Everything comes down to weighing risk and benefit.
– Susan Landers, MD
Cannabis is no longer tucked away on the margins. It’s sold in brightly lit storefronts, packaged as candy-like edibles, and widely framed as low-risk. What often gets lost is a clear, practical discussion of the downsides—especially for teens and young adults, and for people who are pregnant or breastfeeding.
In a recent conversation, neonatologist Susan Landers offered a calm, evidence-based lens on what families need to know now. Her approach is neither alarmist nor dismissive. Instead, she focuses on helping parents and caregivers weigh risks and benefits so they can make informed decisions in real life.
When Use Becomes a Problem
Marijuana use disorder isn’t about an occasional choice; it’s a pattern that becomes difficult to stop even as problems accumulate. People may use daily, develop tolerance, and spend increasing time and money to maintain the same effect. Over time, irritability, anxiety, and sleep problems can appear, while school, work, hobbies, and relationships quietly fall away.
About one in ten regular users develops a use disorder—comparable to other public-health concerns we talk about far more openly. Naming the pattern matters. Early recognition makes earlier conversations possible, and earlier conversations lead to better outcomes.
Potency, Dose, and the Illusion of Control
Whether cannabis is smoked, vaped, or eaten, dose and potency vary widely. Unlike prescriptions, products don’t always deliver predictable amounts. Edibles in particular can be easy to overshoot, leading to stronger and longer-lasting effects than intended. The consistent risk factor across forms is frequency and strength: the more often and the stronger the product, the higher the risk.
A Condition Many Families Haven’t Heard Of
Clinicians are seeing more cases of cannabis hyperemesis syndrome (CHS)—recurrent, severe vomiting and abdominal pain in frequent users. People may cycle through emergency rooms for IV fluids, often finding temporary relief in hot showers. The key detail is simple but crucial: when cannabis use stops, the vomiting stops. Awareness can spare months—or years—of unnecessary suffering.
Motivation, Mood, and the Slow Slide
Chronic use can also be associated with what’s often called amotivational symptoms: flattened affect, withdrawal, missed classes or shifts, and growing irritability. Responsibilities slide. Social life shrinks. The good news is that cutting back, addressing underlying anxiety with appropriate care, and adding therapy can help people regain momentum.
Who Is Most at Risk?
Starting young (especially between ages 14 and 16), daily use, and high-potency products raise the likelihood of later problems. Using cannabis to self-treat anxiety is common—but can backfire over time. Youth, frequency, and potency together are particularly concerning, which is why early, calm conversations matter.
How to Talk With Teens and Young Adults
A productive conversation doesn’t begin with confrontation. It begins with care: “I love you, and I’m worried.” Open questions—How much are you using? Is it affecting school, work, sleep, or friends?—invite reflection rather than defensiveness. Curiosity keeps the door open; accusations close it.
Pregnancy Is Different
Some pregnant people turn to cannabis for nausea or pain, assuming legal access means safety. Pregnancy is a special case. THC enters the bloodstream, crosses the placenta, and reaches the developing baby. Heavier, daily use has been linked with prematurity and low birth weight, and research has followed associations with later attention and learning challenges. When evidence points to risk, minimizing exposure is the prudent choice. Evidence-based alternatives for nausea and anxiety are available through obstetric care.
Breastfeeding and Lingering Exposure
THC concentrates in fat, and breast milk is rich in fat. That means THC can linger in milk for weeks, exposing an infant’s developing brain long after use. Pediatric guidance advises against marijuana use while breastfeeding. In situations where exposure is possible, avoiding use is the safest path.
Edibles and Accidental Ingestions
Edibles pose a separate risk in homes with children. Because they look and taste like candy, kids can ingest large amounts quickly. Treat edibles like medication: locked, out of sight, and out of reach—every time.
If Cannabis Is Being Used to Cope
When anxiety or nausea is driving use, the next step is not judgment—it’s care. A proper evaluation and evidence-based treatments can help right away, while longer-term support addresses root causes. The goal is relief without trading short-term comfort for longer-term harm.
The Takeaway
Cannabis is part of today’s landscape. That reality makes clear, compassionate information more important—not less. Recognizing early warning signs, understanding special risks during pregnancy and breastfeeding, and choosing calm, honest conversations can help families navigate this moment with steadiness and care.
Clear eyes, open dialogue, and evidence-informed choices remain the most reliable tools we have.
