High-potency cannabis use among Oregon’s adolescents is putting them at risk of psychosis and other mental health problems, according to mental health and addiction experts who want the state to adopt policies that will curb underage use.
Invited experts, officials and advocates testified Tuesday before the state’s senate Committee on Early Childhood and Behavioral Health on the danger marijuana poses to children and young adults. Speakers included David Rettew, a child and adolescent psychiatrist and the medical director with Lane County Behavioral Health.
“I don't want to be apocalyptic about cannabis — I don't think it's the most toxic substance on Earth, but it is particularly risky for youth,” Rettew told the committee. “And unlike many other substances, there is an enormous gap between cannabis’ actual risk and its perceived risk.
“People know that tobacco and alcohol are dangerous,” he added. “But people do not know that cannabis is dangerous. The signs on the stores have green crosses on them. There is an enormous educational gap here.”
That lack of awareness combined with marijuana’saccessibility, low prices and positive image — make it particularly appealing to children and young adults. According to the Oregon Student Health Survey, 32% of 8th graders and 45% of 11th graders believe that regular marijuana use carries little to no risk of harm.
For the vast majority of people, about 90%, their substance use disorder began in their youth. And the majority of youths with a substance use disorder engaged in the substance in school, according to Wes Rivers, a policy analyst with the state’s Alcohol and Drug Policy Committee.
Rivers referenced an investigation by The Lund Report that detailed public schools’ lack of science-based educational programs around drug use and addiction. Oregon law requires every public school district to have a robust substance use prevention strategy based on research. Yet 60% of Oregon schools do not use evidence-based prevention curricula or programs at any grade level, according to the nation’s top prevention and curricula clearinghouses.
Pediatrician and committee chair Sen. Lisa Reynolds, a Democrat, said the state can't treat its way out of its substance use disorder crisis, and needs to focus on preventing and delaying marijuana use among youth. “We need to stop minting new people who have addictions,” she said.
Marijuana-based products can have high contents of tetrahydrocannabinol, or THC, the primary psychoactive compound found in cannabis. But their promotion as medicine causes people to believe they are safe, according to Rettew. THC levels in cannabis products in the U.S. averaged around 4-7% TCH in past decades, but have jumped to 25-35% or higher, in some products.
Multiple studies have linked heavy marijuana use at a young age with an increased risk of mental illness, notably schizophrenia. A report issued by the National Academy of Sciences cites evidence that heavy marijuana use, prolonged length of exposure and age at the beginning of exposure may all be risk factors in triggering a first episode of psychosis.
“The psychiatric risks associated with cannabis are quite vast,” Rettew said. “There's overwhelming evidence that cannabis use, particularly for young people, changes the brain, and this is particularly true for adolescents. But when it comes to psychosis, there's really strong evidence at this point that cannabis raises the risk of psychotic disorders more than other drugs, even methamphetamines, which is surprising.”
The hearing was not connected to specific legislation, but could inform a state substance use plan to be released next year.
Rivers proposes centering prevention efforts through a one-stop shop that provides schools and the community with access to data, evaluation tools, training, workforce development and culturally responsive technical assistance.
Any plan shouldn't be just about educating children, but parents as well, according to Paul Bryant, executive director of Madrona Recovery and a drug and alcohol counselor who started working with youths and families in 2004.
“Parental involvement is hugely important,” Bryant said. “There is research that shows that parental attitudes that discourage use of any substances actually reduce youth use, and so it's very important that we tell parents and teach them to say, ‘ I don't want you doing this. It's not okay. I don't want it in my house.’”
Lee Stewart, a prevention advocate, expressed concern that potent cannabis products are marketed to younger kids.
“There are lots of flavored candies and flavored vapes like watermelon splash and orange dreamsicle,” she said. “It also comes with exciting labels and eye-catching images that are attractive to young people. Furthermore, kids today are bombarded with positive messaging about cannabis.”
Oregon legalized marijuana use in 2014, and today anyone 21 and older can buy a wide selection of marijuana products from licensed retailers across the state. State law allows growing up to four marijuana plants per household. The industry is overseen by the Oregon Liquor and Cannabis Commission, or OLCC.
A recent OLCC report showed that many hemp products sold in Oregon exceed legal THC limits, often lack proper labeling, and are being sold without adequate age verification. OLCC officials intend to launch a hemp product register in 2026 to track testing, labeling, and safety compliance.
Abundant harvests across the state have kept retail prices low in Oregon, and that is expected to continue based on a banner year in 2024.
David Jernigan, a Boston University School of Public Health professor, urged lawmakers to take a lesson from the power of alcohol and tobacco industries, and not let the cannabis industry’s push for profit influence state policies.
Jernigan recommended measures to prevent marketing to children, as well as more aggressive suggestions unlikely to go over well with Oregon’s billion-dollar marijuana industry. They included prohibiting high-potency THC products, setting higher, potency-based taxes, and even banning edibles and drinkables altogether. If they are not banned, the state should prohibit sales within 1,500 feet of a school.
