Everything comes down to weighing risk and benefit.
– Susan Landers, MD
Cannabis is everywhere right now—stores on busy corners, colorful packages, gummies that look like candy. What we don’t talk about enough are the hidden downsides for teens and young adults, and the very real implications for pregnancy, breastfeeding, and babies. In this conversation, neonatologist Dr. Susan Landers—host of Moms Matter and author of So Many Babies—joins Stacey Chillemi for a clear, compassionate look at what families need to know without scare tactics or jargon.
Together, they walk through what marijuana use disorder actually looks like day to day, why cycles of severe vomiting (cannabis hyperemesis syndrome) are showing up in frequent users, how amotivational symptoms can derail school and work, and what changes during pregnancy and breastfeeding. You’ll also hear practical ways to spot red flags, start loving conversations with teens and young adults, and choose safer options when anxiety or nausea are part of the picture—all with Dr. Landers’ steady risk–benefit approach.
Thank you so much for joining us! Our readers would love to get to know you a bit better. Can you tell us a bit about your backstory?
I’m a neonatologist who has spent my career caring for vulnerable babies and guiding families through high-stakes decisions. These days, I share practical, plain-spoken advice through my Moms Matter podcast, weekly newsletter, blog, and the memoir So Many Babies. I focus on helping parents weigh risks and benefits so they can make calm, informed choices. At home, I’m also chasing Rudy, our very spirited lab puppy, which keeps me honest about “real life.”
What exactly is marijuana (cannabis) use disorder, and how common is it?
It’s a pattern of use that becomes hard to cut back or stop, even as it causes problems. People may use daily, build tolerance, and spend growing time and money to keep the same effect. Irritability, anxiety, or sleep trouble can creep in; school, work, hobbies, and friendships can fall away. Continuing to use despite these harms, including risky choices like driving while high, fits the diagnosis described in our conversation.
Roughly 10% of regular users develop a use disorder. That’s similar to other public-health issues we openly discuss, which makes it striking that families often hear so little about it. Calling it what it is helps parents see it sooner. Early recognition means earlier conversations and better outcomes.
Can you clarify cannabis, marijuana, and THC?
“Cannabis” is the umbrella term; marijuana is one form. THC (tetrahydrocannabinol) is the psychoactive ingredient that acts on cannabinoid receptors in the brain. With frequent exposure, tolerance builds, and dependence can follow. Whatever the form, the effect on the brain is real and dose-dependent.
Do forms of use (smoking, vaping, edibles) matter?
Potency and dose can vary a lot across smoking, vaping, and edibles. Unlike a prescription, you don’t always know how much you’re truly taking, which makes it easy to overshoot. Some edibles are described as “less potent,” but heavy, frequent use in any form can become problematic. The bottom line: more often and stronger products raise risk.
What attitudes do people have toward legalization?
Support is strongest among young adults, solid in mid-life adults, and more cautious in older groups. Broadly speaking, Democrats tend to be more supportive than Republicans. Many young adults view marijuana as low-risk, which can make it harder to notice when use is crossing a line. That cultural backdrop is exactly why clear, compassionate education matters.
What red flags should parents look for?
Daily use, escalating amounts, and needing more to get the same effect are early signs. Watch for slipping grades or job performance, stepping back from activities, and changes in mood or sleep. Irritability, anxiety, and social withdrawal often tag along. If someone keeps using, as problems stack up, that’s a serious clue to step in and talk.
What is cannabis hyperemesis syndrome (CHS)?
CHS is a pattern of repeated, severe vomiting and abdominal pain in frequent users. We discussed a young woman who kept landing in the ER for IV fluids until a resident asked about cannabis and connected the dots. Hot showers can briefly ease symptoms, but the real fix is stopping cannabis. Once use stops, the vomiting cycles stop—an important point for families and clinicians.
How common is CHS in young adults?
