How To Talk About Cannabis Use: A Guide for Parents and Health Providers
October 21, 2021
About 9 in 10 Americans support some form of marijuana legalization, according to data from the Pew Research Center, and states are increasingly legalizing cannabis for medical and recreational use. Although attitudes are changing around cannabis, and the perceived medical benefits can help alleviate certain medical conditions, proliferation of cannabis may also come with public health side effects.
Increasing availability of commercial cannabis will make conversations between healthcare providers, patients, parents and children more important.
Read on to learn more about the state of cannabis in the U.S., and how to navigate conversations around the substance.
A Primer on Cannabis
Although marijuana is still federally classified as an illegal substance, many states have legalized its recreational and/or medical use.
Cannabidiol (CBD): One of the two most prevalent cannabinoids in cannabis, which does not lead to an altered mental state.
Cannabis: all products derived from the Cannabis sativa plant.
Tetrahydrocannabinol (THC): One of the two most prevalent cannabinoids in cannabis, which causes a high/altered mental state.
Legalization: Measures at the state-level to permit possession, use and/or sales of medical and/or recreational cannabis, or decriminalize marijuana possession. Marijuana is still federally illegal.
Medical marijuana/medical cannabis: Marijuana or substances extracted from cannabis prescribed to treat conditions such as pain, anxiety, nausea and glaucoma.
Cannabinoids: Chemical substances found within the cannabis plant, the most common of which are tetrahydrocannabinol (THC) and cannabidiol (CBD).
Decriminalization: Laws that do not allow jurisdictions to prosecute people for possessing small amounts of marijuana, especially for the first offense.
Hemp: Cannabis containing less than 0.3% THC.
Marijuana: Cannabis containing more than 0.3% THC.
Recreational marijauna/recreational cannabis: Cannabis used without medical intent or a prescription.
Some states still maintain strict cannabis laws. For example: Idaho, Nebraska and Kansas do not have public cannabis access programs for medical or recreational use.
In Alabama: Medical marijuana and CBD are legal. But possessing any amount of marijuana for personal use is a misdemeanor that can be punished with up to a year in jail and up to $6,000 in fines. And possessing any amount for any purpose other than personal use is a felony that carries a mandatory minimum sentence of one year and a day or up to 10 years in prison, or fines up to $15,000.
In Florida: Medical marijuana and medical CBD are legal. However, a person caught possessing 20 grams to 25 pounds of marijuana without a prescription could be charged with a felony punishable by up to 5 years in jail and fines up to $5,000. Possessing less than 20 grams is a misdemeanor that could lead to penalties of up to a year incarceration and a maximum fine of $1,000.
In Illinois:CBD is permitted but THC is not. Possession of any amount of marijuana is a misdemeanor that carries a penalty of 180 days of jail time and up to $1,000 in fines. Possessing less than 30 grams is a misdemeanor that carries a possible 1-year jail sentence or up to $5,000 in fines. And possessing more than 30 grams is a felony with fines up to $10,000 and 2.5 years in jail.
Timeline of Key and Recent U.S. Cannabis Legislation
Oregon becomes first state to decriminalize cannabis.
California becomes the first state to legalize medical cannabis.
Colorado and Washington become the first states to legalize recreational cannabis.
Utahbecomes the first state to legalize low-THC/high-CBD medical cannabis.
Vermont becomes the first state to legalize cannabis through the state legislature, rather than by ballot measure.
New York, Virgina, New Mexico and Connecticut legalize recreational cannabis.
As state-level legalization of cannabis becomes more widespread, the American Public Health Association (APHA) has called for a public health approach to regulating the substance that prioritizes health equity and social justice.
Although rates of cannabis use are similar across races, cannabis-related arrests have historically been higher among Black and Latino communities than within their white counterparts. Such arrests can carry negative health consequences for individuals and entire communities.
“Racial disparities in cannabis-related criminal justice encounters are rooted in public policy,” the APHA wrote in a policy statement. “Decriminalization and implementation of public health regulatory and enforcement structures must be supported by current evidence and best practices and must keep health equity and social justice at the forefront of public health policy and enforcement efforts.”
Cannabis Clinical Uses, Health Consequences and Public Health Effects
How Health Providers Can Talk to Patients About Cannabis
As availability of cannabis grows, conversations between healthcare providers and patients will become more important. These strategies may help clinicians have open conversations about cannabis with both adolescent and adult patients.
Communication Tips for Healthcare Providers: Talking to Youth About Cannabis
Start conversations with young adolescents.
Ask screening questions about a patient’s cannabis use, as well as exposure to peers and family members who use cannabis.
Discuss cannabis in different contexts—during routine visits, or when a patient presents with symptoms that may indicate cannabis use.
Explain the legal and health implications of cannabis use to young patients, including those who have not used it.
Talk about how cannabis can interrupt a patient’s goals.
Engage in open conversations without judgment.
Use the “8 A’s”.
The infographic above shows the “8 A’s” which include assuring patient privacy, asking about cannabis use, answering questions, assessing impacts of cannabis use, appraising a patient’s willingness to change, assisting with goal-setting, arranging for a follow-up, and acknowledging parental concerns.