title: Cannabis and adolescents: Exploring the substance misuse treatment provider experience in a climate of legalization.
abstract: Understanding consumer attitudes toward drugs is vital for the design and implementation of effective substance misuse prevention and treatment programs. Research that enhances our understanding of these perceptions is of the utmost importance in the climate of cannabis legalization. While there is a body of literature focused on the perceptions of drug use among adolescents, less attention has been paid to the experiences of health care professionals who serve this vulnerable population. Research aimed at better understanding the experiences of professionals may improve cannabis misuse prevention efforts and inform policy decisions as cannabis moves closer to legalization nationwide.
  
  
  
  The present study applied a grounded theory qualitative methodology to interview 11 adolescent substance misuse treatment providers. Each participant had at least two years of clinical practice in Colorado before January 1, 2014, when cannabis became available for recreational sale.
  
  
  
  Extensive analysis of data obtained from participant interviews, yielded seven core concepts related to cannabis use and decriminalization: normalizing, increasing access, rising addiction potential, link to opioids and other drugs, complicating substance treatment, diversity issues, and responding to change. According to participants, legalization has contributed to the continuing normalization of cannabis, validation of its consumption, and greater access to a host of new and more potent THC products by adolescents. Providers attributed these attitudinal changes to heavier use of both cannabis and other drugs and increased resistance to treatment efforts and interventions.
  
  
  
  These results support the need to expand access to a wider range of substance misuse treatment options for adolescents and to further our understanding of the impact on this population of the cannabis laws.
authors.affiliation: Graduate School of Professional Psychology, Office of Graduate Studies, University of Denver, 9993 East 29th Ave, Denver, CO 80238, United States. Electronic address: mattsobesky@gmail.com.
authors.forename: Matthew
authors.initials: M
authors.lastname: Sobesky
authors.affiliation: Graduate School of Professional Psychology, Office of Graduate Studies, University of Denver, 9993 East 29th Ave, Denver, CO 80238, United States.
authors.forename: Kim
authors.initials: K
authors.lastname: Gorgens
mesh_terms: D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D003120:Colorado; D005260:Female; D066296:Grounded Theory; D006282:Health Personnel / Q000523:psychology*; D006297:Health Services Accessibility; D006801:Humans; D007407:Interviews as Topic; D007880:Legislation, Drug; D008297:Male; D002189:Marijuana Abuse / Q000453:epidemiology* / Q000534:rehabilitation; D008385:Marijuana Smoking / Q000453:epidemiology / Q000331:legislation & jurisprudence*
keywords: Access; Addiction; Adolescents; Cannabis; Legalization; Treatment