High-Potency Cannabis, Early Use, and the Risk of Psychosis in Adolescents

Abstract

Cannabis is the most widely used illicit substance globally, with an estimated 244 million people reporting its use in 2025. Cannabis remains the most widely used illicit substance globally, and its increasing prevalence among adolescents has raised critical public health concerns due to heightened neurodevelopmental vulnerability during this stage. In this review, we will attempt to explore and synthesise the existing literature on the relationship between cannabis use in adolescents and the development of psychosis. This narrative review synthesises evidence from peer-reviewed studies published over the past seven years, focusing on the association between adolescent cannabis use and the onset of psychosis. A comprehensive search was conducted in PubMed, PsycINFO, and Google Scholar. The search was restricted to studies published between 2018 and 2025. Epidemiological data indicate that early initiation and frequent cannabis use substantially increase the risk of psychotic experiences and their persistence into adulthood. High-potency cannabis products further amplify this risk, even among adolescents without prior psychiatric history. Clinical studies demonstrate that cannabis use disorder frequently co-occurs with first-episode psychosis, complicating treatment and prognosis. Moreover, emerging patterns of cannabis consumption, including concentrates and edibles, present additional psychiatric risks for youth. Collectively, these findings underscore the need for targeted prevention strategies, early clinical intervention, and more refined research into individual susceptibility factors. Addressing cannabis-related psychiatric morbidity in adolescents requires both clinical vigilance and evidence-informed policy responses.