Sports, good grades, and good friends. High school seemed to be going just fine for her son.But the Massachusetts mom was missing his heavy use of high-potency cannabis.”I didn’t realize that he was smoking. He seemed, he never appeared high to me. He didn’t smell like it,” she said.That was no accident.The teen, in an interview with 5 Investigates, said he started smoking cannabis flower with friends during the summer. But he began to switch to vape pens, devices that let him inhale cannabis products that are nearly pure THC, far more potent than the flower.”It was easier to sneak around,” he said. “I was able to do it wherever I wanted to. It didn’t smell. You could literally do it in this room, and the smell would go away in 30 seconds.”He began not only using the highly potent THC, but using it multiple times in a day, every day.”I would do it during school, then I would do it during work, then I would just do it pretty much all day,” he said. “Even if I woke up in the middle of the night, I would just smoke and go back to bed.”His parents didn’t notice until it became impossible not to. The first clue?”Maybe a week before he was hospitalized was his friends were saying that he was saying bizarre stuff at lunch, but they laughed about it,” his mother said. “They thought he was being funny.”By then, the teen was unraveling, slipping into what they would later be told was cannabis-induced psychosis.”Words couldn’t really describe what was going on,” the teen said, who along with his mother spoke to 5 Investigates on the condition they not be identified. “Sometimes I would be out to dinner or something and I would literally feel like I wasn’t in a body. And then there were other times where I would hear voices.”By the time they went to the emergency room, the teen was in full-blown mania.”I didn’t know if he was ever going to come back,” his mother said. “We thought, ‘We don’t know if he’ll ever be lucid again.’ It’s very, very scary to go through that.”With the help of months of treatment, including two months in a residential facility, the teen is not only lucid again, he’s back on track to a successful life.But he’s hardly alone.We talked to physicians, psychiatrists and other clinicians who help teens and young adults with their mental health and addiction issues. From the prestigious teaching hospitals of Boston to peer counseling centers in suburban strip malls, they tell us the same thing: the teens and young adults in their care are now overwhelmingly needing treatment for their cannabis use.”Cannabis is the number one reason for kids coming to the program,” said Dr. Sharon Levy, chief of Boston Children’s Hospital Division of Addiction Medicine.”We’re seeing increasing rates of psychosis associated with cannabis use,” said James McKowen, a psychologist and program director of Massachusetts General Hospital’s Addiction Recovery Management Service (ARMS), which serves teens and young adults.”It’s become common, the young adults we see with psychosis,” said Chris Herren, a former NBA basketball player now in recovery who is an owner of Herren Wellness, a residential treatment center in southeastern Massachusetts.”Almost all of them are vaping high-potency THC,” said Dr. Aaron Quiggle, a psychiatrist and medical director of Mass General’s ARMS program.Quiggle treated the teen whom we interviewed and some of the hundreds of other patients who have been to the ARMS clinic in recent years. The risks, he said, are clear.”Teenagers who use high potency cannabis and use cannabis regularly are more likely to develop a cannabis use disorder and certainly are more likely to develop a psychosis,” he said.”Do you think the average person out there understands this risk?” 5 Investigates’ Mike Beauet asked.”I don’t think so, no,” Quiggle replied.Video: An extended interview with Dr. Aaron Quiggle, medical director of Mass General’s Addiction Recovery Management Service clinic:The ARMS clinic also works closely with parents, who are often surprised to learn how different today’s cannabis is from the pot they may have smoked at that age.That begins with potency. Testing of marijuana seized by law enforcement over the decades shows how potency has risen, from 1-2 percent in the early 1970s to 3-5 percent in the 1990s to around 16 percent in the 2000s, according to Quiggle.But cannabis products today, like the vapes that the Massachusetts teen was using, reach potencies of 85 to 95 percent.And Quiggle and others told us they are seeing many of their young patients use these high-potency products all day, every day.”Many of them are smoking daily or near-daily, and a large proportion of them are smoking multiple times a day. So it’s not uncommon for me to hear, ‘I’m sleeping with it under my pillow. I put it next to my toothbrush. It’s the first thing I do in the morning,'” Quiggle said.Quiggle said the association between teens and young adults using cannabis and psychosis and other problems is clear. It’s hard to say for sure how the higher potency is affecting the outcomes, though it’s also clear that it does.”There’s certainly a high correlation between using higher potency cannabis and developing psychosis. There’s also an association between using higher potency cannabis and developing an addiction. So teenagers who use high-potency cannabis and use cannabis regularly are more likely to develop a cannabis use disorder and certainly are more likely to develop a psychosis,” he said.For treatment, Quiggle said anyone in that teen’s situation who decided to resume marijuana use would be risking a relapse into psychosis.”I think people can go back to normal. People do go back to normal,” Quiggle said.But there is also a risk that cannabis-induced psychosis will develop into a lifetime of schizophrenia or bipolar disorder. Quiggle cited a large study done in Denmark that followed people “who had an initial cannabis induced psychosis and followed them for 20 years. And roughly half of those people went on to develop either schizophrenia or bipolar disorder. The caveat there is that we don’t know how many of them continued to use cannabis versus how many of those sort of stopped using after that initial episode,” Quiggle said.While Quiggle said there is no doubt about the link between heavy use and these serious mental health outcomes, proving that cannabis and only cannabis caused the psychosis is more difficult.”But what I can say is that teenagers in particular who use cannabis are 27 times more likely to end up in an emergency room or a hospital with a psychotic disorder than their same-aged peers who don’t use cannabis,” he said.The ARMS clinic, where Quiggle serves as medical director, also works closely with the parents of its young patients, and parent engagement in care is a big factor.Parents often don’t understand how different today’s high-potency cannabis products are from the pot they may have smoked when they were young, said psychologist James McKowen, clinical director at the ARMS clinic.”For parents, getting informed is number one. So, that can be Google-ing different types of cannabis. It can even be going into a dispensary. I sometimes advise parents to go in, look around, ask questions, learn about vaping, learn about potency,” McKowen said.Sometimes parents will come into the clinic before their child is ready to accept treatment, McKowen said.”Parents learn boundaries and limits, the use of carrots and sticks or positive reinforcement for change. They learn about improved communication. We talk to them about their own self-care,” McKowen said.Video: An extended interview with James McKowen, psychologist and clinical director of Mass General’s Addiction Recovery Management Service clinic:The teen and his mother credit Quiggle and the ARMS clinic with helping turn around his life, but they wish they had known about the risks of high-potency cannabis.”I’ve never heard anything about it online or on the news or YouTube or in school or in health class or in anything,” the teen said.”There is a lot more damage that can be done with marijuana that people understand. No one has any idea. I don’t know why it’s not out there about the dangers,” his mother said.