The legal status of marijuana has been making headlines for nearly a decade. Everyone from lobbyists to next-door neighbors debate what cannabis legalization will mean for our political, social and economic systems. While there are many layers to the legalization debate, one in particular deserves our primary attention as prevention agents: the health risks of marijuana use for teens. The Cannabis Debate Has Normalized Its Use The debate about legalizing cannabis has shifted perceptions of marijuana in both students and adults. The majority of people choose not to use marijuana, but it does appear more normal and acceptable to teens than it has been in the past. In fact, we're now seeing the highest levels of marijuana use among college students over the past 35 years. The American Academy of Pediatrics and other experts agree on the long-term effects, the cultural shift will impact the health of the next generation. Cutting through the Misinformation For teens today, pro-marijuana messaging is almost unavoidable. Unsubstantiated positive messages quickly spread across social media, music, legislation and traditional marketing channels as cannabis sales become legal. Youth are bombarded with misinformation and promotional materials, leading to normative beliefs about the drug's safety. Although misinformation is common, especially regarding alcohol and other drugs, it leads to increased rates of substance use. We need to confront the misinformation to encourage more informed decision-making among our students. Because marijuana is more addictive for teens than it is for adults, the cannabis debate and wildfire misinformation come at greater costs to our students. The research demonstrates legitimate risks that are linked with cannabis use, including its impacts on the developing brain, and we need to openly and plainly address the risks our students face. How Adults Can Help to Inform and Shape a Student's Substance Use It may seem like adults have little say in the discussion about cannabis and marijuana. It may feel like students will choose to use or not use of their own volition, regardless of our input. But that's simply not true. There are a number of ways we can influence their decisions and help them choose healthy, rewarding behaviors over alcohol and other drug use. We Can Steer Them Toward Health We can anchor these conversations in student health. By consistently using a health perspective to engage in these discussions, adults can feel confident standing their ground and challenging misperceptions from a caring, nonjudgmental place. We can respect the political leanings, religious beliefs and social justice perspectives of our students, families and communities while still asking, "And what's the impact on your health, as a teen?" We Can Provide Accurate Risk Information We can provide the critical information students need to accurately answer health questions related to cannabis or other drug use. Resources like Stanford Medicine's Cannabis/Marijuana Awareness and Prevention Toolkit and research centers like the National Institute on Drug Abuse make it easy to learn and pass on age-appropriate information to kids, teens and parents. Current research studies confirm that: Marijuana can impair hand-eye coordination, motor skills, thought processing and mental tasks such as planning, organizing, problem-solving, decision-making, memorizing and controlling emotions and behavior. Marijuana has been implicated in IQ declines for teenagers who persistently use it. Seventeen percent of teens who use marijuana become addicted to it. Early marijuana use predicts opioid use disorder later in life. The majority of school-age youth don't ever use marijuana. In 2018, less than forty-four percent of U.S. twelfth-grade students reported that they had used marijuana in their lifetime. Now's the Time to Have a Conversation A changing legal landscape does not make marijuana use any less risky for the developing brain. All use equals risk, especially for teens. It's more important than ever for adults to correct lowered-marijuana risk perceptions among youth and to guide marijuana and other drug conversations toward health. Kids Look to Other Kids to Inform Their Decisions Having discussed an adult's influence over students' decision-making, it's valuable now to look to their other spheres of influence. Of particular note are other students. Social influences matter, especially during a student's teen years. When it comes to substance use, research shows that a close friend's use of alcohol or tobacco strongly predicts a teen's future use. Until recently, teenage marijuana use behavior has been more difficult to research, because it is done secretly and goes unreported. Conflicting Reports about Teenage Marijuana Use In 2019, researchers reported that youth risk perceptions about cannabis and marijuana use were decreasing rapidly. Despite this slightly unsettling trend, there is also good news: most teens are not using marijuana any more than they were prior to the cannabis legalization movements across the United States. Why Social Scuttlebutt Matters When discussing marijuana from a health perspective, it's important to remember why our attitudes about cannabis and other drugs matter. General perceptions about a drug don't necessarily translate into higher rates of use, but unhealthy peer attitudes could make a difference on a smaller scale—in neighborhoods and on teams, in classrooms and among friends. Use the Social Norms Approach to Clarify Opaque Teen Opinions As caring adults, we can continue to discuss prevention within the context of a social norms approach. Here are some healthy highlights to share with students, from the 2009-2019 international Hazelden Betty Ford Student Attitudes and Behavior Survey: Seventy-seven percent of high school students have never used marijuana. Seventy-five percent of high school students would disapprove if a friend was regularly using marijuana. Only 14 percent of tenth graders report using marijuana one to two times a year. Seventy-four percent of tenth-graders believe students typically use marijuana As the final bullet points out, teenagers tend to greatly overestimate their peers' actual substance use. Although students may