Cannabis Facts

Cannabis, also known as marijuana,1 is an addictive psychoactive drug from the cannabis plant; it can also be called weed, pot, or bud, refers to the dried flowers, leaves, stems, and seeds.2 Cannabis (Cannabis sativa L.) is a plant that contains over 80 different naturally occurring compounds called “cannabinoids”;3 the most well known are: Cannabidiol (CBD) and Tetrahydrocannabinol (THC). THC is the psychoactive ingredient in cannabis that gives users a ‘high’.

The amount of THC in cannabis products has increased from 3% to as high as 90% in the current market, with an average concentration around 15%. The use of high potency products (THC over 10%), is associated with an increased risk of psychotic and nonpsychotic unipolar depression and bipolar disorder,4 psychosis, schizophrenia and cannabis use disorder.5

Cannabis, along with alcohol and nicotine, is often considered a gateway drug6, 7 to the use of other substances. However, the biggest contributor to using other substances later on in life is the age of initiation and the frequency of use. Cannabis use in adolescence and early adulthood is associated with a range of adverse outcomes later in life. Using cannabis prior to the age of 15 greatly increases the risk for: later substance use, delinquency, truancy, and mental health problems including anxiety and depression.8

Average THC concentration in cannabis products has increased five-fold, from 3% to 15%, during 1995 to 2024.
In general, new research shows the regular and frequent use of cannabis during adolescence increases the likelihood of problems such as: behavior patterns, psychiatric disorders (like depression or anxiety), problems in the family, difficulties in peer relationships, disruption to recreation engagement or social isolation, and work adjustments.9
 

Synthetic Cannabinoids

 

What Are Synthetic Cannabinoids [Derived Psychoactive Cannabis Products (DPCPs)]?

  • Lab-made compounds designed to mimic chemicals found in natural cannabis.
  • Often are more potent and potentially more dangerous.10

These synthetic products used to be on the market as “spice”, “K2”, “fake weed”, and “herbal incense”.11 Now you might see these products marketed as having: CBG, CBN, Delta-6, -8, -9, -10, or -11, THC-A, -B, -JD, -O, -P, -X and THCV. They are often sold in disposable vapes, vape carts, pre-rolls, dabs, vape pods or as edibles, like gummies.

vape cartsIn order to turn the CBD in hemp (cannabis’s cousin plant, that does not have THC levels that would get a person high) into the products being sold as having the THC/Deltas listed above, laboratories need to use a solvent. These solvents are types of acids, including: toluene, heptane, or methylene chloride.12 These strong acids and residual metals can be left behind in the product sold to people, as well as byproducts that we don’t know the safety of for human inhalation.13 Many supplies are contaminated. Most states do not require testing and these products are being marketed to young people.14

Some synthetic cannabinoids have potential or current medical uses, yet many are illicitly manufactured and sold. Without quality control measures, this can lead to an increased risk of contamination and harmful additives. These products are found across the U.S. in convenience stores, gas stations, drug paraphernalia shops, novelty stores, and online.

Key Facts
Increased Potency – Synthetic cannabinoids can be 10 to 100 times more potent than natural cannabis, enhancing their psychoactive effects and other risks.15
Unpredictable Effects – The health effects from using synthetic cannabinoids can be unpredictable, harmful, and even deadly. Possible side effects include increased heart rate, vomiting, aggressive behavior, kidney damage, seizures, and even death.16

Young People & Synthetic Cannabinoids

The use of synthetic cannabinoids remains a concern due to their increased potency and associated risks. The use of synthetic cannabis has fluctuated slightly over the years

  • 2019: 8.57% of students reported using synthetic cannabinoids.17
  • 2021: 10.08% of students reported using synthetic cannabinoids.18
  • 2023: 9.6% of students reported using synthetic cannabinoids.19

Additionally, youth may not report the use of synthetic cannabinoids if they perceive the product they are using as real or not synthetic.

delta 8 THC cannabis gummies packaging
Marketing efforts for synthetic cannabinoids have targeted youth through enticing, playful packaging, and messaging that claims it’s a cheaper alternative to cannabis. Both mental and physical effects of synthetic cannabis use in youth may differ from adults, with available studies suggesting greater harm:

  • Nationally, high school students who had used synthetic cannabinoids were more likely to engage in potentially harmful behaviors related to their sexual and physical health compared to students who used cannabis only.20
  • Severe neurological effects like seizures or coma are more commonly seen with youth using synthetic cannabinoids versus cannabis only and more commonly seen in youth compared to adults.21
Navigating Cannabis Laws in New Hampshirecannabis in New Hampshire

Over the last decade, cannabis laws in New Hampshire have changed significantly.

