It would be a good idea to ask them about it.

Recently, The Lancet published the first-ever report of marijuana use by Americans aged 12 and over between 2002 and 2014 using data from the National Survey on Drug Use and Health. The data and a discussion of their public health implications are included as part of the CDC’s Morbidity and Mortality Weekly Report.

A lot changed, marijuana-wise, between 2002 and 2014. State laws related to marijuana loosened considerably. Public support for legalization climbed significantly. And public perception of risk of using marijuana dropped off. How have these changes affected marijuana use and addiction? Is the sky falling?

No, it’s still up there. In fact, the number of adolescents ages 12-17 who smoke pot actually went down during that time period. The kids are all right.

Perhaps unsurprisingly, the number of adults who use marijuana increased during the same period. As an organization dedicated to reducing substance-related harms, were particularly interested in heavy users, since heavy use is associated with a higher risk for addiction and other mental health disorders.

Marijuana Use Trending Upward Among Emerging Adults

The report indicates that the number of adults who had consumed marijuana daily or almost daily for a least a year almost doubled between 2002 and 2014.

Many of these adults could more properly be categorized as “emerging adults,” people between the ages of 18 and 25 who often have a whole lot of autonomy, but still-developing brains. The analysis showed that in 2014, 6.9% of all 18-25 year olds had used marijuana daily or almost daily for at least one year, up from 4.3% in 2002.


Seven Out of 100 Young Adults Use Marijuana Daily. Is That A High Number?

That 6.9% of 18-25 year olds adds up to about 1.8 million young Americans. It’s lower than the number of 18-25 year olds who engage in “heavy drinking” (five drinks or more at least five times per month), which is at about 12%. But unlike heavy alcohol use, daily marijuana use is growing quickly in this age group.

It’s difficult to assess the implications of this trend because the risks of regular marijuana use are not well-understood. As with all risks, not everyone who engages in the behavior will experience consequences. However, our existing body of research indicates that a person who uses marijuana every day has a 25-50% chance of becoming addicted.

In short, daily marijuana use is something to keep an eye on, especially among this age group with the highest levels of use and–as we know–a brain that’s not quite done developing.

What Else Do We Know About This Age Group?

John Kelly has written a lot about emerging adults and substance use. At a 2014 collegiate recovery conference, he presented an excellent overview of how and why to offer substance use-related support to 18-25 year olds. Folks in this age group, he said:

– Are often experiencing the first chance to access “forbidden fruit” (e.g., drugs and alcohol) that have long been associated with “being a grown up”

– Often have new social freedom, financial resources, and live independently

– Perceive their capabilities as having shifted abruptly (e.g., going to college, getting their first job, first apartment, etc)–this is not in line with the psychobiological reality, which is that they continue to undergo gradual development changes

Pretty obvious. We’ve all seen this. But emerging adults also experience specific stressors that demonstrably affect their mental health. More than any other age group:

– They are more likely to move

– They are more likely to experience poverty

– They are more likely to suffer serious psychological distress

They also are unlikely to seek help for a substance use disorder on their own initiative. When an 18-25 year old meets the criteria for a substance use disorder (SUD), she will probably report lower levels of readiness to change than other age groups. Emerging adults typically do not reach out for specialty care, which is consistent with research indicating that many people live with SUDs for at least five years before attempting to find treatment.

Screening, Brief Intervention and Referral to Treatment Can Support These Youth

This appears to be a quandary: an age group engaging in high levels of risky substance use, managing additional stressors that can destabilize mental health, with minimal interest in asking for help.

However, these individuals will encounter primary care, emergency departments, social services, and/or the criminal justice system. All of these points of contact are opportunities to perform an evidence-based intervention called Screening, Brief Intervention and Referral to Treatment (SBIRT).


SBIRT has been shown to reduce at-risk substance use. It is recommended by the U.S. Preventive Services Task Force, which has deemed it as effective as a flu shot. The use of SBIRT in systems that emerging adults do intersect can provide a few important benefits.

SBIRT can be:

– An opportunity for emerging adults to reflect on their marijuana use–its frequency and its effect on their lives

– A source of motivation to make changes in marijuana use behavior

– A jumping off point for seeking specialty treatment for substance use or mental health disorders

Basic info about SBIRT and additional resources are listed on our website.

We know that an intervention earlier in life can lessen the impact and duration of an SUD. Addressing substance use in a variety of settings is a wonderful way to target a higher-risk age group who may benefit from education, motivation, and additional services.

If we wait around for them to show up in addiction treatment, it will take years.

In Colorado, SBIRT Practitioners Address Marijuana Like Alcohol

There’s a big difference between the asking a patient “Do you use street drugs?” and “How often do you use marijuana?”

SBIRT Colorado, a statewide public health initiative, has found that asking about the amount and frequency of marijuana use can be an effective way to address marijuana use in a state where adults commonly–and legally–consume marijuana. This approach is similar SBIRT for alcohol use.

They’ve created guidance for any health or human service professional who wants to open up a conversation about marijuana use with the people that they serve. We recommend it as a starting point for anyone who wants do a better job of addressing marijuana use as part of overall health. Click here to download it.