Clinicians are recognizing it more often in heavy, frequent users. The risk grows with persistent use and higher potency, which is why honest screening questions matter. When someone has unexplained cyclical vomiting, asking about cannabis can be the difference between repeated admissions and real recovery. Awareness prevents a lot of unnecessary suffering.
What is amotivational syndrome?
With chronic cannabis use, some people become flat, withdrawn, and unmotivated. Responsibilities slide, classes or shifts get skipped, and procrastination takes over. Irritability increases, and social life shrinks to almost nothing. Cutting back, treating underlying anxiety appropriately, and adding therapy can help people regain momentum—something I’ve seen up close.
Who is at greater risk of problems?
Starting young—ages 14 to 16—raises the chance of later addiction. Daily use and high-potency products add fuel to the fire. Using marijuana to “self-treat” anxiety is common but can backfire over time. Youth, frequency, and potency together are especially concerning, which is why early, calm conversations matter.
What should parents actually say to a teen or young adult?
Keep it loving and calm: “I love you, and I’m worried.” Ask open questions like, “How much are you using? Is it affecting school, work, sleep, or friends? How much are you spending?” Stay curious rather than accusatory so the conversation stays open. The aim is honest reflection, not a showdown—and that tone makes change more likely.
What about pregnant women who use cannabis for nausea or pain?
Some pregnant women turn to marijuana for nausea, but professional guidance recommends against it. THC enters the mother’s bloodstream, crosses the placenta, and reaches the developing baby. Legal access can feel reassuring, yet pregnancy is a special case where exposures matter. The safer move is to talk with an OB about evidence-based options for nausea or anxiety.
What pregnancy outcomes are linked with heavy use?
Heavier, daily use is linked with prematurity and low birth weight, and newer research tracks neurodevelopmental concerns later on. Studies cited on my site note associations with lower scores in verbal and memory domains by age 4, attention and hyperactivity issues by age 10, and lower reading, math, and spelling scores by age 14. While some research can be confounded by tobacco, the risk signal is strong enough to urge caution. When in doubt, minimizing exposure is the prudent choice.
Is breastfeeding while using marijuana safe?
THC concentrates in fat, and breast milk is rich in fat, so THC lingers. Guidance on my site explains THC can remain in milk for up to six weeks, meaning a baby may be exposed long after a mother uses cannabis. The American Academy of Pediatrics advises against marijuana use while breastfeeding; if a mother does use, some discuss “pump and dump,” but avoiding exposure is safest for the infant’s brain. This is one of those times where the developmental stakes are high and caution pays off.
Are edibles especially risky for kids at home?
Yes—because edibles look and taste like candy, curious kids can swallow a lot before anyone realizes what happened. We talked about real-world emergencies—including ICU-level care—after children found an adult’s gummies. Treat edibles like medicine: lock them up, out of sight and reach every single time. Safe storage prevents accidental ingestions and scary ER visits.
If someone is using to cope with anxiety, what’s a safer next step?
Start with a real evaluation and a conversation about proven anxiety treatments. For pregnancy-related nausea or anxiety, there are safer remedies—some non-drug and some medications an obstetrician can recommend. Gentle, practical supports can help right away, while longer-term care addresses the root cause. The goal is to feel better without relying on cannabis.
How can our readers further follow your work online?
Please visit Susanlandersmd.com. There you’ll find my books, resources on late preterm babies, the free Moms Matter newsletter, and helpful blog posts… including one focused on the dangers of cannabis use among young adults [READ IT HERE!]. The newsletter is published on Substack and can be subscribed to HERE. Download your free Cannabis Use Disorder and Amotivational Syndrome checklist PDFs to use as reference when you are faced with these situations.
You can also connect with me on LinkedIn. I welcome thoughtful messages and do my best to point families to reliable help. Clear, compassionate information is my north star.
Susan, thank you for such a clear, compassionate conversation. I know a lot of families will feel more equipped after this.
Thank you for having me. I’m grateful for the chance to share practical guidance, and I’m always here to help parents find trustworthy, real-world information.