  • Therapeutic/Medical Cannabis – In 2013, therapeutic cannabis was legalized, allowing regulated Alternative Treatment Centers (ATCs) to provide cannabis to individuals with a qualifying medical condition and a certification from their healthcare provider.22, 23
  • Decriminalization – In 2017, NH decriminalized cannabis.24 While still illegal, people over the age of 18 found with up to three-quarters of an ounce now receive a $100 fine instead of jail time. This change aimed to reduce the harsh penalties for minor offenses.
  • Legalizing – On June 13, 2024 New Hampshire House Bill 1633, relative to the legalization and regulation of cannabis and making appropriations therefor, was removed from the table as the motion failed to pass during the Regular Calendar (162-189), House Journal 16.25

Current State of Cannabis Laws
Discussions and debates about fully legalizing recreational cannabis for adults are on-going, which could lead to expanded access for adults in the near future. Staying informed about these laws is essential to understand what is legal and what isn’t. For the latest updates on cannabis legislation, visit the NH Department of Health and Human Services,22 the official state legislature site,26 and New Futures.27
 

Podcast: Cannabis Commercialization - What You Need to Know with Kate Frey
The Partnership sits down with Kate Frey from New Futures to explain the range of options on the table to expand legal access to cannabis. Kate walks us through the lessons learned from other states and helps us understand some common-sense recommendations to protect the public’s health and limit the negative consequences especially for youth.

Changing Attitudes and Beliefs About Cannabis

Attitudes and beliefs about cannabis use have also changed over time. These changes include:

Decreased Perception of Risk
From 2013 to 2019, fewer NH students saw using cannabis once or twice a week as very risky, with the percentage dropping from 21.7% in 2013 to 10.3% in 2019.17 More recent data from 2021 indicate a continuing decline in the perception of risk associated with cannabis use among students, with less than 10% viewing occasional use as very risky​.18
Decline in Parental and Peer Disapproval
From 2013 to 2021, fewer students believed their parents thought it was wrong to smoke marijuana, falling from 82.4% to 79.7%. Parental disapproval remains a significant factor in preventing youth substance use.28 The 2023 data19 indicates:

2023: 77.8% of students believe their parents feel it would be wrong or very wrong for them to smoke marijuana.
2023: 45.5% of students reported that their friends feel it would be wrong or very wrong for them to smoke marijuana.

While a majority of students still perceive parental disapproval, the percentage has continued to slightly decline over time. Peer disapproval is also relatively low, which could contribute to higher usage rates among students.

Increased Cannabis Use
  • 2015: 22.2% of NH high school students reported using marijuana.17
  • 2019: This increased to 26.1%.17
  • 2021: Cannabis use among high school students decreased, with 17.8% reporting use in the last month.18
  • 2023: 18.1% of students used marijuana in the last month.19

This data shows that cannabis use is seen as less harmful because it is widespread and easy to access. When protective factors like perceived risk and parental disapproval go down, coupled with expanded access and marketing, the risk of use goes up among youth.

Effects of Cannabis Use
 
On the Developing Brain

Our brains don’t fully develop until late adolescence, around age 25, and any cannabis use before that can have long-term effects.

  • Short-term effects – Intoxication, increased heart rate, impaired movement, memory issues, altered senses, mood changes, and hallucinations (in high doses).29
  • Long-term effects – Changes in memory, learning, attention, decision-making, coordination, emotions, and reaction time.29
  • Regular cannabis use by teens and young adults can hinder relationships, school performance, safety, and memory. Effects may be long-lasting or permanent.
Mental Health Risks
  • Linked to mental illness, especially in those with a family history of mental health issues.
  • Associated with depression, anxiety, and suicide among teens.
  • Regular use increases the risk of psychosis and long-term mental disorders, such as schizophrenia.29 Learn more in our podcast with Dr. Kristen Gilliland.30

High Risk Behaviors
Adolescents using cannabis are more likely to engage in risky behaviors like unsafe sex, using other substances, and driving while intoxicated. This can lead to poor educational outcomes and future unemployment difficulties.31
Addiction
About 1 in 10 cannabis users32 will develop Cannabis Use Disorder (CUD). This risk increases to 1 in 6 for youth who start using cannabis before age 18. 33
On the Body
Inhaling cannabis smoke contains many of the same harmful toxins and carcinogens as tobacco smoke. Smoking cannabis can harm lung tissue and cause scarring.34
Pregnancy Risks

Today is for me.Cannabis use during pregnancy can harm the baby, leading to higher rates of learning, attention, and behavior challenges like attention-deficit/hyperactivity disorder (ADHD).35 Learn more about cannabis and pregnancy with NH’s Today is For Me. campaign.

