Delta-8 THC: The Legal High Flying Under the Radar
Do you know about Delta-8?
Over the past few years, the rise in the use of Delta-8 tetrahydrocannabinol (THC), or “Delta-8,” has been dramatic. According to the National Institute of Health, in 2023 11% of 12th graders in the United States reported use of Delta-8 within the past year. Delta-8 is a much more potent, more mind-altering component of cannabis. It is only found as naturally occurring in very small quantities in nature. Despite its very small naturally occurring concentration, it is estimated to be about 50-75% as psychoactive as the traditional delta-9 THC that makes up the vast majority of the cannabis plant.
Unlike its more well-known counterpart, Delta-9 THC (the primary intoxicant in cannabis), Delta-8 is currently legal under federal law due to a loophole in the 2018 Farm Bill. As a result, it is being sold in gas stations, smoke shops, and convenience stores in many states—including those where cannabis itself remains illegal.
This situation presents both clinical and regulatory challenges, especially for those of us working in behavioral health.
Legal but Largely Unregulated
Delta-8 is typically synthesized from cannabidiol (CBD) extracted from hemp. Because hemp-derived cannabinoids are legal under federal law, Delta-8 exists in a gray zone where it is both legal and widely accessible—without meaningful oversight. Products can vary widely in potency, purity, and chemical composition. Unlike regulated cannabis sold in dispensaries, Delta-8 products are not subject to the same testing standards for contaminants, labeling accuracy, or, most concerningly, age restrictions.
The result is a more potent derivative of cannabis is easily available to children, teens, and adults, even in jurisdictions where cannabis itself remains illegal. This can be confusing to consumers and concerning to clinicians.
Mental Health Implications
From a psychiatric perspective, the potential risks associated with Delta-8 mirror those of very high-potency cannabis products. While formal research is still emerging, anecdotal reports and preliminary data suggest that Delta-8 may carry similar risks for cannabis-induced psychosis, particularly in adolescents, frequent users, and those with a family history of psychiatric illness.
We also know from existing research on cannabis that early and frequent cannabis use—particularly before the age of 26, when the frontal lobe is still developing—is associated with an increased risk of developing potentially irreversible psychotic symptoms and psychotic disorders. Delta-8 is often (mistakenly) marketed as a “milder alternative,” but its effects can be unpredictable, especially in unregulated formulations.
This is particularly relevant for our adolescent and young adult population, who may be drawn to these products due to their accessibility and perceived legality. As an Addiction Psychiatrist, I’ve cared for 8 different patients under the age of 18 who developed cannabis-induced psychosis. This means these kids became paranoid, delusional, and began seeing and hearing things after using cannabis. 7 of these 8 teens who developed severe psychotic symptoms had used Delta-8 exclusively. All the teens required prescription anti-psychotic medication for symptom management. In 3 of the 8 teens, the psychotic symptoms of seeing and hearing voices never resolved. This is scary stuff.
Rethinking “Safe” vs. “Legal”
As with substances like alcohol and tobacco, the legal status of a compound does not necessarily imply safety—especially for frequent or early use. Delta-8 is a clear example of how business can often outpace regulation, leaving clinicians, families, and vulnerable young people with more questions than answers.
Where We Go from Here
As the legal landscape around cannabis and its derivatives continues to evolve, it’s important that we:
• Educate patients, families, and youth that Delta-8 is a much more potent and potentially dangerous derivative of the traditional cannabis product
• Advocate for clearer federal and state regulations to ensure safety, especially when addictive products like Delta-8 and Kratom are being sold over the counter.
• Support further research into the psychiatric and cognitive effects of cannabinoids, particularly among young users.
Delta-8 THC is a developing issue, and we are still learning about its full impact. Staying informed and engaged in the conversation will help ensure we’re prepared to address both the risks and the realities that come with its growing availability.
-Lauren