wildly overestimate their peers' cannabis use, we can share with them the healthy reality and help them to realize how few of their peers actually use—and how many make the healthy decision not to. This perspective can help teens build the data-driven confidence that their healthy choices are actually common! Why Social Norms Matter At schools all over the world, our prevention specialists use the evidence-based social norms approach to substance use prevention. Through classroom exercises and discussion, we help students identify how their overestimation of peers' marijuana use is not grounded in evidence. From there, healthier attitudes can take shape to guide future student behavior. Students daydream about their futures. The social norms term for this daydreaming is anticipatory socialization, where someone envisions their future self performing an assumedly normative behavior. For teens, daydreams of this sort may include driving, dating, parties and more independence all around. Such activities are understandably exciting. However, when kids mistakenly anticipate that marijuana use is a normal part of being a teen, such risky use might find its way from daydreams into real life. Fortunately, when presented with information about the reality of actual use rates among peers, students will often end up removing marijuana use as an expectation of what's next for them. All Use Equals Risk, Especially for Teens As the legal landscape of marijuana continues to change, students may continue to overestimate their peers' use. When talking to one another about cannabis and marijuana, they are likely to swap rumors and misinformation. Trying to navigate this information on their own often leads to false beliefs and puts youth at higher risk. As adults who care, it is our responsibility to continue to remind our students that: Marijuana use disrupts the healthy development of the teenage brain. Marijuana use has the potential to lower IQ. People who use marijuana are twice as likely to have trouble concentrating on important tasks compared to their non-using peers. Depression and anxiety are associated with ongoing marijuana use. The majority of young people make the healthy choice not to use marijuana. Let's Inform Students about the Realities of Marijuana Use Prevention is both a science and an art. Research asserts that youth who hold the accurate perception that teen marijuana use is uncommon, unhealthy and risky are much less likely to use. While data about actual use rates among peers can inform teens, we must also help students integrate this information into their daily life choices. The blend of both is what keeps healthy kids healthy. How to Build a Climate of Prevention Preventing marijuana and other drug use among students requires a healthy climate in which young people can grow and thrive. It's up to us as caring adults to do our part to build that climate. So what is a prevention climate, and how can we build one? A healthy prevention climate includes all members of a community: a school, families and caretakers, and students themselves. As the adults, we intervene on any unhealthy behavior we see in students' lives and actively work to reduce overall risk in students' environments. We contribute to a healthy environment with open, health-based dialogues between ourselves and students; we convey the health reasons for a young person to delay their use of alcohol, cannabis and all other addictive drugs; and we take responsibility for outlining and enforcing the consequences of substance use among teens. Adults Have to Model Healthy Behavior At Hazelden Betty Ford's Prevention Solutions division, we encourage parents and educators to become a combined force within the prevention process. In 2019, because of the shifting environment around marijuana legalization, we saw a large uptick in adult marijuana use—a risk factor for students. More parents and caretakers are now using marijuana than they were a decade ago. In places where marijuana use is recreationally or medically legal, adults should answer these questions for themselves: What does adult use of marijuana look like? How might this use be risky for our students and teens? The biggest difference between adult and teen use is the still-developing teenage brain. An environment that normalizes the use of marijuana is a major risk factor for young people. Adults who refuse to use marijuana in front of children can mitigate this new environmental risk. How You Can Help Research shows that adult marijuana use, especially by parents, increases the likelihood of youth use. Let's combat this risk together! Here are some prevention steps adults can take that will help to engage in the marijuana legalization conversation with young people from a health perspective, learn the differences between adult and adolescent use, and encourage the modeling of healthy attitudes and behaviors: Highlight the different impacts of marijuana use on a still-developing teenage brain compared to a fully developed adult brain. Model healthy substance use behavior at all times, including the appropriate use of medications. Don't use marijuana in front of young people. Stay up-to-date on the latest information about the impact of marijuana on the brain. Be aware that the potency of marijuana has increased drastically over the past decade, intensifying the health risks to all who use the drug, especially teens. Building an Environment of Hope As adults who care, we have the opportunity to carry out a prevention mission in schools and communities. We can start nonjudgmental, health-based conversations with young people about marijuana legalization. Within these discussions, we can provide accurate, health-based information, challenge misperceptions and provide the space and time for teens to learn protective skills for living healthy lives. We can teach kids that all use equals risk within any legal climate and that non-use is a safe, healthy, rewarding and normal option for anyone. Educators, parents and other caring adults who have regular conversations about marijuana, who model healthy behavior and who listen to their children's attitudes and opinions have the best chance of preventing marijuana use among students and adolescents.