Prevention Strategies

Prevention Strategies

The proven prevention strategies for cannabis use are similar to the prevention strategies for other substances. When teachers, coaches, and other caring adults talk with young people about using any substances, they strengthen healthy coping skills and help youth avoid the negative physical, mental and social costs associated with misuse.

Honest Conversations

talk to your kids

  • Talk openly with the youth in your life about the risks of cannabis use.
  • Teach refusal skills and stress the importance of their health and safety.
  • Discuss the misleading portrayal of cannabis in the media.

Learn more about The Partnership’s resources for parents and caregivers.

Even if cannabis/marijuana is right for you, it’s not for them. As an adult you may choose to use cannabis/marijuana for a number of reasons, but it is important to understand and educate young people about the risks associated with their use of the product. Visit our Stronger Than You Think campaign to learn more about how to have the conversations around use with youth.

 

Stronger Than You Think campaign graphic that says "you are the number one influence on whether the youth in your life choose to use substances" with a man and teen talking
Safe Use and Safe Storage

Safe use and storage

  • Follow provider recommendations for therapeutic use.
  • Store cannabis in child-safe containers and lock it away, up high to prevent accidental poisoning.
  • Avoid using cannabis around children or while caring for them.

Learn more about therapeutic cannabis laws and responsible use in NH.

 

Universal Screening

SBIRTSupport Screening, Brief Intervention, and Referral to Treatment (SBIRT) in schools and pediatrician offices to identify and prevent substance misuse early.

For more information on SBIRT, visit SBIRTNH.org.

spotlight

Infographic: Screening, Brief Intervention and Referral to Treatment (SBIRT): A school-based approach to reinforce healthy behaviors

Learn how your school and other community settings can strengthen healthy coping skills and identify risky behaviors early among youth. Screening, Brief Intervention and Referral to Treatment (SBIRT) is part of a comprehensive prevention program.

Resources, Supports & ServicesResources

The Partnership has Fact Sheets on many topics including cannabis/marijuana at the Factsheets & Materials page.

Many prevention and harm reduction campaigns highlighted at our Prevention Campaigns & Toolkits page deal with cannabis/marijuana use as well as other substances and offer more information and free shareable media for your social and websites.

 

Additional Resources

  • Marijuana Talk Kit – What you need to know to talk with your teen about marijuana from The Partnership to End Addiction.
  • Know the Risks of Marijuana – SAMHSA offers facts about how marijuana use comes with real risks that can impact a person’s health and life.
  • Preventing the Use of Marijuana: Focus on Women and Pregnancy – SAMHSA’s goal for this Guide is to inform women of the potential effects of marijuana use, especially during pregnancy and during the postpartum period, and to promote healthy decision making. This guide examines the scientific literature, examines emerging and best practices and identifies key components of peer-reviewed models and discusses the challenges and strategies involved in implementing prevention programs.
  • Marijuana Resource Center – Comprehensive site developed and maintained by The Partnership to End Addiction.
Citations
1Important Note: The Partnership uses the term ‘cannabis’ to refer to the plant and all types of derived products, including vape cartridges, edibles, smokable “weed” or “pot”, oils and tinctures. We do not use the term “marijuana” less often on most of our resources because it has a complicated past that was intentionally harmful toward certain groups of people. However, we understand that “marijuana” is a common term for products with THC (Delta 9), and we want to ensure that when we share health information, it is understood and accessible and therefore may use both terms together.

2https://www.cdc.gov/cannabis/about/index.html

3https://www.fda.gov/news-events/public-health-focus/fda-and-cannabis-research-and-drug-approval-process

4Sorensen CJ, DeSanto K, Borgelt L, Phillips KT, Monte AA. Cannabinoid Hyperemesis Syndrome: Diagnosis, Pathophysiology, and Treatment-a Systematic Review. J Med Toxicol. 2017 Mar;13(1):71-87. doi: 10.1007/s13181-016-0595-z. Epub 2016 Dec 20. PMID: 28000146; PMCID: PMC5330965.

