With changes in cannabis legislation across the country, pervasive marketing and widening public use of CBD gummies, oils, pot brownies and other edibles — how does this societal evolution affect when parents should talk about marijuana with kids and how they should approach this nuanced issue?

Currently, only three U.S. states (Idaho, Kansas and Nebraska) restrict all public use of marijuana, while all others now allow either medical, recreational or CBD/Low tetrahydrocannabinol (THC) use. With the drastic increase in cannabis accessibility and with dispensaries popping up across the country, the number of occurrences in which young children accidentally ingest edible cannabis products has increased 1,375{b574a629d83ad7698d9c0ca2d3a10ad895e8e51aa97c347fc42e9508f0e4325d} since 2017.

“Try to be honest with your kids without overwhelming them,” says Kristen Ward, a clinical assistant professor of pharmacy and clinical pharmacist at Michigan Medicine, and a parent of two. “It can be really difficult to find the right level of information to share, but starting by asking them questions about what they already know and believe can help get the ball rolling.”

Here are some simple steps and prompts to get you and your kids talking about marijuana use.

1. Start conversations early and continue them at age-appropriate levels

“The American Academy of Pediatrics recommends that parents start these conversations in grade school,” adds Ward. “It makes sense because these early conversations can help build a foundation with your kids so they feel comfortable discussing difficult topics with you before they are encountering situations with peers and drugs later on.”

According to Bethany Cook, a Chicago-based licensed clinical psychologist and author of “For What It’s Worth – A Perspective on How to Thrive and Survive Parenting Ages 0-2,” ‘age-appropriate’ is not about the topic but about how the information is delivered, when and why.

“If [your children] are in elementary school, then [it can be a] more complex conversation and should focus on the fact that it can really alter reality,” says Dr. Baback Bob Gabbay, attending psychiatrist and chief medical director at Destinations for Teens in Woodland Hills, California. “For late elementary, middle and high school students, it is recommended to ask them how much they know and if they have any questions before parents [offer] their own feedback that they have learned already.”

Gabbay says that many clinicians favor at least introducing this topic at the beginning of middle school, whether that be the fifth or sixth grade for your child.

2. Make sure you and your parenting partner (if you have one) are aligned

In families with two or more parents, Cook stresses the importance of knowing one another’s points of view and agreeing on what you plan on sharing with the kids before you begin the conversation. “You can come from different perspectives,” she adds, “just talk ahead of time and stick to the script.”

3. Coordinate with your child’s school curriculum on drug education

When it comes to the marijuana talk, you don’t have to do it alone. “As a parent, you are never prepared to have the drugs conversation with your kids. You want to keep them little as long as possible, but when they come asking, you can’t hide your head in the sand,” says Shannon H., a mom of two in the Greater Seattle area. Her 12-year-old daughter learned about different types of drugs during the recently revamped D.A.R.E. curriculum, which was brought back to her school while she was in the fourth grade.

“Find out from the school teachers or administrators when they plan to have drug education (including cannabis) as part of the school curriculum and follow that lead,” says Gabbay. 

4. Take advantage of teachable moments around drug use

Gabbay describes “teachable moments” as something that comes up in day-to-day life, such as a story in the news about drug use, especially in a school-age child. “This makes it more relevant to the youngster’s life and allows them to more likely to be open to a conversation with a trusted parent.”

Ward agrees that asking kids if they know people who use marijuana or cannabis products, what they think when they see people on TV using, or even asking about the billboards and dispensaries around town can be a starting point. “Keeping the discussion short,” she says, “especially in the beginning and with younger kids, and coming back to it periodically will help the difficult discussions get easier with time.”

Shannon H. says her daughter has friends with older siblings who have had experience with vaping, which opened the door to one of their recurring conversations about drugs. She adds that where she lives cannabis stores are common, often with clever puns in their business names. “At 12, my daughter knows that you must be 21 to go into them.” 

5. Explain medical marijuana

Marijuana and CBD are now advertised as medical treatments for everything from muscle pain to anxiety, yet “there are few evidence-based instances where cannabis can be clearly medicinally helpful,” says Gabbay. “One may be for young children who have very severe seizure disorders. Another is for some adults with cancer that are extremely underweight [who find it] hard to consume food as marijuana/cannabis can increase appetite.”

