harmful effects of cannabis than adults? A placebo-controlled study in human males. Transl Psychiatry, 6 (11), e961. doi: 10.1038/tp.2016.225.
17. Murray, D. W., Rosanbalm, K., & Christopoulos, C. (2015). Self-Regulation and Toxic Stress: Implications for Programs and Practice. OPRE Report #2015-97, Washington, DC: Office of Planning, Research and E.
18. Onrust, S. A., Otten, R., Lammers, J., & Smit, F. (2016). School-based programmes to reduce and prevent substance use in different age groups: What works for whom? Systematic review and meta-regression analysis. Clin Psychol Rev, 44, 45-59. doi: 10.1016/j.cpr.2015.11.002.
19. Rice, J., & Cameron, M. (2018). Cannabinoids for Treatment of MS Symptoms: State of the Evidence. Curr Neurol Neurosci Rep, 18 (8), 50. doi: 10.1007/s11910-018-0859-x.
20. Russell, C., Rueda, S., Room, R., Tyndall, M., & Fischer, B. (2018). Routes of administration for cannabis use - basic prevalence and related health outcomes: A scoping review and synthesis. Int J Drug Policy, 52, 87-96. doi: 10.1016/j.drugpo.2017.11.008.
21. SAMHSA. (2014). Risk and Protective Factors Assciated with Youth Marijuana Use. SAMHSA's Center for the Application of Prevention Technologies Using Prevention Research to Guide Prevention Practice.
22. SAMHSA. (2018). National Survey on Drug Use and Health (NSDUH) Key Substance Use and Mental Health Indicators in the United States: Results from the 2018 National Survey on Drug Use and Health.
23. Sarvet, A. L., Wall, M. M., Fink, D. S., Greene, E., Le, A., Boustead, A. E., Hasin, D. S. (2018). Medical marijuana laws and adolescent marijuana use in the United States: a systematic review and meta-analysis. Addiction, 113 (6), 1003-1016. doi: 10.1111/add.14136.
24. Schmid, Y., Scholz, I., Mueller, L., Exadaktylos, A. K., Ceschi, A., Liechti, M. E., & Liakoni, E. (2020). Emergency department presentations related to acute toxicity following recreational use of cannabis products in Switzerland. Drug Alcohol Depend, 206, 107726. doi: 10.1016/j.drugalcdep.2019.107726.
25. Volkow, N. D., Baler, R. D., Compton, W. M., & Weiss, S. R. (2014). Adverse health effects of marijuana use. N Engl J Med, 370 (23), 2219-2227. doi: 10.1056/NEJMra1402309.
26. Volkow, N. D., Wang, G. J., Telang, F., Fowler, J. S., Alexoff, D., Logan, J., Tomasi, D. (2014). Decreased dopamine brain reactivity in marijuana abusers is associated with negative emotionality and addiction severity. Proc Natl Acad Sci U S A, 111 (30), E3149-3156. doi: 10.1073/pnas.1411228111.
27. Watson, R. J., Park, M., Taylor, A. B., Fish, J. N., Corliss, H. L., Eisenberg, M. E., & Saewyc, E. M. (2020). Associations Between Community-Level LGBTQ-Supportive Factors and Substance Use Among Sexual Minority Adolescents. LGBT Health, 7 (2), 82-89. doi: 10.1089/lgbt.2019.0205.
28. Werner, E. E. (2004). Journeys from childhood to midlife: risk, resilience, and recovery. Pediatrics, 114 (2), 492. doi: 10.1542/peds.114.2.492.
29. Wong, K. U., & Baum, C. R. (2019). Acute Cannabis Toxicity. Pediatr Emerg Care, 35 (11), 799-804. doi: 10.1097/PEC.0000000000001970.
30. Zimmerman, M. A., Stoddard, S. A., Eisman, A. B., Caldwell, C. H., Aiyer, S. M., & Miller, A. (2013). Adolescent Resilience: Promotive Factors That Inform Prevention. Child Dev Perspect, 7 (4). doi: 10.1111/cdep.12042.