Researchers from Mayo Clinic warn in a new commentary in the clinic’s medical journal that physicians should refrain from prescribing medical marijuana to adolescents with chronic pain.

Although acknowledging the potentially devastating effects of chronic pain in this hard to diagnose and treat population—including impaired socialization, quality of life, activities of living and physical activity—the researchers write in Mayo Clinic Proceedings (2013 Jun 20. [Epub ahead of print]) that the potential risks associated with marijuana use in adolescents can far outweigh the potential benefits.

“The consequences may be very, very severe, particularly for adolescents who may get rid of their pain—or not—at the expense of the rest of their life,” said co-author J. Michael Bostwick, MD, professor of psychiatry, Mayo Clinic, in a press statement.

The authors of the new piece stress that data on the potential safety and efficacy of medical marijuana in adults are limited, and well-conducted research is even scarcer in adolescents. They point out that there are multiple potential adverse events associated with marijuana use, including anxiety, fatigue, decreases in reaction times, concentration problems, reduced motivation and dizziness and confusion, adding that potential problems are compounded in younger individuals. For example, research has shown that marijuana use in individuals under the age of 16 has been linked to an increase risk for schizophrenia (J Clin Psychiatry 2013;74:e08), poorer cognitive performance, higher rates of addiction and greater levels of depression (Arch Pediatr 2011;18:737-744; Drug Alcohol Depend 2003;69:303-310).

“If you’re a pain patient, and you’re using this drug or others, narcotics as well, one of the side effects is to be out of it, and out of it when the goal of a pain rehab program is actually to get you into it,” Dr. Bostwick said in the press statement. “The whole point is function restoration, not further functional decline.”

Although the legalization of medical marijuana in some states has been anecdotally attributed to increased recreational use among adolescents, a new study conducted by University of Florida researchers and published in the American Journal of Health Policy using data from the Youth Risk Behavior Survey (2013 Jun 13. [Epub ahead of print]) showed that medical marijuana laws had no significant effects on use among adolescents following the first few years of their enactment, but posited that longer-term studies might show different results.

Teens in pain should be screened for marijuana use, said the researchers of the Mayo Clinic study, and those testing positive should be considered for nonpharmacologic treatments such as acupuncture, biofeedback and physical therapy. They called for further researcher to determine how many adolescent pain patients are using medical marijuana as well as how it is affecting their functioning.