5Association of cannabis potency with mental ill health and addiction: a systematic review, Petrilli, K., MRes Shelan Ofori, M., Hines, L., Taylor, G., Adams, S., Freeman, T. The Lancet Psy. July 25, 2022. DOI: doi.org/10.1016/S2215-0366(22)00161-4

6Miller ML, Hurd YL. Testing the Gateway Hypothesis. Neuropsychopharmacology. 2017 Apr;42(5):985-986. doi: 10.1038/npp.2016.279. Epub 2017 Jan 18. PMID: 28096528; PMCID: PMC5506797.

7https://www.samhsa.gov/data/sites/default/files/WebFiles_TEDS_SR142_AgeatInit_07-10-14/TEDS-SR142-AgeatInit-2014.pdf

8https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5225546/

9https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5225546/

10https://nida.nih.gov/research-topics/synthetic-cannabinoids

11 Kenichi Tamama, Chapter Five – Synthetic drugs of abuse, Advances in Clinical Chemistry, Elsevier, Volume 103,
2021, https://doi.org/10.1016/bs.acc.2020.10.001.

12Golombek P, Müller M, Barthlott I, Sproll C, Lachenmeier DW. Conversion of Cannabidiol (CBD) into Psychotropic Cannabinoids Including Tetrahydrocannabinol (THC): A Controversy in the Scientific Literature. Toxics. 2020 Jun 3;8(2):41. doi: 10.3390/toxics8020041.

13Erickson, B. Delta-8-THC craze concerns chemists, Chemical & Engineering News. August 30, 2021, ISSN 0009-2347.

14Derived Psychoactive Cannabis Products (DPCP), An overlooked threat to public safety. University of North Texas, Health Science Center, https://www.unthsc.edu/school-of-public-health/derived-psychoactive-cannabis-products-dpcps/

15https://adf.org.au/resources/health-professionals/synthetic-cannabinoids/synthetic-cannabinoids-harm/

16https://adf.org.au/drug-facts/synthetic-cannabinoids/

17https://nccd.cdc.gov/youthonline/App/Results.aspx?TT=C&SID=HS&QID=H23&LID=NH&LID2=SL&YID=2019&YID2=SY&SYID=&EYID=&HT=QQ&LCT=LL&COL=T&ROW1=N&ROW2=N&TST=false&C1=&C2=&SC=DEFAULT&SO=ASC&VA=ST&CS=Y&DP=2&QP=G&FG=G1&FA=A1&FR=R1&FS=S1&FSC=P1&FSI=I1

18https://www.dhhs.nh.gov/programs-services/population-health/health-statistics-informatics/youth-risk-behavior-survey

19https://wisdom.dhhs.nh.gov/wisdom/assets/content/resources/yrbs-2023/2023NHH%20Summary%20Tables.pdf

20Heather B. Clayton, Richard Lowry, Carmen Ashley, Amy Wolkin, Althea M. Grant; Health Risk Behaviors With Synthetic Cannabinoids Versus Marijuana. Pediatrics April 2017; 139 (4): e20162675. 10.1542/peds.2016-2675

21Sarah Ann R. Anderson, Anna M. Oprescu, Diane P. Calello, Andrew Monte, Peter S. Dayan, Yasmin L. Hurd, Alex F. Manini, on behalf of the ToxIC Investigators; Neuropsychiatric Sequelae in Adolescents With Acute Synthetic Cannabinoid Toxicity. Pediatrics August 2019; 144 (2): e20182690. 10.1542/peds.2018-2690

22https://www.dhhs.nh.gov/programs-services/population-health/therapeutic-cannabis

23https://www.dhhs.nh.gov/programs-services/population-health/therapeutic-cannabis/alternative-treatment-centers

24https://newhampshirecannabis.org/laws

25https://legiscan.com/NH/bill/HB1633/2024

26https://www.gencourt.state.nh.us/

27https://new-futures.org/cannabis

28https://drugfreenh.org/for-families/talk-they-hear-you/

29https://nida.nih.gov/publications/drugfacts/cannabis-marijuana

30https://drugfreenh.org/podcast-episode/making-sense-of-the-science-how-cannabis-use-impacts-the-adolescent-brain-with-dr-kristen-gilliland/

31https://www.jahonline.org/article/S1054-139X(18)30238-6/fulltext

32https://www.yalemedicine.org/conditions/marijuana-use-disorder

33https://nida.nih.gov/sites/default/files/teens_brochure_2013.pdf

34https://www.lung.org/quit-smoking/smoking-facts/health-effects/marijuana-and-lung-health

35https://mothertobaby.org/fact-sheets/marijuana-pregnancy/