Which drug products are abused by adolescents?

Marijuana, cannabis products, kratom, and fentanyl are all dangerous products which may lead to drug abuse in adolescents, according to data presented at the 44th National Conference on Pediatric Health Care on March 18, 2023.

According to the National Center for Drug Abuse Statistics, drug abuse is seen in at least 1 in 8 teenagers. Alcohol abuse is seen in 61% of teenagers participating in drug abuse, marijuana and other cannabis products in 45%, and other drugs in 19%. Cigarette use, including vaping, is also seen in this population.

From 2019 to 2020, deaths from drug overdose in youths aged 14 to 18 years increased by 94%., then 20% from 2020 to 2021. These dramatic spikes contrast with a steady trend of drug overdose deaths from 2010 to 2019.

Concerns from parents which may be associated with drug use include changes in behavior, grades, and friends, withdrawing, depression, internet or social media searches, unsafe sex, and less interest in activities. Warning signs include hiding use, defensive or denying substance use, asking for money or displaying changes in spending, and changes in health.

Drug dependence is the appearance of withdrawal symptoms when substance use ceases, while addiction is compulsive use of drugs despite negative consequences. Substance abuse may lead to depression, IQ decline, poor cognitive development, and impaired critical thinking.

Marijuana use disorder is common, with 40% of high school students reporting marijuana use in their lifetime. This condition often goes untreated, but marijuana use is associated with increased risk of stroke, psychosis, heart disease, and other vascular diseases.

Respiratory symptoms of marijuana include cough, shortness of breath, and chest pain. Cannabis use also has negative outcomes on the brain. Neurophysiological processes develop until age 25, making youths at a greater risk of negative impacts to brain development.

Social anxiety, depression, suicidal thoughts, and attempted suicide are all more likely in teenagers after cannabis use. Acute psychosis and schizophrenia-type symptoms are also more likely in teenagers engaging in chronic cannabis use.

There are also toxicity symptoms from cannabis use. The toxicity of cannabis can lead to severe paranoia, anxiety, panic attacks, hallucinations, heart rate ventricular tachycardia, postural hypotension, respiratory depression, cyclic vomiting syndrome, and withdrawal symptoms.

Pharmacotherapy is not available for treating marijuana use disorder. However, individual focused, family, and group therapies are available for patients.

Kratom use is also dangerous in youths. Kratom is an opioid-like substance harvested from the leaves of an evergreen tree. It is not received any FDA approval for medical use, and regular use is linked to addiction and psychotic symptoms.

Short-term effects from Kratom last 10 minutes to 5 to 7 hours after ingestion, with the strongest effects appearing 2 to 4 hours after ingestion. Kratom use may lead to contamination or liver injury.

There is no specific treatment for kratom use disorder. Acute withdrawal and long-term maintenance are often seen, and behavioral therapy may be used to treat cravings.

Opiate addiction is also a risk in adolescents, with physical and psychological effects. Fentanyl is a synthetic opioid 50 times stronger than heroin and 100 times stronger than morphine. Adolescent overdoses from fentanyl have seen dramatic spikes in recent years.

Fentanyl can lead to fatal and nonfatal overdoses, with multiple doses of naloxone or continuous infusion potentially necessary to reverse the opioid action of fentanyl. Naloxone may be used to prevent overdose.

Reference

Clark LM. 410: Kratom, cannabis & kids: adolescent substance use and addiction. Presented at: 44th National Conference on Pediatric Health Care. March 15-19, Orlando, Florida.