In Colorado, a wide swath of politicians, regulatory agencies and industry representatives have seized on the Healthy Kids Colorado Survey as definitive proof that the legalization of cannabis in Colorado has led to a decrease in teen use. However, parents and local addiction counselors that work with youth point to an exponential increase in cannabis use among teens, particularly of dangerous and untested high potency THC products.
Colorado’s young people are facing deadly health consequences as a result of this increased access and use:
- From 2013-2023, Colorado Poison Center calls for marijuana exposure tripled from 62 to 251 per year for youth 0-19 years of age. In 2023, 60% of these calls were for children under five. Similarly, for edibles, products that look and taste like candy, there were no poison center calls registered before legalization, but in 2023, they represented over half of the Colorado youth marijuana poison center calls.
- After legalization in Colorado, cannabis-related ER visits for 13-21 year olds quadrupled, with a majority of adolescent cases requiring psychiatric treatment, according to reports from the Colorado Department of Public Health and Environment.
- Since legalization, toxicology reports for Colorado youth aged 10-18 who committed suicide show that 25% had THC in their system at the time of death. These toxicology reports show that cannabis was the substance most commonly present at time of death, nearly double the rate of alcohol. Furthermore, from 2019-2022, a third of Black and Hispanic children who committed suicide had THC in their system at the time of death.
The Healthy Kids Colorado Survey is a voluntary, confidential survey administered in school by the State of Colorado. The online survey asks for children to self-report on a variety of behaviors including drug use.
People who work with Colorado youth have shared that kids don’t believe the results are confidential, and some laughed out loud when told that the Healthy Kids Survey shows a drop in teenage marijuana use since legalization.
Avani Dilger, executive director of Boulder nonprofit Natural Highs, has worked with people who use cannabis for over 20 years. She has observed more Boulder teens developing very serious addiction to cannabis products with withdrawal symptoms that manifest as mental health issues such as anxiety, depression and psychosis, as well as new physical symptoms such as Cannabis Hyperemesis Syndrome (cyclical vomiting).
“Legalization in Colorado meant commercialization of high THC products,” Dilger said. “While the original cannabis plant contained under 1% THC, Colorado teens are now vaping THC products that contain up to 99% THC, and it’s really a completely new drug. Prior to legalization, when cannabis contained lower THC levels, we never saw anything like this with people who used marijuana.”
Similarly, many impacted Colorado families have found that since legalization, cannabis is increasingly available to youth, particularly in untested high-potency products. Supply is legally purchased at licensed dispensaries and then diverted for resale to youth.
Research into the use of surveys on self-reported drug use has concluded that such surveys underestimate actual drug use by 30-60% and should be verified by “objective measures” such as hair toxicology.
An objective measure on actual teen use is the Colorado Department of Education’s disciplinary incidents data. This measure aggregates annual disciplinary reports from all public schools in Colorado. The first year cannabis disciplinary data was recorded was in the 2015-2016 school year, one year after recreational sales began in the state.
Over a seven-year period, disciplinary incidents involving cannabis in Colorado schools nearly doubled, increasing from 3,704 to 6,671 per year, while total enrollment decreased by less than 1%. Furthermore, in the 2022-23 school year, there were 6.5 times as many disciplinary incidents for cannabis in school as there were for alcohol.
It is not plausible that teen use goes down while disciplinary incidents in Colorado schools go up.
Another objective measure of actual teen use is law enforcement criminal citations involving minors for possession or sale of marijuana or paraphernalia. This data is not currently aggregated or available at a statewide level. Requesting this data from law enforcement agencies is time consuming and costly as it requires payment of Colorado Open Records Access fees, but could be required annual reporting under Colorado law to increase transparency around teen use.
I encourage greater curiosity among the public health scientists, regulators and politicians who are loudly heralding the Colorado cannabis success story solely based on the self-reported results from the Colorado Healthy Kids Survey. It is time to triangulate the Healthy Kids Survey data with these other data points that show increasing youth marijuana use and negative health impacts. Our kids deserve laws based on science and safety.
Anna Segur is a Boulder-based mother and activist. She has a master’s degree in International Affairs from Columbia University.