Ward agrees, “Given the changing regulations with marijuana/cannabis, it wasn’t able to be studied in great depth for medical ailments until recently,” and adds that there is some interesting research in adults that is ongoing like using specific components of marijuana to treat nausea and pain.

6. Review the negative effects of cannabis use

“In the vast majority of cases, especially when it comes to mental health, behavior and learning in teenagers and pre-teens, marijuana/cannabis can be extremely harmful,” emphasizes Gabbay.

Some concerns about cannabis use include:

• An increased risk of major depressive and major anxiety disorders.
• An increased risk of psychosis and psychotic disorders.
• Impairment of short-term memory, concentration, coordination and problem-solving.
• Dependency risk that is “more difficult to treat than ten to twenty years ago” due to increased potency in today’s marijuana/cannabis.

Gabbay also adds that in his practice, he has seen youth affected by cannabis use via “an increase in appetite and obesity, which can be very deleterious when coupled with other factors in society contributing to adolescent obesity.”

7. Cover how cannabis use can affect a child’s development

“Marijuana/cannabis can harm children and adolescents whose brains are still developing,” says Ward. THC found in cannabis influences the same system in the brain that directs brain development, which causes youth to be especially sensitive to its potentially irreversible effects. 

“With our kids, we can honestly tell them that it is not medicine and can make it harder for them to learn, play sports and think clearly,” explains Ward.

“Some studies have shown that chronic cannabis use of approximately two years or greater may actually impair IQ,” says Gabbay. “Many (not all) who use cannabis chronically can suffer from a significant decrease in motivation [and] enjoyment of everyday activities and are less likely to socialize as well, which is very crucial for social development with peers.”

8. Social justice around marijuana use is a separate issue

“Despite roughly equal usage rates, Blacks are 3.73 times more likely than whites to be arrested for marijuana,” reports American Civil Liberties Union (ACLU). The criminal justice system’s unequal prosecution of drug possession and usage for BIPOC communities is one of the big reasons for the movement to decriminalize marijuana use, but it is important to emphasize that marijuana use is still illegal for kids.

“We began treating the ongoing discussion of marijuana the same as we would tobacco or alcohol,” says Shannon H. “We have said it is something that grown-ups are legally allowed to choose to do, and you must be 21 to make that choice legally.”

9. On increased risks and family history

Cook recommends talking to kids about any increased risks of marijuana usage due to a family history of substance use disorders or mental health conditions, just like you would if your family has a history of heart attacks or high blood pressure. “You’d talk about the genetic component, signs, symptoms, treatments, etc. … Share what your family tree has in this arena,” she explains. “I’d pair it with a few positive physical or psychological traits that your family tree has as well.” 

Gabbay also recognizes the additional challenge with this topic when it comes to stigma and family history. He suggests that if you’re comfortable, to allow a family member with personal experience with substance use disorder speak with the child.

10. On avoiding accidental ingestion

As mentioned earlier, accidental ingestion of cannabis edibles has increased exponentially in recent years. Explain to kids that they should never eat anything (especially gummies or baked goods) that have not been offered to them by a trusted source. Parents should keep any marijuana products, especially edibles, out of kids’ reach and in child-proof containers, if you keep them at home.

“Educate children that when marijuana is ingested it can take a long time for the effects to go away (e.g., 24 hours) and the experience is very uncomfortable, comes in uncomfortable waves and is hard to shake off,” says Gabbay. In young children, large doses of cannabis can result in respiratory issues requiring ventilation, loss of consciousness or seizures.

11. How to tell kids where you stand on cannabis usage

“Even if you are a proponent of cannabis, it is important to discuss with kids that we know it can hurt them while they are still growing,” says Ward. “After that, I think having an open and honest discussion about your stance on the subject, while being a good role model, will help build respect and make the discussion more productive.”

12. Offer objective support and nonjudgmental guidance

“Make sure [kids] know they can come to you regardless of your stance if they have questions and you’ll try to offer objective support and nonjudgmental guidance,” says Cook. “If you don’t feel you can offer this type of support, help them find someone who can.” 

13. Keep the topic open and safe

“Conversations should never be ‘one and done’ especially on hot topics,” notes Cook, “as we are always learning and evolving our opinions about things … there will inevitably be a shift in understanding and awareness for both parents and our kids as science [uncovers] more about the pros and cons of marijuana.”