"Feels like there could risk of some cross-over usage here for this age group. What is the best way to evaluate whether a teenager is a good fit for cannabis, as an alternative to what feels like a long term pharma solution?"
Cannabidiol (CBD), a non-psychoactive component of the plant is a potent anxiolytic and has very few potential side effects (it can interfer with sleep if taken too late in the day and it is an appetite suppressant). Regardless of age, CBD is a highly effective medicinal for the treatment of anxiety. Cannabis use leads to illegal drug use and dependence the same way eating French fries leads to overeating and obesity. Most obese people ate French fries in adolescence but most adolescents who eat French fries do not become obese. I am a board-certified pediatrician with a strong background in developmental pediatrics, and in assessing patients with behavior and school problems. I’ve treated hundreds of patients with anxiety with CBD and am far more comfortable with it than using pharmaceuticals like benzodiazepines, antidepressants, and gaba analogs. I would have zero concerns about using a high CBD variety cannabis for the long term treatment of anxiety in adolescents. And I might add that the neurodevelopmental changes that occur in the developing brain are associated with THC, not CBD. THC would not be my choice for treating anxiety in adolescents or adults.