Adolescent Marijuana Use in 2019: Results from the National Survey on Drug Use and Health (NSDUH)

By Laura Stack

Since 1971, the National Survey on Drug Use and Health (NSDUH) has tracked substance use and related health issues in the United States as a whole, under the auspices of the Substance Abuse and Mental Health Services Administration (SAMHSA). The substances tracked include not only illicit drugs, but also alcohol, tobacco, and now kratom, an Asian herb believed to be potentially dangerous. Marijuana was just one of the substances asked about. Also tracked are substance use disorders (SUDs), substance use treatment, use of mental health services, and generalized mental health issues associated with substance abuse. The intent of the NSDUH is to help policymakers, researchers, clinicians, and the public better understand the current situation so they can make more informed decisions.

The 2019 report, which was published in September 2020, bases its data on 67,625 interviews from respondents aged 12 or older, collected from households all over the United States. One of the segments of the population it surveys are individuals aged 12-17; 16,894 interviews were conducted with adolescents in this age range. All the above substances are illicit for adolescents and potentially dangerous to their mental health.

A Quick Reminder

After alcohol, marijuana is America’s second most popular drug, and as such has been the subject of many studies over the years. Marijuana causes its own recognized SUD, Cannabis Use Disorder (also called Marijuana Use Disorder), of which addiction is a subset.

Based on peer-reviewed research, we know that cannabis use interferes with the development of the prefrontal cortex of the brain in anyone until the mid-20s. Marijuana use until then can cause a wide variety of negative effects, including a greatly increased risk of schizophrenia (seven times normal); increases in suicidal thought and behavior (five times the norm); anxiety and panic attacks; paranoia; psychosis; a loss of as many as 6-8 IQ points after prolonged use; and marijuana toxicity.

Survey Says…

According to the 2019 NSDUH, the percentage of adolescents who self-reported using marijuana products in the past year has increased to 13.2% 2019 from 12.5% in 2018. We will need to see next year’s data to see if this is a trend.

An estimate that has remained relatively steady since 2002 for the 12-17 ages group is the number of “marijuana initiates,” i.e., those who reported that they first started using marijuana in the past year. However, this number peaked in 2019 to 1.4 million youths from 1.3 million in 2018. So, more than 100,000 youth tried marijuana last year than ever before. To put it in perspective, that’s 3,700 youth per day trying marijuana for the first time! Let that sink in.

As pointed out in the report, “One factor that can influence whether people will use tobacco, alcohol, or illicit drugs is the extent to which they believe that using these substances might cause harm.” The respondents were asked how they felt about the risk of using specific substances ones or twice weekly or daily (depending on the substance). There was a steady decline in the percentage of youth who believed that using marijuana presented “great risk.” In adolescents, the total dropped from 40.6% in 2015 to 34.6% in 2019. This is due to the narrative they’re exposed to trying to convince them it’s safe and thereby addict the next generation of users. Marijuana was considered the least harmful of all substances asked about, including alcohol, tobacco, heroin, and cocaine. To put this in perspective, the alcohol and tobacco were presented as great risks if imbibed daily, with marijuana and the other drugs taken weekly. Sadly, the perception of “great risk” for all substances, including cocaine and heroin, has dropped annually since 2017.

Marijuana and Mental Health

According to the NSDUH survey, the occurrence of Marijuana Use Disorder (a.k.a. Cannabis Use Disorder), which had been dropping steady among the adolescent cohort since 2011, rose sharply in 2019. In 2018, it was 2.1%; in 2019, 2.8%. That may not seem like a big deal, but my son Johnny is included in that estimate of 699,000 more kids. The survey for 2020 will help determine whether this was a fluke or the beginning of a trend.

In any case, MUD presents a significantly higher figure for 2019 than any other substance use disorders covered, including alcohol use disorder (which has declined significantly in recent years). That 2.8% accounts for most of the 3.6% of responding adolescents with SUDs for illicit drugs. Other SUDs covered included those for heroin, cocaine, stimulants, methamphetamines, and opioid pain relievers.

In terms of depression, 1.6 million adolescents reported having experienced a Major Depressive Episode (MDE) for which they received treatment, which is a bit higher than recent years. Of those 1.6 million, 1.3 million reported a severe impairment with their MDE. Of course, marijuana can cause depression in adolescents.


According to the 2019 NSDUH survey, self-reported marijuana use rose in 2019 for kids 12-17, though it has not yet risen to its 2002-2004 levels. This may not seem like such bad news, but to some extent, the statistics may be an artifact of (a) the way the data was collected (self-reporting) and (b) the way the data was broken down and presented. MUD represented a disproportionate percentage of all SUDs, especially when compared to Alcohol Use Disorder (AUD) and Opioid Use Disorder (OUD).

Incidentally, the next older group, individuals 18-25 (young adults) still includes young people in the danger zone of under 21. That group has much higher use ratios than any other—so much so that the next age group for each category was usually 26+, which had statistical rates about the same as or lower than the adolescent group. Of course, young people 18-21 tend to have much more free agency than younger cohorts, as most are out of their parental home by then and often in situations (college, military, etc.) where they can acquire the substances discussed more easily.

Overall, the NSDUH does offer valuable information, but I feel it would be more useful if more focus was placed on marijuana’s effects of mental health, with some discussion of how many sufferers of MUD attempted to get or received aid during the previous year.

We, as concerned parents and citizens, must continue to make our voices heard! Please join Johnny’s Ambassadors in educating parents and teens about the dangers of today’s high-THC marijuana on adolescent brain development and suicide!

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