Table 4 Service providers’ recommendations related to youth cannabis use

Increase information on youth cannabis use, and its risks and harms

“I don’t think there is a lot of information on risks. There is a lot of information about medical cannabis lately which makes it seem like it is not harmful. I operate from a harm reduction perspective, so I do not advise young adults not to use cannabis.”

“Lack of information altogether, in terms of evidence-based studies. It was legalized without enough education in terms of risk. Young parents using while they have kids in their care, without thinking anything of it. Same with using and driving. No idea about the risk of developing psychosis and the long-term consequence of that.”

“[More] on adverse effects. [More] statistics on onset of psychotic disorders caused by cannabis. [Also] the number of young people ending up in ER due to cannabis induced symptoms (i.e., hyperemesis, respiratory problems, psychosis).”

Enhance training and education of service providers

“Need to provide training and education for front line staff who work with youth to ensure that use of cannabis is part of the assessments and treatment plans.”

“Professional development for school mental health providers (psychology and social work) regarding harm reduction, stats about current use/abuse and how legislation has increased access to cannabis (store at every corner it seems).”

“The support/education is left up to mental health providers (and medical) now that it has been legalized rather than the government taking on that responsibility. Having any structured education/ resources would be extremely beneficial.”

“Many of my clients (who are primarily queer and trans) use cannabis and they tend to consider it self-medicating. Many of them have come to use cannabis to regulate sleep and anxiety…I want to respect that but a part of me doesn’t fully understand the physiological and psychological impacts of cannabis use on the brain for youth…It’s difficult to know how to fully educate my youth clients when I’m not 100% sure where I stand on the issue. More information would be helpful to fully inform my clients.”

Improve regulation and policies to protect youth

“Raising the legal age would be helpful.”

“More regulation, limit on number of dispensaries, and improve policies around how cannabis is promoted.”

Reduce stigma and minimization

“Substance use is poorly integrated into mental health services and they often perpetuate stigma, judgment, and shame in their efforts to support people seeking services.”

“It is a one-sided conversation because we are viewed as not progressive enough and stigmatizing if we disagree with the way cannabis use is normalized and even glorified.”

Use anti-racist, diversity, equity, and inclusion approaches in addressing cannabis use in youth

“Anti-Black racism and colonialism need to be understood when intervening around cannabis because those systems shaped present day and historical legal and policy approaches to it.”

“I think cannabis is not stigmatized and actually normalized, but for some youth like the Indigenous youth in our community, there are a lot of assumptions and stigma when they are getting services in non-Indigenous treatment centres.”

Increase equitable access to mental health and addiction services for youth and their families

“Most youth don’t have access to therapy at all and if they do, it’s typically time-limited and often not culturally relevant or trauma-informed.”

“We need more services for cannabis use. Youth are dealing with so many difficulties and while it is clear that marijuana is causing problems, they are sometimes dealing with poverty, homelessness, and more fatal substance use like opioids so it sometimes seems to be less critical than the other issues.”